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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.
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A bladder that does not work properly because of nerve damage. This condition is often caused by spinal cord injuries, traumatic brain injury, or multiple sclerosis. The VA rates neurogenic bladder under voiding dysfunction criteria based on how often you need to change absorbent materials or use an appliance.
The percentages this diagnostic code can be rated at. Which one applies depends on the findings — no tool here can tell you in advance.
Rated under 38 CFR 4.115a, DC 7542. The examiner records findings on the DBQ; a rating specialist makes the decision.
| Rating | Rating criteria | What that means for you |
|---|---|---|
| 0% | Neurogenic bladder: Rate as voiding dysfunction or urinary tract infection, whichever is predominant. Voiding dysfunction. Obstructed voiding — Obstructive symptomatology with or without stricture disease requiring dilatation 1 to 2 times per year. Urinary tract infection — Recurrent symptomatic infection not requiring hospitalization, but requiring suppressive drug therapy for less than 6 months | You have a diagnosis of neurogenic bladder but you do not meet the requirements for a compensable rung on either route — your voiding intervals, leakage and retention are below the compensable bands, and any infection does not require hospitalization or six months of suppressive therapy. A 0% rating establishes service connection. |
What supports this level
| ||
| 10% | Neurogenic bladder: Rate as voiding dysfunction or urinary tract infection, whichever is predominant. Voiding dysfunction. Obstructed voiding — Marked obstructive symptomatology (hesitancy, slow or weak stream, decreased force of stream) with any one or combination of the following: 1. Post void residuals greater than 150 cc. 2. Uroflowmetry; markedly diminished peak flow rate (less than 10 cc/sec). 3. Recurrent urinary tract infections secondary to obstruction. 4. Stricture disease requiring periodic dilatation every 2 to 3 months | Your neurogenic bladder causes marked obstructive symptoms — hesitancy, a slow or weak stream, decreased force of stream — with elevated post-void residuals, a markedly diminished peak flow rate, or recurrent urinary tract infections secondary to obstruction. |
What supports this level
| ||
| 20% | Neurogenic bladder: Rate as voiding dysfunction or urinary tract infection, whichever is predominant. Voiding dysfunction. Continual Urine Leakage, Post Surgical Urinary Diversion, Urinary Incontinence, or Stress Incontinence — Requiring the wearing of absorbent materials which must be changed less than 2 times per day | Your neurogenic bladder causes continual urine leakage requiring absorbent materials that must be changed less than 2 times per day. |
What supports this level
| ||
| 30% | Neurogenic bladder: Rate as voiding dysfunction or urinary tract infection, whichever is predominant. Voiding dysfunction. Obstructed voiding — Urinary retention requiring intermittent or continuous catheterization | Your neurogenic bladder causes urinary retention that requires intermittent or continuous catheterization to empty your bladder — the pattern for a veteran on a clean intermittent catheterization regimen. |
What supports this level
| ||
| 40% | Neurogenic bladder: Rate as voiding dysfunction or urinary tract infection, whichever is predominant. Voiding dysfunction. Continual Urine Leakage, Post Surgical Urinary Diversion, Urinary Incontinence, or Stress Incontinence — Requiring the wearing of absorbent materials which must be changed 2 to 4 times per day | Your neurogenic bladder causes continual urine leakage requiring absorbent materials that must be changed 2 to 4 times per day. |
What supports this level
| ||
| 60% | Neurogenic bladder: Rate as voiding dysfunction or urinary tract infection, whichever is predominant. Voiding dysfunction. Continual Urine Leakage, Post Surgical Urinary Diversion, Urinary Incontinence, or Stress Incontinence — Requiring the use of an appliance or the wearing of absorbent materials which must be changed more than 4 times per day | Your neurogenic bladder causes continual urine leakage requiring the use of a collecting appliance, or absorbent materials that must be changed more than 4 times per day. 60 percent is the top of the voiding dysfunction table — catheterization for retention on its own is the 30 percent obstructed-voiding rung, and § 4.115a rates only the predominant area of dysfunction. |
What supports this level
| ||
The middle column is our transcription of the criteria at 38 CFR 4.115a, DC 7542, 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.
Not documenting the connection between your neurogenic bladder and the underlying neurological condition — the VA needs to see a clear link to a service-connected spinal cord injury, TBI, multiple sclerosis, or other nerve damage.
Not accurately reporting how many times per day you change absorbent materials — the rating is based directly on this number, so keeping a daily log is important.
Not filing for the neurogenic bladder separately from the underlying condition — even if your spinal cord injury or TBI is already rated, the bladder dysfunction can often be rated as a separate secondary condition.
Not requesting urodynamic testing to confirm the neurogenic cause — this specialized test provides strong objective evidence that your bladder problems are caused by nerve damage rather than another condition.
Not filing for additional secondary conditions caused by neurogenic bladder — recurrent urinary tract infections, kidney damage from urine backup, skin breakdown from incontinence, and depression from the impact on daily life may each qualify for separate ratings.
These apply to every C&P exam, whatever the condition.