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Veterans Law

VA Disability Ratings for Kidney Disease

February 24, 2021
VA Disability Ratings for Kidney Disease

Conditions affecting the kidney can severely impact a veteran’s quality of life.  Living with kidney disease can often feel debilitating and overwhelming.  Veterans may develop kidney disease as a result of their service, which may make them eligible to receive disability benefits from the VA.

Types of Kidney Disease

The kidneys are two organs in the renal system that sit on either side of the spine and work to filter the blood in the body.  They also help the body dispose waste as urine.  Kidney disease can impact the body’s ability to regulate blood pressure, filter waste, and can cause serious health problems.

Acute Kidney Failure

Acute kidney failure can occur when the kidneys become unable to filter the blood in the body.  This means that high levels of waste can accumulate in the blood.  The condition occurs commonly in people who have already been hospitalized, often in those who are critically ill and need intensive care.

Symptoms of acute kidney failure can include:

  • Decreased urination
  • Swelling in the lower extremities
  • Shortness of breath
  • Fatigue
  • Confusion
  • Nausea
  • Weakness
  • Irregular heartbeat

Sometimes acute kidney failure can occur without any signs or symptoms.  In this case, lab work will likely detect the issue.

There are multiple causes of acute kidney failure and some risk factors can increase a person’s risk of developing acute kidney failure.  Having a condition that slows blood flow to the kidneys may lead to acute kidney failure.  Injuries which cause direct damage to the kidneys can also cause acute kidney failure.  If a person’s ureters, or the kidneys’ urine drainage tubes, become blocked, usually waste then becomes unable to leave the body and acute kidney failure can result.

The following conditions, which can slow blood flow to the kidneys, can increase the chances of a person developing kidney disease:

  • Blood loss
  • Blood pressure medication
  • Heart attack or heart disease
  • Serious infection
  • Liver failure
  • Severe allergic reaction
  • Severe burns
  • Dehydration
  • Certain medications, such as aspirin, ibuprofen, or naproxen sodium, may also lead to acute kidney failure

Some cancers, which typically affect the urinary system, can also lead to acute kidney failure.  These cancers include bladder cancer, cervical cancer, colon cancer, and prostate cancer.  Blood clots in the urinary tract, kidney stones, an enlarged prostate, or nerve damage to nerves surrounding the bladder can also impact how the kidneys are able to filter waste out of the body through urine.

Acute kidney failure is a serious condition.  Complications can accompany acute kidney failure such as chest pain, muscle weakness, permanent kidney damage, and even death.  It is important to seek treatment as soon as possible for acute kidney failure.

Diabetic Nephropathy

Diabetic nephropathy is most often a complication of Type 1 and Type 2 diabetes.  Diabetes can damage blood vessel clusters in the kidneys.  Such damage can limit the kidneys’ ability to filter water from the blood.  High blood pressure may also accompany this kidney condition and could increase the damage to the kidneys.

Diabetic nephropathy may not display symptoms in the early stages.  However, as the condition progresses, the symptoms can severe.  Below are some symptoms of diabetic nephropathy:

  • Fatigue
  • Swelling in feet, ankles, hands, or eyes
  • Increased urination or urge to urinate
  • Confusion or difficulty concentrating
  • Shortness of breath
  • Loss of appetite
  • Nausea and vomiting
  • Persistent itching
  • Reduced need for insulin or diabetes medication

It is important to seek treatment for diabetic nephropathy if displaying symptoms.  A doctor will be able to perform a urine test and/or a blood test to determine if the kidneys are functioning successfully.

There are some factors that can increase the risk of diabetic nephropathy, including:

  • High blood sugar, most often that is not well controlled
  • High blood pressure, also often not well controlled
  • History of smoking
  • High blood cholesterol
  • Family history of diabetes and kidney disease

The best ways to prevent diabetic nephropathy are to treat diabetes with medication, manage high blood pressure, maintain a healthy weight, and refrain from smoking.Can Agent Orange Cause Nerve Damage?

Chronic Kidney Disease

Chronic kidney disease (CKD), or chronic kidney failure, refers to the gradual loss of use of the kidneys.  This essentially means that the kidneys can no longer filter waste from the blood and body as they should.  Without successful filtration from the kidneys, dangerous amounts of fluids, electrolytes, and waste can build up in the body.

Like diabetic nephropathy, the symptoms of chronic kidney disease may not become noticeable until the kidney function is significantly impaired.  Importantly, chronic kidney disease can progress into end-stage kidney failure, which can be fatal.

Symptoms of chronic kidney disease can include:

  • Fatigue
  • Nausea
  • Weakness
  • Vomiting
  • Loss of appetite
  • Difficulty sleeping
  • Changes in urination
  • Muscle spasms or cramps
  • Swelling in lower extremities
  • Persistent itching
  • Shortness of breath
  • Chest pain
  • High blood pressure, often difficult to control

Chronic kidney disease is most commonly caused when another condition or disability damages the kidneys over time.  Below are some examples of conditions which might damage the kidneys:

  • Type 1 or Type 2 diabetes
  • High blood pressure
  • Obstruction of the urinary tract, which could be caused by cancer, kidney stones, or an enlarged prostate
  • Inflammation of the kidney’s filtering units, glomeruli
  • Inflammation of the kidney’s tubules and surrounding structures
  • Polycystic kidney disease
  • Recuring kidney infections
  • Vesicoureteral reflux, a condition where urine goes back up into the kidneys

End-Stage Renal Failure

End-stage renal failure, or end-stage kidney disease, occurs when chronic kidney disease reaches an advanced stage.  This means that the gradual loss of kidney function has progressed to the point where the kidneys can no longer function to meet the body’s needs.

A person with end-stage renal failure will generally need dialysis or a kidney transplant in order to survive.  Symptoms of end-stage renal cancer can include:

  • Nausea
  • Vomiting
  • Loss of Appetite
  • Muscle spasms or cramping
  • Swelling in lower extremities
  • Changes in urination
  • Fatigue
  • Weakness
  • Decrease in focus, concentration, and coherence
  • Persistent itching
  • Shortness of breath, when fluid builds up in the lungs
  • Chest pain, if fluid builds up around the lining of the heart
  • High blood pressure, that is often hard to control

Many of the same conditions which lead to chronic kidney disease can also lead to end-stage renal failure.  Kidney disease is typically measured through a blood test.  The test will look for creatinine, which is a waste product produced by the muscles.  Since the kidneys filter out waste products, the test will determine how much creatinine is in the blood, and therefore how effective the kidneys are working to filter the blood.  The levels of creatinine are measured with a glomerular filtration rate (GFR).  Higher glomerular filtration rates correspond to more effective kidney filtration, while lower glomerular filtration rates indicate weaker kidney function.  End-stage renal failure corresponds to a very low glomerular filtration rate, which indicates kidney failure.

Diagnosing Kidney Disease

Doctors may use different tests to diagnose and assess kidney disease.  As mentioned above, blood tests measuring the glomerular filtration rate can determine how well the kidneys are functioning to filter the blood.  Blood tests may also measure for blood urea nitrogen (BUN).  Urea nitrogen enters the blood through food.  Normal BUN levels typically range between 7 and 20.  If the kidneys are not functioning at a normal level, the BUN level will be higher.

Additionally, a urine test may also be used.  Urine tests are typically conducted by placing a dipstick in a urine sample.  The dipstick will then change colors to indicate abnormalities in the urine.  Urine tests can determine if there is protein in the person’s urine.  If there are significant amounts of protein, or albumin, in the urine, it may indicate that the person is experiencing kidney disease.

Other tests which might be used to determine kidney disease are an ultrasound or CT scan to examine pictures of the kidneys.  These results from these tests may be used to determine if there are any abnormalities in the size, shape, or position of the kidneys.

Once a diagnosis of kidney disease has been given by a doctor, a veteran can use this to apply for disability compensation benefits from VA.

How Does VA Rate Kidney Disease?

Veterans with kidney disease may qualify for disability compensation benefits from VA.  VA rates kidney disease under the genitourinary system.  The genitourinary system includes both the organs of the reproductive system and the urinary system.  Specifically, kidney diseases are rated under 38 CFR § 4.115a, Ratings of the Genitourinary System – dysfunctions, using the criteria for renal dysfunction.  The criteria for each disability rating are as follows:

  • 100% – requiring regular dialysis, or precluding more than sedentary activity from one of the following: persistent edema and albuminuria; or, BUN more than 80mg%; or, creatinine more than 8mg%; or, markedly decreased function of kidney or other organ systems; especially cardiovascular
  • 80% – persistent edema and albuminuria with BUN 40 to 80mg%; or, creatinine 4 to 8mg%; or, generalized poor health characterized by lethargy, weakness, anorexia, weight loss, or limitation of exertion
  • 60% – constant albuminuria with some edema; or, definite decrease in kidney function; or, hypertension at least 40% disabling under DC 7101
  • 30% – albumin constant or recurring with hyaline and granular casts or red blood cells; or, transient or slight edema or hypertension at least 10% disabling under DC 7101
  • 0% – albumin and casts with acute nephritis; or, hypertension non-compensable under DC 7101”

Diabetes and Kidney Disease: Secondary Service Connection

Diabetes is a disease in which a person requires insulin because their body does not produce enough insulin or cannot use the insulin produced properly.  Insulin is the hormone that regulates the amount of sugar in the bloodstream at any given moment.

There are two types of diabetes that are most common: Type 1 and Type 2.

  • Type 1 Diabetes – also known as juvenile-onset diabetes, typically occurs in children. This form of diabetes is caused by the pancreas not making enough insulin.  People with Type 1 diabetes usually need to take insulin injections for the entirety of their lives.
  • Type 2 Diabetes – or sometimes referred to as adult-onset diabetes. This form of diabetes is usually found in people over the age of 40.  The pancreas does make insulin with this form of diabetes, except the body does not use it properly.  High blood sugar levels, with this form of diabetes, may be controlled with medication or specific diets and sometimes insulin may also be used.

Diabetes can injure the small blood vessels in the body.  When the blood vessels are injured, the kidneys cannot properly filter the blood.  According to the National Kidney Foundation, type 2 diabetes is one of the leading causes of kidney disease.

Many veterans who have type 2 diabetes will also experience kidney disease.  If the veteran is service-connected for their diabetes, they may be eligible for secondary service connection for their kidney disease.  A secondary service-connected disability is a disability that resulted from a condition that is already service-connected.  Veterans who develop kidney disease because of their diabetes may be eligible for additional benefits through secondary service connection.

In order to file a claim for secondary service connection, the veteran should submit the following to VA:

  • VA Form 21-526EZ
  • A current diagnosis of kidney disease
  • Medical evidence showing the relationship between their type 2 diabetes and kidney disease

The Agent Orange Presumption

If you were exposed to Agent Orange during military service and later developed diabetes, you may qualify for service-connected disability benefits for your diabetes. If you believe that your Agent Orange-related diabetes has caused your kidney disease, you may qualify for compensation through secondary service connection.

Call for a Free Case Evaluation with Chisholm Chisholm & Kilpatrick LTD

If you are seeking assistance with appealing a denied VA claim for kidney disease, the veterans’ representatives at Chisholm Chisholm & Kilpatrick LTD may be able to help.  Call 800-544-9144 to speak with a member of our team for a free case evaluation.