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Type 2 Diabetes and VA Disability Compensation

Type 2 Diabetes and VA Disability Compensation

What is diabetes mellitus type 2?

Type 2 diabetes is a chronic condition that causes a person to experience increased blood glucose levels due to insulin resistance or deficiency. The severity of this condition varies on a case-by-case basis.  Some people are able to control their type 2 diabetes with a restricted diet, whereas others may find it difficult to control blood sugar levels, even with regular insulin injections. As type 2 diabetes progresses, blood sugar may become harder to control, resulting in complications that can lead to an increased degree of disability.

How does the VA rate Type 2 Diabetes?

Diabetes mellitus type 2 is rated by the VA under 38 CFR 4.119, Diagnostic Code 7913; under this schedule, Veterans can be assigned a 100%, 60%, 40%, 20% or 10% disability rating. Ratings for type 2 diabetes vary among veterans based on the progression or severity of their condition. Below are the criteria VA has set in place to rate veterans with type 2 diabetes:

100% disability ratings are reserved for veterans who:

  • Require insulin injections more than once per day;
  • Must remain on a restricted diet;
  • Need to regulate their activity (such as avoiding “strenuous occupational and recreational activities”);
  • Are hospitalized three or more times per year or require “weekly visits to a diabetic care provider” due to hypoglycemic reactions or episodes of ketoacidosis;
  • Are experiencing progressive weight loss or strength reduction; OR complications that “would be compensable if separately evaluated.”

60% disability ratings are assigned to veterans who:

  • Need one or more injection(s) of insulin daily;
  • Require a restricted diet;
  • Require regulated activity;
  • Experience hypoglycemic reactions or episodes of ketoacidosis that render them hospitalized once or twice per year, or warrant “twice a month visits to a diabetic care provider”
  • Are suffering complications NOT compensable if evaluated separately.

40% schedular ratings are given to veterans who:

  • Need one or more insulin injection(s) daily;
  • Require a restricted diet;
  • Require regulated activity.

20% ratings are assigned to veterans who:

  • Require insulin injections one or more time(s) daily;
  • Require a restricted diet; OR
  • Need to take an oral hypoglycemic agent while also remaining on a restricted diet.

10% ratings are awarded if the veteran can manage their blood sugar levels using only a restricted diet.

Secondary conditions

Due to the chronic nature of type 2 diabetes, complications can develop that may warrant separate disability ratings for secondary conditions. Secondary conditions stemming from type 2 diabetes must be “at least as likely as not” caused or aggravated by diabetes in order for a veteran to be compensated for them. To be rated separately for secondary conditions or complications, the conditions must not have been considered in your initial rating decision. Below are some secondary conditions that can emerge when type 2 diabetes progresses or is uncontrolled:

  • Diabetic Peripheral neuropathy (nerve damage)
  • Renal (kidney) dysfunction
  • Diabetic Retinopathy
  • Erectile Dysfunction
  • Cardiac Conditions such as coronary artery disease, heart attack, stroke
  • Arteriosclerosis
  • Hypertension (high blood pressure)
  • Peripheral Vascular Disease (narrowed blood vessels)
  • Skin Conditions
  • Eye conditions other than diabetic retinopathy, such as cataracts

Is Diabetes Type 2 a presumptive condition?

Diabetes mellitus type 2 is included on VA’s list of presumptive conditions associated with exposure to Agent Orange or other herbicides. Veterans who served in some the following areas during the specified time periods and later developed diabetes mellitus type 2 do not have to prove a connection between their condition and military service to receive disability compensation or VA healthcare:

  • Veterans with “boots on the ground” and those serving on inland waterways in Vietnam between January 9, 1962 and May 7, 1975;
  • Veterans “who flew on or worked on C-123 aircraft” during the Vietnam War era;
  • Veterans who served along the Korean Demilitarized Zone (Korean DMZ) between April 1, 1968 and August 31, 1971;
  • Veterans who served on or near Thailand military bases between February 28, 1961 and May 7, 1975.

This is not an all-encompassing list of qualified veterans. For more information, visit our website.

Category: Veterans Law

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