Autonomic Neuropathy

DC 8599Neurological38 CFR 4.124a, DC 8599

Damage to the nerves that control automatic body functions like blood pressure, heart rate, digestion, and sweating. The VA rates autonomic neuropathy by analogy because there is no specific diagnostic code for it. It is commonly secondary to diabetes.

How the VA rates this condition

The VA rates this condition based on how much it affects your ability to work and carry out daily activities. The examiner will focus on the functional limitations your condition causes, not just the diagnosis itself.

Diagnostic code

DC 8599

Rating range

10% – 60%

Rating levels

Rating criteria are defined in 38 CFR 4.124a, DC 8599. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

You have severe autonomic neuropathy. You have frequent fainting episodes, severe digestive problems, and difficulty staying upright, making it very hard to work or perform daily activities.

What the VA looks for

Frequent syncopal episodes documented
Severe gastrointestinal dysfunction (severe gastroparesis, malnutrition risk)
Inability to maintain upright position for sustained periods
Tilt table test showing severe autonomic failure
Multiple medications with incomplete symptom control
Significant occupational impairment documented

Common Pitfalls

⚠Not getting autonomic function testing (tilt table test, QSART, thermoregulatory sweat test) — these tests objectively measure the severity of your autonomic dysfunction and are the strongest evidence for your rating.
⚠Not documenting the connection to a service-connected condition — autonomic neuropathy is most commonly secondary to diabetes. If your diabetes is service-connected, file autonomic neuropathy as secondary.
⚠Not tracking blood pressure readings in different positions (lying down, sitting, standing) — documented drops in blood pressure when you change position directly support orthostatic hypotension claims.
⚠Not reporting all affected body systems — autonomic neuropathy can affect the heart, digestive system, bladder, and sweat glands. Each affected system may support a higher rating or separate claims.
⚠Not documenting fainting episodes with witness statements — syncopal episodes often happen without warning. Buddy statements from family, friends, or coworkers who have seen you faint are critical evidence.

Related DBQ Forms

DBQ Peripheral Nerves Conditions

View evidence checklist →C&P exam prep guide →See secondary conditions →

Related Conditions

Conditions commonly associated with Autonomic Neuropathy or rated under the same body system.

Migraine Headaches

DC 8100·Neurological

Radiculopathy — Sciatic Nerve

DC 8520·Neurological

Peripheral Neuropathy — Lower Extremities

DC 8520·Neurological

Peripheral Neuropathy — Upper Extremities

DC 8515·Neurological

Traumatic Brain Injury (TBI)

DC 8045·Neurological

Epilepsy — Grand Mal (Generalized Convulsive)

DC 8910·Neurological

Epilepsy — Petit Mal (Absence)

DC 8911·Neurological

Trigeminal Neuralgia

DC 8205·Neurological

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

How the VA rates this condition

Diagnostic code

DC 8599

Rating range

10% – 60%

Rating levels

Rating Levels

You have severe autonomic neuropathy. You have frequent fainting episodes, severe digestive problems, and difficulty staying upright, making it very hard to work or perform daily activities.

What the VA looks for

Frequent syncopal episodes documented
Severe gastrointestinal dysfunction (severe gastroparesis, malnutrition risk)
Inability to maintain upright position for sustained periods
Tilt table test showing severe autonomic failure
Multiple medications with incomplete symptom control
Significant occupational impairment documented

Common Pitfalls

⚠Not getting autonomic function testing (tilt table test, QSART, thermoregulatory sweat test) — these tests objectively measure the severity of your autonomic dysfunction and are the strongest evidence for your rating.

⚠Not documenting the connection to a service-connected condition — autonomic neuropathy is most commonly secondary to diabetes. If your diabetes is service-connected, file autonomic neuropathy as secondary.

⚠Not tracking blood pressure readings in different positions (lying down, sitting, standing) — documented drops in blood pressure when you change position directly support orthostatic hypotension claims.

⚠Not reporting all affected body systems — autonomic neuropathy can affect the heart, digestive system, bladder, and sweat glands. Each affected system may support a higher rating or separate claims.

⚠Not documenting fainting episodes with witness statements — syncopal episodes often happen without warning. Buddy statements from family, friends, or coworkers who have seen you faint are critical evidence.