VA Disability Ratings for Kidney Disease
According to the Department of Veterans Affairs (VA), the rate of kidney disease is estimated to be 34 percent higher in the veteran population than in the general population. This may be due to the prevalence of type 2 diabetes and hypertension (i.e., high blood pressure) among veterans, which are some of the leading risk factors for kidney disease. Veterans often develop such conditions due to the nature of military service.
Conditions affecting the kidney can often feel debilitating and overwhelming. If you have a service-related kidney disease, you may be eligible to receive VA disability compensation.
What Is Kidney Disease?
The kidneys are two organs in the renal system that sit on either side of the spine. They work to filter the blood in the body and help dispose waste as urine.
Kidney disease is a blanket term for several types of conditions in which the kidney gradually loses function. These conditions occur when damage to the kidneys impacts the body’s ability to regulate blood pressure and filter waste, leading to serious health problems.
Types of Kidney Disease
The following are the types of kidney disease, their symptoms, and potential causes and risk factors.
Acute Kidney Failure
Acute kidney failure, or acute kidney disease, can occur when the kidneys become unable to filter the blood in the body. This can lead to high levels of waste accumulating in the blood. Acute kidney failure commonly affects people who have already been hospitalized, occurring often in those who are critically ill and need intensive care.
Common symptoms of acute kidney failure include:
- Decreased urination
- Swelling in the lower extremities
- Shortness of breath
- 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 and risk factors associated with acute kidney failure. For example, conditions that slow blood flow to the kidneys may lead to acute kidney failure. Additionally, injuries which cause direct damage to the kidneys can cause acute kidney failure. If a person’s ureters or the kidneys’ urine drainage tubes become blocked, waste usually then becomes unable to leave the body and acute kidney failure can occur.
The following conditions 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
- Certain medications, such as aspirin, ibuprofen, or naproxen sodium, may also lead to acute kidney failure
Some cancers (i.e., bladder cancer, cervical cancer, colon cancer, and prostate cancer) can also lead to acute kidney failure. Blood clots in the urinary tract, kidney stones, an enlarged prostate, or damage to nerves surrounding the bladder can also impact the kidneys’ ability to filter waste through urine.
Acute kidney failure is a serious condition. Complications that accompany acute kidney failure include 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, also known as diabetic kidney disease, 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 develop and become more severe. Below are some symptoms of diabetic nephropathy:
- 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 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.
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.
Similar to 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.
Common symptoms of chronic kidney disease include:
- 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 most often occurs 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 to survive. Symptoms of end-stage renal failure can include:
- Loss of Appetite
- Muscle spasms or cramping
- Swelling in lower extremities
- Changes in urination
- 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.
Diagnosing Kidney Disease
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 effectively 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.
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 that may be used to determine kidney disease include ultrasounds or CT scans to examine pictures of the kidneys. The results from these tests can help 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.
VA Ratings for Kidney Disease
If you developed kidney disease due to your military service, you may qualify for disability compensation benefits from VA. VA rates kidney disease under the 38 CFR § 4.115a, Ratings of the Genitourinary System – Dysfunctions, which includes both the organs of the reproductive system and the urinary system. Specifically, kidney diseases are rated using the criteria for renal dysfunction.
There are five rating percentages for renal dysfunction/kidney disease, which are primarily based on:
- Glomerular filtration rate (GFR) estimates
- Severity of symptoms
- Amount of waste (BUN) collected in a blood test
- Amount of albuminuria present in the urine sample
The criteria for each VA rating for kidney disease are as follows:
- 100 percent – “Chronic kidney disease with glomerular filtration rate (GFR) less than 15 mL/min/1.73 m 2 for at least 3 consecutive months during the past 12 months; or requiring regular routine dialysis; or eligible kidney transplant recipient.”
- 80 percent – “Chronic kidney disease with GFR from 15 to 29 mL/min/1.73 m 2 for at least 3 consecutive months during the past 12 months.”
- 60 percent – “Chronic kidney disease with GFR from 30 to 44 mL/min/1.73 m 2 for at least 3 consecutive months during the past 12 months.”
- 30 percent – “Chronic kidney disease with GFR from 45 to 59 mL/min/1.73 m 2 for at least 3 consecutive months during the past 12 months.”
- 0 percent – “GFR from 60 to 89 mL/min/1.73 m 2 and either recurrent red blood cell (RBC) casts, white blood cell (WBC) casts, or granular casts for at least 3 consecutive months during the past 12 months; OR GFR from 60 to 89 mL/min/1.73 m 2 and structural kidney abnormalities (cystic, obstructive, or glomerular) for at least 3 consecutive months during the past 12 months; OR GFR from 60 to 89 mL/min/1.73 m 2 and albumin/creatinine ratio (ACR) ≥30 mg/g for at least 3 consecutive months during the past 12 months.”
VA Disability Rating for Chronic Kidney Disease Stage 3
Veterans with stage 3 chronic kidney disease typically have a GFR between 30 and 59, indicating moderate kidney damage. As mentioned above, a 30 to 44 GFR warrants a 60 percent rating, while a GFR between 45 and 59 warrants a 30 percent rating. Therefore, veterans with service-connected stage 3 kidney disease will likely be assigned one of these two VA ratings.
Veterans with stage 4 chronic kidney disease (i.e., severely reduced kidney function, a GFR of 15 to 29) are rated at 80 percent, while veterans with end-stage renal failure are generally given a 100 percent disability rating.
What Is the VA Disability Rating for Kidney Stones?
Kidney stones, also known as nephrolithiasis, are primarily rated under 38 CFR § 4.115b, diagnostic code 7508. Veterans with service-connected recurring kidney stones that require invasive or on-invasive procedures more than two times a year are rated at 30 percent.
VA also rates kidney stones analogous to hydronephrosis, which is evaluated under diagnostic code 7509. Hydronephrosis is the swelling of one or both kidneys, and severe hydronephrosis is rated using criteria for renal dysfunction. The criteria under this diagnostic code are as follows:
- 30 percent – “Frequent attacks of colic with infection, kidney function impaired.”
- 20 percent – “Frequent attacks of colic, requiring catheter drainage.”
- 10 percent – “Only occasional attack of colic, not infected and not requiring catheter drainage.”
For reference, renal colic occurs when a kidney stone gets lodged in a person’s urinary tract. The stone then stretches and causes intense pain in the area.
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 – 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 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. Veterans who develop kidney disease because of their diabetes may be eligible for additional benefits through secondary service connection.
Agent Orange and Kidney Disease
The recently passed Honoring Our PACT Act has increased the presumptions available to veterans who may have been exposed to Agent Orange during their service, essentially making it easier for these veterans to receive VA disability benefits for conditions relating to their exposure.
VA has extended the presumption of herbicide exposure to include service members with active military naval, air, or space service who served in:
- The Republic of Vietnam between January 9, 1972 and May 7, 1975;
- Thailand, at any US or Thai base, January 9, 1972 and June 30, 1976;
- Laos between December 1, 1965 an September 30, 1969;
- Cambodia, specifically at Mimot or Krek, Kampong Cham Province, between April 1969 and April 30, 1969;
- Guam or American Samoa or in the territorial waters thereof between January 9, 1962 and July 30, 1980;
- Johnston Atoll island or Johnston Atoll the ship between January 1, 1972 and September 30, 1977
Agent Orange Presumption for Diabetes
If you were exposed to Agent Orange during military service and later developed type 2 diabetes, you may qualify for service-connected disability benefits. If you believe that your Agent Orange-related diabetes has caused your kidney disease, you may qualify for compensation through secondary service connection.
Camp Lejeune and Kidney Disease
If you developed kidney disease after being exposed to the variety of toxins in the water at Camp Lejeune, the Honoring Our PACT Act may have recently enabled you to receive compensation.
The PACT Act has created a federal cause of action for an individual, including veterans, who resided, worked at, or otherwise was exposed to Camp Lejeune’s water, including in utero exposure, for at least 30 days between August 1, 1953 and December 31, 1987. This means that those exposed under the above criteria can sue the federal government for benefits related to exposure.
These claims for benefits are under the exclusive jurisdiction of the Eastern District of North Carolina. Any awards that are granted are subject to offsets for federal benefits the claimant condition receives for the claimed condition. The statute of limitations for the federal cause of action is two years from the date of passage of the Honoring Our PACT Act or 180 days after the claim is denied under 28 USC § 2675, whichever is later.
CCK Offers Free Case Evaluations
If VA denied your claim for kidney disease, the veterans’ representatives at Chisholm Chisholm & Kilpatrick LTD may be able to help. The CCK team has decades of experience helping veterans successfully appeal VA denials and secure the benefits they deserve. Call 800-544-9144 for a free case evaluation.
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