VA Math // Paired Extremities
The VA Bilateral Factor Explained
The bilateral factor is where kitchen-table calculators go off the rails. It can apply to compensable disabilities affecting paired extremities or paired skeletal muscles—but it is a sequence rule, not a free ten-point bonus.
01 // Eligibility
“I have two knees” is not the bilateral test.
The word “bilateral” is not a magic ten-point coupon. Section 4.26 applies to partial disability of compensable degree in each of two paired extremities or paired skeletal muscles. The regulation treats the arm, forearm, and hand as the upper extremity, and the thigh, leg, and foot as the lower extremity.
The two ratings do not have to involve identical joints or diagnoses. They must satisfy the paired-extremity rule described by the regulation.
02 // Sequence
Combine first. Add the factor second. Do not improvise.
Qualifying right-and-left ratings are combined as usual. Ten percent of that combined value is then added—not combined—to create the bilateral value.
That bilateral value is treated as one disability for severity ordering and further combinations with the remaining evaluations.
03 // Current exception
If the factor makes the result worse, the rule has a backstop.
The current § 4.26(d) requires VA to remove one or more disabilities from the bilateral calculation when including them would produce a lower combined evaluation than combining them separately.
VACB’s calculator models the standard bilateral sequence but does not currently optimize every § 4.26(d) comparison. If the result is close to a rounding threshold, verify both paths against the current rule.
Source rack
Trust, but verify. Mostly verify.
These official sources carry the factual load. Rules and public guidance change; screenshots and confident strangers do not receive automatic grandfather status.