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What is pyramiding in relation to VA disability claims? Examples included!

If you're looking to get the maximum value out of your VA disability benefits, then you're going to want to become aware of pyramiding – an unfortunately common situation that can occur when Veterans seek disability benefits for multiple different service-connected conditions.


Here's everything you need to know about pyramiding (and how to avoid it) when preparing to file a VA disability benefits claim:


What is pyramiding in relation to VA disability claims?

The short answer: The pyramiding principle is where no two conditions or symptoms can be rated twice. 


Sometimes two conditions can have overlapping symptoms making it difficult to determine which symptoms are related to which condition.  This often leads to the VA combining conditions under one rating.  


There's an in-depth explanation of the VA's policies regarding the evaluation of a disability diagnosed as both a physical and mental disorder within section V.iii.13.1.h of the VA's M21-1 adjudication procedures manual. It states the following: "To warrant separate evaluations, symptoms considered must be distinct and not overlap." So, even if two conditions DO have overlapping symptoms – it's all about how you document your evidence. We'll get to that below.


Examples of pyramiding with VA disability claims


Pyramiding can occur with a variety of different claim combinations – these two examples below are common:


  • Fibromyalgia and PTSD: Imagine a Veteran receives a service-connected rating for PTSD with anxiety as a symptom. They also file a separate claim for fibromyalgia, but only consider the anxiety symptom for PTSD since listing it for fibromyalgia as well would cause pyramiding.


  • GERD and Irritable Bowel Syndrome (IBS): Due to similar symptoms (abdominal pain, nausea, bowel movement irregularity), pyramiding can occur with these two conditions if there isn't clear enough differentiation between symptoms. Typically, these end up getting rated as one condition – with the rating level being assigned  from whichever is more severe.


How to avoid pyramiding in your VA disability claim


At MRPY Professional Services, we have years of experience with avoiding pyramiding when helping our clients prepare documents for their VA disability claim. We understand how to write an effective Nexus Letter that gets optimal results. Backing up your symptoms with both medical expert opinion and organized documentation is the best way to avoid pyramiding in a VA disability benefits claim. If you're ready to get started, we can help you get the ball rolling. Begin by signing up for a chart review or another one of our services here.


A strong VA disability benefits claim starts with proper documentation. Nexus Letters, DBQs, chart reviews, and more – we can help you get what you need to be prepared. Sign up for a chart review, and view other services here. Instead of going it alone, work with one of our professional medical experts to get exactly what you need.



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