VA Disability Ratings for Kidney Disease
Alyse Philips: Hello everyone and welcome to CCK Live. My name is Alyse Phillips, and I am an Attorney at Chisholm Chisholm & Kilpatrick. Today I’m joined with two of my colleagues, Alex Gamache, an accredited claims agent with the firm, and Alec Saxe, an attorney with the firm.
Today we’re going to be talking about VA disability benefits associated with kidney conditions. So specifically, we’ll be talking about kidney disease and diabetic neuropathy.
Just a little bit of background on the kidneys. The kidneys are two organs that sat on either side of the spine. They work to filter your blood through the body. They help the body to dispose of waste and turn that waste into urine. And kidneys specifically can impact the body’s ability to regulate blood pressure, filter waste, and can cause serious health problems. So, why don’t we get started with just talking about the types of kidney diseases. Alex, do you want to get us started?
Alex Gamache: Yeah, so the first one we’re going to go over is acute kidney failure. So acute kidney failure can occur when the kidneys become unable to filter blood in the body. This means that high levels of waste can accumulate in the blood. This condition occurs, commonly in people who have already been hospitalized often those who are critically ill and need intensive care.
There are multiple causes of acute kidney failure and some risk factors can increase a person’s risk of developing acute kidney failure. For example, having a condition that slows blood flow to the kidneys or injuries that directly damage the kidney,s may lead to acute kidney failure. Cancers affecting the urinary system can also lead to acute kidney failure. Complications can accompany acute kidney failures 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.
The second one will go over as diabetic nephropathy. So, 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 kidney’s 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 but as the condition progresses the symptoms can become more severe. It’s 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. The best way to prevent diabetic nephropathy is to treat diabetes with medication, manage high blood pressure and maintain a healthy weight, and refrain from smoking.
Alyse: Thank you very much. Alec, why don’t you tell us a little bit about another two: chronic kidney diseases and end-stage renal failure.
Alec Saxe: Sure. Chronic kidney disease or chronic kidney failure refers to the gradual loss of use of the kidneys. This essentially means that the kidneys can no longer function or filter waste from the body as they should. So, without successful filtration from the kidneys, dangerous amounts of fluids, electrolytes, and waste can build up and this causes the disease.
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 or renal failure which is fatal.
Chronic kidney disease is most commonly caused when another condition or disability damages the kidney over time, such as diabetes or high blood pressure, and then 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 that the kidneys can no longer function and meet the body’s needs. So, a person with end-stage renal failure will generally need dialysis or a kidney transplant in order to survive.
Alyse: Now, let’s talk a little bit about how kidney disease is diagnosed. So, it’s typically diagnosed through measuring, basically through a blood test. Blood tests will measure the glomerular filtration rate and that can determine how well the kidneys are functioning to filter your blood. Other blood tests might include a BUN test. So, BUN levels are simply arranged between 7 and 20. If the kidneys are not functioning normally you’ll see a higher BUN than that 7-20 range.
Sometimes they will also use urine tests, and that can be used to determine if there is a protein in a person’s urine. If there is a significant amount of protein in the urine, that might indicate that a person is experiencing kidney disease.
Other tests might be an ultrasound or a CT scan to actually get pictures of the kidneys. And the results of these tests might be used to determine if there’s any abnormalities in size, shape, or position of the kidneys.
Alex, why don’t you tell us a little bit about the kidney conditioning treatments?
Alex: Sure. So the first one we’re going to talk about is dialysis care. So, dialysis care is a covered benefit under VA’s medical benefits package for veterans enrolled in VA Health Care. This includes veterans who have been previously diagnosed with a kidney condition. Self-care dialysis performed by a patient or designated caregiver in their home is also an alternative to an in-center dialysis if the veteran chooses VA as their health care provider.
So, veterans who desire this option and who are medically acceptable candidates must be provided with the necessary training, medical equipment and supplies, and home support required to perform the home dialysis care.
The second is regarding kidney transplants. Transplant services are available for those who are eligible, and Veterans should visit the VA national transplant program page or contact their local VHA dialysis facility for more information.
Alyse: Great. Thank you very much, Alec, could you tell us a little bit about ratings that you could get with kidney disease?
Alec: Yeah, the VA rates kidney disease under the genitourinary system. The genitourinary system includes both organs of the reproductive system and the urinary system. Specifically, kidney diseases are rated under regulation 38 CFR section 4.115a, which rates the genitourinary system, and the rating contemplates evaluations from totally disabling 100 percent down to 0 percent — 100, 80, 60, 30, and 0.
And there’s also the option to become service-connected, secondary service-connected, for kidney disease if you are service-connected already for diabetes. So, 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. And there are two common types of diabetes, type 1 and type 2. Type 2 is one of the leading causes of kidney disease and probably the more common of the two at least that we see in our practice.
In order to file a claim for secondary service connection for kidney disease due to a service-connected condition, such as diabetes, veterans should submit to VA a claims form, a VA Form, 21-526Z is the name of the form, evidence of a current diagnosis of their kidney disease, and then medical evidence showing the relationship between the type 2 diabetes and kidney disease.
Alyse: Thank you both, so much. Before we wrap up today. I did just want to mention one other thing. If you were exposed to Agent Orange during your service and you did later develop diabetes, that’s going to be another way for you to potentially qualify for service connection for kidney disease. So, if you do believe that your Agent Orange-related diabetes has caused kidney disease, you might qualify through secondary service connection, which is what Alec was just telling us a little bit about.
And that will wrap it up on kidney disease today. So, thank you very much for watching, and please be sure to check out our blog on topics discussed today in the video as well as other topics in the area of VA law. Also, please don’t forget to subscribe to our YouTube channel. Thank you.
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