Understanding VA Disability Ratings for Diabetes
Posted in Uncategorized on November 14, 2017
Diabetes mellitus – also known as “Type II” or “adult onset” diabetes – is a growing health issue among U.S. veterans. In fact, the U.S. Department of Veterans Affairs (VA) recently listed type II diabetes as the number 9 most-prevalent disability claim among compensation recipients, with more than 431,000 veterans receiving some level of disability support while suffering from the condition.
VA Disability Ratings for Diabetes
Like other VA disabilities, to receive disability compensation, a veteran’s diabetes type II diagnosis must be proven to be connected to his or her service in the Armed Forces, via a letter – or “nexus” – from an expert or physician citing that the condition is “more likely than not” connected to military service. If the diabetes is diagnosed while on active duty, or within a year of his or her Expiration of Term of Service (ETS), it may be easier to make the connection.
Personal records may be sufficient to determine the diagnosis of diabetes; otherwise, It may require a VA examination. It is important, when making a claim, that a veteran provide detailed records – or “evidence” – of the ongoing condition, symptoms, required treatments, hospitalizations and physical complications related to the diabetes. You will also be required to include dates and details on your service periods, as they relate to your diagnosis.
The one major exception to having to prove that diabetes mellitus is service-connected is if the veteran served in Vietnam and was exposed to Agent Orange. In this case, the VA automatically presumes an existing connection between this service and the diagnosis. To be eligible for diabetes mellitus disability benefits in this situation, the veteran must have physically served or visited the Republic of Vietnam between January 9, 1962 and May 7, 1975 (including service in the waters offshore, coming to port, and disembarking) and have been discharged under conditions other than dishonorable.
If you are a in-country Vietnam veteran diagnosed with diabetes mellitus and have been denied a disability rating in the past (especially before new regulations went into place in May 2011), it may be worth your time to reapply at your local VA office. You may even be eligible for retroactive awards of your benefits. Additionally, if your diabetic condition has worsened since you first received your rating, you can visit your local VA office and apply for a reevaluation. If you are the spouse of an in-country Vietnam veteran who died from complications of diabetes type II, you may be you may be eligible for Dependents and Indemnity Compensation (DIC) or Parents' DIC.
Once your diabetes mellitus has been categorized as “service-connected,” the VA will then look at several factors to determine the percentage rating – and monetary benefit – you should be able to receive. There are currently four levels of ratings for service-connected diabetes mellitus; your monthly payment increases with each level, and once you are past a 10% rating, it also considers any dependents:
- Level 1: Diabetes is manageable by a restricted diet only. Rating is 10%
- Level 2: Veteran requires insulin and restricted diet, OR an oral hypoglycemic agent and restricted diet. Rating is 20%
- Level 3: Diabetic condition requires insulin AND restricted diet AND regulation of activities (being directed by doctor to not do certain tasks). Rating is 40%
- Level 4: Veteran requires insulin AND restricted diet AND regulation of activities, AND has a record of episodes of ketoacidosis or hypoglycemic reactions requiring one or two hospitalizations per year, or twice-a-month visits to a diabetic care provider. This diagnosis may include physical complications that would not be compensable if separately evaluated, such as diabetic foot problems, fatigue, hypertension, early stages of kidney conditions, peripheral neuropathy, retinopathy or weight problems. Rating is 60%
A good starting point is to contact your local VA office and make an appointment to discuss your potential claim. You may then either be scheduled with a VA medical professional or a private contractor to conduct your examination. You can also download a Disability Benefits Questionnaire (DBQ) to capture essential information for evaluating disability compensation and/or pension claims (diabetes is included in the “Endocrinological” section).