Blog Details

Multiple Mental Health Ratings: Understanding the Anti-Pyramiding Rule


Do you ever wonder why the VA gives you a single rating when you’re service-connected for more than one mental health condition? Or why you might receive a combined rating for a mental health condition and a Traumatic Brain Injury (TBI)? The answer lies within the VA’s anti-pyramiding rule, and today, on VA Made Easy, we’re here to break it down for you.

The VA’s Rating System: Separation is the Norm

In the world of VA ratings, the general rule is that all disabilities are rated separately. However, there’s one crucial exception to this rule – the anti-pyramiding provision. So, what exactly is anti-pyramiding? It’s essentially a rule that prevents veterans from being compensated more than once for the same disability or the same set of symptoms.

Imagine you’re dealing with two service-connected mental health conditions, such as bipolar disorder and PTSD. The VA has assigned you a single rating of 70% for both conditions, but you believe you should receive two separate ratings because these are two distinct mental health issues. While that’s a valid point, it’s essential to understand that mental health conditions often share overlapping symptoms. To navigate the anti-pyramiding rule successfully, you’ll need solid medical evidence demonstrating that these conditions manifest different symptoms.

For example, in our case of bipolar disorder and PTSD, if you can provide medical evidence showing that only bipolar is causing psychosis and sleep disturbances while only PTSD is responsible for irritability and anxiety, you might have a chance at two separate ratings. But, let’s be honest, finding a medical professional willing to make such distinctions might be a challenge. And even if you manage to separate the ratings, the VA’s math might not work in your favor.

The VA’s Math and Combined Ratings

The VA is known for its complex math when combining ratings. Say you’re initially rated at 70% for the combined bipolar and PTSD. You successfully separate the conditions, but now only some symptoms are attributed to each. The VA might give you 30% for bipolar and 50% for PTSD. In VA math, 30% and 50% don’t add up to 80% – it’s 65%, which gets rounded up to 70%. In the end, you’re right back where you started.

The Game-Changer: Mental Health Conditions and TBI

Now, let’s switch gears and consider a scenario where you have a mental health condition combined with a Traumatic Brain Injury (TBI). Here’s where things can get interesting. It’s often easier to attribute certain symptoms to TBI rather than the mental health condition itself. TBI symptoms tend to be directly related to neurological issues, such as motor skill difficulties or communication problems.
But there’s a catch – you still need solid medical evidence that clearly distinguishes which symptoms are linked to your mental health condition and which are due to TBI.

Wrapping It Up

So, what’s the takeaway from all of this? Well, getting separate ratings for multiple mental health conditions can be a challenging and time-consuming endeavor, and it might not be worth the effort. However, depending on the specific symptoms related to your TBI, it could be worthwhile to ask the VA to separate the ratings.

In the world of VA ratings, the anti-pyramiding rule may seem like a daunting obstacle, but armed with the right evidence and a clear understanding of how it all works, you can navigate the system more effectively. Remember, at VA Made Easy, we’re here to simplify the complex and make your VA journey a little smoother. Stay tuned for more insights and tips in the future!