Rating Ledger

Combined ratings / 50% and 20%

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

50% and 20% VA rating combined

A 50% and a 20% rating combine to 60, which VA rounds to exactly 60%. The 20% is not added to the 50%: it takes 20% of the 50% efficiency the first rating leaves, which is 10 points. At 60% a veteran alone receives $1,435.02 a month and a veteran with a spouse $1,566.02.

Table I value60%Rounded once60%50 + 20 → 601234
  1. 1First rating 50 squares
  2. 220% of what is left 10 squares
  3. 3Efficiency left 40%
  4. 4Combined rating 60%
Table I value
60%
VA rating
60%
Monthly, alone
$1,435.02
Efficiency left
40%

The arithmetic, step by step

  1. Order by severity: 50% first, then 20%.
  2. After the 50% rating, 50% efficiency is left. The 20% rating takes 20% of that: 20 × 50 ÷ 100 = 10.
  3. 50 + 10 = 60. That is the figure printed in Table I at row 50, column 20.
  4. Round once to the nearest 10, values ending in 5 going up: 60 becomes 60%.

The Table I value is already a multiple of ten, so no rounding is needed: the pair is rated 60% on the nose. That happens for only 1 of the 45 pairs with exactly this value.

Added together, the two ratings would make 70. VA's method gives 60, 10 points less. The gap grows with the size of the ratings, because each later rating works on a smaller remainder.

What 60% pays

50% alone$1,132.9050% + 20% (60%)$1,435.02With another 20% (70%)$1,808.45
Monthly compensation, veteran with no dependents, VA rates effective December 1, 2025. Bars to scale from zero.

At 60%, VA's table effective December 1, 2025 pays $1,435.02 a month to a veteran alone, $1,566.02 with a spouse, and $1,663.02 with a spouse and one child under 18. Compared with 50% alone ($1,132.90), the pair adds $302.12 a month for a veteran with no dependents. The 60% pay page lists every dependent row.

If a third rating is added

A third 10% rating would combine with 60, not with 60: 60 and 10 give 64, rated 60%, no change in the rating. The smallest single rating that moves this pair up a step is 20%, reaching 68 and 70% ($1,808.45 a month alone).

The 50% rating meets the 40% part of the 38 CFR 4.16(a) threshold for unemployability, but the combined 60% is below the 70% it also requires.

If the two ratings are on paired limbs

When the 50% and the 20% are on the left and right leg (or both arms), 38 CFR 4.26 adds a bilateral factor: 50 and 20 combine to 60, plus 10% of that gives 66, rated 70%. Here the factor moves the rating from 60% to 70%, worth $1,808.45 a month alone instead of $1,435.02. The bilateral factor guide has the full rule.

Conditions that are rated at 50% and 20%

Diagnostic codes on this site with a 50% level include PTSD (DC 9411), Hip replacement (DC 5054), Elbow (forearm) limitation of flexion (DC 5206), Back strain (lumbosacral or cervical strain) (DC 5237), Knee limitation of extension (DC 5261), Flat feet (pes planus) (DC 5276), Migraines (DC 8100), Carpal tunnel (median nerve) (DC 8515), Upper radicular group (C5-C6 nerves) (DC 8510), Sleep apnea (DC 6847), Chronic sinusitis (DC 6510-6514), GERD (acid reflux) (DC 7206), Scars of the head, face or neck (DC 7800), TMJ (temporomandibular disorder) (DC 9905). A 20% level appears in Degenerative arthritis, Shoulder (arm) limitation of motion, Elbow (forearm) limitation of flexion, Back strain (lumbosacral or cervical strain), Intervertebral disc syndrome (IVDS), Knee instability, Knee limitation of flexion, Knee limitation of extension, Ankle limited motion, Plantar fasciitis, Foot injury (other), Hip (thigh) limitation of flexion, Sciatic nerve (radiculopathy), Common peroneal nerve (foot drop), Upper radicular group (C5-C6 nerves), Epilepsy (seizures), Hypertension (high blood pressure), Varicose veins, Irritable bowel syndrome (IBS), Hemorrhoids, Hernia (inguinal, ventral, umbilical), Deep scars (not head, face or neck), Painful or unstable scars, Diabetes mellitus (type 2), Prostate conditions (voiding dysfunction), TMJ (temporomandibular disorder).

38 CFR 4.124a, diagnostic code 8515, Carpal tunnel (median nerve), 50%: “Incomplete paralysis, severe.”

38 CFR 4.71a, diagnostic code 5257, Knee instability, 20%: “Sprain, incomplete ligament tear, or repaired complete tear causing persistent instability, with a prescribed brace and/or assistive device; or an unrepaired or failed-repair complete tear with a prescribed assistive device or bracing. For patellar instability: after surgical repair, requiring one of a brace, cane or walker.”

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

38 CFR 4.97, diagnostic code 6510-6514, Chronic sinusitis, 50%: “Following radical surgery with chronic osteomyelitis, or near constant sinusitis characterized by headaches, pain and tenderness of the affected sinus, and purulent discharge or crusting after repeated surgeries.”

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

Other pairs

4 other pairs also round to 60%: 60+10, 50+10, 40+40, 40+30.

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.