**The Endocrine System**

4.119 Schedule of ratings-endocrine system 4.119-1

**§4.119 Schedule of ratings-endocrine system.**

**[The Endocrine System]{.smallcaps}**

Rating

**7900** Hyperthyroidism

Thyroid enlargement, tachycardia (more than 100 beats per

minute), eye involvement, muscular weakness, loss of

weight, and sympathetic nervous system, cardiovascular,

or gastrointestinal symptoms 100

Emotional instability, tachycardia, fatigability, and increased

pulse pressure or blood pressure 60

Tachycardia, tremor, and increased pulse pressure or blood pressure 30

Tachycardia, which may be intermittent, and tremor, or;

continuous medication required for control 10

Note 1: If disease of the heart is the predominant finding, evaluate as
hyperthyroid heart disease (DC 7008) if doing so would result in a
higher evaluation than using the criteria above.

Note 2: If ophthalmopathy is the sole finding, evaluate as field vision,
impairment of (DC 6080); diplopia (DC 6090); or impairment of central
visual acuity (DC 6061-6079).

**7901** Thyroid gland, toxic adenoma of

Thyroid enlargement, tachycardia (more than 100 beats per minute),

eye involvement, muscular weakness, loss of weight, and

sympathetic nervous system, cardiovascular, or gastrointestinal

symptoms 100

Emotional instability, tachycardia, fatigability, and increased pulse

pressure or blood pressure 60

Tachycardia, tremor, and increased pulse pressure or blood pressure 30

Tachycardia, which may be intermittent, and tremor, or;

continuous medication required for control 10

Note (1): If disease of the heart is the predominant finding, evaluate
as hyperthyroid heart disease (DC 7008) if doing so would result in a
higher evaluation than using the criteria above.

Note (2): If ophthalmopathy is the sole finding, evaluate as field
vision, impairment of (DC 6080); diplopia (DC 6090); or impairment of
central visual acuity (DC 6061-6079).

**7902** Thyroid gland, nontoxic adenoma of

With disfigurement of the head or neck 20

Without disfigurement of the head or neck 0

Note: If there are symptoms due to pressure on adjacent organs such as
the trachea, larynx, or esophagus, evaluate under the diagnostic code
for disability of that organ, if doing so would result in a higher
evaluation than using this diagnostic code.

**7903** Hypothyroidism

Cold intolerance, muscular weakness, cardiovascular involvement,

mental disturbance (dementia, slowing of thought, depression),

bradycardia (less than 60 beats per minute), and sleepiness 100

Muscular weakness, mental disturbance, and weight gain 60

Fatigability, constipation, and mental sluggishness 30

Fatigability, or; continuous medication required for control 10

**7904** Hyperparathyroidism

Generalized decalcification of bones, kidney stones, gastrointestinal

symptoms (nausea, vomiting, anorexia, constipation, weight loss, or

peptic ulcer), and weakness 100

Gastrointestinal symptoms and weakness 60

Continuous medication required for control 10

Note: Following surgery or treatment, evaluate as digestive, skeletal,
renal, or cardiovascular residuals or as endocrine dysfunction.

**7905** Hypoparathyroidism

Marked neuromuscular excitability (such as convulsions, muscular

spasms (tetany), or laryngeal stridor) plus either cataract or

evidence of increased intracranial pressure (such as papilledema) 100

Marked neuromuscular excitability, or; paresthesias (of arms, legs,

or circumoral area) plus either cataract or evidence of

increased intracranial pressure 60

Continuous medication required for control 10

**7907** Cushing's syndrome

As active, progressive disease including loss of muscle strength, areas

of osteoporosis, hypertension, weakness, and enlargement of

pituitary or adrenal gland 100

Loss of muscle strength and enlargement of pituitary or adrenal gland 60

With striae, obesity, moon face, glucose intolerance, and

vascular fragility 30

Note: With recovery or control, evaluate as residuals of adrenal
insufficiency or cardiovascular, psychiatric, skin, or skeletal
complications under appropriate diagnostic code.

**7908** Acromegaly

Evidence of increased intracranial pressure (such as visual field

defect), arthropathy, glucose intolerance, and either hypertension

or cardiomegaly 100

Arthropathy, glucose intolerance, and hypertension 60

Enlargement of acral parts or overgrowth of long bones, and

enlarged sella turcica 30

**7909** Diabetes insipidus

Polyuria with near-continuous thirst, and more than two documented

episodes of dehydration requiring parenteral hydration in the

past year 100

Polyuria with near-continuous thirst, and one or two documented

episodes of dehydration requiring parenteral hydration in the

past year 60

Polyuria with near-continuous thirst, and one or more episodes

of dehydration in the past year not requiring parenteral hydration 40

Polyuria with near-continuous thirst 20

**7911** Addison's disease (adrenal cortical hypofunction)

Four or more crises during the past year 60

Three crises during the past year, or; five or more episodes during

the past year 40

One or two crises during the past year, or; two to four episodes during

the past year, or; weakness and fatigability, or; corticosteroid

therapy required for control 20

Note (1): An Addisonian "crisis" consists of the rapid onset of
peripheral vascular collapse (with acute hypotension and shock), with
findings that may include: anorexia; nausea; vomiting; dehydration;
profound weakness; pain in abdomen, legs, and back; fever; apathy, and
depressed mentation with possible progression to coma, renal shutdown,
and death.

Note (2): An Addisonian "episode," for VA purposes, is a less acute and
less severe event than an Addisonian crisis and may consist of anorexia,
nausea, vomiting, diarrhea, dehydration, weakness, malaise, orthostatic
hypotension, or hypoglycemia, but no peripheral vascular collapse.

Note (3): Tuberculous Addison's disease will be evaluated as active or
inactive tuberculosis. If inactive, these evaluations are not to be
combined with the graduated ratings of 50 percent or 30 percent for
non-pulmonary tuberculosis specified under §4.89. Assign the higher
rating.

**7912** Pluriglandular syndrome

Evaluate according to major manifestations.

**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

Requiring 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

Requiring insulin, restricted diet, and regulation of activities 40

Requiring insulin and restricted diet, or; oral hypoglycemic agent

and restricted diet 20

Manageable by restricted diet only 10

Note (1): Evaluate compensable complications of diabetes separately
unless they are part of the criteria used to support a 100 percent
evaluation. Noncompensable complications are considered part of the
diabetic process under diagnostic code 7913.

Note (2): When diabetes mellitus has been conclusively diagnosed, do not
request a glucose tolerance test solely for rating purposes.

**7914** Neoplasm, malignant, any specified part of the endocrine system
100

Note: A rating of 100 percent shall continue beyond the cessation of any
surgical, X-ray, antineoplastic chemotherapy or other therapeutic
procedure. Six months after discontinuance of such treatment, the
appropriate disability rating shall be determined by mandatory VA
examination. 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 recurrence or metastasis, rate on
residuals.

**7915** Neoplasm, benign, any specified part of the endocrine system

Rate as residuals of endocrine dysfunction.

**7916** Hyperpituitarism (prolactin secreting pituitary dysfunction)

**7917** Hyperaldosteronism (benign or malignant)

**7918** Pheochromocytoma (benign or malignant)

Note: Evaluate diagnostic codes 7916, 7917, and 7918 as malignant or
benign neoplasm as appropriate.

**7919** C-cell hyperplasia of the thyroid 100

Note: A rating of 100 percent shall continue beyond the cessation of any
surgical, X-ray, antineoplastic chemotherapy or other therapeutic
procedure. Six months after discontinuance of such treatment, the
appropriate disability rating shall be determined by mandatory VA
examination. 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 recurrence or metastasis, rate on
residuals.

(Authority: 38 U.S.C. 1155)

\[46 FR 43666, Aug. 31, 1981, as amended at 61 FR 20446, May 7, 1996\]

**Supplement *Highlights* reference**: 16(2)

Reserved