VA diabetes rating for type 1 and type 2 diabetes

Diabetes is rated on how much it takes to manage, not on how high the numbers are. The tiers are short and the first two are easy. The third has a phrase in it that the VA reads narrowly, and complications of diabetes can be rated on their own when they reach a compensable level.

Last reviewed October 2026 · Not legal advice, VA.gov always controls

VA rates service-connected type 1 and type 2 diabetes under the same code, diagnostic code (DC) 7913: 10% when managed by restricted diet only, 20% with insulin or an oral medicine plus diet, and 40%, 60% or 100% when insulin, diet and medically required regulation of activities are all needed, with more criteria at each higher level. Whether diabetes is service connected is a separate question (38 CFR § 4.119).

The tiers

A veteran whose diabetes is managed with an oral agent such as metformin, or with insulin, plus a restricted diet meets the 20% tier. Getting to 40% requires all three of insulin, diet, and regulation of activities, and that last element has to be shown by medical evidence.

Service connection: the Agent Orange presumption

Type 2 diabetes has been on the herbicide presumptive list since 2001. Veterans with qualifying exposure, Vietnam service between January 9, 1962 and May 7, 1975 (including the inland waterways and, since the Blue Water Navy Act of 2019, offshore within 12 nautical miles under 38 U.S.C. § 1116A), the Korean DMZ from September 1, 1967 to August 31, 1971 under 38 U.S.C. § 1116B (the statute's 1967 start date controls over the April 1968 date still printed in § 3.307(a)(6)(iv)), any US or Royal Thai base in Thailand from January 9, 1962 to June 30, 1976 under the PACT Act, and the other locations in 38 U.S.C. § 1116(d) and § 3.307(a)(6), are presumed service connected for type 2 diabetes, which is on the § 3.309(e) list, without a medical nexus opinion, as long as it has reached at least 10% and the presumption is not rebutted. The claim still needs a diagnosis and evidence of the qualifying service. The presumptive conditions guide explains the mechanics and how to reopen an old denial.

Outside the presumption, diabetes is claimed directly through in-service diagnosis or elevated glucose in the service treatment records, through the one-year chronic-disease presumption in § 3.309(a) if it reached a compensable degree within a year of separation, or as secondary to another service-connected condition: medications (some antipsychotics and long-term corticosteroids), pancreatic conditions, or, with a supporting opinion, conditions that drove weight gain. Note (2) to the code says that once diabetes is conclusively diagnosed, the VA will not order a glucose tolerance test just for rating purposes; the diagnosis in your record is enough.

The complications

Note (1) to DC 7913 says to evaluate compensable complications of diabetes separately unless they are being used to support the 100% tier. Non-compensable complications are considered part of the diabetic process. So a complication that is service connected as part of the diabetes and reaches a compensable level gets its own rating, which combines with the diabetes rating. Common ones include:

• Peripheral neuropathy in each extremity, rated under the peripheral nerve codes by degree of incomplete or complete paralysis (for the sciatic nerve under DC 8520: mild 10, moderate 20, moderately severe 40, severe 60, and complete 80%; some other nerve codes have fewer steps). Each leg gets its own rating. When both legs have a compensable rating, § 4.26 combines the ratings for both legs (along with any other compensable disabilities of either leg) and adds 10% of that value, the bilateral factor, before combining the result with the remaining ratings. When the involvement is wholly sensory, § 4.124a limits the rating to mild or, at most, moderate. See how the VA rates nerve damage.
• Erectile dysfunction, rated 0% under DC 7522, which directs a review for SMC-K, a flat monthly amount paid on top of the combined rating.
• Diabetic nephropathy (kidney disease), DC 7541, rated as renal dysfunction under § 4.115a, with ratings from 0% to 100% depending on kidney function and whether dialysis is needed.
• Diabetic retinopathy and cataracts, under the eye codes in § 4.79 (DC 6040 and DC 6027).
• Hypertension and coronary artery disease, under § 4.104; heart disease is rated on the METs workload that brings on symptoms and can reach 60% or 100%. The diabetes DBQ lists hypertension as a complication only when diabetic kidney disease is present, and asks separately whether diabetes has aggravated existing hypertension. That is the form's layout, not a limit on the claim: hypertension secondary to diabetes can still be claimed with a medical opinion. See how the VA rates hypertension.
• Stroke residuals, peripheral vascular disease, skin conditions, gastroparesis, and amputations, each under its own code.

Each complication needs its own diagnosis and a medical finding that it is attributable to the diabetes. The diabetes DBQ lists peripheral neuropathy, nephropathy, and retinopathy as recognized complications for the examiner to check off; for heart conditions, peripheral vascular disease, and the other secondary complications, it asks whether each is at least as likely as not the result of the diabetes. List each complication as its own claimed condition: "peripheral neuropathy, left lower extremity, secondary to diabetes mellitus."

The exam

The diabetes DBQ asks about your treatment regimen (diet, oral agents, insulin and how many injections), whether regulation of activities is required, episodes of ketoacidosis or hypoglycemia and the hospitalizations or provider visits they caused, and a checklist of complications. Bring your medication list, your A1C history, your endocrinology or primary care notes, and a list of every complication with the specialist who diagnosed it. If the examiner marks "no" on regulation of activities and your provider has in fact restricted you, a letter from that provider is the evidence to submit with the claim or on appeal. Read Preparing for a C&P exam for the general approach.

The checklist

1. A diagnosis of diabetes with the date and the current treatment regimen.
2. For presumptive claims: proof of qualifying service location and dates.
3. Pharmacy records showing insulin or oral agents.
4. For the 40% tier and above: a provider's written statement that strenuous activity must be avoided to control the diabetes, and records of any hypoglycemic or ketoacidosis episodes with the hospitalizations or visits they required.
5. Each complication listed as a separate claimed condition, with its diagnosis and the specialist's attribution to diabetes.

VA and the Department of Defense also publish a joint clinical practice guideline for managing type 2 diabetes. It is guidance for treatment, not part of the rating schedule, so it does not set a disability percentage.

Sources

• 38 CFR § 4.119, Diagnostic Code 7913: the five diabetes tiers, the definition of regulation of activities, Note (1) on rating complications separately, and Note (2) on glucose tolerance tests.
• 38 CFR § 4.124a, Diagnostic Code 8520: the sciatic nerve levels used for leg neuropathy, and the mild-or-moderate limit when involvement is wholly sensory.
• 38 CFR § 4.25, Combined ratings table and § 4.26, Bilateral factor: how separate ratings combine, largest first, with the result rounded to the nearest 10 and values ending in 5 rounded up; and how, when each leg has a compensable rating, the ratings for both legs are combined, increased by 10% of that value, and treated as one rating.
• 38 CFR § 4.79, Schedule of ratings, eye, Diagnostic Code 6040 and § 4.115b, Diagnostic Code 7522: diabetic retinopathy, rated on visual impairment or incapacitating episodes, whichever gives the higher evaluation; and erectile dysfunction, rated 0% with a footnote directing review for special monthly compensation under § 3.350.
• 38 CFR § 3.307, Presumptive service connection and § 3.309(a) and (e), Disease subject to presumptive service connection: the Vietnam service dates, the one-year window for chronic diseases, the rule that type 2 diabetes from herbicide exposure can appear at any time after service, diabetes mellitus on the chronic-disease list, and type 2 diabetes on the herbicide list.
• 38 U.S.C. § 1116(d), § 1116A, and § 1116B, the herbicide presumptions: § 1116(d) lists the covered locations, including the PACT Act additions of Thailand, Laos, Cambodia, Guam, American Samoa, and Johnston Atoll; § 1116A covers waters not more than 12 nautical miles offshore of Vietnam from January 9, 1962 to May 7, 1975; and § 1116B covers the Korean DMZ from September 1, 1967 to August 31, 1971, which controls over the April 1, 1968 start date still in § 3.307(a)(6)(iv).
• VA, Agent Orange exposure and disability compensation: VA's list of the service locations and dates that carry a presumption of herbicide exposure.
• VA/DoD Clinical Practice Guideline, Management of Type 2 Diabetes Mellitus (2023): treatment guidance for clinicians, separate from the rating criteria.
• Board of Veterans' Appeals, Citation Nr. A25013074 (Feb. 12, 2025): applies Camacho v. Nicholson to require medical evidence of regulation of activities, and explains that each 40% element must be met.
• VA, Diabetes Mellitus Disability Benefits Questionnaire: the exam form's questions on treatment, regulation of activities, hospitalizations and provider visits, and complications.