Today we are going to discuss the VA’s rule against “pyramiding.” Under the VA rating system, the typical rule is that all disabilities, including those that are the result of a single disease or injury (such as claims for secondary service connection) are rated separately, and then combined into a single rating using the VA’s complicated rating math. The rule against pyramiding is an exception, in that it prohibits compensating a veteran more than once for the same disability or same manifestation.
What does the VA mean by “same disability” or “same manifestation”? The important thing to remember is that if you are looking to receive separate ratings as a result of a single disease or injury, the argument that needs to be made is that you suffer from a variety of symptoms that are covered by diagnostic codes that are not duplicate and do not involve overlapping symptomatology. For instance, a veteran who suffers from disfiguring scars, painful scars, and facial muscle damage that limits functionality can be rated separately under each relevant diagnostic code even though the conditions are the result of the same disability. The key in these cases is that the same symptoms cannot be used to support two separate ratings.
Another common example of pyramiding involves mental disabilities. Quite often a veteran will suffer from more than one mental disorder, such as PTSD and bipolar disorder. It is often difficult to determine what manifestations are the results of one mental disorder, and what manifestations are the results of the other. Therefore, typically all mental disorders are rated together. But, it is possible for a veteran to receive separate ratings for two distinct mental disorders if there are manifestations of one mental disorder which are not manifestations of the other. But note, this would not be a simple argument to make and would most likely require an independent medical opinion that describes how each mental disorder has separate manifestations.
As you can see, pyramiding is a complicated issue, and is it also one that the VA often gets wrong. The VA has had a tendency to over-apply the anti-pyramiding rule, so if you have a disability that results in separate symptoms that do not overlap, you may be able to get separate ratings for each condition, and you should appeal your rating decision if the VA fails to separately rate each condition. For such cases, it would likely be helpful to get an independent medical opinion that shows how the single disability results in distinct, separate conditions that do not have overlapping symptomatology.