Claims

The paired organs and extremities rule

Five specific combinations where a non-service-connected side can be paid as if it were service connected.

What the rule does

Normally VA pays only for service-connected disabilities. Under 38 CFR 3.383, for five specific combinations, VA pays compensation as if both sides were service connected, even though only one side is. The rule does not apply if the non-service-connected disability results from your own willful misconduct.

The five combinations

Eyes: vision impaired in one eye from a service-connected disability and in the other eye from a non-service-connected one, where visual acuity is 20/200 or less in each eye, or the peripheral field is 20 degrees or less in each eye.
Kidneys: loss or loss of use of one kidney from a service-connected disability, and involvement of the other kidney from a non-service-connected disability.
Ears: hearing impairment in one ear from a service-connected disability that is compensable to 10 percent or more, and hearing impairment in the other ear from a non-service-connected disability that meets the hearing standards in 38 CFR 3.385.
Hands or feet: loss or loss of use of one hand or one foot from a service-connected disability, and loss or loss of use of the other hand or foot from a non-service-connected disability.
Lungs: a permanent service-connected disability of one lung rated 50 percent or more, together with a non-service-connected disability of the other lung.

Five combinations

Eyes: 20/200; Kidneys: loss or loss of use; Ears: 10 percent; Hands or feet: loss or loss of use; Lungs: 50 percent.38 CFR 3.383 (eCFR) · Page reviewed September 2026.

What this means for you

The rule is narrow. Each combination has its own conditions, so a general problem with both sides is not enough. Before you file, check your situation against the list above. If it fits one of the five, you can ask VA to consider 38 CFR 3.383 in your claim.

Money you receive from a lawsuit or settlement

If you receive money or property from a court judgment or settlement for the non-service-connected disability, the rule has offset and reporting requirements. Social Security and workers' compensation benefits are not counted for that offset. Read paragraphs (b) through (d) of the regulation, or ask an accredited representative, before you settle a case.

If you disagree with a decision

VA offers three decision review options: a Supplemental Claim (for new and relevant evidence), a Higher-Level Review (no new evidence), or an appeal to the Board of Veterans' Appeals.

Where to call and where to go

Phone

VA benefits hotline: 800-827-1000 (Monday through Friday, 8:00 a.m. to 9:00 p.m. ET)
VA main information line (MyVA411): 800-698-2411 (24/7)
Hearing-impaired callers: relay service 711 (24/7)

Numbers and hours from VA contact page.

Official pages

Free accredited help

Find an accredited representative. VA says services from an accredited VSO representative are always free.

Sources