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C&P Exam Prep: Diabetes Mellitus
DBQ Overview
Interview + Physical- Form Name
- Diabetes_Mellitus
- Form Code
- Diabetes_Mellitus
- Page Count
- 6
- Examiner Type
- Physician
- Estimated Duration
- 30-45 minutes
- Exam Format
- Interview + Physical
What to Expect During Your Exam
Exam Overview
To document the type, severity, treatment requirements, complications, and functional impact of your Diabetes Mellitus for VA disability rating purposes under Diagnostic Code 7913. The examiner will assess how your diabetes is managed, whether you require insulin and/or diet restrictions, whether you have had hypoglycemic or ketoacidotic episodes requiring hospitalization, and whether compensable complications exist.
What the examiner evaluates:
- Confirmed diagnosis of Type I or Type II Diabetes Mellitus and date of diagnosis
- Current treatment regimen: diet-only, oral hypoglycemic agents, insulin (frequency and number of injections per day)
- Whether activities must be regulated or restricted due to diabetes
- Frequency and severity of hypoglycemic reactions, including hospitalizations
- Frequency and severity of ketoacidotic episodes, including hospitalizations
- Frequency of visits to a diabetic care provider
- Whether progressive loss of weight and/or strength is present
- Most recent HbA1c value and fasting plasma glucose levels
- Presence and severity of diabetic complications: peripheral neuropathy, nephropathy/renal dysfunction, retinopathy, erectile dysfunction, female sexual arousal disorder, cardiac conditions, hypertension, peripheral vascular disease, stroke, skin conditions
- Whether complications are compensable if separately evaluated
- Functional impact of diabetes and its complications on occupational and daily activities
The exam will involve both an interview (medical history, symptom review, treatment history) and a focused physical examination. The examiner may review your service treatment records, VA medical records, and any private medical records submitted. Bring a list of all current medications, recent lab results (HbA1c, fasting glucose), and records of any hospitalizations for hypoglycemia or ketoacidosis. In most states, you have the right to record this examination - notify the examiner at the start.
Typical duration: 30-45 minutes
HbA1c (Glycated Hemoglobin)
Average blood glucose control over approximately the prior 2-3 months. A value of 6.5% or greater on two or more occasions confirms the diagnosis of diabetes mellitus.
What to expect:
The examiner will record your most recent HbA1c from your medical records. This is a blood test - no repeat testing will be performed at the C&P exam itself. Bring copies of your most recent lab results.
Key thresholds:
- 6.5% or greater on 2+ occasions — Confirms diagnosis of Diabetes Mellitus for rating purposes
- Persistently elevated despite treatment — Supports documentation of poorly controlled diabetes, potentially supporting higher rating tiers
Tips:
- Bring printed lab results showing your HbA1c values with dates
- If your HbA1c has been consistently elevated, note this pattern to the examiner
- Do not skip insulin or alter your routine before the exam - the exam should reflect your true condition
Pain considerations: Not applicable for this test; however, document any symptoms of hyperglycemia (fatigue, blurred vision, excessive thirst/urination) that accompany elevated HbA1c values.
Fasting Plasma Glucose (FPG)
Blood glucose after fasting for at least 8 hours. A value of 126 mg/dL or greater on two or more occasions is a diagnostic criterion for diabetes mellitus.
What to expect:
The examiner will record the most recent fasting plasma glucose value from your records. No new glucose tolerance test will be ordered solely for rating purposes per 38 CFR Note (2).
Key thresholds:
- 126 mg/dL or greater on 2+ occasions — Confirms diagnosis of Diabetes Mellitus
- 200 mg/dL random plasma glucose with classic symptoms — Alternative diagnostic confirmation of Diabetes Mellitus
Tips:
- Bring your most recent fasting glucose lab results to the exam
- If you have a glucometer log, bring it - patterns of high readings support severity documentation
- Mention any episodes of hyperglycemia requiring emergency care
Pain considerations: Note any physical symptoms that accompany glucose spikes, such as headaches, extreme fatigue, blurred vision, or difficulty concentrating.
Insulin Injection Frequency Assessment
Whether you require one or more than one daily injection of insulin, which is a primary driver of the 40% and above rating tiers under DC 7913.
What to expect:
The examiner will ask about your insulin regimen - type of insulin, number of injections per day (or use of insulin pump), and whether this is required alongside dietary restriction and activity regulation.
Key thresholds:
- One or more daily insulin injections + restricted diet — Minimum criteria for 20% (with oral agent) or 40% (insulin + restricted diet + regulated activities)
- More than one daily injection + restricted diet + regulated activities + hospitalizations/weekly provider visits + weight/strength loss or compensable complications — Supports 100% rating
Tips:
- Bring your current prescription bottles or pharmacy printout showing insulin type and prescribed dosage
- If you use an insulin pump, explain that it delivers multiple basal/bolus doses - the VA considers this equivalent to multiple daily injections
- Specify the exact number of injections per day (e.g., basal once + bolus with each meal = 4 injections daily)
Pain considerations: Describe any pain, bruising, lipodystrophy, or skin complications at injection sites.
Hypoglycemic Episode and Hospitalization Count
The frequency and severity of low blood sugar reactions requiring medical intervention, which directly determines eligibility for the 60% and 100% rating tiers.
What to expect:
The examiner will ask how often you have hypoglycemic reactions, whether they required emergency room visits or hospitalizations, and how many times in the past 12 months. They will also ask about visits to a diabetic care provider.
Key thresholds:
- 1-2 hospitalizations per year for hypoglycemia OR twice-monthly provider visits + non-compensable complications — Supports 60% rating
- 3+ hospitalizations per year for hypoglycemia OR weekly provider visits + compensable complications + weight/strength loss — Supports 100% rating
Tips:
- Bring hospital discharge summaries, ER visit records, or ambulance call logs documenting hypoglycemic episodes
- Count ALL visits to your diabetic care provider - endocrinologist, primary care diabetes management, diabetes nurse educator
- Document episodes where you required assistance from another person even if you did not go to the hospital
- Note episodes of loss of consciousness, seizure, or inability to self-treat
Pain considerations: Describe physical symptoms during hypoglycemic episodes: sweating, shakiness, confusion, heart palpitations, weakness, inability to function.
Ketoacidosis Episode and Hospitalization Count
The frequency of diabetic ketoacidosis (DKA) episodes requiring hospitalization, relevant to 60% and 100% rating tiers.
What to expect:
The examiner will ask about DKA episodes: symptoms, how often they occur, and whether they required hospitalization. This applies primarily to Type I diabetes but can occur in Type II.
Key thresholds:
- 1-2 hospitalizations per year for DKA — Contributes to 60% rating criteria
- 3+ hospitalizations per year for DKA — Contributes to 100% rating criteria
Tips:
- Bring hospital records documenting each DKA admission with dates
- Describe warning signs you experience (nausea, vomiting, abdominal pain, fruity breath, extreme thirst)
- Note any DKA episodes treated in the ER but not resulting in inpatient admission - these still demonstrate severity
Pain considerations: Describe the physical experience of DKA: abdominal pain, vomiting, confusion, extreme weakness, and recovery time after each episode.
Activity Regulation Assessment
Whether your diabetes requires you to avoid strenuous occupational and recreational activities, which is a criterion that distinguishes the 40% from the 60%/100% tiers.
What to expect:
The examiner will ask whether your doctor has instructed you to avoid or limit strenuous activities and how this affects your work and daily life.
Key thresholds:
- Must regulate activities (restrict strenuous occupational/recreational activities) — Required element for 40%, 60%, and 100% ratings when combined with insulin and diet
Tips:
- Bring documentation from your treating physician stating activity restrictions
- Be specific: 'My doctor told me I cannot do jobs requiring heavy lifting, prolonged standing, or work in extreme heat due to risk of hypoglycemia'
- Describe how activity restrictions impact your current or former employment
Pain considerations: Describe fatigue, weakness, or risk of hypoglycemia that necessitates activity restrictions, and how these symptoms manifest during and after exertion.
Rating Criteria Breakdown
| Rating % | Criteria | Key Symptoms |
|---|---|---|
| 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 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. |
CFR: Requiring more than one daily injection of insulin, restricted diet, and regulation of 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. |
| 60% | Requiring one or more daily injection of 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. |
CFR: Requiring one or more daily injection of 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. |
| 40% | Requiring one or more daily injection of insulin, restricted diet, AND regulation of activities (avoidance of strenuous occupational and recreational activities). No hospitalizations required at this level. |
CFR: Requiring one or more daily injection of insulin, restricted diet, and regulation of activities. |
| 20% | Requiring one or more daily injection of insulin and restricted diet; OR oral hypoglycemic agent and restricted diet. Activity regulation is NOT required at this level. |
CFR: Requiring one or more daily injection of insulin and restricted diet, or; oral hypoglycemic agent and restricted diet. |
| 10% | Diabetes mellitus manageable by restricted diet only. No insulin or oral hypoglycemic agents required. |
CFR: Manageable by restricted diet only. Under 38 CFR - 4.119 DC 7913, this is the minimum compensable rating. |
100% Requiring MORE THAN ONE daily injection of insulin, restrict ...
Requiring MORE THAN ONE daily injection of insulin, restricted diet, and regulation of 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.
Key Symptoms
- Multiple daily insulin injections (2 or more) required
- Strict dietary restrictions
- Must avoid strenuous occupational and recreational activities
- 3 or more hospitalizations per year for hypoglycemia or ketoacidosis, OR
- Weekly visits to a diabetic care provider
- AND: Progressive loss of weight and strength, OR
- AND: Compensable complications (e.g., peripheral neuropathy rated 10%+ if separately evaluated, nephropathy, retinopathy, cardiac conditions, etc.)
CFR: Requiring more than one daily injection of insulin, restricted diet, and regulation of 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.
60% Requiring one or more daily injection of insulin, restricted ...
Requiring one or more daily injection of 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.
Key Symptoms
- Insulin-dependent with dietary restrictions and activity regulation
- 1-2 hospitalizations per year for hypoglycemia or ketoacidosis, OR
- Twice-monthly (at least 2 per month) visits to diabetic care provider
- Non-compensable complications present (e.g., mild neuropathy below 10% threshold)
- Poorly controlled glucose despite treatment
CFR: Requiring one or more daily injection of 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.
40% Requiring one or more daily injection of insulin, restricted ...
Requiring one or more daily injection of insulin, restricted diet, AND regulation of activities (avoidance of strenuous occupational and recreational activities). No hospitalizations required at this level.
Key Symptoms
- Daily insulin injection(s) with dietary restrictions
- Must avoid strenuous occupational activities due to diabetes
- Must avoid strenuous recreational activities due to diabetes
- Activity limitations documented by treating physician
- No episodes requiring hospitalization required at this tier
CFR: Requiring one or more daily injection of insulin, restricted diet, and regulation of activities.
20% Requiring one or more daily injection of insulin and restric ...
Requiring one or more daily injection of insulin and restricted diet; OR oral hypoglycemic agent and restricted diet. Activity regulation is NOT required at this level.
Key Symptoms
- Daily insulin injection(s) with dietary restrictions, OR
- Oral hypoglycemic agent(s) with dietary restrictions
- No required regulation of activities at this tier (distinguishes from 40%)
- Blood glucose not fully controlled by diet alone
CFR: Requiring one or more daily injection of insulin and restricted diet, or; oral hypoglycemic agent and restricted diet.
10% Diabetes mellitus manageable by restricted diet only. No ins ...
Diabetes mellitus manageable by restricted diet only. No insulin or oral hypoglycemic agents required.
Key Symptoms
- Blood glucose controlled through dietary modification alone
- No insulin injections required
- No oral hypoglycemic medications required
- Dietary restrictions in place (carbohydrate counting, glycemic index management)
CFR: Manageable by restricted diet only. Under 38 CFR - 4.119 DC 7913, this is the minimum compensable rating.
How to Describe Your Symptoms
Insulin Dependence and Treatment Burden
How to describe:
Describe exactly how many insulin injections you administer per day, what types of insulin (basal, bolus, correction), the times of day, and that this is a medical requirement prescribed by your doctor. If you use an insulin pump, explain that it administers continuous basal insulin plus bolus doses at meals - this constitutes multiple daily insulin dosing. Mention the dietary restrictions you must follow and how they affect your daily choices.
Worst-day example:
“On my worst days, my blood sugar is unpredictable despite taking four insulin injections. I wake up with a high reading, correct with additional insulin, experience a crash mid-morning, must eat immediately to avoid losing consciousness, then spend the afternoon unable to concentrate or function at work. I am essentially managing a second full-time job just monitoring and adjusting my glucose.”
What the examiner listens for:
The examiner needs to document the number of daily injections, type of insulin, requirement for restricted diet, and whether activities must be regulated. They are specifically checking whether you meet the 'one injection' vs. 'more than one injection' threshold, and whether diet restriction and activity regulation are both present.
Understatements to avoid:
Do not say 'I just take a shot once a day and watch what I eat' without clarifying the full picture. If you also take a correction dose, that is an additional injection. If you take rapid-acting insulin with meals, that is multiple injections. Be precise.
Hypoglycemic Episodes
How to describe:
Describe the physical experience of your low blood sugar episodes: the warning signs (shaking, sweating, heart racing, confusion, vision changes), how quickly they come on, whether you can treat them yourself or need assistance, and whether any required emergency care or hospitalization. Give specific dates and counts of hospitalizations or ER visits in the past 12 months.
Worst-day example:
“My worst hypoglycemic episode was when my blood sugar dropped to 38 mg/dL overnight. I woke up confused and soaked in sweat. My spouse had to call 911 because I could not respond coherently. I was taken by ambulance to the ER, given IV dextrose, and held for observation. This has happened three times in the past year. Even mild lows leave me unable to drive, work, or care for myself for hours afterward.”
What the examiner listens for:
The examiner is counting hospitalizations per year and assessing frequency of severe reactions. They distinguish between self-treated lows (less significant) and episodes requiring ER visits, hospitalizations, or assistance from another person. They also assess whether episodes affect your ability to work.
Understatements to avoid:
Do not minimize by saying 'I just had a few low blood sugars.' Specify whether each required you to stop working, whether you needed glucagon or IV glucose, and whether emergency services were involved. Each hospitalization directly affects your rating tier.
Activity Regulation Requirements
How to describe:
Explain, with specific examples, how your diabetes requires you to avoid or significantly limit strenuous activities. Reference your doctor's explicit instructions and the real-world consequences. Describe both occupational limitations (cannot work jobs with heavy exertion, unpredictable schedules, or exposure to extreme temperatures) and recreational limitations (cannot hike, play sports, or engage in prolonged physical activity without risk of severe hypoglycemia).
Worst-day example:
“I used to work in construction but had to change careers because physical exertion causes my blood sugar to crash unpredictably. My endocrinologist has documented that I must avoid strenuous work. Even walking briskly for more than 20 minutes can cause a hypoglycemic episode. I cannot mow my own lawn without stopping to check my glucose multiple times and having fast-acting sugar on hand. I have completely stopped participating in sports I enjoyed before my diagnosis.”
What the examiner listens for:
The examiner needs to confirm that activity regulation is a medical necessity, not merely a personal choice. Documentation from a treating physician stating activity restrictions is ideal. They will note whether this is due to hypoglycemia risk, cardiovascular complications, or other diabetic factors.
Understatements to avoid:
Do not say 'I try to take it easy' - say 'my doctor has instructed me to avoid strenuous activities due to the risk of hypoglycemia.' The distinction between voluntary lifestyle choice and medically required restriction is critical for the 40%+ rating tiers.
Diabetic Complications
How to describe:
Systematically describe each complication you have been diagnosed with, the impact it has on your daily function, and whether it is being treated separately. Key compensable complications include: peripheral neuropathy (numbness, burning, pain in hands/feet), nephropathy (kidney function changes, protein in urine), retinopathy (vision changes, floaters, reduced acuity), erectile dysfunction, hypertension in the presence of diabetic renal disease, peripheral vascular disease, and cardiac conditions.
Worst-day example:
“The neuropathy in my feet is severe enough that I cannot stand on hard floors for more than 10 minutes without burning pain. At night, the sensations are so painful they wake me up. My nephrologist has noted early-stage kidney disease from the diabetes. My ophthalmologist diagnosed background diabetic retinopathy last year. Each of these complications was directly caused by my diabetes and is documented in my VA medical records.”
What the examiner listens for:
The examiner is determining whether each complication would be rated compensably (10% or higher) if evaluated separately - this is the distinction between the 60% tier (non-compensable complications) and 100% tier (compensable complications). They will check boxes for each complication present and may need to complete additional DBQs.
Understatements to avoid:
Do not fail to mention complications because you think they are 'just part of diabetes.' Even if a complication is non-compensable on its own, it still contributes to the 60% criteria. If it IS compensable separately, it is critical evidence for the 100% criteria and may also support separate service-connected claims.
Progressive Weight and Strength Loss
How to describe:
If you have experienced documented weight loss or loss of muscle strength attributable to your diabetes, describe the timeline, the amount of weight lost, and how your physical strength or stamina has declined. This is a specific criterion for the 100% rating and should be supported by medical records showing your baseline weight versus current weight.
Worst-day example:
“I have lost 22 pounds over the past 18 months that my endocrinologist attributes to my poorly controlled diabetes. I have also noticed significant weakness - I used to be able to do yard work for hours but now I tire within minutes. My muscle mass has visibly decreased and my doctor has noted this in my chart as diabetic cachexia.”
What the examiner listens for:
The examiner will document the percentage of baseline weight lost and whether there is objective evidence of strength decline. This element, combined with multiple daily injections, 3+ hospitalizations per year, and restricted diet/activities, supports the 100% threshold.
Understatements to avoid:
Do not omit weight loss data. If you have records showing a significant drop in weight, bring them. If your doctor has ever used the words 'progressive weight loss' in your chart, point the examiner to that documentation.
Provider Visit Frequency
How to describe:
Accurately describe how often you must visit your diabetic care providers - including your endocrinologist, primary care physician for diabetes management, diabetes nurse educator, and any other specialists managing diabetic complications. Twice-monthly visits support the 60% tier; weekly visits support the 100% tier.
Worst-day example:
“I see my endocrinologist every other week because my blood sugar is so difficult to control. I also have monthly visits with my nephrologist and quarterly ophthalmology checks for my retinopathy. My care team has told me this frequency of monitoring is medically necessary to prevent further deterioration.”
What the examiner listens for:
The examiner is counting how often you visit a diabetic care provider specifically. All visits to providers managing your diabetes or its complications should be counted. They will note the frequency against the twice-monthly (60%) and weekly (100%) thresholds.
Understatements to avoid:
Do not undercount your visits. Bring a printout of your appointment history if possible. Count visits to endocrinologists, diabetes nurses, and primary care physicians when the visit is for diabetes management.
Common Mistakes to Avoid
Failing to specify the exact number of daily insulin injections
The difference between 'one injection' and 'more than one injection' per day is the critical distinction between the 40% and the threshold for 100%. Veterans who take a basal insulin once plus bolus doses with meals are taking 3-4+ injections but may say 'I take insulin' without specifying frequency.
Instead: Count every injection: basal insulin (even if once daily), bolus insulin with each meal, and correction doses. If you use an insulin pump, tell the examiner it delivers continuous basal plus multiple bolus doses. Say: 'I inject insulin four times per day - once at bedtime for basal coverage and before each meal.'
Impact: 100% vs. lower tiers
Not documenting hospitalizations for hypoglycemia or ketoacidosis with records
The number of hospitalizations per year is a hard threshold for the 60% and 100% rating tiers. Without documentation, the examiner may not record hospitalizations that occurred, potentially placing you at a lower rating tier than you qualify for.
Instead: Bring hospital discharge summaries, ER records, and ambulance run reports for every hypoglycemic or DKA episode requiring emergency treatment in the past 12 months. If records are unavailable, provide specific dates, facilities, and a written statement describing each episode.
Impact: 60% and 100%
Describing activity restrictions as personal choices rather than medical requirements
The rating criteria specifically require that activities be medically regulated - avoidance of strenuous occupational and recreational activities. If a veteran says 'I choose not to exercise much,' the examiner may not document this as a medically required restriction.
Instead: Reference your doctor's explicit instructions. Say: 'My endocrinologist has instructed me that I must avoid strenuous physical activity because it causes unpredictable blood sugar drops that could be life-threatening.' Bring any written documentation from your treating physician about activity restrictions.
Impact: 40%, 60%, 100%
Not mentioning all diabetic complications, especially those that might be compensable separately
Compensable complications (those that would rate 10% or higher under their own diagnostic code) are required for the 100% threshold and can also be claimed as separate service-connected conditions. Veterans often do not mention peripheral neuropathy, erectile dysfunction, or retinopathy unless asked directly.
Instead: Before your exam, prepare a written list of every diagnosed complication with the diagnosing provider and date of diagnosis. Present this list to the examiner and ask that each complication be addressed in the DBQ. Proactively mention: neuropathy, nephropathy, retinopathy, cardiac issues, hypertension, PVD, ED, skin conditions.
Impact: 60% and 100%
Reporting only 'good day' or current-controlled status rather than the full range of symptoms
Per M21-1 guidance, the VA rating is meant to reflect the average condition over time, including worst-day presentations. Veterans who present on a well-controlled day may describe fewer symptoms than they experience during flare-ups of poor control.
Instead: Describe your condition on your worst days and your typical bad days, not just how you feel on the day of the exam. Say: 'Today is a relatively controlled day, but I want to describe what happens when my diabetes is poorly controlled, which occurs approximately [X] days per month.'
Impact: All levels
Failing to count all visits to diabetic care providers toward the frequency threshold
Veterans may only count endocrinologist visits when the rating criteria count visits to any diabetic care provider. Diabetes-related visits to primary care, nephrology, ophthalmology, podiatry, and diabetes educators all count.
Instead: Compile a complete list of all appointments related to diabetes management in the past 12 months, including all specialists managing diabetic complications. Present this to the examiner and clarify that each is a visit to a diabetic care provider.
Impact: 60% and 100%
Not documenting weight loss with objective measurements
Progressive loss of weight and strength is a specific 100% criterion. Without documented baseline and current weights, the examiner cannot objectively confirm this criterion even if it is occurring.
Instead: Bring records showing your weight over time - VA visit notes, primary care records, or a written log. If you have lost significant weight, tell the examiner the timeframe and amount. Ask that the examiner note this in the DBQ with supporting documentation.
Impact: 100%
Assuming non-compensable complications do not matter
Non-compensable complications (those that would not reach a separate 10% rating) are still required for the 60% rating tier. Veterans may dismiss mild neuropathy, early retinopathy, or borderline kidney function as 'not worth mentioning' when they are directly relevant to their rating.
Instead: Report every complication diagnosed by a physician, regardless of severity. Even early-stage or mild complications support the documentation needed for higher rating tiers.
Impact: 60%
Prep Checklist
Before Your Exam
Day Of
During the Exam
After the Exam
Your Rights During a C&P Exam
- You have the right to request a copy of the completed Disability Benefits Questionnaire (DBQ) after your C&P examination.
- In most states, you have the right to record your C&P examination. Notify the examiner at the start of the exam if you intend to record.
- You have the right to bring a representative (VSO, accredited claims agent, or attorney) or a support person to your C&P examination.
- You have the right to submit your own private medical opinion or Independent Medical Opinion (IMO) from a treating physician to supplement or rebut C&P examination findings.
- You have the right to request a new or supplemental C&P examination if you believe the original examination was inadequate, failed to consider all evidence, or contained factual errors.
- Per 38 CFR Note (2) under DC 7913, the VA may NOT request a glucose tolerance test solely for rating purposes once diabetes mellitus has been conclusively diagnosed.
- Under M21-1 guidance, the scope of a diabetes claim includes all diabetic complications - both those you explicitly claim and any newly discovered complications identified during the examination process.
- You have the right to request that the examiner complete separate DBQs for any compensable diabetic complications (e.g., peripheral neuropathy, retinopathy, nephropathy) identified during the examination.
- You have the right to submit buddy statements and personal statements as lay evidence describing the functional impact of your diabetes and its complications.
- You have the right to appeal a rating decision you disagree with through the Supplemental Claim, Higher-Level Review, or Board of Veterans' Appeals lanes under the Appeals Modernization Act (AMA).
- If you are unable to travel to a C&P examination due to your disability, you have the right to request an accommodation, including an in-home examination or telehealth examination.
Related Conditions
- Diabetic Peripheral Neuropathy Direct complication of Diabetes Mellitus. Rated separately under DC 8104 (peripheral nerves) if compensable. Presence of compensable neuropathy supports the 100% diabetes rating. The examiner should complete a separate Peripheral Nerves DBQ if neuropathy is present.
- Diabetic Nephropathy / Renal Dysfunction Direct complication of Diabetes Mellitus affecting kidney function. Rated separately under the Kidney DBQ if compensable. Hypertension in the presence of diabetic renal disease is also evaluated separately. Presence supports higher diabetes rating tiers.
- Diabetic Retinopathy Direct complication of Diabetes Mellitus affecting vision. Rated under DC 6040 (Diabetic Retinopathy). If compensably ratable separately, it supports the 100% diabetes rating. A separate Eye Conditions DBQ should be completed if retinopathy is present.
- Erectile Dysfunction Common complication of Diabetes Mellitus due to vascular and neurological damage. Rated separately under DC 7522 as a special monthly compensation (SMC) issue rather than a percentage rating. The examiner should note its presence in the Diabetes DBQ and a separate ED evaluation may be warranted.
- Hypertension (Diabetic Renal Disease) Hypertension in the presence of diabetic renal disease is evaluated under DC 7101 and rated separately. This is a common secondary condition to diabetes. The examiner should complete a Hypertension DBQ if this condition is present.
- Peripheral Vascular Disease (Diabetic) Vascular damage from diabetes affecting circulation in the extremities. Rated separately under the Peripheral Arteries DBQ if compensable. Presence supports higher diabetes rating tiers and may lead to separate service connected claims.
- Cardiac Conditions (Diabetic) Cardiovascular complications of diabetes including coronary artery disease and heart failure. Rated separately under the Heart Conditions DBQ if compensable. Compensable cardiac conditions support the 100% diabetes rating threshold.
- Stroke (Cerebrovascular Accident) Diabetes is a significant risk factor for stroke. If stroke occurred as a result of the diabetic process, it may be claimed as a secondary condition. Rated under appropriate neurological DBQs. Compensable stroke residuals support the 100% diabetes rating.
- Skin Conditions (Diabetic) Diabetic skin complications including chronic wounds, ulcers, and infections. Rated separately under the Skin Conditions DBQ if compensable. Chronic non healing wounds or amputations related to diabetes may also support separate claims.
- Female Sexual Arousal Disorder (FSAD) Sexual dysfunction in female veterans as a complication of Diabetes Mellitus due to nerve and vascular damage. The examiner should note its presence in the Diabetes DBQ and a separate evaluation may be warranted.
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This C&P exam preparation guide is for educational purposes only and does not constitute legal, medical, or claims advice. Always consult with a qualified Veterans Service Organization (VSO) representative or VA-accredited attorney for guidance specific to your claim. Never exaggerate, minimize, or fabricate symptoms during a C&P examination.