How the VA Bilateral Factor Works

Under 38 CFR 4.26, the bilateral factor is an additional calculation applied when a veteran has compensable service-connected disabilities affecting both upper extremities or both lower extremities. Instead of combining these disabilities normally, VA first combines all bilateral disabilities, adds 10 percent to that combined value, and then combines the resulting number with any other remaining non-bilateral disabilities.

The bilateral factor applies when you have compensable disabilities on both sides of your upper body (such as your left arm and right hand) or both sides of your lower body (such as your left knee and right ankle). The disabilities do not need to mirror each other exactly, but they must affect paired extremities.

The bilateral factor does not apply simply because a condition is bilateral by name. It only applies to paired extremities (arms and legs) and paired skeletal muscles. It does not apply to the eyes, ears, or kidneys. Additionally, a zero percent non-compensable rating on one side does not trigger the bilateral factor even if the other side is compensable.

VA previously required the bilateral factor to be applied whenever the criteria were met. In recent years, VA updated its rules to recognize that in some specific math scenarios, applying the bilateral factor could actually result in a lower final rounded rating. VA will now exclude a bilateral factor calculation if excluding it results in a higher final combined rating.