38 CFR § 4.14 — Avoidance of pyramiding

Title 38, Code of Federal Regulations · full text below reproduced from the eCFR, revision of 2026-07-01.

In practice: Pyramiding: the same manifestation can't be rated twice — but distinct manifestations of one condition can each be rated. Know the line.

Regulation text

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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.

Amendment history

The eCFR versioner records no amendment to § 4.14 since 2016-12-14 (its point-in-time floor); the text above has been in force at least that long. Earlier amendments are listed in the section’s source note.

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