38 CFR Part 4 — 38 CFR § 4.115
Nephrolithiasis Ureterolithiasis Nephrocalcinosis
dc-7508-nephrolithiasis-ureterolithiasis-nephrocalcinosis
Genitourinary
Diagnostic code
7508
Why your DC matters: DC 7508 is the exact code the VA uses to rate this condition. It determines which symptoms unlock which percentage, what evidence the rater looks for, and which secondaries are most likely to be approved.
Last verified against 38 CFR (eCFR Part 4):
Rating criteria (38 CFR Part 4)
Diagnostic code 7508 — Nephrolithiasis Ureterolithiasis Nephrocalcinosis — is listed under 38 CFR § 4.115 in 38 CFR Part 4. The paragraphs below summarize how this code is used; the official schedule text controls exact percentages, formulas, and notes.
Schedule summary (educational, not a substitute for the regulation): Educational index row from the rating schedule naming convention; confirm exact diagnostic code, effective date, and criteria in the current eCFR Part 4.
Exact rating criteria: Open Part 4 in the eCFR (link under “Official source” below). Locate your diagnostic code number (7508) in the correct body-system subpart, or use Find in Page (Ctrl+F / ⌘F) for “7508”. Copy the verbatim rating table, including any parenthetical notes, exceptions, and cross-references, for the version of Part 4 that applies to your effective date.
Effective dates & which schedule version applies
Which diagnostic code, percentage, and effective date apply depends on the facts of your claim and the version of the rating schedule in force for the period being decided. Generally, VA applies the schedule in effect at the specified time under 38 U.S.C. § 5110 and implementing rules, subject to exceptions (e.g., protected ratings, liberalizing law changes—see regulation and VA manual policy as applicable).
For older claims, the **current** eCFR may not match the text that applied years ago. If your decision references a prior percentage or code, compare against the Part 4 text **as of** your claim’s relevant dates; historical Federal Register / CFR snapshots may be needed for precise comparison.
The “Last verified” date on this page is when we last checked this educational summary against the electronic CFR—not the date of any VA policy or your personal claim decision.
Notes for your claim
Evidence: Show that your diagnosis and severity match the factors the schedule names for DC 7508 (e.g., measurements, frequency, treatment, functional loss), with medical and lay evidence as appropriate.
C&P exams: Results should reflect the schedule’s requirements (correct joints measured, correct formulas). If the exam omits required findings, consider submitting records or requesting clarification.
If you disagree with the DC, percentage, or effective date, review the Part 4 text for your period and consider a supplemental claim or appeal with a VA-accredited representative.
This site does not provide legal advice.
Official source
38 CFR Part 4 (eCFR) — locate diagnostic code 7508 in the subpart for your body system (use Find in Page if needed).
Nephrolithiasis under DC 7508 has a clean two-tier schedule that hinges on recurrence + intervention. The 30% rating requires recurrent stones AND any of: lithotripsy, drug therapy, or invasive procedures. Veterans who pass one stone every year or two without intervention rate 10%; those with multiple lithotripsies or chronic medication for stone prevention should be at 30%. The play is establishing the recurrence pattern + treatment escalation in the chart.
Rating Tiers — What Each Percentage Requires
| Rating | What It Takes | Evidence That Supports It |
|---|---|---|
| 30% | Recurrent stone formation requiring one or more of: diet therapy, drug therapy, OR invasive/non-invasive procedures more than 2 times/year. | Imaging history showing multiple stone episodes; lithotripsy reports; chronic alkalinization or thiazide Rx for stone prevention. |
| 10% | Rated as for hydronephrosis (DC 7509) — recurrent stone formation requiring one or more of: diet therapy, drug therapy, or non-invasive procedures. | At least one stone episode + ongoing dietary modification or alkalinization. |
What Qualifies Under DC 7508?
Diagnosis of nephrolithiasis
Kidney stone disease confirmed by imaging (CT, ultrasound, KUB) or passed-stone analysis. Acute or chronic.
Recurrence + intervention drive tier
DC 7508 has two tiers:
- • 10% — Rated as hydronephrosis (DC 7509) baseline, with recurrence requiring diet, drug, or non-invasive procedures
- • 30% — Recurrent stones + diet + drug + invasive/non-invasive procedures 2+ times/year
Language Your Rater Needs to See
These are the exact (or near-exact) regulatory phrases that unlock specific tiers. If your DBQ or C&P report doesn't use this vocabulary, the rater may default to a lower percentage even when symptoms qualify.
“Invasive or non-invasive procedures more than two times per year”
Lithotripsies, ureteroscopies, stent placements all count. Two or more per year = 30%. Most veterans don't track this. Pull the procedure history.
“Recurrent stone formation requiring drug therapy”
Chronic Rx for stone prevention (potassium citrate, thiazide diuretic, allopurinol for uric acid stones) counts. Many veterans on these for years and still rated only 10%.
“Diet therapy or non-invasive procedures”
Lower threshold — even structured dietary protocols + occasional procedures qualify. Often skipped if veteran says 'I just drink more water.'
Evidence Checklist — Specific to This Condition
Urology evaluation + imaging history
CRITICALCT urograms, ultrasounds showing stones. Comprehensive history of stone events with dates.
Procedure log: every lithotripsy / ureteroscopy / stent
CRITICALProcedure reports for ESWL (lithotripsy), URS, percutaneous nephrolithotomy, stent placement. Count per year.
Stone-prevention medication record
IMPORTANTPotassium citrate, thiazide, allopurinol, magnesium oxide. Long-term Rx supports recurrence + intervention narrative.
24-hour urine collection + stone analysis
SUPPORTINGLab workup documenting metabolic cause (hypercalciuria, hyperuricosuria, etc.) and stone composition (calcium oxalate, uric acid, struvite).
C&P Exam Tips
Bring a chronological stone-event log
Each stone episode: date, where (kidney/ureter), how treated (passed/lithotripsy/URS), where treated.
Bring pharmacy printout of preventive Rx
Potassium citrate, thiazide, etc. show 'drug therapy' for 30% gate.
Don't say 'I just drink more water now'
Sounds like resolved condition. Describe the chronic risk and ongoing preventive measures.
Mention impact on work/duty
Stone passages cause severe pain + ER visits + missed work. Document this — supports TDIU consideration in severe cases.
Common Mistakes That Cost Veterans Points
Accepting 10% when 30% applies
If you've had 2+ lithotripsies in any 12-month period OR are on chronic stone-prevention drug therapy, you're at 30%.
Not counting stent placements as procedures
Ureteral stents (placed during ureteroscopy or for obstruction) count as invasive procedures.
Filing 'kidney stones' generically
Use 'nephrolithiasis (DC 7508)' to anchor the rating code.
Tactical Plays
⚡ Count every lithotripsy, URS, and stent — they ALL qualify
DC 7508 30% requires '2+ procedures per year.' Stent placements during procedures count. Many veterans had 2 stents placed during a single hospitalization and never realized that bumped them to 30%.
⚡ Chronic prevention Rx = automatic 30% path
Potassium citrate, thiazide diuretic, allopurinol for uric acid stones — all qualify as 'drug therapy.' If you've been on any for 6+ months, you're at 30% even with no procedures.
⚡ Audit for hydronephrosis secondary
Recurrent obstruction can chronically dilate the renal pelvis. DC 7509 rates separately. Get a renal ultrasound or CT urogram.
Secondary Conditions to File With This One
Hydronephrosis
MODERATEDC 7509
Recurrent obstruction from stones can cause chronic hydronephrosis, rated separately under DC 7509.
Chronic kidney disease
MODERATEDC 7530
Recurrent obstruction or infection can drive CKD; check eGFR trends.
Recurrent UTI / chronic pyelonephritis
MODERATEDC 7504
Stones predispose to chronic infection; rate under DC 7504.
Erectile dysfunction (medication-related)
SITUATIONALDC 7522
Some stone-prevention meds can cause ED; triggers SMC-K.
Compensation Scenarios
2026 rates (effective Dec 1, 2025, per va.gov)
10% — single, no dependents
Base rating
$180.42
TOTAL
$180.42/mo
One stone event + ongoing dietary modification or alkalinization.
30% — single, no dependents
Base rating
$552.47
TOTAL
$552.47/mo
2+ lithotripsies/year OR chronic stone-prevention drug therapy.
30% nephrolithiasis + 10% hydronephrosis
Base rating
$795.84
TOTAL
$795.84/mo
Combined 37% rounds to 40% if hydronephrosis secondary.
Note: Amounts are approximations rounded to nearest dollar. Actual comp varies with effective date, dependents (spouse, children, parents — each adds), Aid & Attendance, and additional disabilities. Combined ratings use VA Math (§ 4.25), not simple addition.
Key Definitions
💊What counts as 'Drug Therapy'?
Chronic medication for stone prevention — potassium citrate (alkalinization), thiazide diuretic (calcium stones), allopurinol (uric acid stones), magnesium oxide, etc. Topical/symptomatic Rx during a stone event doesn't count.
🌊What is Lithotripsy?
Extracorporeal shock wave lithotripsy (ESWL) — uses focused sound waves to break stones from outside the body. Counts as a non-invasive procedure for DC 7508.
❌Does passing a stone naturally count as a procedure?
No — only physician-performed interventions count (lithotripsy, ureteroscopy, stent, percutaneous nephrolithotomy). Spontaneous passage is a 'stone event,' not a procedure.
How to File Your Claim
Pull urology procedure history + imaging
List every lithotripsy, URS, stent, and PCNL with dates.
Pull pharmacy printout of stone-prevention Rx
Potassium citrate, thiazide, allopurinol — note duration of each.
File 21-526EZ specifying 'nephrolithiasis (DC 7508)'
List recurrence + intervention pattern in the claim narrative.
Submit 24-hour urine collection if available
Documents metabolic cause + supports chronic-disease narrative.
File hydronephrosis (DC 7509) as secondary if applicable
Recurrent obstruction → chronic dilation. Renal ultrasound or CT.
Typical Claim Timeline
File initial claim
Day 0–7: Submit VA Form 21-526EZ with all medical evidence on file
VA acknowledges claim
Week 1–2: Receive confirmation letter and claim tracking number
C&P examination scheduled
Month 1–3: VA contracts an exam vendor and sends you appointment notice
Attend C&P exam
Bring your full evidence package; describe symptoms on your worst days, not your best
Decision & rating notice
Month 3–6: Decision letter with rating percentage and effective date
First payment & retro back pay
Within 15 days of decision; retroactive to claim date (or effective date if earlier)
Timeline varies by case complexity and VA regional office workload. Some claims resolve faster; others take longer.
Important Considerations
2+ procedures per year = 30%
Most veterans don't track procedure count. Pull urology procedure logs — stents, lithotripsies, URS all count.
Chronic prevention Rx = automatic 30% path
Long-term potassium citrate, thiazide, allopurinol — all qualify as 'drug therapy' for the 30% gate.
Audit for hydronephrosis + CKD secondaries
Recurrent obstruction damages the kidney. Get current eGFR and renal imaging.
Related Tools & Resources
Frequently Asked Questions
How many stones do I need to pass to qualify for a rating?
Even one documented stone event with ongoing dietary or drug therapy qualifies for 10%. Multiple events + procedures or chronic Rx escalates to 30%.
Does occasional kidney stone pain qualify?
Acute stone events require ER visits and pain management; they're well-documented in records. Rating is based on recurrence + treatment intensity, not pain frequency alone.
What if I'm on a 'kidney diet' but no medications?
Structured dietary therapy alone supports 10%. If you've also had imaging showing recurrent stones, that anchors the rating.
Can I get a rating for a single stone that passed years ago?
Less likely if currently asymptomatic and no ongoing treatment. But if there's documented recurrence risk or chronic prevention regimen, rating may still apply.
Official Regulatory Source
Nephrolithiasis is rated under 38 CFR § 4.115b, DC 7508.
38 CFR § 4.115b — Genitourinary System (eCFR) →Scroll to DC 7508.
Next Steps
If your rating decision lists DC 7508, compare your current symptoms and documentation against the criteria above. Consider:
- Requesting a copy of your rating decision and C&P exam report from the VA
- Gathering all relevant medical records (VA and private providers)
- Documenting functional limitations and how they impact work and daily activities
- Obtaining a nexus letter if needed to establish or strengthen service connection
- Filing for secondary conditions that may be related to this primary condition
- Contacting a VA-accredited VSO, claims agent, or attorney to review your file
This is general educational information only — not legal or medical advice.
Also: DC code lookup (tools) lists the same index in a compact layout.
Source: 38 CFR Part 4, Diagnostic Code 7508 • va.gov
⚠️ Important Disclaimer
This page provides general educational information only based on public VA regulations (38 CFR) and va.gov resources. It is not legal, medical, or claims assistance. Ratings and service connections are decided case-by-case by the VA based on the individual veteran’s evidence. We do not prepare claims, generate documents, or provide personalized advice. Always consult a VA-accredited Veterans Service Organization (VSO), attorney, or your physician for help with your specific situation. Verify the latest rules on va.gov.