Diabetes, thyroid and adrenal ratings

Diabetes mellitus: what each level needs

38 CFR 4.119, DC 7913

• 10%: manageable by restricted diet only.
• 20%: daily insulin and restricted diet, or an oral hypoglycemic agent (diabetes pills) and restricted diet.
• 40%: insulin, restricted diet, and regulation of activities (avoiding strenuous work and recreation).
• 60%: the 40% criteria, plus ketoacidosis or hypoglycemic reactions needing one or two hospital stays a year or twice-monthly visits to a diabetic care provider, plus complications that would not be compensable on their own.
• 100%: more than one daily insulin injection, restricted diet, regulation of activities, plus three or more hospital stays a year or weekly visits, plus either progressive weight and strength loss or complications that would be compensable on their own.

“Regulation of activities” starts at 40%, not 20%.

Diabetes complications are rated separately

38 CFR 4.119, DC 7913, Note 1

Complications that would be compensable on their own, such as nerve, kidney, eye or heart problems, are rated separately, unless they are already part of the 100% criteria. Complications that rate 0% are treated as part of the diabetes.

Each one is a claim with its own evidence. For nerve levels, see Nerve damage VA ratings. For kidney levels, see kidney conditions VA ratings. For heart levels, see heart conditions VA ratings. See secondary conditions, hypertension and vision and eye benefits.

What VA’s diabetes exam form asks about

VA Diabetes Mellitus DBQ (updated 2026-03-16)

The form has a section on complications. It asks the examiner to check three lists:

• Complications attributed to diabetes: peripheral neuropathy, nephropathy (kidney disease) and retinopathy (eye disease).
• Other conditions the form lists: erectile dysfunction, female sexual arousal disorder, cardiac conditions, peripheral vascular disease, stroke, skin conditions, eye conditions other than retinopathy, and hypertension. For hypertension, the form ties it to diabetic kidney disease.
• Conditions aggravated by diabetes: the form lists conditions such as hypertension and other kidney conditions, and has a box for “Other permanently aggravated condition(s).” It defines aggravation as any increase in severity that would not have occurred but for the diabetes.

Hyperthyroidism (including Graves’ disease)

38 CFR 4.119, DC 7900

• 30% for six months after the initial diagnosis.
• After that, VA rates the residuals under the code for the body system they affect.
• Heart disease from hyperthyroidism is rated separately (DC 7008). Eye involvement from Graves’ disease is rated separately under the eye codes.

Hypothyroidism

38 CFR 4.119, DC 7903

• 30% for hypothyroidism without myxedema, for six months after the initial diagnosis, then residuals are rated.
• 100% for hypothyroidism with myxedema (with cold intolerance, muscular weakness, cardiovascular involvement and mental disturbance). It continues six months after an examining physician finds the crisis stabilized, then residuals are rated.

Other thyroid and parathyroid codes, and diabetes insipidus

38 CFR 4.119

• DC 7901 and 7902 (enlarged thyroid): no percentage of their own. Symptoms are rated under the code that fits, and neck disfigurement under DC 7800.
• DC 7904 (hyperparathyroidism): 100% for six months after surgery, 60% for hypercalcemia, 10% for symptoms despite surgery or medication, 0% if no symptoms.
• DC 7905 (hypoparathyroidism): 100% for three months after diagnosis, then residuals.
• DC 7909 (diabetes insipidus): 30% for three months after diagnosis, then 10% for persistent polyuria or continuous hormone therapy.

Cushing’s syndrome

38 CFR 4.119, DC 7907

• 30%: striae, obesity, moon face, glucose intolerance and vascular fragility.
• 60%: proximal arm or leg muscle wasting that limits rising from a squat, climbing stairs, rising from a deep chair unassisted, or raising the arms.
• 100%: active, progressive disease with osteoporosis, hypertension, and that muscle wasting.

These levels continue for six months after the initial diagnosis, then residuals are rated.

Addison’s disease

38 CFR 4.119, DC 7911

• 20%: one or two crises in the past year, or two to four episodes, or weakness and fatigability, or corticosteroid therapy needed for control.
• 40%: three crises in the past year, or five or more episodes.
• 60%: four or more crises in the past year.

A crisis is a rapid onset of peripheral vascular collapse with acute low blood pressure and shock. An episode is less acute and has no vascular collapse.

Obesity and metabolic syndrome

VA General Counsel opinion 1-2017; Walsh v. Wilkie

• Obesity by itself is not a disability for VA compensation and has no rating, not even 0%.
• It can be an intermediate step: a service-connected condition leads to weight gain, and the weight gain leads to another condition such as sleep apnea, hypertension or diabetes. A doctor’s opinion has to trace each link.
• I found no diagnostic code for metabolic syndrome. Its parts are rated under their own codes.

See mental health secondaries and sleep apnea.

ED is rated 0%, and it can still pay

38 CFR 4.115b, DC 7522; SMC-K

• DC 7522 allows 0% only, with or without penile deformity. There are no 10%, 20% or 40% levels.
• The code tells VA to review for special monthly compensation for loss of use of a creative organ (SMC-K).
• SMC-K is $139.87 a month for 2026 (effective December 1, 2025), added to your basic compensation.

See special monthly compensation.

What your rating depends on

Drawn from the criteria above

• Diabetes: what treatment you are prescribed (diet, pills, insulin), whether activities are restricted, and any hospital stays or care-provider visits.
• Thyroid: the diagnosis date, since the 30% period runs six months from it, and what damage followed.
• Adrenal: a dated count of crises and episodes in the past year.

Agent Orange and this page

Your presumptive-conditions page

Type 2 diabetes and hypothyroidism are on the Agent Orange list on the presumptive-conditions page. A presumptive condition still has to be diagnosed and claimed, and then it is rated under the codes on this page.

What I could not verify

• The adrenal and thyroid levels come from eCFR and Cornell’s copy of 38 CFR 4.119. Both are unofficial, and the official text wins over me. The thyroid change date comes from a Board decision.
• I did not verify medical claims about symptoms, or about which conditions follow which. This page covers the rating criteria only.
• I found no VA code or rule for high cholesterol or for metabolic syndrome, and I did not search VA’s adjudication manual.
• Which complications are compensable depends on their own codes. I did not read each one here.
• The exam form lists above come from VA’s form dated 2026-03-16. VA updates its forms, so check the current one.