Rating Ledger

Combined ratings / 20% and 20%

38 CFR 4.25 Table I · checked 2026-10-20

20% and 20% VA rating combined

A 20% and a 20% rating combine to 36, which VA rounds up to 40%. Two equal ratings never double: it takes 20% of the 80% efficiency the first rating leaves, which is 16 points. At 40% a veteran alone receives $795.84 a month and a veteran with a spouse $882.84.

Table I value36%Rounded once40%20 + 20 → 361234
  1. 1First rating 20 squares
  2. 220% of what is left 16 squares
  3. 3Efficiency left 64%
  4. 4Combined rating 40%
Table I value
36%
VA rating
40%
Monthly, alone
$795.84
Efficiency left
64%

The arithmetic, step by step

  1. Order by severity: 20% first (both are the same, so either goes first), then 20%.
  2. After the 20% rating, 80% efficiency is left. The 20% rating takes 20% of that: 20 × 80 ÷ 100 = 16.
  3. 20 + 16 = 36. That is the figure printed in Table I at row 20, column 20.
  4. Round once to the nearest 10, values ending in 5 going up: 36 becomes 40%.

Because 36 ends in 6, it rounds up, so this pair is rated 4 points above its Table I value. The extra points exist only in the rounded rating: if a third disability is added later, VA combines it with 36, not with 40, because intermediate values are never rounded.

Added together, the two ratings would make 40. VA's method gives 40, 0 points less. The gap grows with the size of the ratings, because each later rating works on a smaller remainder.

What 40% pays

20% alone$356.6620% + 20% (40%)$795.84With another 20% (50%)$1,132.90
Monthly compensation, veteran with no dependents, VA rates effective December 1, 2025. Bars to scale from zero.

At 40%, VA's table effective December 1, 2025 pays $795.84 a month to a veteran alone, $882.84 with a spouse, and $947.84 with a spouse and one child under 18. The 20% rating alone paid a flat $356.66; combining with 20% crosses the 30% line where dependents start to count. The 40% pay page lists every dependent row.

If a third rating is added

A third 10% rating would combine with 36, not with 40: 36 and 10 give 42, rated 40%, no change in the rating. The smallest single rating that moves this pair up a step is 20%, reaching 49 and 50% ($1,132.90 a month alone).

If the two ratings are on paired limbs

When the 20% and the 20% are on the left and right leg (or both arms), 38 CFR 4.26 adds a bilateral factor: 20 and 20 combine to 36, plus 10% of that gives 40, rated 40%. Here the factor raises the exact value but not the rounded rating, which stays at 40%; it can still matter once more ratings are combined. The bilateral factor guide has the full rule.

Conditions that are rated at 20%

Diagnostic codes on this site with a 20% level include Degenerative arthritis (DC 5003), Shoulder (arm) limitation of motion (DC 5201), Elbow (forearm) limitation of flexion (DC 5206), Back strain (lumbosacral or cervical strain) (DC 5237), Intervertebral disc syndrome (IVDS) (DC 5243), Knee instability (DC 5257), Knee limitation of flexion (DC 5260), Knee limitation of extension (DC 5261), Ankle limited motion (DC 5271), Plantar fasciitis (DC 5269), Foot injury (other) (DC 5284), Hip (thigh) limitation of flexion (DC 5252), Sciatic nerve (radiculopathy) (DC 8520), Common peroneal nerve (foot drop) (DC 8521), Upper radicular group (C5-C6 nerves) (DC 8510), Epilepsy (seizures) (DC 8910), Hypertension (high blood pressure) (DC 7101), Varicose veins (DC 7120), Irritable bowel syndrome (IBS) (DC 7319), Hemorrhoids (DC 7336), Hernia (inguinal, ventral, umbilical) (DC 7338), Deep scars (not head, face or neck) (DC 7801), Painful or unstable scars (DC 7804), Diabetes mellitus (type 2) (DC 7913), Prostate conditions (voiding dysfunction) (DC 7527), TMJ (temporomandibular disorder) (DC 9905).

38 CFR 4.71a, diagnostic code 5243, Intervertebral disc syndrome (IVDS), 20%: “Incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks during the past 12 months.”

38 CFR 4.71a, diagnostic code 5206, Elbow (forearm) limitation of flexion, 20%: “Flexion limited to 90 degrees.”

38 CFR 4.71a, diagnostic code 5261, Knee limitation of extension, 20%: “Extension limited to 15 degrees.”

Criteria summarized from the rating schedule; each condition page links to the regulation.

Other pairs

2 other pairs also round to 40%: 30+20, 30+10.

For three or more ratings, or to add dependents, use the calculator. Background: why 50 and 50 is not 100.

Rating Ledger is not part of VA and does not file or decide claims. Amounts are VA's published monthly rates effective December 1, 2025 for a veteran, before any deduction or special monthly compensation; ratings follow 38 CFR 4.25 and 38 CFR 4.26. Last checked 2026-10-20. Only a VA rating decision sets a rating or a payment. See the methodology.