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Diabetes mellitus type 2 — rated by the treatment it requires, from diet control to insulin with regulation of activities, with complications rated separately. This guide quotes the actual rating criteria from 38 CFR Part 4 for diagnostic code 7913, explains what the C&P examiner measures, covers the presumptive and secondary routes to service connection, and lists the reasons these claims come back denied — and how each gets fixed.
How the VA rates type 2 diabetes in 2026 — the exact criteria
These are the criteria a VA rater applies, quoted from the rating schedule (§ 4.119). Your rating is the highest level whose wording your evidence meets — and evidence that never uses these words tends to be rated at the bottom.
DC 7913 — Diabetes mellitus
| Rating | Criteria (38 CFR Part 4 wording) |
|---|---|
| 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 |
Compensable complications of diabetes (peripheral neuropathy, kidney disease, retinopathy, erectile dysfunction) are rated separately unless they are part of the criteria for the 100 percent level.
"Regulation of activities" means a medical need to avoid strenuous activity — it must be prescribed, not self-imposed (Camacho v. Nicholson, 21 Vet. App. 360 (2007)). Type 2 diabetes is presumptive for Agent Orange exposure (38 CFR 3.309(e)).
Honest ceiling: 40% with insulin, restricted diet, and regulation of activities.
What the C&P examiner measures
The examiner records the treatment regimen (diet, oral agents, insulin injections per day), whether activities are medically restricted, hospitalizations for ketoacidosis or hypoglycemia, and complications — neuropathy, kidney, eye, cardiac, ED — which are rated separately.
The questions that get at the rating criteria — answer them for yourself before the exam:
- What do they have you on — pills or insulin?
- Has a doctor ever told you to watch how hard you push yourself because of the sugar?
- Any numbness or tingling in your feet or hands?
Service connection: presumptive, direct, or secondary
Type 2 diabetes is presumptive for Agent Orange exposure (38 CFR 3.309(e)) — Vietnam, the Korean DMZ, Thailand air bases, and C-123 aircraft, with the PACT Act adding more locations. It is also a chronic disease under 3.309(a) within one year of separation.
Every service-connection claim has three legs: a current diagnosis (the C&P exam can supply it), an in-service event, injury, exposure or an already-connected condition, and a link between the two — which the VA's own examiner addresses at the exam for direct and secondary claims, and which the law supplies for presumptive ones. You do not need a private opinion to file; you need one only if the VA denies for lack of nexus, and a supplemental claim within one year keeps your effective date.
Secondary conditions veterans miss
Conditions that commonly develop because of this one can be service-connected on top of it, each with its own rating:
- Peripheral neuropathy secondary to diabetes — PER EXTREMITY — four separate ratings on a bad case
- ED secondary to diabetes — 0% + SMC-K — a flat monthly add-on most eligible veterans never claim
- Kidney disease secondary to diabetes
- Diabetic retinopathy / eye involvement
What the medical literature says
NASEM, Veterans and Agent Orange (updates 2000–2018)
Type 2 diabetes has "limited/suggestive evidence of association" with herbicide exposure — VA presumptive since 2001. Why it matters: AO-exposed vet with T2D: presumptive.
Why type 2 diabetes claims get denied — and the fix
- Rated 20 percent when insulin plus a prescribed restriction of activities supported 40 — the restriction must be medically prescribed and in the record.
- Complications (neuropathy, ED, kidney, eye) never separately rated.
A denial is a grade on the evidence packet, not a verdict on you. Filed as a supplemental claim within one year, the fix keeps your original effective date.
Filing it right the first time
- Intent to File first. It locks your effective date for a year — back pay runs from that day, not from the day the package is ready.
- File everything at once. Every condition with a real symptom and a plausible route — direct, presumptive, secondary, increase — goes in one claim. The VA's duty to assist schedules the exam and pulls your records; a condition held back "for more evidence" only starts its clock later.
- Your statement in the criteria's words. A Statement in Support of Claim (VA Form 21-4138) that describes your worst days and your typical days using the language in the table above is the evidence the rater reads first.
- Your records. VA records through Blue Button, decision letters and code sheet from VA.gov, and private records from each doctor's office or patient portal — or a signed 21-4142 so the VA pulls them.
- Prepare for the exam. Know what the examiner measures (above) and answer honestly, including the bad days.
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See If You Qualify →Frequently asked questions
What is the VA rating for type 2 diabetes?
Type 2 Diabetes is rated under diagnostic code 7913 (§ 4.119) at 10%, 20%, 40%, 60%, 100%. The percentage depends on which criteria in the rating schedule your evidence meets — the full table is on this page.
What is the highest VA rating for type 2 diabetes?
The highest schedular rating available is 100%. Typical grants land around 20%, but every case is decided on its own evidence.
Is type 2 diabetes a presumptive condition?
Type 2 diabetes is presumptive for Agent Orange exposure (38 CFR 3.309(e)) — Vietnam, the Korean DMZ, Thailand air bases, and C-123 aircraft, with the PACT Act adding more locations. It is also a chronic disease under 3.309(a) within one year of separation.
Can type 2 diabetes be claimed as a secondary condition — or cause one?
Yes. Peripheral neuropathy secondary to diabetes; ED secondary to diabetes; Kidney disease secondary to diabetes; Diabetic retinopathy / eye involvement. A secondary condition is rated on top of the primary one, and the VA's own C&P examiner can supply the connecting opinion.
Do I need a nexus letter for type 2 diabetes?
Not to file. The VA's duty to assist schedules a C&P exam where its own examiner addresses the connection, and presumptive conditions need no opinion at all. A private opinion becomes worth buying only if the VA denies for lack of nexus — a supplemental claim within one year keeps your original effective date.
Rating criteria verified against eCFR (38 CFR Part 4) — last reviewed 2026-09-19. Regulations change; confirm anything decision-critical at ecfr.gov.