Endocrine Conditions Rating Guide

The Rules That Decide Every Endocrine Claim

Endocrine conditions are the disorders of the glands that make hormones: the pancreas, the thyroid, the adrenal glands, the pituitary, and the parathyroids. They do not share a single rating measurement the way joints do, but they follow a common logic: the VA rates them on the symptoms you have and how intensively the condition must be treated to control it. A few rules matter more than the rest.

1. Diabetes (DC 7913) is a ladder of treatment intensity

Diabetes is rated by how hard it is to keep under control, not by a single lab number. The ladder climbs through the management the condition requires: a restricted diet at the bottom; oral medication or insulin in the middle; and at the higher levels, "regulation of activities" (a doctor's direction to avoid strenuous activity to prevent low blood sugar) together with episodes of ketoacidosis or hypoglycemia that need hospital care and progressive complications. The more intensive the treatment your doctor documents, the higher the rung.

2. The complications of diabetes are rated separately

This is the most-missed opportunity in the whole system. The complications that diabetes causes are not folded into the diabetes rating. Peripheral neuropathy (nerve damage in the hands and feet), diabetic retinopathy (eye disease), nephropathy (kidney disease), erectile dysfunction, and heart disease each carry their own rating on top of the diabetes evaluation. A veteran who is rated only for the diabetes, with none of the complications claimed, is very often leaving ratings on the table.

3. Thyroid conditions are rated on their own scales

Thyroid disease has its own codes and its own criteria. Hypothyroidism (an underactive thyroid, DC 7903) and hyperthyroidism (an overactive thyroid) are each rated on the symptoms you have and the treatment required to manage them, not on the diabetes ladder. The two directions of thyroid trouble are scored differently, so the specific diagnosis matters.

4. The other glands each have their own code

Beyond diabetes and the thyroid, the adrenal glands, the pituitary, and the parathyroids each have a dedicated diagnostic code. They are rated on the specific hormone problem and its effects on the body. Because these are less common, their exact criteria are best read on the individual code page for the condition.

Find the Guide for Your Condition

The rules above apply across the board. For the exact rating table, the C&P exam, and the Board data for your specific condition, open the dedicated guide:

For other endocrine conditions (adrenal, pituitary, parathyroid, hyperthyroidism) that do not yet have a dedicated guide, open the condition lookup page for the rating levels and Board data.

Common Secondary Conditions

For endocrine claims, the secondary conditions are not a side note, they are the center of the claim. Diabetes in particular drives a cascade of separately-rated conditions, and claiming each one is where the real ratings are found:

• Peripheral neuropathy. Diabetes damages the nerves in the hands and feet, producing numbness, tingling, and pain. It is rated separately under the nerve codes. See the neurological guide.
• Diabetic retinopathy. High blood sugar damages the blood vessels in the eyes over time, a separate eye claim with its own rating.
• Kidney disease (nephropathy). Diabetes is a leading cause of kidney damage, rated on its own under the genitourinary schedule. See the genitourinary guide.
• Erectile dysfunction. A very common vascular and nerve complication of diabetes, claimed as secondary with its own rating. See the genitourinary guide.
• Heart disease. Diabetes raises the risk of coronary artery disease and other heart conditions, each rated separately. See the cardiovascular guide.

Each of these is its own claim and its own rating on top of the diabetes evaluation. For the full picture of how one condition opens the door to others, see secondary conditions. Note that type 2 diabetes is an Agent Orange presumptive, which can make service connection much simpler for veterans with qualifying exposure. See the PACT Act and presumptives guide.

Evidence That Wins

• Lab work. A1c and glucose readings for diabetes, and thyroid panels (TSH) for thyroid conditions, the objective backbone that documents the diagnosis and how well it is controlled.
• Your treatment regimen. Records that show what the condition requires, a restricted diet, oral medication, or insulin, and any prescribed activity restriction. The treatment intensity is what moves the diabetes rating up the ladder.
• Hospitalization records. Documentation of any hospital care for ketoacidosis or hypoglycemia, which the higher diabetes levels depend on.
• Documentation of each complication. A separate record for the neuropathy, retinopathy, kidney disease, erectile dysfunction, or heart disease, because each supports its own claim.
• The matching DBQ for the condition, which prompts the examiner to capture the treatment regimen, activity restriction, and complications. See the DBQ guide.

Common Mistakes

Frequently Asked Questions