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What Is the Bilateral Factor?

The bilateral factor applies when you have service-connected disabilities affecting both paired extremities:

• Both arms (or parts of both arms)
• Both legs (or parts of both legs)
• Paired upper & lower on the same side (left arm + left leg)
• Diagonal pairs also qualify (left arm + right leg)

The VA first combines all bilateral ratings using VA math, then adds 10% of that combined value to the bilateral group total before combining with non-bilateral disabilities.

Impact: This typically adds 1–5 percentage points to your final combined rating, which can push you over a rounding threshold.

Results

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How It Works — Step by Step

Example: Left Knee 10%, Right Knee 10%, PTSD 50%, Tinnitus 10%

1. Identify bilateral pair: Left Knee + Right Knee
2. Combine bilateral ratings (VA math): 10% + 10% = 19% combined
3. Apply 10% bilateral factor: 19% × 0.10 = 1.9%
4. Bilateral group value: 19% + 1.9% = 20.9% → rounds to 21%
5. Combine with non-bilateral: 50% (PTSD), then 21% (bilateral), then 10% (tinnitus) using VA math
6. Final combined: Different (and higher) than without bilateral factor