Diabetes Mellitus Type II VA Disability Rating
- Service connection requires a current diagnosis, an in-service event or exposure, and a medical link (nexus) between the two.
- VA assigns ratings of 10% to 100% under diagnostic code 7913, using the criteria in the rating table below.
- The percentage assigned turns on Insulin, diet & activity restriction.
- Presumptive service connection may apply under the Agent Orange for veterans with qualifying service.
| Rating | Criteria |
|---|---|
| 10% | Managed by restricted diet only. |
| 20% | Requires insulin and restricted diet, or oral hypoglycemic agent and restricted diet. |
| 40% | Requires insulin, restricted diet, and regulation of activities. |
| 60% | Requires insulin, restricted diet, regulation of activities with episodes of ketoacidosis or hypoglycemic reactions requiring one or two hospitalizations per year or twice a month visits to a diabetic care provider, plus complications that would not be compensable if separately evaluated. |
| 100% | Requires more than one daily insulin injection, restricted diet, and regulation of activities, with 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 separately evaluated. |
Illustrative scenarios showing how the criteria above are applied. These are educational examples, not a prediction of any individual veteran's rating.
Managed with insulin and a restricted diet
Illustrates 20%Situation. A veteran manages diabetes with insulin and a restricted diet.
How the criteria apply. Requiring insulin and a restricted diet, or an oral hypoglycemic agent and a restricted diet, rates 20 percent. The treatment the condition actually requires is what sets the level.
Doctor-ordered limits on activity
Illustrates 40%Situation. A veteran needs insulin and a restricted diet, and his doctor has told him to limit strenuous activity to avoid hypoglycemic episodes.
How the criteria apply. Adding regulation of activities, a medically ordered limit on activity, to insulin and a restricted diet rates 40 percent. That documented activity-restriction element is what separates 40 percent from 20 percent.
The rating climbs based on whether insulin is required, dietary restrictions, restricted activities, and frequency of hospital visits.
What VA looks at
Treatment regimen, complications such as neuropathy or retinopathy, hospitalizations.
Common exam and DBQ topics
Insulin use, dietary plan, regulation of activities, complications.
Evidence that usually matters
Endocrinology records, medication history, hospitalization records.
Common misunderstandings
Complications like peripheral neuropathy and retinopathy are usually rated separately.
Drawn directly from the VA Disability Benefits Questionnaire (DBQ). The examiner records each item below; the rating then maps to the table above.
- Confirm diagnosis of Type 1 or Type 2 diabetes mellitus.
- Record whether the veteran requires insulin and how often.
- Document whether a restricted diet is medically required.
- Record whether the veteran is required to regulate activities (avoid strenuous occupational and recreational activities) due to glycemic control concerns, this distinction often drives the difference between 20 and 40 percent.
- Quantify episodes of hypoglycemic reactions or ketoacidosis requiring hospitalization in the past 12 months.
- Document complications (retinopathy, neuropathy, nephropathy, peripheral vascular disease), each may be separately ratable.
Small rules in the regulations decide a surprising number of claims. These are the ones that most often change a diabetes mellitus type ii outcome. None of this is legal advice; it is a map of where to look.
The 40 percent level needs three things together: insulin, a restricted diet, and a doctor telling you to avoid strenuous activity. That activity restriction has to actually be in your records.
WhyDiabetes reaches 40% when it requires insulin, a restricted diet, and regulation of activities, meaning a doctor has told you to avoid strenuous activity. That third requirement is read strictly, so the medical record has to actually show the activity restriction.
38 CFR 4.119Was this helpful?Diabetes complications like nerve, eye, and kidney damage are each rated on their own and combined. Make sure every complication is claimed.
WhyDiabetic nerve damage, eye disease, and kidney disease are each rated on their own and combined with the diabetes rating, except for the specific complications the code folds into a 100% evaluation. Make sure every complication is claimed.
38 CFR 4.119Was this helpful?
- What you and people around you witnessed is real evidence
You do not always need a doctor to prove a symptom you can see, hear, or feel. Statements from you, family, or fellow service members about things like pain, ringing in the ears, or panic attacks are competent lay evidence under 38 CFR 3.159. A clear buddy statement with dates and specifics can carry weight.
38 CFR 3.159 - A tie goes to you
When the evidence for and against a point is roughly equal, VA is required to decide in the veteran's favor. This benefit of the doubt rule lives in 38 CFR 3.102. You do not have to prove a claim beyond all doubt, only to bring the evidence to about even.
38 CFR 3.102 - An unbroken line of symptoms can stand in for a paper trail
For certain chronic conditions, showing symptoms that continued from service to now can help establish service connection even without a perfect record. This continuity of symptomatology idea comes from 38 CFR 3.303(b) and applies to the chronic diseases the regulation lists.
38 CFR 3.303 - If it happened in combat, your word can be enough that the event occurred
For anyone who served in combat, VA must accept your own account of what happened during that combat as proof the event took place, as long as it fits the conditions of your service, even when no record survives. This comes from 38 U.S.C. 1154(b). It does not by itself prove the injury, but it can establish the in service event.
38 U.S.C. 1154(b) - If it was not written down at entry, you are presumed to have entered healthy
Unless a condition was noted on your entrance exam, the law presumes you were sound when you entered service. To rebut that, VA has to show by clear and unmistakable evidence both that the condition existed before service and that service did not make it worse. See 38 CFR 3.304(b).
38 CFR 3.304 - You can reopen a denied claim with new and relevant evidence and keep your date
After a decision, a Supplemental Claim lets you add new and relevant evidence. If you file it within one year of the decision, you protect your original effective date, so back pay can reach further. See 38 CFR 3.2501.
38 CFR 3.2501 - Some conditions are presumed if they show up within a year of getting out
Certain chronic diseases, including hypertension, arthritis, and diabetes, that appear to a compensable degree within one year of leaving service are presumed connected to service, even without proof of a specific cause. See 38 CFR 3.307 and the list in 3.309.
38 CFR 3.309 - A diagnosis years later can still be service connected
A condition first diagnosed long after you left service can still be service connected if the evidence ties it back to something in service. You do not need a diagnosis while still in uniform. See 38 CFR 3.303(d).
38 CFR 3.303
- The same symptom is rated once, but separate problems are rated separately
VA cannot rate the same symptom twice, which is pyramiding under 38 CFR 4.14, but it can and should rate distinct problems on their own. A scar and the loss of motion under it, for example, can each be rated. The Esteban decision is the classic example.
38 CFR 4.14 - One service connected condition can open the door to another
A condition caused by, or made worse by, a service connected condition can be service connected too. Sleep apnea linked to weight gain from a service connected condition, or depression linked to chronic pain, are common examples. This secondary path is in 38 CFR 3.310.
38 CFR 3.310 - Your rating can change by time period
If a condition was worse during one stretch and better during another, VA can assign different ratings for those periods rather than one flat number. These are called staged ratings, and they flow from VA's duty to consider the whole recorded history under 38 CFR 4.1 and 4.2.
38 CFR 4.2 - Ratings are combined with a table, not added
Two disabilities at 50 and 50 do not make 100. VA combines them with the table in 38 CFR 4.25, working from the largest down, then rounds to the nearest 10 only at the very end. This is why a 30 and a 20 can land on 40, not 50.
38 CFR 4.25 - If the schedule does not fit your case, VA can rate outside it
When your disability picture is so unusual that the normal rating schedule does not capture it, for example frequent hospital stays or marked interference with work, VA can refer the case for an extraschedular rating. It is uncommon but real, under 38 CFR 3.321(b)(1).
38 CFR 3.321 - When you are between two ratings, the higher one should win
If your symptoms sit between two rating levels, VA is supposed to assign the higher one when your overall disability picture more nearly matches it. This is the reasonable doubt rule applied to ratings, in 38 CFR 4.7.
38 CFR 4.7 - You do not have to check every box on the list
The symptoms listed at each rating level are examples and guides, not a strict checklist. VA is not supposed to deny a level just because you do not have every single symptom named. See 38 CFR 4.21.
38 CFR 4.21
- You can lock in your start date before the full claim is ready
Filing an intent to file holds your effective date for up to a year while you gather evidence. If you complete the claim within that year, back pay can run from the intent to file date, not the later submission. See 38 CFR 3.155.
38 CFR 3.155 - Older ratings get harder to take away
A rating in place for 5 years is treated as stabilized, one in place for 10 years has protected service connection, and one in place for 20 years generally cannot be reduced below its level except for fraud. See 38 CFR 3.344, 3.957, and 3.951.
38 CFR 3.344 - VA cannot cut a rating without showing real, lasting improvement
To reduce a rating, VA generally has to show actual improvement under the ordinary conditions of life and work, not just one better exam. The rules are in 38 CFR 3.344, and a proposed reduction comes with notice and a chance to respond first.
38 CFR 3.344 - You can be paid at the 100 percent rate without a 100 percent rating
If service connected conditions keep you from holding steady, gainful work, VA can pay you at the 100 percent rate through TDIU, even if your combined rating is lower. Under the Rice decision, VA must consider TDIU whenever the record raises it, even if you never asked for it by name. See 38 CFR 4.16.
38 CFR 4.16 - Your back pay date is worth checking yourself
Your award usually runs from the date you filed or the date entitlement arose, whichever is later, with special rules for claims filed within a year of leaving service. Knowing your effective date under 38 CFR 3.400 is how you catch retroactive pay that came up short.
38 CFR 3.400 - A clear error in an old decision can be fixed back to day one
A final decision that contained a clear and unmistakable error can be revised at any time, and the correction runs back to the original date, not the date you pointed out the error. The bar is high: the error has to be undebatable. See 38 CFR 3.105(a).
38 CFR 3.105 - Needing help at home can add money on top of your rating
If you need help with everyday activities, or are largely confined to your home because of disability, you may qualify for Aid and Attendance or Housebound payments added to your monthly amount. See 38 CFR 3.350 and 3.352.
38 CFR 3.352 - Surgery can earn a temporary 100 percent rating while you heal
After certain surgeries, or when a service connected joint is immobilized in a cast, VA can grant a temporary 100 percent rating during recovery and then return you to your prior rating. It is easy to miss because you have to flag it. See 38 CFR 4.30.
38 CFR 4.30 - A long hospital stay can pay at 100 percent for that time
If you are hospitalized more than 21 days for a service connected condition, VA can pay you at the 100 percent rate for that period, then drop back to your regular rating afterward. See 38 CFR 4.29.
38 CFR 4.29 - Even a 0 percent rating is worth winning
A 0 percent rating still confirms the condition is service connected. That opens the door to secondary claims, to an increase later if it worsens, and can affect VA health care priority. Do not walk away from a noncompensable grant. See 38 CFR 4.31.
38 CFR 4.31 - A new law can pay you back to its start date
When a new law or presumption adds a condition, your benefits can reach back to the law's effective date, up to one year before you filed. This matters for PACT Act and other presumptive expansions. See 38 CFR 3.114.
38 CFR 3.114 - If VA later finds lost service records, your date can reach back
When VA later locates relevant official service records it did not have the first time, it must reconsider the claim, and the effective date can run back to your original filing, even years later. See 38 CFR 3.156(c).
38 CFR 3.156 - An increase can be backdated up to a year
For a condition that got worse, your higher rating can be paid up to one year before you filed, if the record shows the worsening was clearly there during that window. See 38 CFR 3.400(o)(2).
38 CFR 3.400 - One total rating plus 60 percent more can mean extra money
If you have a single disability rated 100 percent and other service connected disabilities adding to 60 percent or more, you may qualify for housebound special monthly compensation, paid on top of the 100 percent rate. See 38 CFR 3.350(i).
38 CFR 3.350
Find medical studies for Diabetes Mellitus Type II
These search starters open PubMed and PubMed Central (the National Library of Medicine's free databases) pre-filled for this condition. Strong, peer reviewed studies can help a qualified provider write a more persuasive nexus opinion.
Studies on how this condition develops and what raises the risk.
Research on how this condition is associated with or follows another.
Systematic reviews and meta analyses that summarize many studies.
Read complete studies for free in PubMed Central.
How does VA rate type 2 diabetes?
By how much management it takes. A restricted diet alone is 20 percent, adding insulin or oral medication moves it up, and the higher levels apply when you also have to regulate your activities and have repeated episodes that need a doctor's care.
Is diabetes an Agent Orange presumptive condition?
Yes. Type 2 diabetes is on the Agent Orange presumptive list, so veterans with qualifying herbicide exposure generally do not have to prove how it started, only that they have it and were exposed.
Why do my diabetes complications matter for the rating?
Because they are often rated on top of the diabetes itself. Nerve damage, eye problems, and kidney issues caused by diabetes can each carry their own rating, so the full picture is usually worth more than the diabetes code alone.
You have three review lanes, pick the one that fits the situation.
Under the Appeals Modernization Act (38 CFR 3.2500), a Higher Level Review or a Board Appeal must be requested within one year of the decision notice. A Supplemental Claim can generally be filed at any time after the decision, but filing any of the three within that one year window is what keeps the claim continuously pursued and protects the original effective date; wait longer and a later award may start from the new filing date instead.
Secondary conditions veterans research
With diabetes (type 2), some veterans research whether these followed. None of this is automatic; a secondary claim needs its own diagnosis and medical nexus evidence.
- Peripheral neuropathy in the feet or hands
the most common researched complication
- Erectile dysfunction
a recognized diabetic complication
- Kidney disease
diabetic nephropathy is a recognized complication; see the kidney pages in the condition library
- Eye conditions (retinopathy)
documented through eye exams; see the vision pages in the condition library
Related conditions
Background reading
Supplemental articles that connect to this condition.
Your VA claims file (the C-File) and your C&P exam reports are the documents VA used to decide your case. You have the right to a copy. Here are the three working request paths in 2026, plus a full guide to what is inside the file, how to read the rating code sheet, and how to use it for an appeal, a supplemental claim, a proposed reduction, or an effective date fight.
Diabetes is rated under DC 7913 by how much treatment and restriction it demands. Here is the 10 to 100 percent scale, why doctor-prescribed regulation of activities is the gate to 40 percent, separately rated complications, the Agent Orange presumptive, and the nuances.
Erectile dysfunction is rated 0 percent under DC 7522 (with or without penile deformity), but a service connected grant triggers special monthly compensation (SMC-K) for loss of use of a creative organ. Here is how 7522 works, why SMC-K is the real benefit, the common secondary paths, and the nuances most veterans miss.
Peripheral neuropathy is rated by the specific nerve affected under 38 CFR 4.124a, commonly the sciatic nerve (DC 8520). Here is the mild to complete scale, why wholly sensory neuropathy is capped at moderate, how each limb combines with the bilateral factor, and the diabetes connection.
Vietnam era veterans and others exposed to Agent Orange can file claims for conditions VA presumes are linked to the herbicide, from ischemic heart disease and type 2 diabetes to several cancers. Here is the current presumptive list, who qualifies by location and dates of service, how to show exposure, and how the PACT Act widened eligibility.
Since Feb 19, 2019, a veteran who disagrees with a VA decision picks from three review lanes: Higher Level Review, Supplemental Claim, or Board Appeal. This is a Walkthrough what each lane is, what it requires, what it costs in time, and how to keep your effective date protected.
What a secondary service connection is, the most common pairings VA actually sees, and what evidence you need to file one.
VA decision letters use a small vocabulary of words that decide everything for years to come: granted, denied, deferred, evaluation continued, remanded. Here is what each one actually means.
Three VA programs cover children of veterans born with certain birth defects: Agent Orange spina bifida (Vietnam, Korea DMZ, Thailand), the Children of Women Vietnam Veterans (CWVV) program for 18 covered birth defects, and the Camp Lejeune Family Member Program (CLFMP) for in utero exposure. Each pays its own benefit, has its own form, and routes through the Denver Regional Office.
The four pieces that interact when a veteran dies, the surviving spouse's DIC, a child's Chapter 18 spina bifida allowance, the helpless child provision under 38 CFR 3.356, and the now-repealed SBP-DIC offset. How each is paid, by whom, and how they sit alongside each other after January 1, 2023.
A Higher Level Review is filed on VA Form 20-0996 and asks a senior VA adjudicator to look at the file again. No new evidence is allowed. This article walks the form, the informal conference, the duty to assist error path, the one year window, and where HLR is the right fit.
When the veteran was rated 100 percent service connected for the 8 continuous years before death AND was married to the surviving spouse during all 8 of those years, the spouse's monthly DIC is boosted by a fixed dollar amount. In 2026 the boost is $360.85 per month. The boost stacks with the per-child add-on and with the A&A boost. The math, what proves the 8 years, and the catch most survivors do not see.
A nexus opinion is stronger when it cites peer reviewed medical literature. This guide shows you where to search (PubMed, PubMed Central, MedlinePlus, and the VA/DoD Clinical Practice Guidelines), how to search well, how to read a study, and how to hand the findings to a provider who writes your nexus letter.
VA primary care and specialty providers can complete Disability Benefits Questionnaires for conditions they treat, and VHA policy tells them to assist. Here is what the directive actually says, the limits that apply (mental health DBQs are a special case), and what to do if your provider says they cannot.
A proposed-reduction letter is one of the worst pieces of mail VA sends. You have 60 days to send evidence and 30 days to demand a predetermination hearing. Beyond that, 38 CFR 3.344 protects long-standing ratings. Here is the procedural roadmap, the stabilization rules that can stop a reduction cold, and a step-by-step response plan.
When VA adds a new herbicide presumptive condition, the Nehmer court orders can reach the effective date back to an earlier claim or the date the condition became presumptive, not the date you file. Here is how 38 CFR 3.816 works, why VA is supposed to find these automatically, and how survivors are included.
The Blue Water Navy Vietnam Veterans Act of 2019 extended the Agent Orange presumption to veterans who served in the offshore waters of Vietnam, within 12 nautical miles, during the herbicide period (38 CFR 3.307). Here is what the law covers, why it matters, and how earlier effective dates can apply.
Your rating may also qualify you for state-level benefits.
VA compensation is federal, but every state layers its own benefits on top. Many states reduce or waive property tax for disabled veterans, and many offer license, tuition, or vehicle benefits at various rating levels. The thresholds, dollar amounts, and eligibility rules vary widely from state to state, so the reliable answer is always your own state's guide.
Put this rating to work
Free calculators and a guide to turn a rating percentage into real numbers. Your figures stay on your device unless you ask us to email an estimate.
Add this condition to your other ratings using VA math, not simple addition.
See the 2026 monthly payment for a rating, including dependents.
Estimate retroactive pay from your effective date.
How one service connected condition can support a claim for another.
Most recent human review on this page, July 18, 2026. Below is the review history across this page, its citations, and the supplemental articles it links to.
- July 18, 2026articleThe DIC 8-Year Provision, How It Boosts Survivor Pay and Why So Many Survivors Miss It
- July 5, 2026articleHow VA Rates Peripheral Neuropathy (DC 8520 and the 4.124a Nerves)
- July 5, 2026articleErectile Dysfunction and SMC-K: The 0 Percent Rating That Still Pays
- July 5, 2026articleHow VA Rates Diabetes (DC 7913): Regulation of Activities and Agent Orange
- July 5, 2026articleBlue Water Navy: Agent Orange Presumption for Offshore Vietnam Service
- July 5, 2026articleNehmer: Retroactive Effective Dates for Agent Orange Presumptive Conditions