Endocrine

Diabetes Mellitus Type II C&P Exam Guide

Associated DBQ Form: DBQ Diabetes Mellitus

What to Expect During Your Exam

The diabetes C&P exam typically lasts 20-30 minutes. The examiner will review your diagnosis, treatment regimen, and any complications.

The exam includes:
1. Review of your diagnosis and medical history
2. Discussion of your current treatment regimen
3. Assessment of any diabetic complications
4. Review of lab results (A1C, blood glucose)
5. Evaluation of activity restrictions

Questions the Examiner May Ask

  • 1 When were you diagnosed with diabetes?
  • 2 Do you take insulin?
  • 3 How many times per day do you take insulin?
  • 4 Do you take oral medications?
  • 5 Do you have to restrict your activities due to diabetes?
  • 6 Have you experienced hypoglycemic episodes?
  • 7 Do you have any diabetic complications (neuropathy, kidney, eyes)?
  • 8 How often do you see your doctor for diabetes management?
  • 9 What is your most recent A1C level?

Documentation to Bring

  • Medical records confirming diabetes diagnosis
  • Lab results (A1C, blood glucose levels over time)
  • Documentation of insulin prescription
  • Records of diabetic complications
  • Agent Orange exposure documentation (if applicable)
  • Service treatment records
  • List of all diabetes medications

How to Prepare

Before your exam:

1. **Know your treatment regimen** - Insulin (how many injections/day), oral medications, dosages

2. **Get recent lab results** - A1C levels, kidney function tests

3. **Document complications** - Neuropathy, retinopathy, nephropathy, etc.

4. **Note activity restrictions** - Does diabetes limit what you can do?

5. **Track hypoglycemic episodes** - Low blood sugar events requiring intervention

Helpful Tips

- VA ratings for diabetes are primarily based on treatment required
- Insulin requirement is a key factor in the rating
- Diabetic complications (neuropathy, retinopathy) are rated separately
- Agent Orange presumptive connection applies for Vietnam veterans
- Know your current A1C and medication regimen
- If you require insulin, know how many injections per day
- Mention any hospitalizations for diabetic ketoacidosis or hypoglycemia

Common Mistakes to Avoid

- Claiming insulin use when records show only oral medications
- Not knowing your current medications or A1C
- Inconsistency between claimed treatment and medical records
- Claiming complications not documented in your records

How VA Rates This Condition

Diabetes Mellitus is rated under 38 CFR § 4.119, Diagnostic Code 7913:

**10%** - Manageable by diet alone

**20%** - Requiring insulin and restricted diet, OR oral hypoglycemic agent and restricted diet

**40%** - Requiring insulin, restricted diet, and regulation of activities

**60%** - Requiring insulin, restricted diet, and regulation of activities with episodes of ketoacidosis or hypoglycemic reactions requiring one or two hospitalizations per year or twice monthly visits to a diabetic care provider, plus complications that would not be compensable if separately evaluated

**100%** - Requiring more than one daily injection of insulin, restricted diet, and regulation of activities with episodes of ketoacidosis or hypoglycemic reactions requiring at least 3 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 rated

**Note:** Complications like diabetic neuropathy, nephropathy, and retinopathy are rated separately.