A is a management schedule, not a lecture about willpower. The Veterans Benefits Administration maps your treatment requirements into a percentage under in . That tracks how Congress wants the schedule to express under .
Here is the core idea. Prove the diagnosis. Prove service connection through direct service, presumptive exposure, or link. Then show which rung of the DC 7913 ladder your record matches today. Complications such as neuropathy or kidney disease may rate on their own under . This page stays close to the regulation text and official VA guidance so you can build a file that matches what raters actually read.
This mirrors the decision path in . Use it next to your treatment notes so you see gaps before VA does.
Start at the bottom of management intensity and move up only when your record actually matches the next tier in 38 CFR § 4.119, DC 7913. This is the clean version of the logic tree raters use.
10%
No daily hypoglycemic medication required in the schedule language.
20%
Oral hypoglycemic and diet, or one or more daily insulin injections and diet.
40%
Insulin, restricted diet, and regulation of activities (avoid strenuous work and recreation per the schedule).
60%
Ketoacidosis or hypoglycemic episodes with one to two hospitalizations per year or twice-monthly diabetic-care visits, plus noncompensable complications as written in the table.
100%
More than one daily insulin injection, diet, regulation of activities, weekly visits or three or more hospitalizations per year, plus progressive weight and strength loss or compensable complications per the table.
10%. Diet alone keeps you on the first rung when the record shows management without daily hypoglycemic medication under the schedule.
20%. Add either oral medication plus diet or insulin plus diet. The "or" in the table matters. Read the actual criteria alongside your prescription list.
40%. Insulin, restricted diet, and regulation of activities. That phrase means medically directed avoidance of strenuous occupational and recreational activities in the regulation. Your strongest evidence is usually a clear provider order in the chart, not a generic statement that you feel tired.
60% and 100%. Same base requirements as 40%, plus the crisis-and-visit pattern spelled out in the table, with different thresholds for hospitalizations or diabetic-care visits and what happens with separately compensable complications. This is the part most people miss: the higher tiers are not "more symptomatic diabetes" in the abstract. They are specific frequency rules tied to ketoacidosis or hypoglycemic reactions and follow-up intensity.
Clinicians often use A1C, fasting glucose, oral glucose tolerance, or random glucose with symptoms. Those tools are summarized for patients by . VA will still decide service connection and rating from your actual treatment records and exams, not from a textbook paragraph.
After diabetes is established, says VA should not order a glucose tolerance test solely for rating purposes. That keeps the focus on real-world management already in the chart.
The rating percentage does not float up because an A1C number scares you. It moves when the record shows the management and visit pattern in . Bring endocrinology notes, hospital discharge summaries, and primary-care medication lists so the rater can see the same story you see.
Buddy letters still help for observable facts such as witnessed hypoglycemic episodes or job accommodations. Pair them with when you submit lay evidence.
| Percentage | Criteria |
|---|---|
| 100% | Requiring more than one daily injection of insulin, restricted diet, and 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. |
| 60% | Requiring one or more daily injection of insulin, restricted diet, and regulation of activities with episodes of ketoacidosis or hypoglycemic reactions requiring one or two hospitalizations per year or twice a month visits to a diabetic care provider, plus complications that would not be compensable if separately evaluated. |
| 40% | Requiring one or more daily injection of insulin, restricted diet, and regulation of activities. |
| 20% | Requiring one or more daily injection of insulin and restricted diet, or; oral hypoglycemic agent and restricted diet. |
| 10% | Manageable by restricted diet only. |
Source: .
Direct claims follow the usual elements in : current disability, in-service onset or aggravation, and medical nexus when needed. In-service treatment entries, glucose checks, or formal diagnosis during service can anchor the timeline when the record supports them.
If you are also tracking toxic exposure, read the PACT Act guide alongside this page so presumptive rules and filing lanes stay straight.
VA lists Type 2 diabetes mellitus as presumptive for veterans with qualifying exposure. Location and date rules expanded under the . The short VA FAQ on presumptive Type 2 is another useful checkpoint:
Presumptive service connection can remove one fight from the claim. You still need a real diagnosis in the record for a rating. The presumption answers causation for eligible veterans, not whether labs exist.
When diabetes is caused or worsened by a service-connected condition, VA can grant secondary service connection under . Typical fact patterns include weight gain and reduced activity after orthopedic limits, certain medication effects, or other pathways your clinician actually supports. A one-sentence nexus without reasoning is weak. A short mechanism paragraph tied to your STRs and post-service treatment is stronger.
If sleep fragmentation, apnea, or mental health conditions overlap with your metabolic story, keep each claim's mechanism clean. The sleep apnea guide and depression guide explain those schedules on their own terms. For leg pain and movement issues that sometimes travel with neuropathy workups, see the restless leg syndrome guide.
tells raters to evaluate compensable complications separately unless those complications are part of the evidence supporting a 100% evaluation under the diabetes code itself. Noncompensable complications stay bundled into the DC 7913 analysis.
Peripheral neuropathy, nephropathy, retinopathy, and other residuals can add separate percentages when the evidence supports them. After you know each standalone rating, run the combined result through the VA disability calculator so you see how bilateral factors and combined tables change take-home pay.
Diagnosis letter or endocrine note with date of diagnosis.
Medication list that matches pharmacy fills when possible.
Hospital records for DKA or severe hypoglycemia if you rely on higher-tier frequency rules.
Work restrictions or activity limits documented as medical orders, not only HR paperwork.
Lay statements on for what others observe on bad days.
Start with official filing guidance for . Upload evidence in one coherent packet when you can. If you add secondary conditions later, keep each theory labeled so the rater does not merge facts that belong in different decisions.
This helps you avoid guesswork at the exam: your narrative already matches the medication list and the crisis dates in the same record.
If diabetes plus other service-connected disabilities block , explore TDIU even when your schedular combined rating is below 100%. Rules on income and eligibility still apply. The dedicated TDIU page walks through the standard in more detail.
100%: $3,938.58 / month
60%: $1,435.02 / month
40%: $795.84 / month
20%: $356.66 / month
10%: $180.42 / month
Source: .
A better month does not erase a protected rating by itself. Future reductions still have to follow VA reexamination and stabilization rules in Part 3 regulations summarized on .