Type 2 Diabetes and VA Disability Compensation
CCK Law: Our Vital Role in Veterans Law
The Department of Veterans Affairs (VA) bases a type 2 diabetes disability rating on a veteran’s insulin use, diet, activity limits, and complications. Veterans with type 2 diabetes may qualify for presumptive service connection through Agent Orange exposure if they served in certain locations during the Vietnam era, while other veterans need to prove a direct or secondary service connection.
Veterans often have trouble getting the highest disability rating that they are entitled to because their records do not properly document every requirement for the next VA rating level. If necessary, the appeal process and experienced, VA-accredited legal assistance may be able to address these issues and earn back pay for the delay in receiving a rating.
This guide covers:
- Type 2 diabetes VA rating criteria for each level
- Which locations qualify for presumptive service connection
- Which complications can receive a separate VA disability rating
- What to do if VA denies or underrates a claim for type 2 diabetes
Who We Are: Chisholm Chisholm & Kilpatrick (CCK Law) has argued many of the cases that define and clarify veterans disability law. Our attorneys serve in many leadership positions and have posted more than 2,500 blogs and 1,100 videos explaining veterans benefits. With 100+ individuals accredited by VA or admitted to practice before the U.S. Court of Appeals for Veterans Claims, CCK Law has recovered over $1 billion in compensation for 36,000+ clients since 1999. (Past results do not guarantee future outcomes.) Contact us to tell us about your case.
What Are the VA Rating Criteria for Type 2 Diabetes?
This condition is rated under 38 CFR § 4.119, Diagnostic Code 7913. VA assigns one of five ratings: 10, 20, 40, 60, or 100 percent.
The rating criteria are successive. This means a veteran must meet every requirement of a lower rating before they can attempt to qualify for the next level.
| Rating | VA’s Required Criteria |
| 10 percent | · Diabetes managed by a restricted diet only, and
· No medication needed. |
| 20 percent | · One or more daily insulin injections and a restricted diet, or
· An oral hypoglycemic agent and restricted diet. |
| 40 percent | · One or more daily insulin injections,
· A restricted diet, and · Regulation of activities (avoiding strenuous occupational and recreational activities). |
| 60 percent | The same requirements as 40 percent, plus:
· Episodes of ketoacidosis or hypoglycemia requiring one or two hospitalizations per year, or twice-monthly visits to a diabetic care provider, and · Complications that would be noncompensable if rated on their own. |
| 100 percent | · More than one daily insulin injection, a restricted diet, and regulation of activities, plus
· Episodes of ketoacidosis or hypoglycemia needing at least three hospitalizations per year or weekly visits for diabetic care, plus · Progressive weight and strength loss, or complications that would be compensable if rated on their own. |
The Crucial “Regulation of Activities” Test for Diabetes VA Disability Claims
VA’s FY2025 Annual Benefits Report shows 64.3 percent of service-connected endocrine disabilities sit at 20 percent versus only three percent at 40. The hurdle for a veteran’s rating can jump from 20 percent to 40 percent or higher is often a doctor’s regulation of activities.
VA and the Court of Appeals for Veterans Claims (CAVC) have held that competent medical evidence, not just a personal statement, must demonstrate that a doctor has restricted strenuous work and recreational activities due to type 2 diabetes. Camacho v. Nicholson, 21 Vet. App. 360, 364 (2007).
Veterans should ask their diabetic care provider to document this restriction directly in their treatment notes.
Is Type 2 Diabetes a Presumptive Condition Through Agent Orange Exposure?
Yes, veterans with type 2 diabetes may qualify for presumptive service connection due to Agent Orange exposure if they served in any of these locations during the specified time periods:
- Vietnam, including “boots on the ground,” Brown Water Navy service on inland waterways, and Blue Water Navy service within 12 nautical miles of the coast, from January 9, 1962, through May 7, 1975.
- The Korean demilitarized zone (DMZ), from September 1, 1967, through August 31, 1971.
- Laos, from December 1, 1965, through September 30, 1969.
- Cambodia, at Mimot or Krek, Kampong Cham Province, from April 16, 1969, through April 30, 1969.
- Guam, American Samoa, or their territorial waters, from January 9, 1962, through July 31, 1980.
- Johnston Atoll or a ship that called at Johnston Atoll from January 1, 1972, to September 30, 1977
- Any U.S. or Royal Thai military base in Thailand, from January 9, 1962, through June 30, 1976.
- Regular contact with a C-123 aircraft that previously sprayed Agent Orange.
Presumptive service connection means the veteran is not required to provide proof of a direct link between their type 2 diabetes and their military service. Presumptive connection applies under 38 USC § 1116 and 38 CFR § 3.309(e).
If a veteran did not serve in these locations during these time periods, they can still file a claim for direct service connection, proving Agent Orange exposure through service records and lay statements.
Watch CCK Law Supervising Attorney Alyse Phillips and colleagues discuss what veterans should know before pursuing VA benefits for type 2 diabetes:
Can Veterans Pursue Direct or Secondary Service Connection for Type 2 Diabetes Even if They Do Not Qualify for a Presumption?
Yes. Veterans who do not qualify for a presumption based on Agent Orange exposure may still be granted VA service connection for type 2 diabetes through a direct or secondary claim.
A claim for direct service connection requires three things:
- A current diagnosis of type 2 diabetes,
- An in-service event, injury, or exposure, and
- A medical nexus opinion linking the two.
Under 38 CFR § 3.310, a secondary service connection claim requires the veteran to provide proof that their already service-connected condition caused or aggravated their diagnosed type 2 diabetes.
For example, if a veteran develops type 2 diabetes as a result of significant weight gain that was caused by their service-connected orthopedic condition, they may qualify for secondary service connection through obesity as an intermediate step.
A veteran may also be able to claim secondary service connection for their diabetes if they develop type 2 diabetes as a result of medications or treatments prescribed for a different service-connected condition. Certain medications have been linked to the development of type 2 diabetes, including:
- Systemic corticosteroids (commonly used to treat respiratory conditions)
- Beta-blockers (commonly prescribed for heart conditions)
- Immunosuppressants (often part of post-cancer treatment and treatment for autoimmune disorders)
What Secondary Conditions Commonly Develop from Type 2 Diabetes?
Type 2 diabetes often causes or contributes to other health conditions. These conditions can then be issued their own ratings, increasing the veteran’s combined rating. Medical conditions that we have found to commonly develop as a result of type 2 diabetes include:
- Hypertension — High blood pressure that often develops alongside diabetes and is rated under 38 CFR § 4.104, Diagnostic Code 7101.
- Diabetic nephropathy (kidney disease) — Reduced kidney function, which is caused by prolonged high blood sugar.
- Peripheral neuropathy — Nerve damage affecting the veteran’s hands and feet. It is common for this to be the first complication people notice.
- Diabetic retinopathy — Damage to the blood vessels in the retina that can affect a person’s vision.
- Erectile dysfunction — A common complication that may also qualify for Special Monthly Compensation.
- Coronary artery disease and other heart conditions — Diabetes speeds up blood vessel damage, raising the risk of ischemic heart disease over time.
Secondary conditions are why, when filing a claim, it is important for veterans to list every complication they have. VA rates each one under its own diagnostic code before combining them with the base diabetes rating to determine a veteran’s overall disability rating.
Watch CCK Law Partner Maura Black, Reviewing Attorney Kevin Medeiros, and VA-accredited Claims Advocate Rachel Foster explain VA ratings for secondary conditions to hypertension:
Can Type 2 Diabetes and Its Complications Qualify a Veteran for TDIU?
Yes, veterans can qualify for total disability based on individual unemployability (TDIU) if their service-connected diabetes and/or its complications prevent them from getting or maintaining substantially gainful employment. TDIU is a VA benefit that pays veterans disability compensation at the 100 percent rate even if their combined schedular VA rating is lower.
Under 38 CFR § 4.16, veterans generally qualify for schedular TDIU by having:
- One condition rated 60-percent disabling or higher; or
- Two or more conditions with a combined rating of at least 70 percent and at least one of those conditions rated 40 percent or higher.
If a veteran does not meet these thresholds, they can still pursue extraschedular TDIU.
What Evidence Can Help Support a Type 2 Diabetes Claim?
The most valuable documentation to support a veteran’s diabetes claim is strong medical evidence. Before filing or appealing a claim for a type 2 diabetes VA rating, it is important to gather these types of documentation:
- Complete treatment records documenting current medications, including whether insulin or an oral hypoglycemic agent is prescribed and how frequently.
- A statement from the treating provider specifically addressing “regulation of activities.” VA and the CAVC require that this be documented by a medical professional.
- Hospitalization records or other documentation of diabetic care visits, as these support the criteria for 60 percent and 100 percent ratings.
- Records of any diagnosed complications, including the date when each one was first noted.
- For presumptive claims, any service records or deployment history that shows the qualifying location and dates of service.
A comprehensive Compensation and Pension (C&P) exam should also address each of these requirements. If a veteran’s C&P exam skips any of the required components, the veteran can and should request a re-examination from VA before a decision is made on their claim.
What Can Veterans Do if VA Denies or Underrates a Type 2 Diabetes Claim?
If VA denies a veteran’s type 2 diabetes claim, or if a veteran believes VA underrated their claim, they can choose from several appeal options based on their unique circumstances:
- File a Supplemental Claim — This option applies when there is “new and relevant” evidence available, such as a medical nexus letter or updated treatment records.
- Request a Higher-Level Review — This option applies when the initial VA decision contains a clear error and no new evidence is required.
- Appeal to the Board of Veterans’ Appeals (BVA) — A Veterans Law Judge will review your case.
If VA attempts to reduce or revoke a diabetes rating, it is important to also keep rating protections in mind. If a veteran has been service-connected for type 2 diabetes for five years or longer, VA considers the condition to be “stabilized,” per 38 CFR § 3.344. This means VA generally cannot reduce the rating for this condition without evidence of sustained, material improvement in the veteran’s daily functioning.
If you disagree with a VA decision, consider contacting Chisholm Chisholm & Kilpatrick. An experienced, VA-accredited law firm may offer significant tools and resources in support of your appeal.
While past results do not guarantee future outcomes, CCK Law has had favorable outcomes in 98.5% of its actions before VA and a 95% win rate before the U.S. Court of Appeals for Veterans Claims (federal court). We have recovered over $1 billion in compensation for 36,000+ clients to date.
Contact us online or at 800-544-9144 to tell us about your case.
Frequently Asked Questions About Type 2 Diabetes VA Ratings
Can VA reduce a veteran’s diabetes rating?
Yes, but VA must follow strict procedures before proposing a rating reduction. Once a veteran’s type 2 diabetes rating has remained at the same level for five or more years, the condition is considered “stabilized,” and VA is required to show evidence of sustained improvement in the veteran’s daily functioning – not just one favorable exam – before proposing a reduction.
Can survivors receive VA benefits if type 2 diabetes contributed to a veteran’s death?
Survivors may qualify for Dependency and Indemnity Compensation (DIC) if type 2 diabetes or one of its complications contributed substantially to a veteran’s death. This is particularly true if the diabetes was service connected or presumptively linked to herbicide exposure.
Is type 2 diabetes on the PACT Act presumptive list?
Type 2 diabetes is not among the presumptive conditions the PACT Act has added for burn pit or airborne hazard exposure. It is a presumptive condition specifically linked to Agent Orange and other herbicide exposures.
A veteran whose type 2 diabetes may be linked to burn pit exposure can still pursue direct or secondary service connection.
Can type 2 diabetes and its complications be rated at the same time?
Yes, just not for the same symptoms more than once.
Under Note (1) in Diagnostic Code 7913, compensable diabetes complications such as neuropathy and retinopathy must be rated separately from diabetes, unless that same complication was already used to justify the initial diabetes rating.
This practice keeps veterans from being rated twice for the same symptom, which is a forbidden practice known as pyramiding.
Does insulin vs. oral medication change a VA rating?
Yes. Veterans who manage their type 2 diabetes with an oral hypoglycemic agent and restricted diet will generally qualify for a 20 percent VA rating. On the other hand, veterans who need daily insulin injections, a restricted diet, and regulation of activities may meet the criteria for a 40-percent rating or higher, depending on the frequency of hospitalizations and other factors.
Do veterans need a glucose tolerance test for a VA diabetes rating?
No. Once a veteran has been diagnosed with type 2 diabetes, VA should not request a glucose tolerance test solely for rating purposes, per Note (2) under Diagnostic Code 7913. To assign a veteran’s disability rating, VA will rely on treatment records, including the veteran’s insulin and medication history.
