# Avoidance of pyramiding

Aggregated by Superinsight from public-domain sources, as of 2026-07-28. Domain: va.

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## § 4.14 — Avoidance of pyramiding {#4.14}

*38 C.F.R. § 4.14*

Official source: <https://www.ecfr.gov/current/title-38/chapter-I/part-4/section-4.14>

The evaluation of the same disability under various diagnoses is to be avoided. Disability from injuries to the muscles, nerves, and joints of an extremity may overlap to a great extent, so that special rules are included in the appropriate bodily system for their evaluation. Dyspnea, tachycardia, nervousness, fatigability, etc., may result from many causes; some may be service connected, others, not. Both the use of manifestations not resulting from service-connected disease or injury in establishing the service-connected evaluation, and the evaluation of the same manifestation under different diagnoses are to be avoided.