CAVC Holds That VA Adjudicators Can’t Deviate From Diagnostic Code

After a veteran is granted service connection, VA has some discretion in evaluating how severe the service-connected disability is. Each disability has a corresponding “diagnostic code” which lists symptoms that are associated with each level of disability rating. It is up to the VA adjudicator to determine what symptoms the veteran has, and then grant an award consistent with that level of disability.

Occasionally, VA adjudicators will, in the course of rating a veteran’s disability, discuss symptoms that are not specifically listed in the diagnostic code. Obviously, most disabilities have a countless number of possible symptoms, and it would be impossible to list them all within the diagnostic code. However, the Court of Appeals for Veterans Claims has now clarified that, in most circumstances, it is inappropriate for the VA adjudicator to consider symptoms that are not listed in the diagnostic code when evaluating a disability.

Jones v. Shinseki

In Jones v. Shinseki, the veteran suffered from all of the symptoms that would warrant a 30% disability rating for his condition, but he was also taking medication that apparently made his condition somewhat better. The use of medication was not a factor listed in the diagnostic code. Even though the veteran had all the symptoms of a 30% disability rating, the Board relied on the veteran’s use of medication to deny a 30% disability rating. On appeal, the Court held that the Board committed error when it considered the use of medication, which was not a factor specifically listed in the diagnostic code.