Receiving the VA disability rating you deserve can still be harder than you expect, and harder than it ought to be, even for Veterans who were wounded in combat.
This is because VA disability compensation is not based simply on the fact that you were wounded in combat but on the nature and severity of the injury and on its lasting effects.
Most Veterans don’t understand the ins and outs of how the system works, but understanding the system is the first, crucial step toward getting the compensation you’re owed. We can help you, and there is no out-of-pocket cost for the Veterans we represent. Call 866-951-0466 or contact us online today.
What Does VA Count as a Combat Wound?
First and foremost, the VA does not rate the wound; it rates what the wound left behind. In other words, combat injuries are rated based on what the wound did to your body and how it affected your tissues, organs, systems, or functions.
A gunshot wound, a blast injury, or a burn while you were serving is the event that establishes a service connection. But what drives the rating is the residual damage: which muscles, nerves, organs, or structures were affected, how severely, and how that damage limits your function today.
Does Having a Purple Heart Make the Claim Easier?
Yes, because it clearly establishes a service connection, but having a Purple Heart is not a substitute for building a complete claim. Under 38 C.F.R. § 3.304(d), receipt of the Purple Heart establishes that an in-service injury occurred. The VA is required to accept the Purple Heart as verification of the in-service stressor or event. But a Veteran with a Purple Heart still has to document what the wound did to their body, how it has progressed, and how it affects their ability to function today.
Here are some examples:
Muscle and joint injuries are rated under 38 C.F.R. § 4.71a (for joints and range of motion) and 38 C.F.R. § 4.73 (for muscle group damage). For muscle injuries like those caused by gunshot wounds and shrapnel, the VA uses Diagnostic Codes 5301–5323 and rates severity on a scale from slight to severe. A slight injury with clean entry and exit wounds and no functional loss rates at 0%. Moderate damage with weakness or tenderness rates at 10%. From there, the scale climbs through moderately severe, where strength loss, limited endurance, or muscle herniation come into play, to severe, where function is markedly impaired, and the Veteran cannot bear weight or grip normally. Ratings at the severe end reach 40–50%.
Amputations are rated under DC 5104–5125 and 5160–5173 based on the level of loss. A below-elbow amputation is rated at 60% to 80%. Above-knee and bilateral amputations can reach 90% to 100%. Veterans with amputations should also be evaluated for Special Monthly Compensation (SMC), which provides payments above the standard disability rate to account for the loss of a limb.
Burns and traumatic scars are rated under 38 C.F.R. § 4.118 based on how much of the body is affected, whether the scarring is painful or unstable, and whether it limits movement in an underlying joint. Disfigurement of the face, head, or neck is rated separately under DC 7800 and can range from 10% to 80% depending on severity, a recognition that visible disfigurement carries consequences beyond physical function.
Nerve damage from a wound is rated on a spectrum under 38 C.F.R. § 4.124a, running from neuritis — pain and sensory loss with the nerve still partially intact — through degrees of incomplete paralysis to complete paralysis. Ratings typically fall between 10% and 80% depending on which nerve was damaged and how severely.
When a wound penetrates the torso and damages the internal organs, the rating comes from whichever body system schedule governs that organ. For example, lung damage is rated under the respiratory schedule at 38 C.F.R. § 4.97; bowel and digestive injuries under the digestive schedule at § 4.114; kidney or bladder damage under the genitourinary schedule at § 4.115a; and cardiac damage under the cardiovascular schedule at § 4.104. Each system has its own criteria based on function, not simply on the presence of injury.
Do I Need to Have Been Diagnosed While I Was Serving?
We get this question a lot. No, you do not have to have had a VA rating in place when you leave the military to eventually receive VA disability compensation. Under 38 C.F.R. § 3.303, the date of the original wound establishes the in-service event. Residual conditions like chronic pain, limited range of motion, nerve damage, and scarring can be claimed and rated at any point after service, as long as you can show they are the result of the combat injury.
That said, compensation is retroactive to the date of the claim, not the date the injury or damage became disabling. This is why we always tell our clients to file as early as possible, even if they’re still gathering their documentation.
Who Can Make a Diagnosis?
The provider documenting your injuries must be a licensed medical professional, but it’s also important that the right provider evaluates the residual injury.
Musculoskeletal and joint residuals are typically documented by an orthopedic specialist or general practitioner. Nerve damage, neuropathy, and TBI residuals usually fall to a neurologist. Burns and scarring may be evaluated by a plastic surgeon or dermatologist, though any qualified medical professional can diagnose these conditions. Respiratory damage from a blast or penetrating chest wound can similarly be evaluated by a pulmonologist or qualified medical provider. A primary care physician can also play a major role, particularly when the supporting evidence, like imaging, nerve conduction studies, or range of motion measurements, is objective and well-documented.
The VA will typically schedule a Compensation and Pension (C&P) exam. It’s very important that you not skip your C&P exam. Missing or refusing portions of the exam is one of the fastest ways to undermine an otherwise strong claim.
What About TBI from Combat?
Blast exposure, the signature wound of the post-9/11 wars, frequently causes Traumatic Brain Injuries (TBI) that were never properly documented during service. Many Veterans were evaluated, cleared, and returned to duty after concussive events without receiving a formal TBI diagnosis. This is a very common situation, and it’s one we’ve dealt with a lot.
TBI from combat qualifies as a service-connected disability, and it is rated based on residual impairment, including cognitive, emotional, physical, and behavioral, under 38 C.F.R. § 4.124a, DC 8045. If you experienced one or more loss-of-consciousness or altered-consciousness events during service and now live with cognitive, emotional, or physical symptoms, TBI residuals may be a separate, ratable condition on top of any physical wounds already rated.
How Secondary Conditions Can Increase Your Overall Rating
As Veterans know, the wound is rarely the whole story. Combat injuries almost always produce secondary conditions that qualify for their own ratings, and identifying them is often a big part of the work required in building a claim.
PTSD is a significant injury for many combat-wounded Veterans and frequently carries one of the highest ratings in a combined claim.
Depression and anxiety commonly develop in response to chronic pain, disfigurement, amputation, or the functional losses that come with serious injury.
Sleep disorders are nearly universal among Veterans dealing with chronic pain, PTSD, or TBI residuals.
Pelvic wounds, spinal injuries, vascular damage, and the medications used to treat service-connected conditions can all contribute to erectile dysfunction, which is rated separately and may support a Special Monthly Compensation claim.
Post-traumatic arthritis and nerve pain frequently develop at the site of a fracture, joint injury, or healed wound, and these are ratable as their own condition.
However, each of these secondary conditions requires medical evidence, such as a nexus opinion, linking the secondary condition to the service-connected wound.
What Documentation Do You Need?
- Service treatment records (STRs): Records of the original wound treatment, surgery, hospitalization, and follow-up care during service
- Purple Heart citation and orders: To establish the in-service event, if available
- Buddy statements: Statements from fellow service members who witnessed the wound or the circumstances that caused it
- Post-service medical records: Physician and specialist notes, imaging, nerve conduction studies, and functional assessments documenting current residuals
- Nexus letter: A written medical opinion connecting your current residual conditions to the combat wound
- Personal statement: Your written account of the wound, its treatment, how the residuals have progressed, and how they affect your daily life and ability to work
How Capovilla & Williams Can Help
You did your job, and you have suffered because of that. The VA system is supposed to recognize that and compensate you, but too many combat Veterans receive ratings that don’t reflect the full extent of their injuries or have residuals that were never rated at all.
Our team at Capovilla & Williams knows the rating schedule, knows what evidence the VA requires, and knows how to build a record that gets results. We handle VA disability claims at no out-of-pocket cost to our clients.
Call 866-951-0466 or reach us through our contact page today and let us go to work for you.
