Body system: Genitourinary SystemRegulation: 38 CFR § 4.115b
Kidney tuberculosis is a Mycobacterium tuberculosis infection of the kidney parenchyma and collecting system, usually caused by hematogenous spread from a primary pulmonary focus. It can produce chronic flank pain, painless hematuria, sterile pyuria, urinary frequency, and progressive renal scarring. Treatment requires multidrug antitubercular therapy for 6-12 months. The VA assigns 100% during active disease. Once inactivity is declared, the post-inactivity rating depends on when your entitlement arose: § 4.88b for entitlements after August 19, 1968 (100% for 1 year, then residuals); § 4.89 for entitlements on or before that date (graduated step-down: 100% for 2 years, 50% for 4 years, 30% for 5 years).
Rating levels
- 100% — You qualify for 100% during active kidney tuberculosis. The active phase covers the full duration of confirmed active TB infection of the kidney, regardless of whether you are inpatient, outpatient, or on multidrug antitubercular therapy. Once active disease has been declared inactive by clinical, imaging, and laboratory criteria, the rating transitions to one of two post-inactivity schedules depending on when your VA disability entitlement first arose: § 4.88b applies if your entitlement is from after August 19, 1968; § 4.89 applies if you were already entitled on or before that date and are protected under Pub. L. 90-493.
- -1% — If your VA entitlement first arose AFTER August 19, 1968, the post-inactivity rule is straightforward: a flat 100% for ONE YEAR after the date your active kidney TB was declared inactive. After that 1-year window, the rating shifts to whatever the residual kidney damage warrants under the renal dysfunction ladder (§ 4.115a) or under any other applicable body system code. No graduated step-down applies under § 4.88b.
- -1% — If you were entitled to VA compensation ON or BEFORE August 19, 1968, you are protected under Public Law 90-493 and the older graduated schedule of § 4.89 applies. After active kidney TB has been declared inactive, the rating steps down on a fixed timetable: 100% for the first 2 years, then 50% for the next 4 years, then 30% for the next 5 years, then transition to residuals-based rating. A minimum 30% rating is preserved throughout the protected step-down period regardless of clinical status.