BPH is rated under diagnostic code 7527 as voiding dysfunction or urinary tract infection, whichever is predominant. Urinary frequency rates 10 to 40 percent by voiding interval, obstructed voiding rates up to 30 percent for retention requiring catheterization, and urine leakage requiring absorbent materials rates 20 to 60 percent by daily pad changes.
Blood in the urine (hematuria) is a sign, not a standalone ratable disability: VA rates the diagnosed condition that causes it. Recurrent kidney stones rate 30 percent under DC 7508 when they require diet therapy, drug therapy, or more than two procedures per year. Bladder and urethral conditions rate as voiding dysfunction under 38 CFR 4.115a, up to 60 percent for severe leakage requiring absorbent materials changed more than four times per day. Kidney disease rates on the renal dysfunction criteria, up to 100 percent. Bladder, ureter, kidney, and related genitourinary cancers rate 100 percent under DC 7528 during active disease and treatment, and several are presumptive for toxic exposure veterans under 38 CFR 3.320.
Chronic cystitis, including interstitial cystitis, is rated under diagnostic code 7512 as voiding dysfunction: urinary frequency rates 10 percent for a daytime interval of 2 to 3 hours or waking twice a night, 20 percent for an interval of 1 to 2 hours or waking 3 to 4 times, and 40 percent for an interval under 1 hour or waking 5 or more times. Urine leakage requiring absorbent materials rates 20 to 60 percent by the number of daily pad changes.
Chronic kidney disease is rated under the renal dysfunction criteria of 38 CFR 4.115a, which since November 14, 2021 are based on glomerular filtration rate (GFR) sustained for at least 3 consecutive months in the past year: 30 percent for GFR 45 to 59, 60 percent for 30 to 44, 80 percent for 15 to 29, and 100 percent for GFR under 15, regular dialysis, or being an eligible kidney transplant recipient. GFR of 60 to 89 with markers such as casts, structural abnormality, or an albumin to creatinine ratio of 30 or more rates 0 percent.
Chronic kidney disease is rated under diagnostic code 7530 by the renal dysfunction criteria of 38 CFR 4.115a based on lab values and clinical findings.
Chronic nephritis is rated under diagnostic code 7502 as renal dysfunction, which since November 14, 2021 is based on glomerular filtration rate (GFR) sustained for at least 3 consecutive months in the past year, from 0 percent (GFR 60 to 89 with markers such as casts or protein) up to 100 percent for GFR under 15, regular dialysis, or transplant eligibility.
Chronic pyelonephritis is rated under diagnostic code 7504 by the renal dysfunction criteria of 38 CFR 4.115a based on lab values and complications.
End-stage renal disease is rated as renal dysfunction under 38 CFR 4.115a (diagnostic code 7530): 100 percent for chronic kidney disease with a GFR below 15 mL/min/1.73 m2 sustained for 3 consecutive months in the past year or requiring regular dialysis, and 80 percent for GFR 15 to 29. The former BUN, creatinine, and edema-based criteria were replaced by GFR tiers effective November 14, 2021 (86 FR 54086).
Interstitial cystitis is rated by analogy under 38 CFR 4.115b DC 7517 (bladder injury) at 10 to 60 percent based on voiding dysfunction and pelvic pain.
Nephrolithiasis is rated under diagnostic code 7508 by analogy to hydronephrosis at 10, 20, or 30 percent based on episode frequency and treatment requirements.
A kidney transplant is rated under diagnostic code 7531 at 100 percent from the date of hospital admission for the surgery, continuing until a mandatory VA examination one year after discharge. After that, residuals are rated as renal dysfunction on sustained GFR ranges, with a floor of 30 percent.
Neurogenic bladder is rated under diagnostic code 7542 by the voiding dysfunction criteria of 38 CFR 4.115a.
Overactive bladder is rated by analogy under 38 CFR 4.115a (voiding dysfunction) at 10 to 60 percent based on voiding frequency and incontinence.
Post-prostatectomy residuals are rated under the voiding dysfunction or urinary frequency criteria of 38 CFR 4.115a. Erectile dysfunction residuals are rated separately under 7522.
Chronic prostatitis is rated under diagnostic code 7527 as voiding dysfunction or urinary tract infection, whichever is predominant. Under the UTI criteria, suppressive drug therapy under 6 months rates 0 percent, 1 to 2 hospitalizations per year or suppressive therapy of 6 months or longer rates 10 percent, and infection requiring drainage by stent or nephrostomy tube, more than 2 hospitalizations per year, or continuous intensive management rates 30 percent.
Recurrent nephrolithiasis is rated under 38 CFR 4.115b DC 7508 at 30 percent when recurrent stones require diet therapy, drug therapy, or invasive procedures more than 2 times per year.
Ureteral stricture is rated under 38 CFR 4.115b DC 7511 (ureter injury) at 30 percent or more based on resulting kidney dysfunction.
Fistula of the urethra is rated under diagnostic code 7519 as voiding dysfunction, with multiple urethroperineal fistulae rating 100 percent. Voiding dysfunction pays by pad changes: 20 percent for less than 2 per day, 40 percent for 2 to 4, and 60 percent for more than 4 or an appliance.
Urethral stricture is rated as obstructed voiding under 38 CFR 4.115a (diagnostic code 7518): 0 percent for obstructive symptoms needing dilatation once or twice a year, 10 percent for stricture disease requiring dilatation every 2 to 3 months or marked obstructive symptomatology, and 30 percent for urinary retention requiring intermittent or continuous catheterization. If leakage or frequency dominates, the voiding dysfunction or urinary frequency formula is used instead, whichever is higher.
Urinary incontinence is rated under the voiding dysfunction criteria of 38 CFR 4.115a at 20, 40, or 60 percent based on the need for absorbent materials.