CFR / Title 38 / Part 4 / Sec. 4.119 Schedule of ratings--endocrine system.------------------------------------------------------------------------

Rating------------------------------------------------------------------------7900 Hyperthyroidism

Thyroid enlargement, tachycardia (more than 100 beats per 100

minute), eye involvement, muscular weakness, loss of weight,

and sympathetic nervous system, cardiovascular, or

astrointestinal symptoms.....................................

Emotional instability, tachycardia, fatigability, and 60

increased pulse pressure or blood pressure...................

Tachycardia, tremor, and increased pulse pressure or blood 30

pressure.....................................................

Tachycardia, which may be intermittent, and tremor, or; 10

continuous medication required for control...................

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 100

minute), eye involvement, muscular weakness, loss of weight,

and sympathetic nervous system, cardiovascular, or

gastrointestinal symptoms....................................

Emotional instability, tachycardia, fatigability, and 60

increased pulse pressure or blood pressure...................

Tachycardia, tremor, and increased pulse pressure or blood 30

pressure.....................................................

Tachycardia, which may be intermittent, and tremor, or; 10

continuous medication required for control...................

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 100

involvement, mental disturbance (dementia, slowing of

thought, depression), bradycardia (less than 60 beats per

minute), and sleepiness......................................

Muscular weakness, mental disturbance, and weight gain........ 60

Fatigability, constipation, and mental sluggishness........... 30

Fatigability, or; continuous medication required for control.. 107904 Hyperparathyroidism

Generalized decalcification of bones, kidney stones, 100

gastrointestinal symptoms (nausea, vomiting, anorexia,

constipation, weight loss, or peptic ulcer), and weakness....

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, 100

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

cataract or evidence of increased intracranial pressure (such

as papilledema)..............................................

Marked neuromuscular excitability, or; paresthesias (of arms, 60

legs, or circumoral area) plus either cataract or evidence of

increased intracranial pressure..............................

Continuous medication required for control.................... 107907 Cushing's syndrome

As active, progressive disease including loss of muscle 100

strength, areas of osteoporosis, hypertension, weakness, and

enlargement of pituitary or adrenal gland....................

Loss of muscle strength and enlargement of pituitary or 60

adrenal gland................................................

With striae, obesity, moon face, glucose intolerance, and 30

vascular fragility...........................................

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 100

field defect), arthropathy, glucose intolerance, and either

hypertension or cardiomegaly.................................

Arthropathy, glucose intolerance, and hypertension............ 60

Enlargement of acral parts or overgrowth of long bones, and 30

enlarged sella turcica.......................................7909 Diabetes insipidus

Polyuria with near-continuous thirst, and more than two 100

documented episodes of dehydration requiring parenteral

hydration in the past year...................................

Polyuria with near-continuous thirst, and one or two 60

documented episodes of dehydration requiring parenteral

hydration in the past year...................................

Polyuria with near-continuous thirst, and one or more episodes 40

of dehydration in the past year not requiring parenteral

hydration....................................................

Polyuria with near-continuous thirst.......................... 207911 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 40

during the past year.........................................

One or two crises during the past year, or; two to four 20

episodes during the past year, or; weakness and fatigability,

or; corticosteroid therapy required for control..............

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 Sec. 4.88b. Assign the higher rating.7912 Pluriglandular syndrome

Evaluate according to major manifestations.7913 Diabetes mellitus

Requiring more than one daily injection of insulin, restricted 100

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..........................

Requiring insulin, restricted diet, and regulation of 60

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....................................................

Requiring insulin, restricted diet, and regulation of 40

activities...................................................

Requiring insulin and restricted diet, or; oral hypoglycemic 20

agent and restricted diet....................................

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 100

system.........................................................

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 Sec.

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