Except as otherwise provided in the rating schedule, all disabilities, including those arising from a single disease entity, are to be rated separately, and then all ratings are to be combined pursuant to 38 C.F.R. § 4.25. One exception provided for is the anti-pyramiding provision of 38 C.F.R. § 4.14, which states that evaluation of the "same disability" or the "same manifestation" under various diagnoses is to be avoided. The Court has interpreted 38 U.S.C. § 1155 as implicitly containing the concept that "the rating schedule may not be employed as a vehicle for compensating a claimant twice (or more) for the same symptomatology; such a result would overcompensate the claimant for the actual impairment of his earning capacity" and would constitute pyramiding. Brady v. Brown, 4 Vet. App. 206 (1993).
When two diagnoses, one organic and the other psychological or psychoneurotic, are presented covering the organic and psychiatric aspects of a single disability entity, only one percentage rating will be assigned under the appropriate diagnostic code determined by the rating board to represent the major degree of disability.
38 C.F.R. § 4.132 (emphasis added.)
In Fanning v. Brown, 4 Vet. App. 225 (1993), the Court reaffirmed its reasoning in Brady that pyramiding of disabilities is to be avoided pursuant to 38 U.S.C. section 1155 and 38 C.F.R. section 4.14. In Fanning, the Court, after stating that it is possible for a veteran to have separate and distinct manifestations from the same injury permitting two different disability ratings, remanded the matter to the BVA because it had failed to state "reasons or bases" for denying the separate ratings due to pyramiding. Id.; see 38 U.S.C. § 7104(d)(1); Gilbert v. Derwinski, 1 Vet. App. 49, 56–57 (1990); Esteban v. Brown, 6 Vet. App. 259, 261 (1994).
Because separate disability ratings are permitted when the symptomatology and manifestations compensated under the DC are not duplicative or overlapping, the Board must specifically consider whether an appellant is entitled to be rated separately, or consider under 38 C.F.R. section 4.14 which of the potentially applicable DCs is more appropriate in the case. See Esteban v. Brown, 6 Vet. App. 259, 262 (1994) (because none of the symptomatology for appellant's three conditions in question was overlapping or duplicative, the appellant was entitled to separate disability ratings for each condition); see also Brady v. Brown, 4 Vet. App. 203, 206 (1993) (the purpose of the anti-pyramiding provision is to prevent the rating schedule from being used as a vehicle for overcompensating a claimant multiple times for the same symptomatology); 38 C.F.R. § 4.14 ("The evaluation of the same disability under various diagnoses is to be avoided.").