No matter what your service-connected impairment is—PTSD, hearing loss, scars, or any of the other hundreds of medical conditions eligible for disability benefits—you should get a rating sheet which will break down the details about your claim. (“Should” is a key qualifier here. The VA does not automatically send this document to all veterans when the actual rating decisions are mailed. Because the Rating Code Sheet is so important, if you don’t get this document, request this from the VA immediately.) One small and often overlooked item on the sheet is a diagnostic code. This code is a four-digit number which the VA defines as “arbitrary numbers for the purpose of showing the basis of the evaluation assigned and for statistical analysis in the Department of Veterans Affairs [which] extend from 5000 to a possible 9999” (38 CFR § 4.27). Typically your diagnostic code will be assigned after a Compensation and Pension Exam.
What Do the VA Diagnostic Codes Mean?
In the VA Schedule for Rating Disabilities (VASRD), the VA groups conditions affecting different parts of the body. Sections include, for example, the Digestive System, the Respiratory System, and the Cardiovascular System. Within each group is a list of diseases or disabilities, each with a unique diagnostic code which specifies the symptoms required for each level of disability rating—expressed as a percentage between 0% and 100% in 10% increments.
Even if the symptoms of your disability could possibly be rated under more than one diagnostic code, you can only be compensated under one code. If two or more codes apply, by law the VA must choose the diagnostic code that will give the highest rating and therefore the highest level of compensation.
Not all disabilities have their own diagnostic code in the VASRD. Those that do not have their own diagnostic code are given analogous ratings which are assigned based on what condition most closely matches the symptoms the veteran is exhibiting.
When you examine your rating code and the level of disability payments the VA awards you, bear in mind that the VA is less focused on the original, in-service injury or illness and how severe that was and more focused on the residual conditions, that is, how the remaining limitations from that injury or illness still impact your ability to work and get through the activities of daily living.
What About 8 Digit Codes?
What does it mean when you see an eight-digit code number? In some instances the four-digit system doesn’t precisely match with your particular condition and the first four digits will represent your initial condition and the last four digits will represent a residual condition—a lingering disability that is the result of a previous service-connected injury or illness.
Why Are Diagnostic Codes Important?
Your rating code is the key to understanding exactly how the VA chose to categorize your condition and its severity and is therefore the key to the level of compensation the VA will award you. The diagnostic codes can be especially important if you disagree with the VA’s evaluation and you wish to appeal the agency’s decision.
What if Your VA Diagnostic Code is Inaccurate?
The symptoms for almost any condition can vary widely making it difficult to pin a condition to a precise diagnostic code. Additionally there are conditions where a specific code has not been assigned (for example, some cardiovascular system diseases do not have a four-digit code number). Human errors can also factor into rating decisions. For these and other reasons, it is possible for the wrong code to be assigned and the affected veteran is short-changed. If you believe that the VA has assigned the wrong diagnostic code for your disability, it is your right to appeal that decision.
VA Disability Attorneys Who Fight for Your Rights
As you can see, diagnostic codes are a small but critical element in your pursuit of the disability compensation you have earned. If you are facing an adverse medical condition and you believe the VA did not award you the correct rating or if your case has been denied, don’t give up hope. Instead contact us at Cuddigan Law for a free evaluation of your case. At Cuddigan Law you have team of professionals in your corner who know the system and will fight for your rights.