Body system: Endocrine SystemRegulation: 38 CFR § 4.119DBQ: DBQ ENDO Diabetes mellitus
Diabetes mellitus is when your body can't properly control blood sugar levels, either because it doesn't make enough insulin or can't use insulin effectively. The VA rates diabetes from 10% to 100% based on how you need to manage it - from just dietary changes at 10% all the way up to requiring multiple daily insulin shots plus serious complications at 100%. The higher ratings also consider how often you have dangerous blood sugar episodes that require hospitalization or frequent medical care.
Rating levels
- 100% — You need multiple daily insulin injections, must follow a strict diet, and have to avoid strenuous work or recreational activities. Your diabetes must be severe enough to cause ketoacidosis (dangerous buildup of acids in blood) or hypoglycemic reactions (dangerously low blood sugar) that require either three or more hospitalizations per year or weekly visits to a diabetes specialist. Additionally, you must be experiencing either progressive weight loss and weakening, or have diabetes-related complications serious enough that they would qualify for their own separate VA disability ratings if evaluated individually.
- 60% — You need daily insulin shots, must follow a strict diet, and have to limit your activities because of your diabetes. Your blood sugar goes dangerously high (ketoacidosis) or dangerously low (hypoglycemic reactions) often enough that you're hospitalized 1-2 times per year or need to see your diabetes doctor twice a month, and you also have other diabetes-related health problems that affect your body.
- 40% — You need to take insulin shots at least once every day to control your blood sugar, follow a special diet with restrictions on what you can eat, and limit or modify your daily activities because of your diabetes. This level means your diabetes requires daily medical management through injections and significantly affects how you live your life.
- 20% — You need to take at least one insulin shot every day and follow a special diet to control your diabetes, OR you take diabetes pills (oral hypoglycemic agents - medications like metformin or glipizide that help lower blood sugar) along with following a restricted diet. Either of these treatment combinations shows your diabetes requires daily medication management beyond just diet and exercise alone.
- 10% — You can control your diabetes just by following a special diet without needing any medications like insulin or pills. Your blood sugar levels stay within acceptable ranges as long as you stick to eating the right foods and avoiding others, but you don't require any medical treatment beyond dietary changes.