The 38 CFR rating schedule is the official rulebook the VA uses to assign disability ratings. Found in Title 38 of the Code of Federal Regulations, Part 4, it contains a diagnostic code (DC) and rating criteria for every condition. This 2026 guide walks through how the schedule is organized and how to read it.
What is 38 CFR Part 4?
38 CFR Part 4 is the VA Schedule for Rating Disabilities. It groups conditions by body system and assigns specific percentage ratings to each condition. Every disability rating decision cites a diagnostic code from this schedule.
How 38 CFR Part 4 is organized
The rating schedule is broken into subparts by body system. Each subpart covers related conditions.
- 4.71a — Musculoskeletal system (spine, knees, hips, shoulders).
- 4.85–4.87 — Hearing impairment and tinnitus.
- 4.88a–4.89 — Infectious diseases and immune disorders.
- 4.97 — Respiratory system (sleep apnea, asthma, COPD).
- 4.100–4.104 — Cardiovascular system (hypertension, heart disease).
- 4.110–4.114 — Digestive system.
- 4.115a–4.115b — Genitourinary system.
- 4.118 — Skin (scars, dermatitis).
- 4.119 — Endocrine (diabetes, thyroid).
- 4.120–4.124a — Neurological (migraines, seizures, peripheral neuropathy).
- 4.130 — Mental disorders (PTSD, depression, anxiety).
- 4.150 — Dental and oral conditions.
How to read a diagnostic code
Each condition lists rating percentages from low to high. The criteria describe symptoms or measurements required for each level. The VA assigns the rating that best fits your worst symptom picture.
Example — Migraines (DC 8100):
- 0% — less frequent attacks.
- 10% — prostrating attacks averaging 1 every 2 months.
- 30% — prostrating attacks averaging once a month.
- 50% — very frequent prostrating attacks productive of severe economic inadaptability.
Key sections to know
- 4.16(a) — Schedular TDIU criteria.
- 4.16(b) — Extraschedular TDIU.
- 4.25 — Combined rating table (the “VA math”).
- 4.26 — Bilateral factor for paired limbs.
- 4.27 — Use of diagnostic code numbers.
- 4.59 — Painful motion principle.
VA Inspector General Finds Painful-Motion Rating Errors
A 2026 report from the VA Office of Inspector General (OIG) reviewed noncompensable joint-disability claims decided from April 2024 through March 2025. It found that claims processors misapplied 38 CFR 4.59 in about half of them. Section 4.59 requires at least the minimum compensable rating for a joint when motion is painful, unstable, or malaligned, even without an X-ray showing arthritis. OIG put the underpayment at close to $45 million across the claims it sampled.
What Petitti v. McDonald Established
The rule traces to Petitti v. McDonald, a 2015 decision from the Court of Appeals for Veterans Claims (CAVC). Petitti held that a veteran does not need objective evidence, such as an X-ray or an instability finding, to get the minimum compensable rating for a painful joint. A veteran's own reported pain during motion is enough on its own. The holding does not create a rating a diagnostic code does not otherwise offer. It raises a qualifying 0% finding to that code's minimum compensable step.
Why the Errors Happened
OIG traced the errors to inconsistent interpretation of the regulation, both across regional offices and within the Veterans Benefits Administration (VBA)'s own Compensation Service. Claims processors reported confusion over how to weigh reported pain against objective exam findings, and unclear language in the Adjudication Procedures Manual and the evaluation builder tool made it worse.
How to Check Your Own Rating
A missed 4.59 rating usually shows up as a 0% finding for a joint where the exam notes painful motion. That 0% keeps the joint out of VA's combined-rating math entirely, and the gap can carry into a TDIU claim, where every combined point counts. Painful motion noted in an exam, with no matching bump in the rating, is the exact pattern OIG flagged.
Check the rating decision and the exam behind it for any joint rated at 0%. A veteran in that position has two options. They can file a supplemental claim with the exam as new evidence, or, if the existing record already supported a higher rating, ask VA to revise the decision for clear and unmistakable error (CUE). A successful CUE claim can pay benefits back to the date of the original decision, not just the date of the new request.
Whether VA Is Fixing It
OIG issued four recommendations to VBA:
- Clarify how 4.59 should be interpreted.
- Update the Adjudication Procedures Manual to match.
- Improve guidance on weighing reported pain against exam findings.
- Fix the evaluation builder tool raters use.
All four remained open as of the report's August 2026 publication date. VBA told OIG in March 2026 that the specific errors found during the review had already been corrected as of February 2026.
Why 38 CFR matters in claims
VA decision letters cite specific 38 CFR sections. Knowing the rating criteria helps you:
- Spot when the rater used the wrong code.
- Identify symptoms that justify a higher rating.
- Build evidence that targets the next level.
- Argue for a separate rating instead of one combined rating.
How to look up 38 CFR Part 4
The full rating schedule lives at the Electronic Code of Federal Regulations. It updates as the VA revises the schedule.