What Exactly is the Bilateral Factor?bilateral factor

The bilateral factor comes into play when a veteran has a service-connected disability that impairs both arms or both legs or paired skeletal muscles (for example pulling muscles—when contracts the other relaxes like how your biceps and triceps work together to bend and then straighten your arm). When you have this level of disability the ratings for your disabilities will be combined for each side and then an additional 10% will be added to your overall rating. This is the VA’s acknowledgement that the severity of a bilateral disability seriously limits a veteran’s ability to function in daily life and makes it difficult to get a job.

The exact definition of the bilateral factor can be found in the Code of Federal Regulations (C.F.R.) § 4.26, which states “a partial disability results from disease or injury of both arms, or of both legs, or of paired skeletal muscles, the ratings for the disabilities of the right and left sides will be combined as usual, and 10% of this value will be added before proceeding with further combinations.”

What Makes an Impairment Bilateral?

As the word itself suggests, bilateral means affecting both sides. You must have two impairments with one affecting each side. They do not have to be the exact same body part. For example, disabilities affecting the use of your left elbow and your right wrist would be considered bilateral. The impairments can be caused by the same illness or injury or by separate and different illnesses or injuries, but they must be service-connected. You will have to offer proof that the impairment or impairments were caused or made worse by your time in service.

For the bilateral factor to be applied to your total disability rating, your conditions must affect either both upper extremities or both lower extremities (not one of each). If, for example, your right knee and left arm have been injured the bilateral factor would not apply.

How Does the VA Compute the Bilateral Disability Rating?

VA math is used to determine the exact type and amount of military disability benefits you will receive if you have more than one service-connected impairment. Each military disability is assigned a rating from 0%—not at all disabled—to 100%—totally disabled. Ratings are assigned in 10% increments. When a veteran has multiple impairments the ratings are combined. But please note that they are combined, not just added together.

Here’s how VA math works. First, the largest disability rating is deducted from 100%. Then the next highest rating is multiplied by what is left and that percentage is added to the first rating percentage.

Here’s an example. Let’s say we have a former Army sergeant with two impairments: a right shoulder injury rated at 30%, and left wrist injury rated at 20%. Subtracting the largest rating—the shoulder injury at 30%—from 100% leaves us with 70%. If we multiply the 70 by 20%—the rating for the wrist injury—we get 14 %. Subtracting this 14% from 70% leaves us with 56%. The bilateral factor dictates that the VA take 10% of that 56%—yielding 5.6%—and add that to the previous 56% from before, which yields a total of 61.6%. The VA rounds this number to the nearest 10% which gives our Army sergeant a combined 60% disability rating.

However, let’s say our Army Sergeant’s disability rating for his left wrist injury was 0%. Because this is a non-compensable injury, no bilateral factor would be included in the overall rating.

(The math for combined ratings and bilateral factor and can be computed easily by using our VA disability calculator. Just click on the buttons for the affected extremities and the rating percentages, our disability calculator automatically applies the bilateral factor when applicable.)

How Can the Bilateral Factor Affect TDIU Eligibility?

Total Disability Individual Unemployability—with the acronym TDIU—is part of the VA’s disability compensation program. If a veteran’s disabilities prevent them from being able to get and keep a job, TDIU allows them to have their disability rating raised to 100% even though the rating on their service-connected disabilities do not equal 100%. Unemployability is the VA’s way of acknowledging that some veterans with disability ratings below 100 are unable to work due to their impairments.

To qualify for TDIU with multiple impairments you must have two or more disabilities with a combined rating of 70% or more and one them has to be rated at 40% or more. Then you must show you are unable to maintain substantial gainful employment as a result of your disabilities. The bilateral factor can be included with the schedular ratings to reach the 70% threshold.

Are You Considering Filing for Benefits or Was Your VA Disability Claim Denied?

VA disability ratings and the math the VA uses to calculate disability benefits is complex and often confusing, especially in cases where there are bilateral impairments. At Cuddigan Law we stand ready to help. We believe that veterans should get the benefits they have rightfully earned from serving their country. If you are considering filing for VA disability benefits or have been turned down for compensation, we will fight for your rights. Call our VA disability attorneys at (402) 933-5405 or send us an email to schedule a free, no-strings-attached evaluation of your case.



Sean D. Cuddigan
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SSA and VA Disability Attorney in Omaha, Nebraska