Genitourinary Conditions Rating Guide

Kidney, bladder, and reproductive conditions share one rating framework under 38 CFR § 4.115. Whatever the specific diagnosis, the schedule almost always makes you choose between two ways of rating the same condition: voiding dysfunction or renal (kidney) dysfunction, whichever pays higher. Learn that choice once and the rest of the framework falls into place. This guide explains the shared rules that decide every genitourinary rating, then points you to the detailed guide for your specific condition.

The Rules That Decide Every Genitourinary Claim

Genitourinary conditions cover a lot of ground, the kidneys, the bladder, and the reproductive organs, but they are scored by a small set of shared rules under 38 CFR § 4.115a and 4.115b. Understanding those rules tells you what the rating actually depends on and which numbers your evidence needs to capture.

1. You rate it as voiding OR renal, whichever is worse

Most genitourinary conditions are rated as either voiding dysfunction or renal (kidney) dysfunction, whichever produces the higher evaluation. You do not rate both and add them together. The schedule directs the rater to pick the single dysfunction that best reflects the disability and use that scale. This one choice drives the majority of genitourinary ratings.

2. Voiding dysfunction is scored on the specific problem

If voiding dysfunction is the higher path, the rating turns on the specific type of problem:

Urine leakage: scored on how often you must change absorbent pads or appliances, and whether an appliance is required.
Urinary frequency: scored on how short the daytime interval between voidings is and how many times you wake at night to void.
Obstructed voiding: scored on symptoms like a weak stream, retention, and whether catheterization or dilation is needed.

3. Renal dysfunction is scored on kidney lab values

If renal dysfunction is the higher path, the rating uses a separate table built on kidney lab values and findings: protein in the urine, BUN and creatinine levels, related hypertension and swelling (edema), and, at the most severe levels, whether regular dialysis is required. The kidney numbers, not symptoms alone, set this rating.

4. Urinary tract infections are rated on how often they recur

A recurrent urinary tract infection is rated on its own scale that turns on how often the infection comes back and needs treatment, including whether it requires long-term drug therapy, drainage, or frequent hospitalization. This is a distinct path from the voiding-versus-renal choice above.

5. Loss of a reproductive organ can carry SMC

Loss or removal of a reproductive organ, and conditions such as erectile dysfunction, can carry special monthly compensation (SMC) for loss of use of a creative organ. That SMC is paid on top of any schedular rating for the condition, so it is separate money that is easy to miss.

The higher-of rule is the whole game. Because the schedule pays the greater of the voiding or renal evaluation, the exam needs to capture both sides, the pad-change and frequency numbers and the kidney labs, so the rater can compare them and assign the higher one. If only one side is documented, you may be rated on the lower path by default.

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:

Area	Guide	DC codes
Urinary conditions (frequency, leakage)	Urinary Claims Guide	7527, 7542
Erectile dysfunction	Erectile Dysfunction Guide	7522
Genitourinary cancer	Cancer Claims Guide	7528

For any code not listed, open its condition lookup page for the rating levels and Board data.

Every Genitourinary Diagnostic Code, With Board Outcomes

Every diagnostic code in this body system, ordered by how often it reaches the Board of Veterans' Appeals. Percentages are the share of each code's Board issues granted, denied, or remanded (sent back for more development); dismissed and other outcomes are not shown, so rows do not sum to 100%. Each code links to its full page: rating criteria, evidence notes, and secondary-condition data.

DC	Condition	Board appeals	Granted	Denied	Remanded
7522	Erectile dysfunction, with or without penile deformity Claims guide →	32,682	16.3%	33.9%	42.6%
7528	Malignant neoplasms of the genitourinary system Claims guide →	30,010	24.3%	33%	35.8%
7527	Prostate gland injuries, infections, hypertrophy, postoperative residuals, bladder outlet obstruction Claims guide →	8,251	11.1%	33.5%	49%
7500	Kidney, removal of one	4,507	9.3%	22.2%	63.8%
7542	Neurogenic bladder Claims guide →	3,724	20.9%	26.8%	46.3%
7525	Prostatitis, urethritis, epididymitis, orchitis (unilateral or bilateral), chronic only	3,684	15%	43%	36.8%
7508	Nephrolithiasis/Ureterolithiasis/Nephrocalcinosis	3,557	13.5%	37.6%	41.7%
7530	Chronic renal disease requiring regular dialysis	2,854	15.6%	31%	49.8%
7543	Varicocele/Hydrocele	2,353	13.5%	41.3%	39.8%
7512	Cystitis, chronic, includes interstitial and all etiologies, infectious and non-infectious	2,120	13.8%	32.4%	48.2%
7541	Renal involvement in diabetes mellitus type I or II	1,598	22.5%	40.4%	28.8%
7524	Testis, removal	1,318	13.6%	36.9%	45.7%
7517	Bladder, injury of	896	10.7%	19.9%	65.3%
7529	Benign neoplasms of the genitourinary system	784	12.1%	35.1%	46.7%
7533	Cystic diseases of the kidneys	608	10%	30.6%	54.1%
7523	Testis, atrophy complete	518	16.4%	35.3%	42.7%
7531	Kidney transplant	515	15.9%	31.3%	45.8%
7536	Glomerulonephritis	475	19.2%	30.9%	43.6%
7518	Urethra, stricture of	457	22.3%	31.5%	43.3%
7502	Nephritis, chronic	447	11%	26.2%	56.6%
7509	Hydronephrosis	400	12.8%	40.3%	39%
7507	Nephrosclerosis, arteriolar	265	16.6%	33.6%	31.3%
7501	Kidney, abscess of	227	15%	39.6%	24.2%
7504	Pyelonephritis, chronic	187	3.2%	28.3%	63.1%
7515	Bladder, calculus in, with symptoms interfering with function	106	20.8%	44.3%	28.3%
7538	Papillary necrosis	70	18.6%	50%	15.7%
7520	Penis, removal of half or more	50	22%	30%	48%
7537	Interstitial nephritis, including gouty nephropathy, disorders of calcium metabolism	15	20%	46.7%	26.7%

Show 12 more codes with too few Board appeals to report (expand)

DC	Condition	Board appeals
7505	Kidney, tuberculosis of	Too few Board appeals to report
7511	Ureter, stricture of	Too few Board appeals to report
7516	Bladder, fistula of	Too few Board appeals to report
7519	Urethra, fistula of	Too few Board appeals to report
7521	Penis, removal of glans	Too few Board appeals to report
7532	Renal tubular disorders (such as renal glycosurias, aminoacidurias, renal tubular acidosis, Fanconi's syndrome, Bartter's syndrome, related disorders of Henle's loop and proximal or distal nephron function, etc.)	Too few Board appeals to report
7534	Atherosclerotic renal disease (renal artery stenosis, atheroembolic renal disease, or large vessel disease, unspecified)	Too few Board appeals to report
7535	Toxic nephropathy (antibotics, radiocontrast agents, nonsteroidal anti-inflammatory agents, heavy metals, and similar agents)	Too few Board appeals to report
7539	Renal amyloid disease	Too few Board appeals to report
7540	Disseminated intravascular coagulation with renal cortical necrosis	Too few Board appeals to report
7544	Renal disease caused by viral infection such as human immunodeficiency virus (HIV), Hepatitis B, and Hepatitis C	Too few Board appeals to report
7545	Bladder, diverticulum of	Too few Board appeals to report

Counts from RateMyVSO's index of published BVA decisions, refreshed weekly. A remand is not a loss; it means the Board needed more evidence before deciding. Descriptive of the published record, not a prediction for any claim.

Common Secondary Conditions

Genitourinary problems are often not the first injury. Many are caused by another service-connected condition, which makes them secondary claims:

Erectile dysfunction as a secondary claim. Erectile dysfunction is frequently secondary to diabetes, a prostate condition, blood-pressure medication, or a service-connected mental-health condition, and it can carry the related SMC-K for loss of use of a creative organ.
Kidney disease from diabetes or hypertension. Long-standing diabetes or high blood pressure can damage the kidneys over time, so kidney disease is a common secondary to either one.
Urinary problems from a spine condition. A back or spine condition that affects the nerves controlling the bladder can produce urinary frequency, urgency, or retention as a secondary claim.
Depression from chronic dysfunction. Long-term urinary or sexual dysfunction takes a mental toll, and depression can be claimed as secondary to the physical condition. See secondary conditions.

Evidence That Helps

A voiding diary. A dated log of pad changes per day, the daytime interval between voidings, and how many times you wake at night gives the rater the exact numbers the voiding-dysfunction scale depends on.
Kidney lab work. Recent creatinine, BUN, and urine-protein results are what the renal-dysfunction table is built on, and they let the rater compare the renal path against the voiding path.
Records of recurrent UTIs. Documentation of how often infections come back and what treatment they required supports the separate UTI-frequency rating.
Support for an SMC-K claim. Documentation of loss of use of a creative organ, such as an erectile-dysfunction diagnosis or the removal of a reproductive organ, supports the special monthly compensation.
The matching DBQ for the condition, which prompts the examiner to capture the specific findings the rating needs. See the DBQ guide.

Evidence Cited in Published Urinary conditions Decisions

We analyzed 19,339 published Board decisions involving urinary conditions for condition-specific evidence, counting only case-specific mentions (boilerplate recitations excluded). "Favorable" is the share of decisions citing that evidence where every issue was granted or the outcome was mixed; the baseline across all these decisions is 51.2%, combining every diagnostic code below. Evidence appearing in a decision does not mean it decided the case. Descriptive of the published record, not a prediction.

Recurrent urinary tract infections documentedfavorable 62%

n = 3,917

Nocturia (nighttime awakening to void) documentedfavorable 64.8%

n = 3,043

Absorbent materials (pad use) documentedfavorable 69%

n = 2,508

Voiding intervals or daytime frequency documentedfavorable 72.1%

n = 1,871

Catheterization documentedfavorable 63.8%

n = 1,784

By diagnostic code

These codes are grouped together above. They do not perform the same, so find your own code here rather than reading the combined figure. Codes retired in the schedule rewrites are left out, because their old decisions were judged under criteria that no longer apply.

DC 7527 Prostate gland injuries, infections, hypertrophy, postoperative residuals, bladder outlet obstructionfavorable 51.6%

n = 7,705 decisions · 304 granted

DC 7530 Chronic renal disease requiring regular dialysisfavorable 44.6%

n = 3,789 decisions · 295 granted

DC 7542 Neurogenic bladderfavorable 55%

n = 3,476 decisions · 258 granted

DC 7512 Cystitis, chronic, includes interstitial and all etiologies, infectious and non-infectiousfavorable 58.7%

n = 3,243 decisions · 212 granted

DC 7517 Bladder, injury offavorable 58.6%

n = 3,116 decisions · 177 granted

Evidence Cited in Published Erectile dysfunction Decisions

We analyzed 25,319 published Board decisions involving erectile dysfunction for condition-specific evidence, counting only case-specific mentions (boilerplate recitations excluded). "Favorable" is the share of decisions citing that evidence where every issue was granted or the outcome was mixed; the baseline across all these decisions is 62.4%. Evidence appearing in a decision does not mean it decided the case. Descriptive of the published record, not a prediction.

SMC-K loss of use of a creative organ addressedfavorable 68.7%

n = 4,789

Medication side-effect etiology discussedfavorable 67%

n = 4,480

Penile deformity finding addressed (DC 7522 requirement)favorable 68.2%

n = 3,939

ED treatment documentedfavorable 61.3%

n = 1,980

Detected by phrase-reading the decision text with condition-specific vocabularies. Source: Board of Veterans' Appeals decisions, RateMyVSO analysis.

Symptoms Recorded in Granted Urinary conditions Decisions

We analyzed 1,104 granted Board decisions involving urinary conditions for symptoms named in sentences about the condition (rating-criteria recitations excluded). Descriptive of the published record, what the Board wrote down, not a checklist of what to report.

Leakage or incontinenceshare of granted 39.2%

n = 433

Urinary frequencyshare of granted 32.2%

n = 355

Urgencyshare of granted 12.5%

n = 138

Nighttime urination (nocturia)share of granted 11.9%

n = 131

Hesitancyshare of granted 6.6%

n = 73

Painful urination (dysuria)share of granted 6.3%

n = 70

Weak, slow, or decreased streamshare of granted 6.1%

n = 67

Detected by phrase-reading the decision text with condition-specific vocabularies. Source: Board of Veterans' Appeals decisions, RateMyVSO analysis.

Common Mistakes

Trying to combine a voiding rating and a renal rating. The schedule pays only the higher of the two, not both added together. Documenting both sides lets the rater assign the higher one; it does not create two separate ratings.
Not documenting pad changes or urinary frequency. These are the exact numbers the voiding-dysfunction rating is built on. Vague notes will not carry the rating; the counts will.
Missing SMC-K. Erectile dysfunction and the loss or removal of a reproductive organ can carry special monthly compensation for loss of use of a creative organ. It is separate money that is often overlooked.
Not connecting kidney disease to a service-connected cause. Kidney disease that developed from service-connected diabetes or hypertension is a secondary claim. Stopping at the primary condition leaves that connection unmade.

Frequently Asked Questions

How does the VA rate genitourinary conditions?

Kidney, bladder, and reproductive conditions are rated under 38 CFR 4.115a and 4.115b. Most are rated as either voiding dysfunction or renal (kidney) dysfunction, whichever produces the higher evaluation, you do not rate both and add them. Recurrent urinary tract infections have their own frequency-based scale, and the loss of a reproductive organ can carry special monthly compensation.

Voiding dysfunction versus renal dysfunction, which one applies?

Whichever produces the higher rating. The schedule directs the rater to score the condition on the single dysfunction that best reflects the disability, and pay the greater of the two. That is why the exam should capture both the voiding numbers (pad changes, frequency) and the kidney labs (creatinine, BUN, urine protein), so the two paths can be compared.

What is SMC-K?

SMC-K is a form of special monthly compensation paid for the loss or loss of use of a creative organ, among other listed anatomical losses. In the genitourinary setting it commonly applies to erectile dysfunction or the removal of a reproductive organ. It is paid on top of any schedular rating for the condition, so it is separate additional money.

Is erectile dysfunction ratable?

Erectile dysfunction is most often addressed through special monthly compensation (SMC-K) for loss of use of a creative organ rather than a large schedular percentage. It is frequently claimed as secondary to diabetes, a prostate condition, blood-pressure medication, or a mental-health condition. See the erectile dysfunction guide for the details.

How are recurring UTIs rated?

Recurrent urinary tract infections are rated on their own scale that turns on how often the infection comes back and needs treatment, including whether it requires long-term drug therapy, drainage procedures, or frequent hospitalization. This is a separate path from the voiding-versus-renal choice that governs most other genitourinary conditions.

Related Tools and Guides

Urinary Claims Guide

Frequency, leakage, and the voiding-dysfunction scale.

Erectile Dysfunction Guide

SMC-K and the common secondary connections.

Diabetes Claims Guide

A frequent cause of both ED and kidney disease.

Hypertension Guide

Long-standing high blood pressure and the kidneys.

Secondary Conditions

How one condition opens the door to another.

DBQ Guide

The exam forms that capture the findings the rating needs.

Sources: 38 CFR 4.115b, genitourinary ratings. Educational only, not legal advice, and not a prediction of any individual claim. Rating criteria and case law change; confirm current details in 38 CFR Part 4. For help with your claim, find a VA-accredited representative.