VASRD Endocrine SystemUpdated: April 9, 2021
The Veteran Affairs Schedule for Rating Disabilities (VASRD) is a government-published collection of medical requirements for VA raters to use as a standard for when they review military members and their medical claims to determine VA official military disability ratings.
These VA disability ratings help determine VA disability percentages to medical conditions. They also help establish how much compensation to offer a veteran for service-connected injuries, illnesses, or other medical conditions.
The VASRD includes a section on the endocrine system, which is described by the Mayo Clinic as a number of glands including:
- Pituitary gland
- Thyroid gland
- Parathyroid glands
- Adrenal glands
- Ovaries where applicable
- Testicles where applicable
There are too many endocrine system disorders rated by the VA to list comprehensively here but the following are some of the major conditions that may receive a VA disability rating.
The Endocrine System
Acromegaly is defined as a condition where the body produces too much growth hormone, which may result in enlargement of the jaw, nose, forehead, hands, and feet.
This condition can be rated as high as 100% depending on the nature and severity of the condition. Other effects of this condition can include increased intracranial pressure, arthropathy, glucose intolerance, hypertension, glucose intolerance, and hypertension.
Hyperthyroidism is a condition where the thyroid gland produces too much of a hormone called thyroxine, resulting in an accelerated metabolism in some cases, plus irregular heartbeat and other symptoms.
This condition can be caused by Graves’ Disease, but not the sole cause. VA instructions to medical raters evaluating hyperthyroidism to rate at a maximum of 30% for six months following an initial diagnosis. In cases where certain cardiac disease is present, those issues are separately reviewed.
A related issue, Toxic Thyroid Enlargement can result in disfigurement of the neck and may be evaluated separately under a Burn/Scarring guideline for the head, face, and neck. A separate evaluation for non-toxic thyroid enlargement is also part of the VASRD.
Hypothyroidism is the inverse of hyperthyroid issues–the thyroid gland does not produce enough hormone. VA ratings can be as high as 100% for this issue, which can include symptoms such as:
- Myxedema or cold intolerance
- Muscular weakness
- Cardiovascular issues such as hypotension, bradycardia, and pericardial effusion
- Mental disturbances such as dementia, depression
Hyperparathyroidism is when the body’s parathyroid glands become overactive, releasing too much parathyroid hormone which can result in too much calcium in the blood. This condition may be rated as high as 100% depending on severity and other factors.
A 100% rating may be issued for six months after surgery for the condition. Similar ratings are approved for Hypercalcemia that meets severity guidelines set by the VA. Other related VA ratings in this area are approved for thyroiditis, and Cushing’s Syndrome,
Addison’s Disease, also known as adrenocortical insufficiency is a condition where the adrenal glands don’t make enough cortisol and/or aldosterone. VA disability ratings for this condition can be as high as 60% for conditions that result in “four or more crises” in the past year, and lower ratings for reduced numbers of crises in the past year.
What is a “crisis”? VA literature defines it as rapid onset of peripheral vascular collapse with acute hypotension and shock. This crisis may include “findings” such as:
- Profound weakness
- Pain in abdomen, legs, and back
- Depressed mentation with possible progression to coma, renal shutdown, and death
VA literature makes a distinction between an “Addisonian episode” and a crisis. Episodes are defined for VA disability rating purposes as “a less acute and less severe event”.
Diabetes mellitus, popularly known simply as “diabetes”, is a condition where the body does not respond to the insulin it has or cannot produce enough insulin.
This condition may be rated at 100% maximum in cases where multiple daily insulin injections are required and a restriction of diet and activities may be needed.
To earn the 100% ratings, incidents of ketoacidosis or hypoglycemic reactions requiring at least three hospitalizations per year or weekly visits to a diabetic care provider can qualify, in addition to “either progressive loss of weight and strength or complications that would be compensable if separately evaluated”.
Diabetes conditions may be rated at 60% or below where these issues are found to be less severe. In cases where the diabetic condition can be managed by restricted diets only the maximum rating is 10%.
Malignant Neoplasm found in “any specified part” of the endocrine system can earn a VA rating as high as 100%. A Neoplasm is basically an uncontrolled growth or tumor. VA rating guidelines instruct the rater that a 100% VA rating “shall continue beyond the cessation of any surgical, X-ray, antineoplastic chemotherapy or other therapeutic procedure” related to this condition.
Six months after ending the treatment, “the appropriate disability rating shall be determined by mandatory VA examination”. In cases where there is no “recurrence or metastasis”, the VA disability rating may hinge on “residuals”.
Joe Wallace is a 13-year veteran of the United States Air Force and a former reporter for Air Force Television News