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View Full Enhanced Guide →38 CFR Part 4 — 38 CFR § 4.119
Diabetes Mellitus
dc-7913-diabetes-mellitus
Endocrine
Diagnostic code
7913
Why your DC matters: DC 7913 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 7913 — Diabetes Mellitus — covers Type 1 and Type 2 diabetes, listed under 38 CFR § 4.119.
Diabetes can be rated at 10%, 20%, 40%, 60%, or 100% based primarily on treatment requirements (diet only vs. insulin) and complications. Most veterans receive 20% for oral medication or 100% for insulin use that is not well-controlled.
For a comprehensive guide with visual compensation breakdowns, secondary conditions, evidence strategies, and claim timelines, visit the detailed guide page for this condition.
Exact rating criteria: 10% for controlled by diet only, 20% for requiring insulin or oral hypoglycemic agent, 40% for requiring insulin and restricted diet or oral medication with significant complications, 60% for requiring insulin with complications requiring intensive management, 100% for requiring more than one daily insulin injection and having poorly controlled diabetes with frequent hypoglycemic reactions or ketoacidosis.
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 7913 (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 7913 in the subpart for your body system (use Find in Page if needed).
Diabetes ratings under DC 7913 climb with treatment requirements, not blood sugar numbers. The leap from 20% to 40% is the single biggest unlock — it requires 'regulation of activities,' which means a documented medical restriction on strenuous activity. Most veterans miss this because their endocrinologist never writes it down.
Rating Tiers — What Each Percentage Requires
| Rating | What It Takes | Evidence That Supports It |
|---|---|---|
| 100% | Insulin (more than one daily injection) + restricted diet + regulation of activities, with episodes of ketoacidosis or hypoglycemic reactions requiring 3+ hospitalizations/year or weekly diabetic care visits, plus complications. | Hospital admission records, endocrinologist visit logs, complications rated separately under their own DCs (neuropathy, nephropathy, retinopathy). |
| 60% | Insulin + restricted diet + regulation of activities, with episodes of ketoacidosis/hypoglycemia requiring 1–2 hospitalizations/year or twice-monthly diabetic care visits. | Discharge summaries showing DKA or severe hypoglycemia; endo notes documenting twice-monthly follow-up. |
| 40% | Insulin + restricted diet + regulation of activities (physician-prescribed avoidance of strenuous activity). | Insulin Rx, written diet plan, and — critically — a provider note stating activity must be limited to avoid hypoglycemia. |
| 20% | Insulin and restricted diet, OR oral hypoglycemic agent and restricted diet. | Metformin/insulin prescription history plus dietary counseling notes. |
| 10% | Manageable by restricted diet only. | A1C labs with diagnosis and dietary management plan; no oral meds or insulin required. |
What Qualifies as 'Diabetes Mellitus' Under DC 7913?
Diagnosis of diabetes mellitus
Type 1 or Type 2, confirmed by laboratory evidence (A1C ≥ 6.5%, fasting glucose ≥ 126 mg/dL, or random glucose ≥ 200 mg/dL with symptoms).
Treatment regimen documents severity
Rating tier depends on TREATMENT requirements, not blood sugar numbers alone. The full schedule reads:
- • Diet only → 10%
- • Diet + oral hypoglycemic OR insulin → 20%
- • Diet + insulin + regulation of activities → 40%
- • Above + episodes of DKA/hypoglycemia requiring 1–2 hospitalizations/yr → 60%
- • Above + 3+ hospitalizations/yr or weekly diabetic visits + complications → 100%
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.
“Regulation of activities required to avoid hypoglycemia”
This exact phrase (or 'avoidance of strenuous occupational and recreational activities') is the gatekeeper to 40%. If your endo note just says 'diet, exercise, insulin' you stay at 20%. Ask your provider to document the activity restriction explicitly in the chart.
“Episodes of ketoacidosis (DKA) requiring hospitalization”
ER visits for hypoglycemia or DKA must be counted by frequency per year. Pull discharge summaries — the rater can't credit an episode that isn't in writing.
“Insulin-dependent / requires insulin”
'Insulin-dependent' is shorthand the rater uses to confirm 20% floor and to gate 40%+. Make sure the DBQ box is checked, not just mentioned in the narrative.
Evidence Checklist — Specific to This Condition
Endocrinology DBQ (Diabetes Mellitus)
CRITICALHave your endocrinologist complete the diabetes DBQ. Confirm boxes for insulin requirement, restricted diet, and regulation of activities are all checked when they apply.
A1C lab series
CRITICALAt least one diagnostic A1C ≥ 6.5% and several follow-up labs showing ongoing management.
Prescription history
IMPORTANTPharmacy printout showing insulin (and number of daily injections), or oral hypoglycemic agents, or both.
Activity restriction documentation
CRITICALProvider note explicitly stating you must avoid strenuous occupational/recreational activity to prevent hypoglycemia. Without this, you cap at 20%.
Hospitalization records
IMPORTANTDischarge summaries for any DKA or severe hypoglycemia ER visits. Each one helps qualify for 60% or 100%.
Complication workup
IMPORTANTRecent eye exam (retinopathy), urine microalbumin / eGFR (nephropathy), monofilament/EMG (peripheral neuropathy). Each complication is a separate, additional rating.
C&P Exam Tips
Bring your current insulin schedule on paper
Examiners frequently undercount injections per day. Hand them a list: long-acting AM, mealtime rapid-acting × 3, correction doses — that's more than one daily injection, which matters at 40% and 100%.
Describe activity limits in concrete terms
Don't say 'I try to be careful.' Say 'My doctor told me not to do yardwork in the heat or lift heavy because I dropped to 47 mg/dL last summer and went to the ER.' Concrete + medically-driven = regulation of activities.
Do not minimize hypoglycemic episodes
'I get low sometimes but I just eat candy' reads as well-controlled. Describe symptoms (sweating, confusion, near-falls), frequency, and whether you've ever needed glucagon or ER care.
Bring complications to the exam
If you have tingling feet, blurry vision, or proteinuria, raise them. Each complication can be filed and rated separately under its own DC (8520 sciatic neuropathy, 6080 vision, 7530s kidney).
Common Mistakes That Cost Veterans Points
Settling for 20% when 40% is available
You're insulin + diet but your records don't say 'regulation of activities.' Ask your endo to add that language at your next visit, then file a claim for increase.
Not filing complications as separate claims
Diabetic peripheral neuropathy (DC 8520-series), retinopathy, and kidney disease are rated separately on top of the diabetes rating. Each can add 10–40%.
Missing presumptive service connection
Vietnam-era veterans with Agent Orange exposure and Camp Lejeune veterans get presumptive service connection for Type 2 diabetes. No nexus letter needed — just exposure proof and the diagnosis.
Tactical Plays
⚡ Agent Orange / Camp Lejeune = presumptive grant
If you set foot in Vietnam (Jan 1962 – May 1975), served in certain Korean DMZ units, or were at Camp Lejeune (Aug 1953 – Dec 1987) for 30+ days, Type 2 diabetes is presumptively service-connected. File with DD-214 showing exposure and current diabetes diagnosis — no nexus letter required.
⚡ ED + SMC-K is automatic if diabetes is service-connected
Diabetes-induced erectile dysfunction qualifies for Special Monthly Compensation (SMC-K) at ~$132/mo on top of your regular comp — even though the ED rating itself is 0%. File the ED claim as secondary to diabetes, lose no penny in 'doubt,' gain ~$1,584/year.
⚡ Stack the neuropathy ratings
Each affected extremity is rated separately. Mild bilateral lower neuropathy = two 10% ratings (combined ~19%). Moderate = two 20%. These stack on top of the diabetes rating and quickly push combined ratings over 70%.
Secondary Conditions to File With This One
Peripheral neuropathy (lower extremities)
STRONGDC 8520
Direct diabetic complication. Each leg is rated separately (0/10/20/40/60/80% depending on severity).
Peripheral neuropathy (upper extremities)
MODERATEDC 8515
Less common but well-documented. Median, ulnar, radial nerves each ratable separately.
Diabetic retinopathy
STRONGDC 6006
Annual dilated eye exam should document. Rated on visual acuity loss.
Diabetic nephropathy
MODERATEDC 7541
Proteinuria or reduced eGFR. Often missed because labs aren't reviewed.
Erectile dysfunction
STRONGDC 7522
Vascular + neuropathic effects of diabetes. 0% rating but unlocks SMC-K (~$132/mo extra).
Hypertension
MODERATEDC 7101
Often co-occurs. Easier to grant as secondary if diabetes was service-connected first.
Compensation Scenarios
2026 rates (effective Dec 1, 2025, per va.gov)
10% — single, no dependents
Base rating
$180.42
TOTAL
$180.42/mo
Diet-controlled diabetes only.
20% — single, no dependents
Base rating
$356.66
TOTAL
$356.66/mo
Diet + oral hypoglycemic OR insulin.
40% — single, no dependents
Base rating
$795.84
TOTAL
$795.84/mo
Diet + insulin + regulation of activities.
60% — single, no dependents
Base rating
$1,435.02
TOTAL
$1,435.02/mo
Above + 1–2 hospitalizations/yr for DKA or severe hypoglycemia.
100% — single, no dependents
Base rating
$3,938.58
TOTAL
$3,938.58/mo
Insulin + regulation + 3+ hospitalizations/yr + complications.
100% with spouse + 1 child
Base rating
$3,938.58
Dependents (spouse + 1 child)
+$380.41
TOTAL
$4,318.99/mo
Catastrophic-tier diabetes with full family.
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 is 'Regulation of Activities'?
A physician-prescribed restriction on strenuous occupational and recreational activity to prevent hypoglycemia. This phrase (or equivalent) must appear in your chart for a 40%+ rating — without it, you cap at 20%.
⚠️What is DKA?
Diabetic ketoacidosis — an acute, life-threatening complication of diabetes marked by high blood ketones, dehydration, and acidosis. Hospitalization for DKA is a 60%/100% rating driver.
📜What is 'Presumptive Service Connection'?
VA accepts service connection without a nexus letter for certain exposure/diagnosis pairs. Vietnam-era Agent Orange and Camp Lejeune contaminated water both presume Type 2 diabetes — file with proof of exposure + current diagnosis.
How to File Your Claim
File VA Form 21-526EZ
List 'diabetes mellitus, type [1/2]' and any complications (neuropathy, retinopathy, nephropathy) separately. Each complication is its own rating, not a sub-issue.
Submit endocrinology DBQ + A1C trend + Rx history
Have your endocrinologist complete the diabetes DBQ. Critical boxes: insulin requirement, restricted diet, AND regulation of activities. Attach pharmacy printout showing insulin schedule.
Establish exposure for presumptive service connection
If Vietnam, Korean DMZ, Thailand, or Camp Lejeune service applies, attach DD-214 and any unit records. No nexus letter required for presumptive grants.
File complications as separate claims
Peripheral neuropathy (DC 8520, each leg), diabetic retinopathy (DC 6006), nephropathy (DC 7541), and ED (DC 7522 → SMC-K) should each be their own line on the 526EZ.
Work with a VSO before filing for increase
If you already have a 20% rating but qualify for 40%, an experienced VSO ensures the 'regulation of activities' language is in the record before the new exam.
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
Get 'regulation of activities' in writing
Without that phrase (or equivalent) in your endocrinologist's note, you cap at 20% even on insulin. Ask your provider to chart the activity restriction at your next visit.
File every complication separately
Diabetic neuropathy, retinopathy, nephropathy, and ED are rated on top of the diabetes rating — not absorbed into it. Veterans regularly leave 30–60% on the table by not filing them.
Presumptive paths skip the nexus
Vietnam-era veterans and Camp Lejeune veterans get presumptive service connection. No nexus letter, no in-service onset proof — just DD-214 + current diagnosis.
ED secondary unlocks SMC-K (~$140/mo)
Diabetic ED is a well-accepted secondary claim. Even at a 0% rating, it triggers SMC-K and adds about $1,678/year to your compensation.
Related Tools & Resources
Frequently Asked Questions
What's the difference between Type 1 and Type 2 for VA rating purposes?
Both are rated under DC 7913 with the same tier structure. The presumption rules differ: Agent Orange and Camp Lejeune presumptions apply only to Type 2. Type 1 typically requires direct service connection evidence.
Do I need to be on insulin for a 40% rating?
Yes — DC 7913 requires insulin + restricted diet + regulation of activities for 40%. Oral hypoglycemic agents alone cap at 20%. The treatment regimen, not blood sugar, drives the rating.
Can I get a rating if my diabetes is well-controlled?
Yes. Ratings reflect the treatment required, not current control. A diet-only diabetic gets 10%; an insulin-dependent diabetic with controlled blood sugar still gets 20–40% based on the regimen required.
What if my hospitalizations are for hypoglycemia, not DKA?
Both count toward the 60% (1–2/yr) and 100% (3+/yr) tiers. The schedule says 'episodes of ketoacidosis or hypoglycemic reactions' — either qualifies.
Should I file Type 2 diabetes separately from PTSD-related weight gain?
Type 2 diabetes can be filed as secondary to PTSD if your medications (atypical antipsychotics like olanzapine, quetiapine) caused metabolic syndrome. This is a recognized secondary pathway when documented.
Official Regulatory Source
Diabetes mellitus is rated under 38 CFR § 4.119, Diagnostic Code 7913.
38 CFR § 4.119 — Endocrine System (eCFR) →Scroll to Diagnostic Code 7913 for the full rating schedule.
⚠️ Verify with a VSO
Diabetes type 1 is rated under the same code (DC 7913) but presumption rules differ. Verify exposure-based presumptions with a VSO if filing under PACT Act or Camp Lejeune.
Next Steps
If your rating decision lists DC 7913, 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 7913 • 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.