Amyotrophic Lateral Sclerosis (ALS) — VA Disability Rating (DC 8017)
Diagnostic Code 8017 · 38 CFR §4.124a
What Is It?
Amyotrophic lateral sclerosis — usually called ALS or Lou Gehrig's disease — is a progressive neurodegenerative condition that destroys the motor neurons in the brain and spinal cord. As those nerve cells die, the muscles they control stop receiving signals and waste away. Early symptoms tend to be subtle: a weak grip, slurred words, a foot that drags. Over months and years, the weakness spreads to the arms, legs, swallowing, breathing, and speech. Cognition and the senses are usually preserved, which is part of what makes the disease so difficult. There is no cure. Multiple studies have shown that military veterans develop ALS at roughly twice the rate of the general population, and the VA has built its rating rules around that reality.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Any active diagnosis of amyotrophic lateral sclerosis carries a 100% schedular evaluation under DC 8017. There is no lower rating tier and no intermediate step — the diagnosis itself is the rating. As the disease progresses, the veteran also becomes eligible for Special Monthly Compensation (SMC) at levels that step up alongside the loss of independence, the need for aid and attendance, and the loss of use of limbs, speech, or the ability to breathe without mechanical assistance. |
Evidence Needed
A neurologist's diagnosis is the central piece of evidence. The diagnosis is usually supported by EMG and nerve-conduction studies showing both upper and lower motor neuron involvement, an MRI ruling out structural causes for the weakness, and blood work ruling out conditions that can look like ALS in the early stages. For service connection under the ALS presumptive (38 CFR §3.318), the only other thing the VA needs to see is verification that the veteran completed at least 90 days of continuous active military service — DD-214 or other separation documents satisfy this. Specific exposure proof is not required.
C&P Exam Tips
The exam for ALS is less about establishing the diagnosis and more about documenting the current level of impairment so the VA can determine the appropriate SMC tier. Bring a current functional summary from your neurologist. Describe the activities you used to do that you can no longer do without help, the assistive devices you rely on (canes, wheelchair, communication boards, BiPAP), and the level of help you need from a spouse, family member, or aide for dressing, feeding, bathing, and managing medications. If swallowing or breathing is affected, make sure that is in the record — those drive SMC at the K, L, M, N, and higher levels.
How to File
File a VA Form 21-526EZ claiming ALS under DC 8017 and cite 38 CFR §3.318 for the presumptive service connection. Attach the neurologist's diagnosis and a copy of the DD-214 showing 90+ days of continuous active service. ALS claims qualify for the VA's priority processing under the Fully Developed Claim and Veterans Benefits Administration Fast Track programs — both the regional office and the National Cemetery Administration have internal guidance that ALS claims should move quickly. If you have not already, also apply for Aid and Attendance, automobile and adaptive equipment grants, and Specially Adapted Housing (SAH) — all are available to veterans rated for ALS.
Common Mistakes
Waiting to file because of uncertainty about the exposure history — exposure proof is not required, the 90-day service threshold is the entire test Filing only for ALS itself and not following up with SMC, Aid and Attendance, automobile grant, and SAH applications as the disease progresses Not updating the VA when functional status changes, which is what drives movement up the SMC tiers
Frequently Asked Questions
Do I need to prove an exposure caused my ALS?
No. 38 CFR §3.318 makes ALS presumptively service-connected for any veteran who served on active duty for 90 days or more continuously. You do not need to show burn pit exposure, Agent Orange, Camp Lejeune water, or any other specific event. The diagnosis plus the service time is the entire claim.
Why is ALS rated 100% even if symptoms are still mild?
The VA recognizes that ALS is progressive, terminal, and irreversible. A mild presentation today will not stay mild. Rather than re-rate the condition every few months as it worsens, the rule sets the schedular evaluation at 100% from the date of diagnosis. SMC then layers on top to track the additional losses — aid and attendance, loss of use of limbs, loss of speech, ventilator dependence — as they occur.
What is SMC and why does it matter for ALS?
Special Monthly Compensation is an additional payment on top of the 100% rating for veterans who have lost the use of a limb, lost the ability to speak or swallow, are housebound, or need regular aid and attendance from another person. It is paid at lettered tiers (K through R) that step up as the disability deepens. For most veterans with ALS, SMC eventually becomes a larger portion of monthly compensation than the underlying 100% rating, so getting it on the record promptly matters.
Can my surviving spouse get benefits?
Yes. A veteran rated 100% for ALS is considered totally and permanently disabled, which makes the surviving spouse eligible for Dependency and Indemnity Compensation (DIC) and CHAMPVA health coverage. If the veteran was rated 100% for the required period before death (or died from a service-connected condition), those benefits flow without an additional service-connection battle.