In order to demonstrate a “regulation of activities,” you must have medical evidence showing that a medical provider has prescribed or advised you, as part of a treatment plan to manage your diabetes, to “avoid strenuous occupational and recreational activities.” An individual’s voluntary restriction on his own exercise or other activity to avoid hypoglycemic events is not sufficient nor is an individual’s belief that he is regulating his own activities enough. A profile might be sufficient if ordered by a medical provider, depending on the scope of the language in the profile. The bottom line is that the phrase “regulation of activities” is a medical determination. Getting an endocrinologist to render a medical opinion that treatment of your Type 1 Diabetes must include the avoidance of strenuous occupational and recreational activities will go a long way to getting you to 40%, assuming you meet the other evaluation criteria under the VASRD, Diagnostic Code 7913.
Take a look at the way VA rates diabetes so that you can be sure you highlight for the VA or other doctors or providers the way you meet the evaluation criteria in an effort to have your service treatment records or VA records substantiate your claim. I’ve attached a copy of Diagnostic Code 7913, under which the VASRD rates diabetes. Here’s a link to the VA DBQ for diabetes so you can see what a VA examiner will be looking for to track to the evaluation criteria.
https://www.benefits.va.gov/compensation/docs/Diabetes_Mellitus.pdf
Diabetes is rated pursuant to
38 C.F.R. § 4.119, DC 7913 (
diabetes mellitus). Under DC 7913, a 20 percent rating is assigned when
diabetes requires
insulin and a restricted diet, or an oral hypoglycemic agent, and a restricted diet. A 40 percent rating is assigned when
insulin, a restricted diet, and regulation of activities are required. A 60 percent rating is assigned when
insulin, a restricted diet, and regulation of activities are required, along 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. A 100 percent rating requires 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 rated.
38 C.F.R. § 4.119, Code 7913.
It is important to remain mindful that each level of increase in the progressive ratings for diabetes requires that the individual must meet both the additional criteria as well as the criteria for the lower ratings to warrant the increase.
