Temporary 100% Ratings — Hospital Stays, Convalescence and Prestabilization
Three regulations in the rating schedule pay a temporary rating while a service-connected condition is being treated or has not yet settled. Two of them, the hospital rating and the convalescent rating, assign 100 percent "without regard to other provisions of the rating schedule." The third, the prestabilization rating, covers the first year after discharge from service. Each ends on its own terms and is followed by a regular schedular rating.
The rules below come from 38 CFR 4.28, 4.29 and 4.30 as published on eCFR (current through October 26, 2026) and read on October 28, 2026.
| Rating | Regulation | Trigger |
|---|---|---|
| Hospital rating, 100% | 38 CFR 4.29 | Hospital treatment or observation for a service-connected disability for more than 21 days |
| Convalescent rating, 100% | 38 CFR 4.30 | Surgery or casting for a service-connected disability that meets one of three conditions |
| Prestabilization, 100% or 50% | 38 CFR 4.28 | An unstabilized condition or unhealed wounds in the period right after discharge from service |
Hospital stays over 21 days (38 CFR 4.29)
VA assigns 100 percent when a service-connected disability has required hospital treatment in a VA or approved hospital for more than 21 days, or hospital observation at VA expense for more than 21 days.
The rating starts on the first day of continuous hospitalization. It ends on the last day of the month of hospital discharge (regular discharge or release to non-bed care), or the last day of the month in which treatment or observation for the service-connected disability ends (4.29(a)). A temporary release approved by the attending VA physician as part of the treatment plan is not counted as an absence. Longer authorized absences can count as a discharge: one of more than 4 days that begins during the first 21 days, or absences totaling more than 8 days in that period (4.29(a)(1)).
If you were admitted for a condition that is not service connected, and treatment for a service-connected disability began and continued for more than 21 days, the 100 percent runs from the first day of that treatment (4.29(b)).
When convalescence is needed, the hospital rating can continue for 1, 2 or 3 more months (4.29(e)). Extensions of 1, 2 or 3 months beyond those first 3 months need approval from the Veterans Service Center Manager (4.29(f)). A veteran discharged with fewer than 21 days who needs post-hospital care and a long convalescence can have the claim referred to the Director of Compensation Service as an extra-schedular case (4.29(g)).
Convalescence after surgery or a cast (38 CFR 4.30)
VA assigns 100 percent when the report at hospital discharge or outpatient release shows that treatment of a service-connected disability resulted in any one of the following.
| Paragraph | What the treatment resulted in |
|---|---|
| 4.30(a)(1) | Surgery needing at least one month of convalescence |
| 4.30(a)(2) | Surgery with severe postoperative residuals, such as incompletely healed surgical wounds, stumps of recent amputations, therapeutic immobilization of one or more major joints, a body cast, house confinement, or continued use of a wheelchair or crutches (regular weight-bearing prohibited) |
| 4.30(a)(3) | Immobilization of one or more major joints by a cast, without surgery |
Any one of the three is enough. Severe residuals are not required where the surgery itself needed a month of convalescence. Outpatient surgery and outpatient casting count; the regulation notes their effective dates of March 1, 1989 and March 10, 1976.
The rating runs from the date of hospital admission or outpatient treatment and continues for 1, 2 or 3 months from the first day of the month after discharge or release. It can be extended by 1, 2 or 3 months beyond the first 3 months under any of the three paragraphs (4.30(b)(1)). Under 4.30(a)(2) or (a)(3), it can be extended by 1 or more months, up to 6 months beyond the first 6, with the Veterans Service Center Manager's approval (4.30(b)(2)). Each total rating needs full justification on the rating sheet.
What happens when it ends
A 4.30 rating is followed by a regular schedular evaluation. If the evidence is not enough to assign one, VA schedules a physical examination before the total rating ends. The end of a 4.29 or 4.30 total rating is not subject to 38 CFR 3.105(e), the rule that otherwise requires a proposed reduction and 60 days to respond before compensation is cut. That makes it worth sending current treatment records before the period runs out, and asking for an extension in writing if you are still recovering.
Prestabilization after discharge (38 CFR 4.28)
The prestabilization rating is for the period right after discharge from service, assigned instead of the ratings found elsewhere in the schedule.
| Prestabilization rating | Condition |
|---|---|
| 100% | Unstabilized condition with severe disability, where substantially gainful employment is not feasible or advisable |
| 50% | Unhealed or incompletely healed wounds or injuries, where material impairment of employability is likely |
It is not assigned when a total rating is immediately available under the regular schedule or on the basis of individual unemployability, and the 50 percent level is not used when 50 percent or more is immediately available. A VA examination is not required first. The rating continues for 12 months after discharge, though it can be changed to a regular total rating or a greater benefit at any time. VA requests an examination between 6 and 12 months after discharge. If that exam supports a lower evaluation, the higher one continues to the end of the 12th month after discharge or the end of the 3.105(e) period, whichever is later. Special monthly compensation is to be assigned at the same time whenever the records show entitlement.
Asking for a temporary rating
For a 4.30 rating, the report at hospital discharge or outpatient release is the evidence the regulation names, so send the discharge summary or operative report and any instructions about recovery time, weight-bearing limits or immobilization. For a 4.29 rating, records showing the admission and discharge dates and the treatment for the service-connected condition do the same work. VA can assign these ratings on its own when the records reach it, but you can also file a claim asking for one.
Note: This article references sections of the VA's M21-1 Adjudication Procedures Manual. The VA periodically reorganizes the M21-1 and section numbers may have changed since this article was written. For the most current section references, visit the VA's public M21-1 Web Automated Reference Material System (WARMS).
Frequently Asked Questions
Does the surgery or hospital stay have to be for a service-connected condition?
Yes. 38 CFR 4.30 requires that treatment of a service-connected disability resulted in the surgery or casting, and 4.29 requires that a service-connected disability required the hospital treatment or observation. A stay that began for another condition counts from the first day treatment for the service-connected disability began, if that treatment lasted more than 21 days (4.29(b)).
Do I need severe residuals to get a convalescent rating?
No. 38 CFR 4.30(a) lists three separate grounds: surgery needing at least one month of convalescence, surgery with severe postoperative residuals, or immobilization of a major joint by a cast without surgery. Any one is enough.
How long can a convalescent rating last?
It starts with 1, 2 or 3 months from the first day of the month after discharge or release. It can be extended by 1, 2 or 3 months beyond the first 3 months, and under 4.30(a)(2) or (a)(3) by 1 or more months up to 6 months beyond the first 6 with the Veterans Service Center Manager's approval (38 CFR 4.30(b)).
Does outpatient surgery count?
Yes. 38 CFR 4.30 applies to outpatient surgery under paragraphs (a)(1) and (a)(2), effective March 1, 1989, and to outpatient casting under (a)(3), effective March 10, 1976.
Will VA send me a proposed reduction before the temporary 100% ends?
No. The end of a total rating under 4.29 or 4.30 is not subject to 38 CFR 3.105(e), the proposed-reduction procedure. A regular schedular evaluation follows, and VA schedules an examination first if the evidence is not enough to assign one (4.30).