VA Disability for Diabetes: Ratings and Service Connection

CCK Law: Our Vital Role in Veterans Law

VA rates diabetes mellitus under 38 CFR § 4.119, Diagnostic Code 7913, at 10, 20, 40, 60, or 100 percent, using the same criteria for type 1 and type 2 diabetes. What separates the two conditions is not the rating criteria but the path a veteran uses to establish service connection. In CCK Law’s experience, many veterans also find that the rating VA assigns does not reflect everything in their medical records, particularly when a complication has never been claimed on its own.

This guide covers:

• The five rating levels under Diagnostic Code 7913 and the single requirement that decides most of them
• Why type 2 diabetes has a presumptive route to service connection and type 1 diabetes does not
• What VA pays at each diabetes rating level in 2026
• How complications like peripheral neuropathy and kidney disease are given their own ratings, increasing veterans’ combined rating

How Does VA Rate Diabetes?

VA rates diabetes mellitus under Diagnostic Code 7913 at one of five levels: 10, 20, 40, 60, or 100 percent. The criteria is not based on blood sugar readings, but on how much treatment the condition requires and how much it restricts a veteran’s activity.

• 10 percent — Diabetes manageable by restricted diet only.
• 20 percent — One or more daily insulin injections and a restricted diet, or an oral hypoglycemic agent and a restricted diet.
• 40 percent — One or more daily insulin injections, a restricted diet, and regulation of activities.
• 60 percent — Everything required at 40 percent, plus episodes of ketoacidosis or hypoglycemic reactions requiring one or two hospitalizations per year or twice-monthly visits to a diabetic care provider, plus complications that would not be compensable if rated separately.
• 100 percent — More than one daily insulin injection, a restricted diet, and regulation of activities, plus episodes of ketoacidosis or hypoglycemic reactions requiring at least three hospitalizations per year or weekly visits to a diabetic care provider, plus either progressive loss of weight and strength or complications that would be compensable if rated separately.

These levels are cumulative. Per the U.S. Court of Appeals for the Federal Circuit, Diagnostic Code 7913 sets out a “structured scheme of specific, successive, cumulative criteria.” Middleton v. Shinseki, 727 F.3d 1172, 1178 (Fed. Cir. 2013). In plain terms, each higher rating carries forward the requirements of the level below it; e.g., meeting two of the three requirements for 40 percent leaves a veteran at 20 percent.

What Does “Regulation of Activities” Mean?

Regulation of activities means a doctor has prescribed or advised avoiding strenuous occupational and recreational activities because of the diabetes. This is the requirement that separates a 20 percent rating from a 40 percent rating, and it is the one veterans most often cannot prove.

The Court of Appeals for Veterans Claims has held that this criterion has to be established by medical evidence, not by a veteran’s own statement. Camacho v. Nicholson, 21 Vet. App. 360, 364-65 (2007). A treatment note or examination report has to show the restriction. There is a counterweight, however: where the evidence is evenly balanced on whether a single criterion is met, reasonable doubt is resolved in the veteran’s favor. Johnson v. Wilkie, 30 Vet. App. 245 (2018).

Does It Matter Whether a Veteran Has Type 1 or Type 2 Diabetes?

For rating purposes, no. VA evaluates both type 1 and type 2 diabetes under the same diagnostic code and the same criteria. For service connection, the type matters a great deal.

• Type 2 diabetes — On VA’s list of conditions presumptively linked to Agent Orange and other herbicide exposure. A veteran who served in a qualifying location during a qualifying period does not have to prove how service caused the condition. Read the full guide to type 2 diabetes and VA disability compensation.
• Type 1 diabetes — No equivalent exposure presumption. Because type 1 diabetes usually appears in childhood or adolescence, the central question is often whether the condition was noted when the veteran entered service and whether service made it permanently worse. Read the full guide to VA disability ratings for type 1 diabetes.

Some sources state that veterans cannot receive VA disability compensation for type 1 diabetes at all. That is not correct. Type 1 diabetes is compensable on the same rating schedule as type 2 diabetes. What type 1 diabetes lacks is the herbicide presumption, which is a difference in how a veteran proves the claim, not in whether benefits are available.

Watch experienced CCK veterans law attorneys discuss VA disability claims and appeals for diabetes:

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How Do Veterans Establish Service Connection for Diabetes?

Service connection for diabetes means a veteran has shown VA that a condition is related to military service. Veterans can use one of several routes, and more than one route can apply to the same claim.

1. Presumptive service connection through herbicide exposure. Type 2 diabetes qualifies under 38 USC § 1116 and 38 CFR § 3.309(e) for veterans who served in listed locations, including Vietnam, Thailand, Laos, Cambodia, Guam, American Samoa, the Korean demilitarized zone, and Johnston Atoll. Our Agent Orange locations map shows the qualifying places and dates.
2. The one-year chronic disease presumption. Diabetes mellitus appears on VA’s chronic disease list at 38 CFR § 3.309(a). If the condition became at least 10 percent disabling within one year of separation, VA presumes service connection without proof of a specific in-service event, though VA can rebut that presumption with affirmative evidence. This route requires wartime service or peacetime service on or after January 1, 1947.
3. Direct service connection. A veteran shows 1) a current diagnosis, 2) an in-service event, injury, or exposure, and 3) a medical opinion linking the two.
4. Secondary service connection. Diabetes can be granted as secondary to (in other words, caused by) an already service-connected condition or to the medication used to treat it. For example, weight gain caused by a service-connected orthopedic condition is one recognized pathway.
5. Aggravation. Where diabetes existed before service, the question is whether service worsened it beyond its natural progression; in other words, the veteran’s diabetes would not have been as serious if it hadn’t been for service. This is the route most type 1 diabetes claims travel.

How Much Does VA Pay for a Diabetes Rating?

Monthly compensation depends on a veteran’s combined rating, not on the diabetes rating alone. For a veteran with no dependents, the 2026 VA disability compensation rates at the diabetes rating levels are:

• 10 percent — $180.42 per month
• 20 percent — $356.66 per month
• 40 percent — $795.84 per month
• 60 percent — $1,435.02 per month
• 100 percent — $3,938.58 per month

At 30 percent and above, the monthly amount can increase with eligible dependents. Because diabetes so often brings additional service-connected conditions with it, most veterans with diabetes are paid at a combined rate higher than the figures above.

Other Sources of VA Compensation for Diabetes

How Does VA Rate Diabetes Complications (Secondary Conditions)?

VA rates compensable complications of diabetes separately from diabetes itself. Note (1) to Diagnostic Code 7913 sets out one exception: a complication that is part of the criteria being used to support a 100 percent diabetes rating is not also rated on its own. Complications rated at 0 percent are treated as part of the diabetic process.

Common conditions secondary to diabetes include:

• Peripheral neuropathy, often the first complication a veteran notices
• Diabetic retinopathy
• Diabetic nephropathy, or kidney disease
• Hypertension and heart conditions
• Erectile dysfunction

Separate ratings are combined rather than added. VA uses the formula at 38 CFR § 4.25, sometimes called “VA math,” under which a second rating applies only to the share of function the first rating left unaffected. CCK Law’s VA disability calculator estimates a combined rating.

Does VA Grant TDIU for Veterans With Diabetes Who Have Trouble Working?

Two additional benefits are worth knowing about. A veteran whose diabetes or its complications prevent substantially gainful employment may qualify for total disability based on individual unemployability (TDIU), which pays at the 100 percent rate even when the schedular rating is lower. A veteran who needs help with activities of daily living, including insulin administration or blood sugar monitoring, may qualify for Special Monthly Compensation.

Frequently Asked Questions About VA Disability for Diabetes

Does a veteran’s A1C level determine their VA diabetes rating?

No. Diagnostic Code 7913 contains no laboratory thresholds. A veteran with well-controlled blood sugar who requires daily insulin, a restricted diet, and prescribed activity restrictions can meet the 40 percent criteria, while a veteran with high A1C readings managed by diet alone falls at 10 percent.

Can VA assign a 0 percent rating for diabetes?

Diagnostic Code 7913 has no 0 percent level. When VA grants service connection but finds that the criteria for a compensable rating are not met, it assigns 0 percent under 38 CFR § 4.31. A 0 percent rating pays nothing, but it establishes service connection, which matters later for claims involving complications.

Can a veteran be rated for both type 1 and type 2 diabetes?

No. Diabetes mellitus is rated once under Diagnostic Code 7913 regardless of type, and a veteran does not carry both diagnoses. Diabetes insipidus is a separate condition rated under Diagnostic Code 7909, so a veteran diagnosed with both diabetes mellitus and diabetes insipidus can receive a rating for each.

Does using an insulin pump instead of injections affect a diabetes rating?

The criteria are written in terms of daily insulin injections, and VA has not published clear guidance on how continuous insulin infusion through a pump is counted. Veterans using a pump should make sure their treatment records describe the insulin regimen in detail, including daily dosing, rather than only naming the device.

What should a veteran do if VA denies a diabetes claim or assigns a low rating?

A veteran can file a Supplemental Claim with new and relevant evidence, request a Higher-Level Review if the decision contains a clear error, or appeal to the Board of Veterans’ Appeals. CCK Law’s VA claims and appeals interactive tool walks through which option fits which situation. Before a decision is issued, a veteran can also ask VA for a new Compensation and Pension (C&P) exam if the first exam never addressed regulation of activities.

Where Can Veterans Get Help With a Diabetes Appeal? (Free Case Evaluation)