The U.S. Department of Veterans Affairs (VA) assigns disability ratings for diabetes at 10%, 20%, 40%, 60%, and 100%, based on your treatment requirements and how the condition affects your daily life. Your rating determines your monthly compensation and access to VA healthcare benefits.
We understand that managing diabetes while navigating the VA disability system can be complicated and frustrating. Our Houston veterans disability lawyers explain how the VA evaluates diabetes and what you need to know about securing your benefits.
How does the VA Rate Diabetes?
The VA evaluates diabetes mellitus according to the Schedule for Rating Disabilities. Your rating primarily depends on your treatment requirements, including insulin usage, dietary restrictions, and activity regulation.
The VA also considers factors like how often you need to see your healthcare provider for diabetic care. They also check whether you experience episodes of ketoacidosis or hypoglycemic reactions.
Medical documentation of your treatment plan and any diabetes-related complications is part of determining your rating. A lawyer can collect and present these records to show how your diabetes affects your health and prognosis.
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What Are the Different VA Rating Levels for Diabetes?
The VA uses disability ratings to say how much a particular disease or disability impairs you. This is done on a percentage scale. The VA ratings for diabetes are:
10% Rating Level
A 10% rating is assigned when your diabetes is manageable through a restricted diet only. At this level, you don’t require insulin or oral medication to control your blood sugar levels.
20% Rating Level
The 20% rating applies when you need insulin or an oral hypoglycemic agent like metformin, plus a restricted diet. This is the most common rating for veterans with Type 2 diabetes who take medication to control their condition.
40% Rating Level
A 40% rating requires insulin, a restricted diet, and regulation of activities. “Regulation of activities” means you must avoid strenuous occupational and recreational activities to prevent blood sugar fluctuations.
60% Rating Level
At the 60% level, you require insulin, a restricted diet, and regulation of activities, plus you experience episodes of ketoacidosis or hypoglycemic reactions requiring hospitalization or regular visits to your diabetic care provider.
100% Rating Level
The highest rating of 100% indicates severe complications with episodes of ketoacidosis or hypoglycemic reactions requiring at least three hospitalizations per year or weekly visits to your diabetic care provider.
What Evidence do I Need to Support My Diabetes Rating?
Medical records are essential for establishing your diabetes rating. These should include your diagnosis, treatment plan, and documentation of any complications or hospitalizations. Your healthcare provider should document how often you need medical care for your diabetes.
You should also keep personal records of your blood sugar readings, insulin requirements, and how diabetes affects your daily activities and work capacity.
A lawyer can tell you exactly what you need to document for your case if you need to dispute your VA rating for diabetes.
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How do Secondary Conditions Affect My Rating?
Diabetes often causes secondary conditions that may qualify for additional VA disability ratings. The VA evaluates these conditions separately from your primary diabetes rating, but if you receive multiple ratings, then you may qualify for greater benefits.
Common secondary conditions include peripheral neuropathy, cardiovascular disease, kidney disease, and diabetic retinopathy.
Each can receive its own VA rating. The VA combines these separate ratings using their combined ratings table to determine your total disability percentage.
Understanding Total Combined Disability Percentage
Your diabetes rating and any secondary condition ratings combine to create your total disability percentage using a formula by the VA to determine how disabled you are.
For example, if you have a 40% rating for diabetes and a 30% rating for peripheral neuropathy, your combined rating would be higher than 40% but not necessarily 70%. The VA calculates these ratings incrementally, starting with the highest rating.
You may qualify for Total Disability with Individual Unemployability (TDIU) if your diabetes and its secondary conditions prevent you from substantially gainful employment, even if your combined rating is less than 100%.
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Can My Diabetes Rating Change Over Time?
Your diabetes rating may change if your condition worsens or your treatment requirements increase. You can file for an increased rating if your condition becomes more severe.
The VA might schedule periodic reviews to assess your condition. These reviews ensure that your rating accurately reflects your current health status. If the VA believes your diabetes is improving or being better controlled, it may lower your rating.
You have the right to challenge any proposed rating reduction. We recommend maintaining regular medical care and documenting any changes in your condition in case this happens. This evidence will help your lawyer with your appeal.
Speak With a Veterans Affairs Lawyer About Your VA Rating for Diabetes
Understanding your VA disability rating for diabetes is essential for receiving the benefits you deserve. Our team is ready to help you navigate the VA disability claims process and secure the appropriate rating for your diabetes.
Contact Marc Whitehead & Associates today to discuss your claim and learn how we can help you obtain the benefits you’ve earned through your service.
Call or text 800-562-9830 or complete a Free Case Evaluation form