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Diabetes Mellitus Type I

An autoimmune condition where the body’s immune system destroys insulin-producing cells in the pancreas, requiring lifelong insulin treatment. The VA rates based on the level of treatment and complications.

Code: 7913
Criteria: 38 CFR 4.119, DC 7913
Exam length: ~30-45 minutes
Form: Diabetes Mellitus DBQ

Rating steps

0%
10%
20%
40%
60%
100%

The percentages this diagnostic code can be rated at. Which one applies depends on the findings — no tool here can tell you in advance.

What happens at the appointment

The examiner will focus heavily on your insulin regimen: type of insulin (rapid-acting, long-acting, pump), dosing frequency, and how you manage blood sugar throughout the day.
You will be asked about A1C levels, blood sugar variability, and episodes of hypoglycemia — including severe episodes with loss of consciousness, seizures, or confusion.
The examiner will assess whether your activities are medically restricted due to risk of hypoglycemic episodes — this is the critical threshold for the 40% and higher ratings under DC 7913.
You will be asked about hospitalizations for diabetic ketoacidosis (DKA) or severe hypoglycemic reactions — frequency and recency are key rating factors.
The examiner will check for diabetic complications: peripheral neuropathy, retinopathy, nephropathy, gastroparesis, and cardiovascular disease.

What the examiner is actually filling in

01Treatment required: insulin type and frequency, dietary management, and whether activities are medically restricted — the three pillars of DC 7913 rating.
02Frequency of ketoacidosis or hypoglycemic reactions requiring hospitalization — 1-2 per year vs. 3+ per year significantly changes the rating.
03Whether the veteran requires twice-monthly or more frequent visits to a diabetic care provider for regulation of the condition.
04Progressive loss of weight and strength attributable to diabetes — this is a criterion for the 100% rating.
05Presence and severity of each diabetic complication: neuropathy (sensory and motor findings in each extremity), retinopathy stage, nephropathy stage, and other secondary conditions.

Rated under 38 CFR 4.119, DC 7913. The examiner records findings on the DBQ; a rating specialist makes the decision.

A complete answer sounds like

Know DC 7913 criteria: insulin + restricted diet = 20%; add regulation of activities = 40%; add ketoacidosis/hypoglycemic episodes requiring 1-2 hospitalizations per year or twice-monthly provider visits = 60%; add progressive weight/strength loss = 100%.
The phrase "regulation of activities" must appear in your medical records — ask your endocrinologist to write: "Patient requires regulation of activities to avoid hypoglycemic events due to insulin-dependent diabetes mellitus."
Log every hypoglycemic event, especially those where you needed help from another person: "My spouse had to give me juice because I was too confused to help myself" — these demonstrate lack of independent blood sugar control.
File for each complication individually: peripheral neuropathy in each extremity can be rated 10-40% per extremity; retinopathy is rated on visual acuity; nephropathy on renal function. These add up significantly.
If you use an insulin pump or continuous glucose monitor, bring the device reports showing glucose variability, time in range, and hypoglycemia alerts — this data objectively demonstrates how difficult control is.

What costs veterans points

Assuming Type 1 diabetes automatically gets a 20% rating because you take insulin — the VA also requires "restricted diet" to be documented, and "regulation of activities" for 40%.
Not understanding that "regulation of activities" has a very specific meaning: your doctor must have told you to avoid strenuous activity because of the risk of hypoglycemia, and this must be in your medical records.
Not documenting hypoglycemic episodes — many Type 1 diabetics experience frequent lows but do not log them, losing crucial evidence for higher ratings.
Failing to file for diabetic complications separately — neuropathy in all four extremities, retinopathy, nephropathy, and gastroparesis each have their own rating and add to your combined total.
Not mentioning the frequency of endocrinologist visits — DC 7913 considers whether you require visits to a diabetic care provider twice per month or more for the 100% criteria.

The rating criteria, in plain language

Rating levels for Diabetes Mellitus Type I under 38 CFR 4.119, DC 7913
Rating	Rating criteria	What that means for you
0%	In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met.	Your type 1 diabetes requires no restricted diet, no insulin and no oral hypoglycemic agent. DC 7913’s lowest printed rung, 10%, is for diabetes “manageable by restricted diet only”, so a veteran who needs no dietary restriction and no medication at all falls below it. A honeymoon phase shortly after diagnosis, or glucose control restored by a pancreas or islet transplant, is the route to this level. DC 7913 prints no 0% rung of its own; § 4.31 supplies it: no monthly payment, but the condition is on record and a later increase runs from it. The lowest compensable level under this code is 10 percent.
0%	What supports this level Treatment records showing no prescribed restricted diet Medication list showing no insulin and no oral hypoglycemic agent HbA1c and fasting glucose results in the range your provider treats as controlled without therapy A dated record of the condition so that a later increase claim has a starting point
10%	7913 Diabetes mellitus: Manageable by restricted diet only — 10.	Your type 1 diabetes is manageable by restricted diet only.
10%	What supports this level Diabetes diagnosis Records showing management by restricted diet only
20%	7913 Diabetes mellitus: Requiring one or more daily injection of insulin and restricted diet, or; oral hypoglycemic agent and restricted diet — 20.	Your type 1 diabetes requires one or more daily insulin injection and a restricted diet, or an oral hypoglycemic agent and a restricted diet.
20%	What supports this level Insulin or oral hypoglycemic agent prescription records Documentation of a prescribed restricted diet
40%	7913 Diabetes mellitus: Requiring one or more daily injection of insulin, restricted diet, and regulation of activities — 40.	Your type 1 diabetes requires one or more daily insulin injection, a restricted diet, and regulation of activities.
40%	What supports this level Daily insulin injection records Prescribed restricted diet Physician's written regulation of activities (avoidance of strenuous occupational and recreational activity)
60%	7913 Diabetes mellitus: 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 — 60.	Your type 1 diabetes requires one or more daily insulin injection, a restricted diet and regulation of activities, with episodes of ketoacidosis or hypoglycemia needing one or two hospitalizations a year or twice-monthly provider visits, plus complications that would not be separately compensable.
60%	What supports this level Daily insulin, restricted diet, and regulation of activities documented One or two hospitalizations per year for ketoacidosis or hypoglycemia, or twice-monthly diabetic care visits Records of non-compensable complications
100%	7913 Diabetes mellitus: 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 — 100.	Your type 1 diabetes requires more than one daily insulin injection, a restricted diet, and regulation of activities, with episodes of ketoacidosis or hypoglycemia needing at least three hospitalizations a year or weekly provider visits, plus either progressive loss of weight and strength or complications that would be compensable if rated separately.
100%	What supports this level More than one daily insulin injection, restricted diet, and regulation of activities At least three hospitalizations per year, or weekly diabetic care visits Progressive loss of weight and strength, or complications that would be separately compensable

The middle column is our transcription of the criteria at 38 CFR 4.119, DC 7913, condensed for reading. Read the section itself on eCFR before relying on the exact wording. The items under each level are the kinds of evidence that document it — not a VA checklist, and not a prediction of which level applies to you.

Mistakes we see most often

Not documenting "regulation of activities" — the 40% rating requires a doctor to specifically state that your activities must be regulated due to diabetes.

Not tracking hospitalizations for ketoacidosis or severe hypoglycemia episodes.

Not filing separately for each diabetic complication (neuropathy, retinopathy, nephropathy, erectile dysfunction) — these are rated in addition to the diabetes rating.

Not documenting the frequency of diabetic care provider visits.

Before & after your exam

These apply to every C&P exam, whatever the condition.

Do not miss the appointment: Missing your C&P exam without a good reason can cost you. Under 38 CFR § 3.655, a missed exam can cause a claim for an increased rating or a reopened claim to be denied, and can cause an original claim to be decided on the evidence already in your file. If you cannot make it, call the VA or the exam company right away to reschedule — a documented good reason (illness, work conflict, no transportation, a family emergency) protects your claim.
Your examiner may be a contractor: Many C&P exams are performed by VA-contracted companies — QTC, Optum Serve (LHI), VES, or MSLA — not at a VA hospital. They will call, text, or mail you to schedule. Do not ignore an unknown number or letter while your claim is pending, and confirm the exam location and time before you go.
The examiner does not decide your claim: The examiner's job is to record findings on the Disability Benefits Questionnaire (DBQ). A rating specialist at the Regional Office makes the actual decision, using the exam together with your full record — service records, medical records, and lay statements. One appointment does not settle everything.
Get a copy of your exam report: After the exam you can request the report (often called the DBQ or C&P exam results) through VA.gov, the Blue Button tool, or your accredited representative. Reading it lets you catch errors while you still have time to respond.
If the exam was inadequate, you have options: If the examiner rushed you, evaluated the wrong condition, or the report is inaccurate, you can submit a statement and new evidence, and — after a decision — request a review (a Supplemental Claim or Higher-Level Review). A single bad exam is not the end of your claim.

View condition guide →View evidence checklist →

Folder readiness

Tick these off as you gather them. Nothing here is required — the exam happens either way — but each one is something the examiner cannot record if it is not in front of them.

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Take it with you

Print the whole guide — what the examiner records, the folder list with your ticks, the criteria table and the mistakes to avoid — and bring it to the appointment.

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C&P Exam Preparation Guides

The VA orders this exam to verify your diagnosis and measure how severe it is right now. It can shape your rating and your monthly compensation — but it does not decide your claim. A rating specialist weighs it against your full record, and if the exam does not reflect your condition, you can say so and ask the VA to correct it.

Source forms
Coverage

What happens at the appointment

The examiner will focus heavily on your insulin regimen: type of insulin (rapid-acting, long-acting, pump), dosing frequency, and how you manage blood sugar throughout the day.
You will be asked about A1C levels, blood sugar variability, and episodes of hypoglycemia — including severe episodes with loss of consciousness, seizures, or confusion.
The examiner will assess whether your activities are medically restricted due to risk of hypoglycemic episodes — this is the critical threshold for the 40% and higher ratings under DC 7913.
You will be asked about hospitalizations for diabetic ketoacidosis (DKA) or severe hypoglycemic reactions — frequency and recency are key rating factors.
The examiner will check for diabetic complications: peripheral neuropathy, retinopathy, nephropathy, gastroparesis, and cardiovascular disease.

What the examiner is actually filling in

01Treatment required: insulin type and frequency, dietary management, and whether activities are medically restricted — the three pillars of DC 7913 rating.
02Frequency of ketoacidosis or hypoglycemic reactions requiring hospitalization — 1-2 per year vs. 3+ per year significantly changes the rating.
03Whether the veteran requires twice-monthly or more frequent visits to a diabetic care provider for regulation of the condition.
04Progressive loss of weight and strength attributable to diabetes — this is a criterion for the 100% rating.
05Presence and severity of each diabetic complication: neuropathy (sensory and motor findings in each extremity), retinopathy stage, nephropathy stage, and other secondary conditions.

Rated under 38 CFR 4.119, DC 7913. The examiner records findings on the DBQ; a rating specialist makes the decision.

A complete answer sounds like

Know DC 7913 criteria: insulin + restricted diet = 20%; add regulation of activities = 40%; add ketoacidosis/hypoglycemic episodes requiring 1-2 hospitalizations per year or twice-monthly provider visits = 60%; add progressive weight/strength loss = 100%.
The phrase "regulation of activities" must appear in your medical records — ask your endocrinologist to write: "Patient requires regulation of activities to avoid hypoglycemic events due to insulin-dependent diabetes mellitus."
Log every hypoglycemic event, especially those where you needed help from another person: "My spouse had to give me juice because I was too confused to help myself" — these demonstrate lack of independent blood sugar control.
File for each complication individually: peripheral neuropathy in each extremity can be rated 10-40% per extremity; retinopathy is rated on visual acuity; nephropathy on renal function. These add up significantly.
If you use an insulin pump or continuous glucose monitor, bring the device reports showing glucose variability, time in range, and hypoglycemia alerts — this data objectively demonstrates how difficult control is.

What costs veterans points

Assuming Type 1 diabetes automatically gets a 20% rating because you take insulin — the VA also requires "restricted diet" to be documented, and "regulation of activities" for 40%.
Not understanding that "regulation of activities" has a very specific meaning: your doctor must have told you to avoid strenuous activity because of the risk of hypoglycemia, and this must be in your medical records.
Not documenting hypoglycemic episodes — many Type 1 diabetics experience frequent lows but do not log them, losing crucial evidence for higher ratings.
Failing to file for diabetic complications separately — neuropathy in all four extremities, retinopathy, nephropathy, and gastroparesis each have their own rating and add to your combined total.
Not mentioning the frequency of endocrinologist visits — DC 7913 considers whether you require visits to a diabetic care provider twice per month or more for the 100% criteria.

The rating criteria, in plain language

Rating levels for Diabetes Mellitus Type I under 38 CFR 4.119, DC 7913
Rating	Rating criteria	What that means for you
0%	In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met.	Your type 1 diabetes requires no restricted diet, no insulin and no oral hypoglycemic agent. DC 7913’s lowest printed rung, 10%, is for diabetes “manageable by restricted diet only”, so a veteran who needs no dietary restriction and no medication at all falls below it. A honeymoon phase shortly after diagnosis, or glucose control restored by a pancreas or islet transplant, is the route to this level. DC 7913 prints no 0% rung of its own; § 4.31 supplies it: no monthly payment, but the condition is on record and a later increase runs from it. The lowest compensable level under this code is 10 percent.
0%	What supports this level Treatment records showing no prescribed restricted diet Medication list showing no insulin and no oral hypoglycemic agent HbA1c and fasting glucose results in the range your provider treats as controlled without therapy A dated record of the condition so that a later increase claim has a starting point
10%	7913 Diabetes mellitus: Manageable by restricted diet only — 10.	Your type 1 diabetes is manageable by restricted diet only.
10%	What supports this level Diabetes diagnosis Records showing management by restricted diet only
20%	7913 Diabetes mellitus: Requiring one or more daily injection of insulin and restricted diet, or; oral hypoglycemic agent and restricted diet — 20.	Your type 1 diabetes requires one or more daily insulin injection and a restricted diet, or an oral hypoglycemic agent and a restricted diet.
20%	What supports this level Insulin or oral hypoglycemic agent prescription records Documentation of a prescribed restricted diet
40%	7913 Diabetes mellitus: Requiring one or more daily injection of insulin, restricted diet, and regulation of activities — 40.	Your type 1 diabetes requires one or more daily insulin injection, a restricted diet, and regulation of activities.
40%	What supports this level Daily insulin injection records Prescribed restricted diet Physician's written regulation of activities (avoidance of strenuous occupational and recreational activity)
60%	7913 Diabetes mellitus: 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 — 60.	Your type 1 diabetes requires one or more daily insulin injection, a restricted diet and regulation of activities, with episodes of ketoacidosis or hypoglycemia needing one or two hospitalizations a year or twice-monthly provider visits, plus complications that would not be separately compensable.
60%	What supports this level Daily insulin, restricted diet, and regulation of activities documented One or two hospitalizations per year for ketoacidosis or hypoglycemia, or twice-monthly diabetic care visits Records of non-compensable complications
100%	7913 Diabetes mellitus: 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 — 100.	Your type 1 diabetes requires more than one daily insulin injection, a restricted diet, and regulation of activities, with episodes of ketoacidosis or hypoglycemia needing at least three hospitalizations a year or weekly provider visits, plus either progressive loss of weight and strength or complications that would be compensable if rated separately.
100%	What supports this level More than one daily insulin injection, restricted diet, and regulation of activities At least three hospitalizations per year, or weekly diabetic care visits Progressive loss of weight and strength, or complications that would be separately compensable

Mistakes we see most often

Not documenting "regulation of activities" — the 40% rating requires a doctor to specifically state that your activities must be regulated due to diabetes.

Not tracking hospitalizations for ketoacidosis or severe hypoglycemia episodes.

Not filing separately for each diabetic complication (neuropathy, retinopathy, nephropathy, erectile dysfunction) — these are rated in addition to the diabetes rating.

Not documenting the frequency of diabetic care provider visits.

Before & after your exam

These apply to every C&P exam, whatever the condition.

Do not miss the appointment: Missing your C&P exam without a good reason can cost you. Under 38 CFR § 3.655, a missed exam can cause a claim for an increased rating or a reopened claim to be denied, and can cause an original claim to be decided on the evidence already in your file. If you cannot make it, call the VA or the exam company right away to reschedule — a documented good reason (illness, work conflict, no transportation, a family emergency) protects your claim.
Your examiner may be a contractor: Many C&P exams are performed by VA-contracted companies — QTC, Optum Serve (LHI), VES, or MSLA — not at a VA hospital. They will call, text, or mail you to schedule. Do not ignore an unknown number or letter while your claim is pending, and confirm the exam location and time before you go.
The examiner does not decide your claim: The examiner's job is to record findings on the Disability Benefits Questionnaire (DBQ). A rating specialist at the Regional Office makes the actual decision, using the exam together with your full record — service records, medical records, and lay statements. One appointment does not settle everything.
Get a copy of your exam report: After the exam you can request the report (often called the DBQ or C&P exam results) through VA.gov, the Blue Button tool, or your accredited representative. Reading it lets you catch errors while you still have time to respond.
If the exam was inadequate, you have options: If the examiner rushed you, evaluated the wrong condition, or the report is inaccurate, you can submit a statement and new evidence, and — after a decision — request a review (a Supplemental Claim or Higher-Level Review). A single bad exam is not the end of your claim.

Diabetes Mellitus Type I

Rating steps

What happens at the appointment

What the examiner is actually filling in

A complete answer sounds like

What costs veterans points

The rating criteria, in plain language

What supports this level

What supports this level

What supports this level

What supports this level

What supports this level

What supports this level

Mistakes we see most often

Before & after your exam

Diabetes Mellitus Type I

Rating steps

What happens at the appointment

What the examiner is actually filling in

A complete answer sounds like

What costs veterans points

The rating criteria, in plain language

What supports this level

What supports this level

What supports this level

What supports this level

What supports this level

What supports this level

Mistakes we see most often

Before & after your exam