Rated analogously

Due to the the sheer volume and duplication of symptoms that the human mind and body can have, it is impractical for the rating schedule to have a rating for every single disability by name. In such cases that the Veteran's disability/disease/condition is not mentioned by name in the rating schedule, it will be rated under the most comparable rating.

Take for instance, there is only a rating for migraine type headaches in the schedule. If the Veteran has a diagnosis of tension headaches, the VA will rate under the Migraine schedule.

When an unlisted disease, injury, or residual condition is encountered, requiring rating by analogy, the code numbers will be “built-up” as follows:

The first 2 digits will be selected from the part of the schedule most closely identifying the part, or system, of the body involved; the last 2 digits will be “99” for all unlisted conditions. Then the next code will be the code the condition is being rated under.

So our example would be coded as 8199-8100; With first two digits of the first code being 81 (Central nervous system) then 99 showing condition is analogous. Then we have the second code being 8100 which is the code for migraines.

Code-Extensions (Hyphenated Code (XXXX-XXXX))

You may notice that some conditions on your code sheet are hyphenated. This is usually done to show:

• Condition is rated analogously;

• Condition is a residual;

• Condition considered under Gulf War presumptive; or to

• Note avoidance of Pyramiding.

IMPORTANT NOTE:

• The second code ALWAYS represents the rating schedule the condition is rated under!

Pyramiding avoidance

When Pyramiding rules require the rater to combine 2 or more conditions into a singular rating, the codes will be hyphenated with the first code being the less advantageous condition and the second code being the one which provides the Veteran with the highest rating.

NOTES:

In the event the 2 conditions are equal in terms of end rating, the rater may order them in any order.

In the event there are more than 2 conditions, the rater must leave off the additional codes as the system does not support having more than 2 codes per condition.

Residual condition

For conditions rated based upon residuals of a primary condition, the first code will belong to the primary condition and the second code will belong to the residual condition.

IMPORTANT NOTE:

• This coding is NOT used for conditions which are merely secondary! In short, it is for when the primary condition causes another disability and the primary condition is NOT rated separately or the schedule says to rate based on residuals of the condition.

For example:

Rheumatoid (atrophic) arthritis rated as Ankylosis of the lumbar spine would be coded as 5002-5240.

Other common examples in which this coding is used include but is not limited to:

• Cancers;

• Multiple sclerosis;

• Parkinson’s disease;

• Stroke; and

• Tumors.

Considered under Gulf War presumptive

To help the VA internally track conditions considered under Gulf presumptives, the VA has rater use specific coding.

The first code is 88XX; with the Xs being replaced with the first 2 digits of the second code. The second code is what the condition is rated under.

For example:

8850-5025 would be Fibromyalgia.