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GARP Chapter 21: Paired Organs, Explained Simply

One eye, one kidney, one ear. Double the rating, compare with what losing both is worth, take the lesser. It lifted the Guide's own example from 20 points to 35.

Veterans Health Centre · 7 September 2026 · 3 min read

Short chapter, simple idea, and it can lift your rating significantly.

The idea

You have two eyes, two kidneys, two ears. If service damaged one of them, the other one now matters far more than it used to.

Losing your second kidney is not twice as bad as losing your first. It is much worse than that. The paired organs rule recognises this.

How it works

Three steps:

Take the rating for the damaged organ and double it.
Work out what losing both would be worth.
Take the lesser of those two.

The Guide's example

One eye is accepted, and scores 20 points on its own.

Doubled: 40.
The binocular rating for the level of loss: 35.
Lesser of the two: 35.

So the veteran gets 35 instead of 20. That is a 15-point lift from a rule that fits on one page.

Where it applies

Vision
Hearing (though hearing has its own version inside Chapter 7, not this chapter)
Kidneys
Testes, ovaries and adrenals

It applies only when the accepted condition affects one of the pair, and when losing both would be worth more than double losing one.

Where it does not apply

Arms and legs. The Guide is explicit about this. Limbs are already rated as functional units in Chapter 3, so the effect is built in.

That is the answer to the question veterans always ask: no, you cannot get this for one bad knee.

What this means for you

If service damaged one eye, one kidney, or one ear, ask whether this rule was applied.
Check the arithmetic. It is two lines. Doubled rating versus both-organ rating, lesser wins.
Hearing has its own version inside Chapter 7. Ask about that one specifically.
Do not expect it for limbs. Chapter 3 already handles that.

Common questions

My other kidney is healthy. Does that mean no rating?

No. The rule exists precisely because the healthy one now carries all the risk.

Why not for legs?

Because Chapter 3 already rates both legs as one working unit. The allowance is built in.

Who applies it?

The assessor should. If it is missing from a one-eye or one-kidney assessment, it is a reasonable thing to query.

Next in this series

Chapter 22: your lifestyle rating — the part you control.

Want a hand with yours?

If you have a permanent impairment assessment coming up, we do these every week. Call 0429 146 039 or email reception@vhc.org.au.

Dr Thomas Perkins

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Dr Thomas Perkins is the founding doctor at the Veterans Health Centre in Ipswich, Queensland, and the leading expert in veterans’ medicolegal work in Australia. He has spent over 13 years working exclusively with current and former Australian Defence Force members — treating conditions, writing reports, and navigating the DVA system alongside them.

With 100,000+ DVA claims submitted and over 2,000 Permanent Impairment Assessments completed, Dr Perkins brings a depth of experience that simply cannot be replicated from a textbook. He understands the Statements of Principles, the GARP tables, the imaging that proves what a physical examination alone cannot — and the difference that a properly written report makes at every level, from initial liability through to the VRB.

Every chart review, every diagnostic assessment, and every impairment rating is personally overseen by Dr Perkins. If you’re looking for a doctor who knows veterans medicine inside and out, you’ve found the right clinic.

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