VA Disability for Diabetes (Type 2): Ratings, Evidence & Secondary Conditions

How the VA rates Diabetes (Type 2)

Diabetes (Type 2) is rated under 38 CFR 4.119, Diagnostic Code 7913 (ratings of 10%–100%). Each criterion below is transcribed verbatim from the VA rating schedule and verified against the regulation (eCFR / Cornell LII) — never paraphrased.

• 10%

  Manageable by restricted diet only.

• 20%

  Requiring one or more daily injection of insulin and restricted diet, or; oral hypoglycemic agent and restricted diet.

• 40%

  Requiring one or more daily injection of insulin, restricted diet, and regulation of activities.

• 60%

  Requiring one or more daily injection of insulin, restricted diet, and regulation of activities with episodes of ketoacidosis or hypoglycemic reactions requiring one or two hospitalizations per year or twice a month visits to a diabetic care provider, plus complications that would not be compensable if separately evaluated.

• 100%

  Requiring more than one daily injection of insulin, restricted diet, and regulation of activities (avoidance of strenuous occupational and recreational activities) with episodes of ketoacidosis or hypoglycemic reactions requiring at least three hospitalizations per year or weekly visits to a diabetic care provider, plus either progressive loss of weight and strength or complications that would be compensable if separately evaluated.

Common conditions secondary to Diabetes (Type 2)

Veterans routinely under-claim because they don't know a secondary condition exists. These are commonly claimed as secondary to service-connected Diabetes (Type 2) — each is a candidate to raise with your provider, not an automatic grant, and each needs a medical nexus opinion.

• Peripheral neuropathy (lower extremities)

  Peripheral neuropathy is one of the most common diabetic complications and is regularly granted as secondary to service-connected diabetes.

• Erectile dysfunction

  Erectile dysfunction is a well-recognized complication of diabetes and is commonly claimed as secondary (and may support SMC-K).

• Diabetic retinopathy / eye condition

  Diabetic eye disease (retinopathy) is a recognized secondary complication of service-connected diabetes.

• Kidney disease (diabetic nephropathy)

  Diabetic kidney disease (nephropathy) is a recognized secondary complication of service-connected diabetes.

• Hypertension (high blood pressure)

  Diabetes is a recognized contributor to hypertension through diabetic vascular and kidney changes; commonly claimed as secondary with a nexus opinion.

• Ischemic heart disease / coronary artery disease

  Ischemic / coronary artery disease is a recognized complication of diabetes (and is itself an Agent Orange presumptive). Worth claiming as secondary to service-connected diabetes with a nexus opinion.

Evidence the VA looks for

A strong Diabetes (Type 2) claim ties a current diagnosis to your service with a medical nexus. The records that move a Diabetes (Type 2) claim, in priority order:

• A current diabetes diagnosis and lab work (A1C, fasting glucose)
• A treatment record showing what controls it — restricted diet, oral hypoglycemic agents, and/or insulin injections (the rating turns on this)
• Documentation of any regulation of activities ordered by your doctor
• Records of ketoacidosis, hypoglycemic episodes, hospitalizations, or frequent provider visits
• Evidence tying the diabetes to service — for many veterans, Agent Orange / herbicide exposure makes Type 2 diabetes a presumptive condition

The C&P exam & the nexus

For most Diabetes (Type 2) claims the VA schedules a Compensation & Pension (C&P) exam. The examiner measures the things the rating schedule turns on and gives a medical opinion on whether your Diabetes (Type 2) is at least as likely as not connected to your service (the “nexus”). Knowing what the examiner will assess — and bringing the evidence above — is the single biggest thing you control. Prepare for the exam and check that your records support a nexus before you file.

Diabetes (Type 2) VA disability: frequently asked questions

How does the VA rate diabetes?

Diabetes is rated at 10, 20, 40, 60, or 100 percent under 38 CFR 4.119 (Diagnostic Code 7913). The level depends on the treatment required — diet alone (10%), insulin and restricted diet (20%), and higher levels as 'regulation of activities,' hospitalizations, and complications are added.

Is diabetes a presumptive condition?

Type 2 diabetes is a presumptive condition for veterans with qualifying Agent Orange / herbicide exposure (e.g. Vietnam, the Korean DMZ, and certain other locations). If a presumption applies, you don't have to separately prove the medical nexus to service.

What conditions are secondary to diabetes?

Peripheral neuropathy, diabetic retinopathy, kidney disease (nephropathy), erectile dysfunction, hypertension, and ischemic heart disease are recognized secondary complications of service-connected diabetes — each separately ratable with a nexus opinion.

Can I get a higher combined rating from diabetes complications?

Often, yes. The diabetes rating itself may be modest, but separately rating each secondary complication (neuropathy in each extremity, eye disease, kidney disease) can substantially raise your combined rating under 38 CFR 4.25.