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Diabetes Rating Increase

by | Jun 16, 2011 | Veterans Disability Benefits |

If a veteran’s diabetes mellitus (“DM”) is found to be service connected, the VA will rate it according to the Code 7913.

7913 Diabetes mellitus

Requiring more than one daily injection of insulin, restricted diet, and regulation of activities (avoidance of strenuous occupational and recreational 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………………100

Requiring insulin, restricted diet, and 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 ………………………………………..60

Requiring insulin, restricted diet, and regulation of activities ……40

Requiring insulin and restricted diet, or; oral hypoglycemic agent and restricted diet ……………………………………………..20

Manageable by restricted diet only ……………………………….10

If the veteran’s DM is service connected and the veteran’s diet has been restricted, 10% is warranted. 20% is warranted once medication is prescribed. The 40% rating is where most of the trouble begins. Many veterans are currently rated at 20% and are seeking an increased rating. They run into trouble with “regulations of activities”. Regulation of activities means “avoidance of strenuous occupational recreational activities.”

The veteran must show that DM, and not other conditions, causes regulation of activities. Comacho v. Nicholson, 21 Vet. App. 360 (2007). This is very difficult to do if the veteran suffers other medical conditions. The veteran will need to provide medical evidence that states any restrictions DM causes.

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