Choosing to slow down does not move a diabetes rating. The jump from 20 to 40 percent turns on regulation of activities, and the courts read that as a restriction a doctor prescribed in the record, not a lifestyle change you made yourself. Meanwhile the complications, neuropathy, retinopathy, nephropathy, and ED with its SMC-K payment, often out-pay the diabetes code itself.
Choosing to slow down on your own does not move a diabetes rating. The jump from 20 to 40 percent turns on regulation of activities, and the courts read that as a restriction a doctor prescribed in the record, not a lifestyle change you made yourself. Meanwhile, the complications, neuropathy, retinopathy, nephropathy, and ED with its SMC-K payment, often out-pay the diabetes code itself.
How VA rates diabetes
Diabetes mellitus is rated under diagnostic code 7913 in 38 CFR 4.119. The percentage climbs with how much treatment and life restriction the disease demands:
- 10 percent: manageable by a restricted diet alone.
- 20 percent: requires insulin and a restricted diet, or an oral hypoglycemic agent and a restricted diet.
- 40 percent: requires insulin, a restricted diet, and regulation of activities.
- 60 percent: requires insulin, a restricted diet, and regulation of activities, plus episodes of ketoacidosis or hypoglycemic reactions needing one or two hospitalizations a year or twice-monthly visits to a provider, plus complications.
- 100 percent: requires more than one daily insulin injection, a restricted diet, and regulation of activities, with episodes of ketoacidosis or hypoglycemic reactions requiring at least three hospitalizations a year or weekly provider visits, plus progressive weight and strength loss or severe complications.
What "regulation of activities" means for your rating
The jump from 20 to 40 percent hinges on three words: regulation of activities. Courts have held, in the Camacho case, that this means a doctor has medically prescribed that you avoid strenuous occupational and recreational activities because of the diabetes. Your own choice to slow down is not enough. It has to be in the medical record as a prescribed restriction. If your endocrinologist has told you to limit exertion, make sure that instruction is written down.
Complications are rated separately
Diabetes rarely travels alone. Its complications get their own ratings that combine with the 7913 evaluation:
- Diabetic peripheral neuropathy in the limbs, under the nerve codes.
- Diabetic retinopathy (eyes).
- Diabetic nephropathy (kidneys).
- Erectile dysfunction, which can support special monthly compensation (SMC-K).
The Agent Orange presumptive
Type 2 diabetes is on the Agent Orange presumptive list (38 CFR 3.309). A veteran with qualifying herbicide exposure generally does not have to prove the nexus. The presumption supplies it. See our presumptive and Agent Orange guides.
Common rating errors to watch for
- "Regulation of activities" must be doctor-prescribed, per Camacho, to reach 40 percent and above. Get it in writing.
- Complications are separate ratings, and neuropathy, retinopathy, and nephropathy often add more than the diabetes code itself.
- Type 2 diabetes is Agent Orange presumptive, so qualifying exposure can carry service connection without a nexus opinion.
- Erectile dysfunction can mean SMC-K, a flat extra payment, even when its own rating is 0 percent.
- Diet alone is 10 percent. The medication and restriction requirements are what move the number up.
Related on this site
- How VA rates eye conditions (38 CFR 4.79)
- How VA rates kidney disease (38 CFR 4.115a)
- Presumptive conditions and toxic exposure
- Agent Orange claims
- How VA rates radiculopathy (DC 8520)
- Special Monthly Compensation (SMC), explained
Common questions
What are the diabetes rating levels?
Under diagnostic code 7913, the percentage climbs with how much treatment and restriction the disease demands: 10 percent for a restricted diet alone; 20 percent for insulin or an oral hypoglycemic agent plus a restricted diet; 40 percent for insulin, restricted diet, and regulation of activities; 60 and 100 percent add episodes of ketoacidosis or hypoglycemia requiring hospitalizations or frequent provider visits, plus complications.
What does regulation of activities mean for the 40 percent rating?
It is the gate between 20 and 40 percent, and courts have held (the Camacho case) that it means a doctor has medically prescribed that you avoid strenuous occupational and recreational activities because of the diabetes. Your own choice to slow down is not enough. If your endocrinologist has told you to limit exertion, make sure that instruction is written in the medical record.
Are diabetes complications rated separately?
Yes, and they often add more than the diabetes code itself. Diabetic peripheral neuropathy is rated under the nerve codes, retinopathy under the eye schedule, and nephropathy under the kidney criteria, each combining with the 7913 evaluation. Erectile dysfunction can support SMC-K, a flat extra monthly payment, even when its own rating is 0 percent.
Is type 2 diabetes presumptive for Agent Orange exposure?
Yes. Type 2 diabetes is on the Agent Orange presumptive list at 38 CFR 3.309, so a veteran with qualifying herbicide exposure generally does not have to prove the nexus; the presumption supplies it.