Claim Raven explanation
What this means
In specified combinations, VA can pay compensation as if disabilities affecting both paired organs or extremities were service connected even when only one side is service connected.
The rule covers particular combinations and severity requirements for vision, kidneys, hearing, hands or feet, and lungs. Having a condition on both sides is not enough without meeting the applicable provision.
How this helps your claim
If a serious disability affects the matching organ or extremity, compare both sides' findings with this rule. It may explain why VA needed measurements from a side that is not itself service connected.
What to check in your records
Use your decision, examination reports, and relevant records to check the following points.
- Confirm which side is service connected and which is not.
- Gather the required measurements or loss-of-use findings for both sides.
- Check whether VA evaluated the specific paired-organ provision that matches the disabilities.
Check each side against the specified combination
Paired-organ compensation requires more than two similar diagnoses. The regulation identifies particular organs or extremities and severity combinations. The service-connected side and the other side each need to satisfy the conditions of the applicable provision.
Keep the measurements or functional findings for each side clearly labeled. A combined summary can obscure whether both meet the stated threshold. Also distinguish a payment rule treating a pair as if service connected from a separate determination that the second disability is actually related to service.
Does this automatically grant service connection for the other side?
No. The provision allows compensation on a specified basis for qualifying pairs; that is not the same as proving a service relationship for every nonservice-connected impairment. Read the award's explanation and the exact pairing requirements before assuming that the legal status of the second condition changed.
Official regulatory text
38 CFR § 3.383
eCFR snapshot: September 3, 2026. Layout and spacing are adapted for reading. The full section and its tables are included below.
§ 3.383 Special consideration for paired organs and extremities.
(a) Entitlement criteria. Compensation is payable for the combinations of service-connected and nonservice-connected disabilities specified in paragraphs (a)(1) through (a)(5) of this section as if both disabilities were service-connected, provided the nonservice-connected disability is not the result of the veteran's own willful misconduct.
(1) Impairment of vision in one eye as a result of service-connected disability and impairment of vision in the other eye as a result of non-service-connected disability and
(i) The impairment of vision in each eye is rated at a visual acuity of 20/200 or less; or
(ii) The peripheral field of vision for each eye is 20 degrees or less.
(2) Loss or loss of use of one kidney as a result of service-connected disability and involvement of the other kidney as a result of nonservice-connected disability.
(3) Hearing impairment in one ear compensable to a degree of 10 percent or more as a result of service-connected disability and hearing impairment as a result of nonservice-connected disability that meets the provisions of § 3.385 in the other ear.
(4) Loss or loss of use of one hand or one foot as a result of service-connected disability and loss or loss of use of the other hand or foot as a result of nonservice-connected disability.
(5) Permanent service-connected disability of one lung, rated 50 percent or more disabling, in combination with a nonservice-connected disability of the other lung.
(b) Effect of judgment or settlement.
(1) If a veteran receives any money or property of value pursuant to an award in a judicial proceeding based upon, or a settlement or compromise of, any cause of action for damages for the nonservice-connected disability which established entitlement under this section, the increased compensation payable by reason of this section shall not be paid for any month following the month in which any such money or property is received until such time as the total amount of such increased compensation that would otherwise have been payable equals the total of the amount of any such money received and the fair market value of any such property received. The provisions of this paragraph do not apply, however, to any portion of such increased compensation payable for any period preceding the end of the month in which such money or property of value was received.
(2) With respect to the disability combinations specified in paragraphs (a)(1), (a)(2), (a)(3) and (a)(5) of this section, the provisions of this paragraph apply only to awards of increased compensation made on or after October 28, 1986.
(c) Social security and workers' compensation. Benefits received under social security or workers' compensation are not subject to recoupment under paragraph (b) of this section even though such benefits may have been awarded pursuant to a judicial proceeding.
(d) Veteran's duty to report. Any person entitled to increased compensation under this section shall promptly report to VA the receipt of any money or property received pursuant to a judicial proceeding based upon, or a settlement or compromise of, any cause of action or other right of recovery for damages for the nonservice-connected loss or loss of use of the impaired extremity upon which entitlement under this section is based. The amount to be reported is the total of the amount of money received and the fair market value of property received. Expenses incident to recovery, such as attorneys' fees, may not be deducted from the amount to be reported.
(Authority: 38 U.S.C. 501(a), 1160)
Cross References:
§ 3.385 Disability due to impaired hearing; § 4.85 Evaluation of hearing impairment.
[53 FR 23236, June 21, 1988, as amended at 69 FR 48149, Aug. 9, 2004; 74 FR 11483, Mar. 18, 2009]
Related references
- 38 CFR § 3.385: When Hearing Loss Counts as a VA Disability
- 38 CFR § 4.85: How VA rates hearing loss
- 38 CFR § 4.1: What a VA disability rating measures
- 38 CFR § 3.159: VA duty to assist: records and examinations
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