★ Endocrine
Diabetes Mellitus Type II VA Rating
38 CFR § 4.119, Diagnostic Code 7913
Overview
Higher ratings require multiple criteria — for example, 40% requires insulin, restricted diet, AND regulation of activities (avoidance of strenuous occupational and recreational activities).
Diabetes opens many secondary claims: peripheral neuropathy, retinopathy, nephropathy, ED, and cardiovascular disease.
Presumptive for Vietnam-era Agent Orange-exposed veterans.
In Depth
Type II Diabetes Mellitus is rated under 38 CFR § 4.119, DC 7913 with five tiers: 10% (managed by restricted diet only), 20% (oral hypoglycemic agent + restricted diet), 40% (insulin + restricted diet + regulation of activities), 60% (insulin + restricted diet + regulation of activities + episodes of ketoacidosis or hypoglycemic reactions requiring 1-2 hospitalizations per year, OR twice-monthly visits to a diabetic care provider, plus complications not otherwise compensable), 100% (similar to 60% with even more frequent hospitalizations and progressive loss of weight and strength).
'Regulation of activities' is a specific term of art — it requires that the veteran avoid strenuous occupational and recreational activities to prevent hypoglycemia. A general 'try to exercise more' is not regulation of activities. This is the main hurdle to the 40% rating.
Type II Diabetes is presumptive for Vietnam-era Agent Orange-exposed veterans under 38 CFR § 3.309(e). The PACT Act extended several presumptive locations.
Diabetic complications — peripheral neuropathy, retinopathy, nephropathy, erectile dysfunction, cardiovascular disease — are each separately ratable. A complete diabetes claim should always pursue these complications.
How to Establish Service Connection
- Agent Orange / herbicide presumption.
- PACT Act may apply for newer exposure locations.
Rating Criteria
Paraphrased from 38 CFR § 4.119, Diagnostic Code 7913
| Rating | Criteria |
|---|---|
| 10% | Manageable by restricted diet only. |
| 20% | Requires insulin and restricted diet; or oral hypoglycemic agent and restricted diet. |
| 40% | Requires insulin, restricted diet, and regulation of activities. |
| 60% | Requires insulin, restricted diet, regulation of activities, with episodes of ketoacidosis or hypoglycemic reactions requiring 1–2 hospitalizations per year or twice-monthly visits to a diabetic care provider, plus complications. |
| 100% | Requires more than one daily injection of insulin, restricted diet, regulation of activities (avoidance of strenuous occupational and recreational activities), with episodes of ketoacidosis or hypoglycemic reactions requiring at least three hospitalizations per year or weekly visits to a diabetic care provider, plus either progressive loss of weight and strength or complications that would be compensable if separately evaluated. |
See what each percentage pays in 2026 and how it combines with your current rating →
Evidence Checklist
- Endocrinology records and A1C history.
- Documentation that physician has prescribed regulation of activities (essential for 40%+).
- Records of ketoacidosis or hypoglycemic episodes.
Evidence Templates
Common formats of evidence the VA looks for in this type of claim. These describe what the documents typically include — they are not legal forms or medical opinions, and Oakridge Claims does not draft them.
Endocrinologist Statement on Regulation of Activities
Written statement from the treating endocrinologist explicitly stating the patient must avoid strenuous occupational and recreational activities to prevent hypoglycemia.
Lab Records (HbA1c, glucose logs)
Long-term glycemic control records supporting severity of disease.
Evidence VA Commonly Cites in These Claims
Descriptive summary of evidence types frequently referenced in rating decisions for this condition. Not a checklist of actions to take — every claim is decided on its own facts.
- ★When insulin and a restricted diet are prescribed, written 'regulation of activities' instructions from the prescribing physician are commonly the evidence that elevates an evaluation from 20% to 40%.
- ★Each separately ratable complication is commonly evaluated: peripheral neuropathy (each extremity), retinopathy, nephropathy, erectile dysfunction (with SMC-K).
- ★When Agent Orange exposure applies, the presumption removes the nexus burden.
Illustrative Scenarios
These are hypothetical educational examples — not actual case results, predictions, or guarantees of outcomes.
Scenario — From 20% to 40%
A veteran on insulin with a restricted diet was rated 20% for diabetes. After requesting written guidance from their endocrinologist, they obtained documentation that physical activities must be regulated to prevent hypoglycemia. Combined with insulin and dietary restriction, this evidence may potentially support a 40% rating under DC 7913 — though the actual decision is the VA's.
Common pitfalls VA sees
- Not pursuing each complication as a separate rating.
- Accepting 20% when on insulin and restricted diet without seeking documented regulation of activities.
- Missing the Agent Orange presumption.
Common Secondary Conditions
Conditions frequently service-connected as secondary to Diabetes Mellitus Type II:
Frequently Asked Questions
Useful Tools & Topics
Have a Diabetes Mellitus Type II claim or denial?
Four fields. A VA-accredited claims agent reviews it and responds within 3–5 business days. Contingent fees apply only to awarded past-due benefits on appeals — never on initial claims.
Requesting a consultation does not create representation and is not a guarantee of any outcome. Representation begins only after a written fee agreement and VA Form 21-22a are signed.
Educational content only — not legal advice and not medical advice. Rating criteria on this page are summarized in plain English from 38 CFR Part 4; consult VA.gov or the current Code of Federal Regulations for official criteria. This page provides general education about how the VA rates this condition; it is not individualized advice, does not establish a representation relationship, and should not be used to self-diagnose, self-treat, or decide a course of action without speaking to a qualified clinician and a VA-accredited representative. Outcomes depend on each veteran's individual facts, evidence, and the adjudicator's judgment; no specific rating, effective date, or other result is guaranteed. Oakridge Claims is a private business and is not affiliated with, endorsed by, or operated by the US Department of Veterans Affairs.
Related Conditions
Diabetic Peripheral Neuropathy
Nerve damage secondary to diabetes — most common diabetic complication; rated per nerve under § 4.124a.
Diabetic Nephropathy (Kidney Disease)
Kidney dysfunction secondary to diabetes; rated under the Renal Dysfunction formula.
Peripheral Neuropathy
Mild / moderate / severe paralysis under the nerve schedule.
Coronary Artery Disease (Ischemic Heart Disease)
METs-based rating; Agent Orange presumptive.
Erectile Dysfunction
0% schedular + Special Monthly Compensation (SMC-K) for loss of use.