◢ Internal • 38 CFR § 4.119, DC 7913
Diabetes Mellitus Type 2
Type 2 diabetes is rated by treatment intensity, not by blood sugar numbers. The schedule moves up as the regimen escalates: oral medication (10%), insulin or restricted diet (20%), insulin plus restricted diet plus regulation of activities (40%, 60%, 100%). Vietnam veterans and others with documented Agent Orange exposure get presumptive service connection.
Rating tiers under 38 CFR § 4.119, DC 7913
The VA rates diabetes mellitus type 2 at these schedular tiers. Most veterans land at the middle tiers — extreme tiers require correspondingly extreme documentation.
Manageable by restricted diet only.
Requires insulin and restricted diet, or oral hypoglycemic agent and restricted diet.
Requires insulin, restricted diet, and regulation of activities (avoidance of strenuous occupational and recreational activities).
Requires insulin, restricted diet, regulation of activities, with episodes of ketoacidosis or hypoglycemic reactions requiring 1-2 hospitalizations per year, or weekly visits to a diabetic care provider.
Requires more than one daily injection of insulin, restricted diet, regulation of activities, with episodes of ketoacidosis or hypoglycemic reactions requiring at least 3 hospitalizations per year, or weekly visits to a provider, plus progressive loss of weight and strength.
Presumptive service connection
Vietnam, Korean DMZ (1968-71), Thailand (1961-75), and other locations with Agent Orange use under 38 CFR § 3.307. PACT Act burn pit veterans for newer presumptive conditions.
Evidence the C&P examiner needs
Build the record before the exam. Walk in with documentation, walk out with a stronger rating.
- 01
Diabetes Mellitus DBQ documenting treatment regimen
- 02
Endocrinologist or primary-care notes confirming insulin or oral hypoglycemic prescription
- 03
Restricted diet documentation (in clinical notes)
- 04
For Vietnam veterans: DD-214 with Vietnam service dates
- 05
For other presumptive theaters: documentation of Agent Orange or burn pit exposure under PACT Act provisions
- 06
Hospitalization records for ketoacidosis or hypoglycemic events (for higher tiers)
Secondary conditions to file alongside
These conditions frequently develop as a consequence of diabetes mellitus type 2 and are often missed. Each can be filed as a secondary claim and add to your combined rating.
Peripheral neuropathy (diabetic)
Rated separately under DC 8520 per affected limb, 10-40% per limb. Often raises combined rating significantly.
Diabetic retinopathy
Rated under eye conditions, 10-100% based on visual acuity loss.
Erectile dysfunction (secondary to diabetes)
Service-connected as secondary, no separate rating but adds SMC-K.
Coronary artery disease (Agent Orange presumptive)
Vietnam veterans with diabetes often qualify for ischemic heart disease presumptive at 10-100%.
Common mistakes that lower the rating
- 01
Not claiming neuropathy as secondary — diabetic peripheral neuropathy is rated per-limb and dramatically increases combined ratings
- 02
Vietnam veterans not citing Agent Orange presumption — diabetes is on the presumptive list under 38 CFR § 3.309(e)
- 03
Stopping at 20% — if your endocrinologist has restricted your activities, document it and request the 40% rating
Pro tip
If you served in Vietnam between January 9, 1962 and May 7, 1975 and have type 2 diabetes, file under the Agent Orange presumption (38 CFR § 3.309(e)). You do not need to prove exposure or in-service onset.
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Source: 38 CFR Part 4 (VA Schedule for Rating Disabilities) and VA M21-1 Adjudication Procedures Manual. This guide explains the regulation; it is not legal advice and does not substitute for an accredited VA claims agent or VSO. Find a free VSO at va.gov/ogc/apps/accreditation.