38 C.F.R. § 4.14
Avoidance of pyramiding
The evaluation of the same disability under various diagnoses is to be avoided. Disability from injuries to the muscles, nerves, and joints of an extremity may overlap to a great extent, so that special rules are included in the appropriate bodily system for their evaluation. Dyspnea, tachycardia, nervousness, fatigability, etc., may result from many causes; some may be service connected, others, not. Both the use of manifestations not resulting from service-connected disease or injury in establishing the service-connected evaluation, and the evaluation of the same manifestation under different diagnoses are to be avoided.
Notes of Decisions
Cited in 363
cases (34 in the last 5 years), 1992–2025 · leading case: Esteban v. Brown, 6 Vet. App. 259 (Vet. App. 1994).
Esteban v. Brown, 6 Vet. App. 259 (Vet. App. 1994). “One exception provided for is the anti-pyramiding provision of 38 C.F.R. § 4.14 (1993), which states that evaluation of the “same disability” or the “same manifestation” under various diagnoses is to be avoided.”
DeLuca v. Brown, 8 Vet. App. 202 (Vet. App. 1995). “In support of its conclusion, the Board cited 38 C.F.R. § 4.14 , “Avoidance of pyramiding”, which provides: The evaluation of the same disability under various diagnoses is to be avoided.”
Amberman v. Shinseki, 570 F.3d 1377 (Fed. Cir. 2009). “Because the Veterans Court properly interpreted 38 C.F.R. § 4.14 to pro *1379 hibit separately rating the same symptoms merely because those symptoms have multiple causes, we affirm.”
Joe L. Monzingo v. Eric K. Shinseki, 26 Vet. App. 97 (Vet. App. 2012). “87 , Diagnostic Code (DC) 6260 (2012) ("Tinnitus"); see 38 C.F.R. § 4.14 (2012) (stating the Secretary's practice to avoid "the evaluation of the same manifestation under different diagnoses"); VA Adjudication Procedures Manual (M21- 1MR), pt.”
Ellis C. Smith v. R. James Nicholson, 19 Vet. App. 63 (Vet. App. 2005). “19 Both the Secretary and the General Counsel quote the Supplementary Information published in the Federal Register at the time of the promulgation of the final rule, which stated in relevant part: To rate each ear separately for this single disability would violate the…”
Fanning v. Brown, 4 Vet. App. 225 (Vet. App. 1993). “” 38 C.F.R. § 4.14 (1992); Brady, 4 Vet.App.”
Scott v. Wilkie, 920 F.3d 1375 (Fed. Cir. 2019). “The Veterans Court found that the Board's "selection" of DC 5276 over DC 5284 was not arbitrary and capricious because (1) the Board had considered the evidence of record and concluded that "DC 5276 most nearly approximated his symptoms," and (2) evaluating Scott's plantar…”
Russell W. Burton v. Eric K. Shinseki, 25 Vet. App. 1 (Vet. App. 2011). “See 38 C.F.R. § 4.14 (“The evaluation of the same disability under various diagnoses is to be avoided.”
Robert Fountain v. Robert A. McDonald, 27 Vet. App. 258 (Vet. App. 2015). “The Final Rule states that because tinnitus is a single disability arising in the brain, evaluating it as two separate disabilities would violate the principles against pyramiding, 38 C.F.R. § 4.14 (2002), and the principle in 38 C.”
Thompson v. McDonald, 815 F.3d 781 (Fed. Cir. 2016). “40 ,’ and ’38 C.F.R. § 4.14 does not forbid consideration of a higher rating based on a greater limitation of motion due to pain on use including during flare-ups.”
Perciavalle v. McDonough, 74 F.4th 1374 (Fed. Cir. 2023). “38 C.F.R. § 4.14 (1971). II In order to understand Mr.”
Bagwell v. Brown, 9 Vet. App. 337 (Vet. App. 1996). “It appears that the Board did not obtain the results of the March 1993 eye examination because, in its opinion, pursuant to 38 C.F.R. §§ 4.14 and 3.383(a) (1995), the appellant’s evaluation would not change unless the veteran was also blind in his right eye.”
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