Diabetes mellitus — VA Rating Criteria (38 CFR DC 7913)

The VA rates Diabetes mellitus under Diagnostic Code 7913 at the following tiers: 10%, 20%, 40%, 60%, 100%. The minimum 10% rating requires: Manageable by restricted diet only. The maximum 100% rating requires: 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.

Diagnostic Code 7913 is the VA rating identifier for Diabetes mellitus within 38 CFR 38 CFR § 4.119. It defines the specific symptom criteria and percentage thresholds a VA adjudicator uses to assign a disability rating. The diagnostic code is listed on a veteran's rating decision letter.

The highest schedular rating for Diabetes mellitus under DC 7913 is 100%. This tier requires: 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. Veterans who cannot secure substantially gainful employment due to Diabetes mellitus alone or in combination with other service-connected conditions may also qualify for TDIU at the 100% compensation rate under 38 CFR § 4.16.

Diabetes mellitus is rated under 38 CFR 38 CFR § 4.119, Diagnostic Code 7913. This section is part of the Schedule for Rating Disabilities (38 CFR Part 4) and can be read in full at the eCFR website.

Conditions commonly secondary to Diabetes mellitus include: Carpal Tunnel Syndrome (Diabetic), Coronary Artery Disease / Ischemic Heart Disease, Diabetic Nephropathy (Chronic Kidney Disease), Diabetic Retinopathy / Vision Loss, Erectile Dysfunction (Diabetic), Falls and Fractures Secondary to Diabetic Neuropathy, Gastroparesis (Diabetic), Hypertension (Diabetic), Peripheral Neuropathy (Diabetic). Secondary conditions caused or aggravated by a service-connected disability are ratable under 38 CFR § 3.310. Medical nexus evidence linking the primary and secondary condition is required.

Service connection for Diabetes mellitus requires three elements: (1) a current diagnosis of the condition, (2) an in-service event, injury, or disease that may have caused or aggravated it, and (3) a medical nexus connecting the current diagnosis to that in-service event. A nexus letter from a treating physician or independent medical examiner is the most reliable nexus evidence. C&P exam findings can also establish nexus if adequately documented.