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VA pyramiding means you can’t be paid twice for the same symptoms, even if you have multiple diagnoses. For example, pain, numbness, and tingling in your legs could be caused by radiculopathy (from a back condition) or neuropathy (often from diabetes). If both conditions cause the same symptoms, VA will only rate you once, not separately for each diagnosis. The same thing happens with mental health conditions. Veterans often have multiple diagnoses like PTSD, anxiety, depression, or schizophreni
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