The VA Bilateral Factor Explained

What is the bilateral factor?

Per 38 CFR § 4.26, when a veteran has compensable disabilities of both arms, both legs, or paired skeletal muscles, the VA combines those ratings and adds an additional 10% before combining with other non-bilateral disabilities.

Which conditions qualify?

• Both knees, ankles, hips, or feet
• Both shoulders, elbows, wrists, or hands
• Paired skeletal muscle groups

Conditions affecting the spine, head, or a single limb don't qualify.

Example: bilateral knees at 20% each

1. Combine 20% + 20% using VA math: 100 − (0.8 × 0.8 × 100) = 36%.
2. Add 10% bilateral factor: 36 + 3.6 = 39.6%.
3. Combine with any other ratings, then round to the nearest 10%.

Use our calculator

On the VA Disability Calculator, check the “Bilateral” box next to each paired-limb rating. We automatically apply the 10% factor and combine your final number.