VA Disability Benefits for Urinary Incontinence

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What is Urinary Incontinence?

Urinary incontinence refers to the loss of bladder control and is a common condition that many people suffer from.  The severity can range from occasionally leaking urine when you cough or sneeze to having an urge to urinate that is so sudden and strong you cannot make it to the bathroom in time.  There are several types of urinary incontinence, including the following:

• Stress incontinence. Urine leaks when you exert pressure on your bladder by coughing, sneezing, laughing, exercising, or lifting something heavy.
• Urge incontinence. You have a sudden, intense urge to urinate followed by an involuntary loss of urine.  You may need to urinate often, including throughout the night.  Urge incontinence may be caused by a minor condition, such as an infection, or a more severe condition such as a neurologic disorder.
• Overflow incontinence. You experience frequent or constant dribbling of urine due to a bladder that doesn’t empty completely.
• Functional incontinence. A physical or mental impairment keeps you from making it to the toilet in time.
• Mixed incontinence. You experience more than one type of incontinence.

It is important to note that urinary incontinence is not a disease itself.  Instead, it is a symptom of a disease.  As such, it typically requires a thorough evaluation by a medical professional to determine the cause of your incontinence.  To confirm you are suffering from incontinence, your doctor will likely recommend the following:

• A sample of your urine is checked for signs of infection, traces of blood, or other abnormalities.
• Bladder diary. For several days you record how much you drink, when you urinate, the amount of urine you produce, whether you had an urge to urinate, and the number of incontinence episodes.
• Post-void residual measurement. You’re asked to urinate (void) into a container that measures urine output.  Then your doctor checks the amount of leftover urine in your bladder using a catheter or ultrasound test.  A large amount of leftover urine in your bladder may mean that you have an obstruction in your urinary tract or a problem with your bladder nerves or muscles.

Treatment for urinary incontinence depends on the type of incontinence, its severity, and the underlying cause.  Overall, doctors may recommend a combination of treatments.

Urinary Rating Systems

VA uses three different rating systems when evaluating conditions of the urinary system: (1) urinary frequency; (2) obstructed voiding; and (3) voiding dysfunction.  Urinary frequency refers to a condition in which the body urinates more often than normal.  Under VA’s rating criteria for this condition, veterans are assigned a higher disability rating the more often they urinate throughout the day and night.  Disability ratings for urinary frequency range from 0 to 40 percent based on severity.

Obstructed voiding is a condition that makes it hard for an individual to urinate.  The severity of this condition is often based on symptoms such as a slow or weak stream, hesitancy to start urinating, and if there is a certain amount of urine left over in your bladder after you urinate.  Here, VA assigns a disability rating between 0 and 30 percent depending on severity.  The final urinary rating system, voiding dysfunction, is used to rate urinary incontinence.

How VA Rates Urinary Incontinence

All urinary conditions, including urinary incontinence, that cannot be rated as urinary frequency or obstructed voiding, are rated according to the voiding dysfunction urinary rating system.  VA rates urinary incontinence as follows:

• 60% – requires the use of a catheter or other urinary assistive appliance to remove urine from the bladder, or the use of absorbent materials that must be changed more than 4 times per day
• 40% – requires the use of absorbent materials that must be changed 2-4 times per day
• 20% – requires the use of absorbent materials that must be changed only once a day

These disability ratings are significant considering they are likely being combined with disability ratings related to the veteran’s primary condition (e.g., prostate cancer, renal disease).

How to Prove Your Urinary Incontinence Claim to VA

In order to receive VA disability benefits for urinary incontinence, veterans must first establish service connection.  For many conditions, direct service connection is usually the most common way to pursue VA disability compensation; however, when it comes to incontinence, it may be more relevant to pursue service connection on a secondary basis.  A secondary service-connected condition is one that resulted from a separate condition that is already service-connected.  For example, a veteran is service-connected for prostate cancer and later develops urinary incontinence.  Here, the veteran’s urinary incontinence may warrant secondary service connection if it is the result of their service-connected prostate cancer.

To prove secondary service connection for urinary incontinence, veterans will need to demonstrate two things to VA: (1) a diagnosis for urinary incontinence; and (2) medical evidence showing the link between your service-connected condition and their urinary incontinence.  In claims for secondary service connection, proving a medical link, or nexus, is especially important.

Medical opinions from either VA healthcare providers or private doctors are critical pieces of evidence in claims for secondary service connection.  Lay evidence may also be helpful in regards to secondary service connection claims for urinary incontinence.  Specifically, veterans can submit lay statements outlining how their primary service-connected condition caused or aggravated their urinary incontinence.  Furthermore, veterans can also describe the severity of their urinary incontinence within a lay statement.