On this page
- ALS VA rating criteria (DC 8017)
- The ALS service presumption and the 90-day rule
- Why the diagnosis matters more than proving one exposure
- Special monthly compensation with ALS
- How much VA pays for ALS
- How to prove ALS is service connected
- The C&P exam and the ALS DBQ
- Why VA denies ALS claims
- Questions veterans ask about ALS
- Sources
Service-connected amyotrophic lateral sclerosis, or ALS, has a 100 percent VA rating under DC 8017. You do not need to reach a particular stage of symptoms to move through a percentage ladder. The code lists one rating and tells VA to consider special monthly compensation.
The separate service-connection rule is just as important. Section 3.318 provides a presumption for ALS after qualifying active service, subject to its exceptions. This page explains both rules and the records to prepare. The Board section below covers ALS appeals where enough data exists to show a particular breakdown.
ALS VA rating criteria (DC 8017)
38 CFR § 4.124a provides this rating:
| Rating | DC 8017 |
|---|---|
| 100% | "Amyotrophic lateral sclerosis" |
Its note reads: "Consider the need for special monthly compensation."
The rating and service connection are separate decisions. The 100 percent entry tells VA how to rate ALS once it is service connected. It does not remove the need to establish the diagnosis and qualifying service or another supported service-connection theory.
The ALS service presumption and the 90-day rule
38 CFR § 3.318(a) states:
Except as provided in paragraph (b) of this section, the development of amyotrophic lateral sclerosis manifested at any time after discharge or release from active military, naval, air, or space service is sufficient to establish service connection for that disease.
Paragraph (b) then states that service connection will not be established under this section:
| Exception | Exact regulatory text |
|---|---|
| Evidence against service incurrence or aggravation | "If there is affirmative evidence that amyotrophic lateral sclerosis was not incurred during or aggravated by active military, naval, or air service;" |
| Willful misconduct | "If there is affirmative evidence that amyotrophic lateral sclerosis is due to the veteran's own willful misconduct; or" |
| Service duration | "If the veteran did not have active, continuous service of 90 days or more." |
The rule does not limit the presumption to a particular war or deployment. It also does not require ALS to appear within one year of separation. Its wording is "at any time after discharge or release," subject to the exceptions.
For a Guard or Reserve history, identify the exact periods and character of service in the records. Do not assume that membership or drill time alone establishes the active, continuous service this regulation requires. Submit the service documents for VA to determine whether the qualifying period is met.
Why the diagnosis matters more than proving one exposure
Research has examined the association between military service and ALS. A 2017 meta-analysis combined eight case-control studies and three cohort studies and found higher pooled odds of ALS among military personnel than among nonmilitary personnel. The authors reported variation between studies and called for further research into contributing factors (Tai and colleagues, 2017).
That association does not prove a specific exposure caused an individual case. Under § 3.318, an eligible claimant can rely on the presumption without identifying one particular chemical, injury or deployment as the cause. Focus first on the neurologist's ALS diagnosis and the qualifying service record.
If a presumption requirement is not met, that does not by itself decide every possible claim. Section 3.303(d) permits service connection for a disease diagnosed after discharge when all the evidence establishes that it was incurred in service. That route needs evidence addressing the individual case.
Special monthly compensation with ALS
The DC 8017 note tells VA to consider SMC. Eligibility depends on the additional criteria in 38 CFR §§ 3.350 and 3.352; ALS alone does not automatically establish every SMC level.
Section 3.350(b) includes qualifying loss or loss of use of extremities, being permanently bedridden, or needing regular aid and attendance. Section 3.352(a) identifies daily-care needs to consider, including dressing, keeping ordinarily clean, feeding, attending to the wants of nature and protection from daily hazards. It says the evidence must establish a need for regular aid and attendance, "not that there be a constant need."
Write down the help you need and why the service-connected condition makes it necessary. Useful details include whether you can dress, eat, use the toilet or move safely without another person's assistance, and what assistive equipment you use. A clinician's description should connect those needs to the medical findings. Needing help does not automatically decide which statutory SMC rate applies.
How much VA pays for ALS
At VA's rates effective December 1, 2025, the ordinary 100 percent disability rate for a veteran without dependents is $3,938.58 a month. Dependent family members can change that amount. SMC has its own rules and rates, so a decision should address that question separately when the evidence raises it.
The combined rating calculator explains ordinary combined percentages. It does not replace review of SMC eligibility. Keep the question of additional care or loss of use separate from whether the ordinary ALS percentage is already correct.
How to prove ALS is service connected
A claim under § 3.318
Gather the neurologist's diagnosis, records of when ALS manifested and service records showing the active, continuous period. Compare a denial with the precise requirement VA says is missing. A statement that the condition began many years after service does not, by itself, answer a rule that covers manifestation at any time after discharge.
A claim needing an individual medical link
If the presumption does not apply, a medical opinion should explain the relationship between the diagnosed ALS and the relevant service evidence under § 3.303. A general article about military service and ALS supplies background, not a substitute for that explanation.
Evidence for additional compensation
Include records of functional loss and regular assistance even when the ALS diagnosis already supports the ordinary 100 percent evaluation. DC 8017 expressly raises SMC. Keep the daily-care description, clinical findings and supporting records together so VA can consider the applicable requirements.
The C&P exam and the ALS DBQ
The ALS DBQ guide helps organize the medical record for the claim.
- Bring the diagnosis. Include the specialist's assessment and the records supporting it.
- Bring the service dates. The continuous qualifying period matters to the presumption.
- Describe your actual function. Include limb use, mobility, speaking, swallowing and breathing problems documented by your clinicians.
- Describe regular assistance. Say what another person does, how often and why it is needed.
- Include equipment and care records. They can help explain the assistance and remaining function.
Raven Scan can help you review your uploaded medical records while preparing the documents for the claim.
Why VA denies ALS claims
The Board section below shows the available ALS appeal results. Some detailed breakdowns are withheld when too few appeals support them. The evidence issues below come from the diagnosis, service and compensation requirements described above.
The diagnosis is not established. Symptoms or a different neurological diagnosis do not by themselves establish ALS. Submit the specialist's conclusion.
The service requirement is unresolved. Identify the exact active, continuous period rather than giving only years of military affiliation.
The decision invokes an exception. Read which § 3.318 exception VA relied on and the evidence it cited. Address that specific finding when seeking review.
SMC evidence is incomplete. A correct ordinary 100 percent rating does not answer whether additional compensation is warranted. Document the functional loss or care needs relevant to §§ 3.350 and 3.352.
Questions veterans ask about ALS
What is the VA disability rating for ALS?
Service-connected ALS is rated 100 percent under DC 8017. The code also directs VA to consider special monthly compensation.
Does ALS have to start within one year of discharge?
No. Section 3.318 covers ALS manifested at any time after qualifying discharge or release. The service requirement and stated exceptions still apply.
Do I need a Gulf War deployment to qualify?
Section 3.318 does not require a particular war or deployment. It requires qualifying active service, including at least 90 days of active, continuous service, subject to the other exceptions.
Does a 100 percent ALS rating automatically include SMC?
No. VA must consider SMC, but the applicable loss-of-use or care requirements need supporting evidence. Describe the help you need and submit the medical findings.
Can I claim ALS without the 90-day qualifying period?
That period is required for the § 3.318 presumption. A different service-connection theory would need evidence establishing its own requirements, such as an individual link under § 3.303.
Sources
- 38 CFR § 4.124a, DC 8017 (opens in a new tab), eCFR current through October 5, 2026
- 38 CFR § 3.318, ALS presumption and exceptions (opens in a new tab)
- 38 CFR § 3.303, service connection (opens in a new tab)
- 38 CFR § 3.350, special monthly compensation (opens in a new tab)
- 38 CFR § 3.352, aid and attendance (opens in a new tab)
- Tai H and colleagues. Military service and the risk of amyotrophic lateral sclerosis: A meta-analysis. J Clin Neurosci. 2017;45:337-342. doi:10.1016/j.jocn.2017.08.035 (opens in a new tab)
- VA disability compensation rates (opens in a new tab), effective December 1, 2025
- ALS DBQ guide