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In November 2024, the Department of Veterans Affairs published a proposed update to amend how neurological conditions and seizure disorders are evaluated under VA’s disability pay structure. The changes are part of a major overhaul of the Schedule for Rating Disabilities, aiming to modernize rating methods in step with current medical knowledge.
Let’s have a look at the proposed changes and what they could mean for veterans’ disability benefits moving forward.
Why Is VA Changing the Rating Schedule?
As part of a broader push to modernize service delivery and reduce administrative hurdles for veterans, VA is attempting to modernize the rating system.
According to the VA, the proposed changes aim to:
- update the medical terminology;
- add medical conditions not currently found in the rating schedule;
- refine evaluation criteria based on medical advances and current understanding of functional changes associated with disease or injury, and;
- remove or modify outdated or obsolete diagnostic codes
The system in place today relies on decades-old categories and medical terms that struggle to align with the modern understanding and treatment of neurologic and convulsive conditions. For example, outdated terms like “neuralgia” and “neuritis” don’t reflect modern diagnostic language.
VA also wants to align disability codes with current clinical evaluation tools, introducing objective measurement scales like muscle-strength grading or standard functional scales to replace subjectivity and ambiguous descriptors.
What Do the Proposed Changes Cover?
Regarding AQ73-Proposed Rule-Schedule for Rating Disabilities: Neurological Conditions and Convulsive Disorders, VA’s suggestions highlight two major areas: new or updated diagnostic codes and a General Rating Formula (GRF) for specified neurologic disorders.
Updated and New Diagnostic Codes
VA plans to revise existing codes and add new ones to better capture specific conditions and align them with diagnostic criteria. The proposal includes code changes for conditions like the following:
- Parkinson’s disease
- Parkinson’s Plus (secondary Parkinsonism)
- Stroke residuals
- Multiple sclerosis
- Demyelinating diseases
- Brain tumors
- Encephalitis
- Essential tremor
- Dystonia
- Primary lateral sclerosis (PLS)
- Hemifacial spasm
- Epilepsy/seizure codes (e.g., distinct codes for different seizure types)
According to the VA, code changes for these conditions aim to allow a more precise match between a veteran’s medical reality and how their condition is recorded and rated.
General Rating Formula (GRF) for Movement Disorders
For movement-related conditions like Parkinson’s, Essential Tremor, Dystonia, and possibly others under the neurologic category, VA wants to apply a clear, structured set of functional benchmarks (0–100%) that correspond to the impact on daily life.
The proposed benchmarks are as follows:
- 100%: Inability to maintain any independent living functions.
- 60%: Daily reliance on mobility aids (walker, wheelchair).
- 30%: Intermittent or occasional use of assistance.
- 10%: Mild impairment in speech, balance, or fine motor skills.
VA plans to use validated clinical scales such as the Hoehn–Yahr scale for Parkinson’s, or the Medical Research Council (MRC) scale for muscle strength, tying ratings to measurable data rather than subjective observation.
How Might the Proposed Changes Impact Veterans Benefits?
Updated terminology could help avoid confusion and better reflect today’s diagnostic standards. New disability codes could help veterans get compensated based on their specific diagnosis by bringing visibility to conditions previously lumped under analog rules, like Essential Tremor or PLS.
By specifying functional benchmarks and linking disabilities to measurable scales, evaluations become more consistent, meaning veterans with similar impairment levels are more likely to receive the same ratings.
In the best-case scenario, structured criteria and standardized codes would speed up VA decisions, reduce appeals, and give more predictable outcomes.
Of course, with any proposed change, there are concerns. The public was invited to weigh in on VA’s proposed changes (comments closed in January 2025).
Veterans worry that shifts in criteria or new definitions could indirectly lower existing ratings. For example, one public comment stresses that under 38 U.S.C. § 1155, ratings shouldn’t be reduced unless improvement is evident, but revisions might blur that protection.
Some responders noted that disorders like narcolepsy or other sleep-related conditions aren’t well-represented. Comments urge VA to consider adding sleep disorders under the neurological rubric given diagnostic similarity (EEG, polysomnogram use).
And while more codes add precision, they make the system more complex. Some worry clinical examiners and adjudicators may struggle with new scales, potentially slowing rather than speeding claims.
Finally, there’s debate over how (and whether) ratings keyed to scales like Hoehn–Yahr accurately reflect the full functional impairment veterans live with. Some conditions have side impacts (like mood, cognitive fatigue) not captured in movement-based scales.
While veterans with conditions like Essential Tremor or Dystonia may see clearer eligibility for service-connected benefits, some veterans could see unchanged, higher, or even lower ratings if their condition’s severity doesn’t align with new functional thresholds.
What Should Veterans Do in the Meantime?
If you’re affected by these updates, now is the time to gather documentation, understand your current rating, and prepare for potential re-ratings under the new structure.
- Review Your Current Code and Rating: Know the diagnostic code(s) VA has assigned you and the basis for your percentage rating.
- Compare Against Proposed Codes: If you have or suspect you have a condition like Essential Tremor, dystonia, or a Parkinsonism syndrome, see whether new codes would better reflect your situation.
- Collect Objective Evidence: Documentation like neurologist evaluations, functional assessments, or MRC muscle-testing results can be valuable, especially once new criteria take effect.
- Prepare for Re-Evaluation: If your condition is subject to updated criteria, reach out to your VA provider or a private neurologist to ensure exams align with the new scales.
- Stay Informed About Final Rule: Watch for updates. VA is reviewing feedback and will eventually issue a final rule. At that point, new ratings become official.
For more information on disability ratings, read our free eBook: VA Disability Claims: An Essential Guide for U.S. Veterans.
If any questions come up about how these changes might affect your VA disability rating, don’t hesitate to contact our VA disability law firm. We’re here to help you navigate the system and make sure your service-connected condition is properly recognized and valued. Call 888.878.9350 or Connect Online.