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| The Genitourinary System | 4.115 – 4.115b | ||||||||||
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38 U.S.C. 1155, unless otherwise noted.
29 FR 6718, May 22, 1964, unless otherwise noted.
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Albuminuria alone is not nephritis, nor will the presence of transient albumin and casts following acute febrile illness be taken as nephritis. The glomerular type of nephritis is usually preceded by or associated with severe infectious disease; the onset is sudden, and the course marked by red blood cells, salt retention, and edema; it may clear up entirely or progress to a chronic condition. The nephrosclerotic type, originating in hypertension or arteriosclerosis, develops slowly, with minimum laboratory findings, and is associated with natural progress. Separate ratings are not to be assigned for disability from disease of the heart and any form of nephritis, on account of the close interrelationships of cardiovascular disabilities. If, however, absence of a kidney is the sole renal disability, even if removal was required because of nephritis, the absent kidney and any hypertension or heart disease will be separately rated. Also, in the event that chronic renal disease has progressed to the point where regular dialysis is required, any coexisting hypertension or heart disease will be separately rated.
[41 FR 34258, Aug. 13, 1976, as amended at 59 FR 2527, Jan. 18, 1994]
Diseases of the genitourinary system generally result in disabilities related to renal or voiding dysfunctions, infections, or a combination of these. The following section provides descriptions of various levels of disability in each of these symptom areas. Where diagnostic codes refer the decision maker to these specific areas of dysfunction, only the predominant area of dysfunction shall be considered for rating purposes. Distinct disabilities may be evaluated separately under this section, pursuant to § 4.14, if the symptoms do not overlap. Since the areas of dysfunction described below do not cover all symptoms resulting from genitourinary diseases, specific diagnoses may include a description of symptoms assigned to that diagnosis.
| Rating | |
|---|---|
| Renal dysfunction: | |
| Chronic kidney disease with glomerular filtration rate (GFR) less than 15 mL/min/1.73 m2 for at least 3 consecutive months during the past 12 months; or requiring regular routine dialysis; or eligible kidney transplant recipient | 100 |
| Chronic kidney disease with GFR from 15 to 29 mL/min/1.73 m2 for at least 3 consecutive months during the past 12 months | 80 |
| Chronic kidney disease with GFR from 30 to 44 mL/min/1.73 m2 for at least 3 consecutive months during the past 12 months | 60 |
| Chronic kidney disease with GFR from 45 to 59 mL/min/1.73 m2 for at least 3 consecutive months during the past 12 months | 30 |
| GFR from 60 to 89 mL/min/1.73 m2 and either recurrent red blood cell (RBC) casts, white blood cell (WBC) casts, or granular casts for at least 3 consecutive months during the past 12 months; or | |
| GFR from 60 to 89 mL/min/1.73 m2 and structural kidney abnormalities (cystic, obstructive, or glomerular) for at least 3 consecutive months during the past 12 months; or | |
| GFR from 60 to 89 mL/min/1.73 m2 and albumin/creatinine ratio (ACR) ≥30 mg/g for at least 3 consecutive months during the past 12 months | 0 |
| Note: GFR, estimated GFR (eGFR), and creatinine-based approximations of GFR will be accepted for evaluation purposes under this section when determined to be appropriate and calculated by a medical professional. | |
| Voiding dysfunction: | |
| Rate particular condition as urine leakage, frequency, or obstructed voiding | |
| 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 | 60 |
| Requiring the wearing of absorbent materials which must be changed 2 to 4 times per day | 40 |
| Requiring the wearing of absorbent materials which must be changed less than 2 times per day | 20 |
| Urinary frequency: | |
| Daytime voiding interval less than one hour, or; awakening to void five or more times per night | 40 |
| Daytime voiding interval between one and two hours, or; awakening to void three to four times per night | 20 |
| Daytime voiding interval between two and three hours, or; awakening to void two times per night | 10 |
| Obstructed voiding: | |
| Urinary retention requiring intermittent or continuous catheterization | 30 |
| 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 | 10 |
| Obstructive symptomatology with or without stricture disease requiring dilatation 1 to 2 times per year | 0 |
| Urinary tract infection: | |
| Poor renal function: Rate as renal dysfunction. | |
| Recurrent symptomatic infection requiring drainage by stent or nephrostomy tube; or requiring greater than 2 hospitalizations per year; or requiring continuous intensive management | 30 |
| Recurrent symptomatic infection requiring 1-2 hospitalizations per year or suppressive drug therapy lasting six months or longer | 10 |
| Recurrent symptomatic infection not requiring hospitalization, but requiring suppressive drug therapy for less than 6 months | 0 |
[59 FR 2527, Jan. 18, 1994; 59 FR 10676, Mar. 7, 1994; 86 FR 54085, Sept. 30, 2021]
| Rating | |
|---|---|
| Note: When evaluating any claim involving loss or loss of use of one or more creative organs, refer to § 3.350 of this chapter to determine whether the veteran may be entitled to special monthly compensation. Footnotes in the schedule indicate conditions which potentially establish entitlement to special monthly compensation; however, there are other conditions in this section which under certain circumstances also establish entitlement to special monthly compensation. | |
| 7500 Kidney, removal of one: | |
| Minimum evaluation | 30 |
| Or rate as renal dysfunction if there is nephritis, infection, or pathology of the other. | |
| 7501 Kidney, abscess of: | |
| Rate as urinary tract infection | |
| 7502 Nephritis, chronic: | |
| Rate as renal dysfunction. | |
| 7504 Pyelonephritis, chronic: | |
| Rate as renal dysfunction or urinary tract infection, whichever is predominant. | |
| 7505 Kidney, tuberculosis of: | |
| Rate in accordance with §§ 4.88b or 4.89, whichever is appropriate. | |
| 7507 Nephrosclerosis, arteriolar: | |
| Rate according to predominant symptoms as renal dysfunction, hypertension or heart disease. If rated under the cardiovascular schedule, however, the percentage rating which would otherwise be assigned will be elevated to the next higher evaluation. | |
| 7508 Nephrolithiasis/Ureterolithiasis/Nephrocalcinosis: | |
| Rate as hydronephrosis, except for recurrent stone formation requiring invasive or non-invasive procedures more than two times/year | 30 |
| 7509 Hydronephrosis: | |
| Severe; Rate as renal dysfunction. | |
| Frequent attacks of colic with infection (pyonephrosis), kidney function impaired | 30 |
| Frequent attacks of colic, requiring catheter drainage | 20 |
| Only an occasional attack of colic, not infected and not requiring catheter drainage | 10 |
| 7511 Ureter, stricture of: | |
| Rate as hydronephrosis, except for recurrent stone formation requiring one or more of the following: | |
| 1. diet therapy | |
| 2. drug therapy | |
| 3. invasive or non-invasive procedures more than two times/year | 30 |
| 7512 Cystitis, chronic, includes interstitial and all etiologies, infectious and non-infectious: | |
| Rate as voiding dysfunction. | |
| 7515 Bladder, calculus in, with symptoms interfering with function: | |
| Rate as voiding dysfunction | |
| 7516 Bladder, fistula of: | |
| Rate as voiding dysfunction or urinary tract infection, whichever is predominant. | |
| Postoperative, suprapubic cystotomy | 100 |
| 7517 Bladder, injury of: | |
| Rate as voiding dysfunction. | |
| 7518 Urethra, stricture of: | |
| Rate as voiding dysfunction. | |
| 7519 Urethra, fistula of: | |
| Rate as voiding dysfunction. | |
| Multiple urethroperineal fistulae | 100 |
| 7520 Penis, removal of half or more | 1 30 |
| 7521 Penis, removal of glans | 1 20 |
| 7522 Erectile dysfunction, with or without penile deformity | 1 0 |
| Note: For the purpose of VA disability evaluation, a disease or traumatic injury of the penis resulting in scarring or deformity shall be rated under diagnostic code 7522. | |
| 7523 Testis, atrophy complete: | |
| Both—20 1 | |
| One—0 1 | |
| 7524 Testis, removal: | |
| Both | 1 30 |
| One | 1 0 |
| Note: In cases of the removal of one testis as the result of a service-incurred injury or disease, other than an undescended or congenitally undeveloped testis, with the absence or nonfunctioning of the other testis unrelated to service, an evaluation of 30 percent will be assigned for the service-connected testicular loss. Testis, undescended, or congenitally undeveloped is not a ratable disability. | |
| 7525 Prostatitis, urethritis, epididymitis, orchitis (unilateral or bilateral), chronic only: | |
| Rate as urinary tract infection. | |
| For tubercular infections: Rate in accordance with §§ 4.88b or 4.89, whichever is appropriate. | |
| 7527 Prostate gland injuries, infections, hypertrophy, postoperative residuals, bladder outlet obstruction: | |
| Rate as voiding dysfunction or urinary tract infection, whichever is predominant. | |
| 7528 Malignant neoplasms of the genitourinary system | 100 |
| Note—Following the cessation of surgical, X-ray, antineoplastic chemotherapy or other therapeutic procedure, the rating of 100 percent shall continue with a mandatory VA examination at the expiration of six months. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of § 3.105(e) of this chapter. If there has been no local reoccurrence or metastasis, rate on residuals as voiding dysfunction or renal dysfunction, whichever is predominant. | |
| 7529 Benign neoplasms of the genitourinary system: | |
| Rate as voiding dysfunction or renal dysfunction, whichever is predominant. | |
| 7530 Chronic renal disease requiring regular dialysis: | |
| Rate as renal dysfunction. | |
| 7531 Kidney transplant: | |
| Following transplant surgery | 100 |
| Thereafter: Rate on residuals as renal dysfunction, minimum rating | 30 |
| Note—The 100 percent evaluation shall be assigned as of the date of hospital admission for transplant surgery and shall continue with a mandatory VA examination one year following hospital discharge. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of § 3.105(e) of this chapter. | |
| 7532 Renal tubular disorders (such as renal glycosurias, aminoacidurias, renal tubular acidosis, Fanconi's syndrome, Bartter's syndrome, related disorders of Henle's loop and proximal or distal nephron function, etc.): | |
| Minimum rating for symptomatic condition | 20 |
| Or rate as renal dysfunction. | |
| 7533 Cystic diseases of the kidneys: | |
| Rate as renal dysfunction. | |
| Note: Cystic diseases of the kidneys include, but are not limited to, polycystic disease, uremic medullary cystic disease, medullary sponge kidney, and similar conditions such as Alport's syndrome, cystinosis, primary oxalosis, and Fabry's disease. | |
| 7534 Atherosclerotic renal disease (renal artery stenosis, atheroembolic renal disease, or large vessel disease, unspecified): | |
| Rate as renal dysfunction. | |
| 7535 Toxic nephropathy (antibotics, radiocontrast agents, nonsteroidal anti-inflammatory agents, heavy metals, and similar agents): | |
| Rate as renal dysfunction. | |
| 7536 Glomerulonephritis: | |
| Rate as renal dysfunction. | |
| 7537 Interstitial nephritis, including gouty nephropathy, disorders of calcium metabolism: | |
| Rate as renal dysfunction. | |
| 7538 Papillary necrosis: | |
| Rate as renal dysfunction. | |
| 7539 Renal amyloid disease: | |
| Rate as renal dysfunction. | |
| Note: This diagnostic code pertains to renal involvement secondary to all glomerulonephritis conditions, all vasculitis conditions and their derivatives, and other renal conditions caused by systemic diseases, such as Lupus erythematosus, systemic lupus erythematosus nephritis, Henoch-Schonlein syndrome, scleroderma, hemolytic uremic syndrome, polyarthritis, Wegener's granulomatosis, Goodpasture's syndrome, and sickle cell disease. | |
| 7540 Disseminated intravascular coagulation with renal cortical necrosis: | |
| Rate as renal dysfunction. | |
| 7541 Renal involvement in diabetes mellitus type I or II: | |
| Rate as renal dysfunction. | |
| 7542 Neurogenic bladder: | |
| Rate as voiding dysfunction or urinary tract infection, whichever is predominant. | |
| 7543 Varicocele/Hydrocele | 1 0 |
| 7544 Renal disease caused by viral infection such as human immunodeficiency virus (HIV), Hepatitis B, and Hepatitis C: | |
| Rate as renal dysfunction. | |
| 7545 Bladder, diverticulum of: | |
| Rate as voiding dysfunction or urinary tract infection, whichever is predominant. | |
| 1 Review for entitlement to special monthly compensation under § 3.350 of this chapter. | |
[59 FR 2527, Jan. 18, 1994; 59 FR 14567, Mar. 29, 1994, as amended at 59 FR 46339, Sept. 8, 1994; 86 FR 54086, Sept. 30, 2021]