Get ready for your exam
Diabetes (type 2)
Diabetes type 2
What it is
Type 2 diabetes means your body can't control your blood sugar well.
VA's code numbers for this: 7913
What the examiner will do
Who does it: A VA doctor or a VA contract examiner. VA's exam page (updated Aug 15, 2025) names four contract companies: Loyal Source Government Services, OptumServe Health Services, Leidos QTC Health Services, and Veterans Evaluation Services (VES). (LHI is an older name; it is now part of OptumServe.) You can't pick which one. Answer every call or letter about scheduling.
- A VA or contract doctor, NP, or PA. Often 20-30 minutes.
- Questions: When diagnosed? What medicines and insulin? Diet? Has a provider limited your activities? Hospital visits for sugar? How often do you see your diabetes provider? Problems with eyes, feet, kidneys, nerves, ED?
- They may check your feet, pulses, and sensation and review lab results.
Tests, in plain words
- A1C
- A blood test showing your average sugar over about 3 months. 6.5% or higher usually means diabetes.
- 'Oral hypoglycemic agent'
- A pill that lowers blood sugar, like metformin.
- 'Regulation of activities'
- A doctor's order to avoid hard work and hard exercise to prevent low sugar. It must come from a medical provider, not just your own choice.
- Ketoacidosis / hypoglycemic reaction
- Dangerously high sugar with acid in the blood / dangerously low sugar (shaky, sweaty, confused, passing out).
- Complications rated separately
- Nerve damage (neuropathy), eye damage, kidney damage, and ED are rated on their own if they reach at least 10%.
The examiner fills out a form called a DBQ. You can read it ahead of time: Diabetes Mellitus DBQ (opens VA's site).
The rating levels, in plain words
VA picks the level that best matches how often and how badly the condition affects you.
10%
Controlled with a special diet only.
VA's exact words
Manageable by restricted diet only
Rule: 38 CFR 4.119, DC 7913
20%
Diet PLUS diabetes pills, OR diet PLUS insulin shots.
VA's exact words
Requiring one or more daily injection of insulin and restricted diet, or; oral hypoglycemic agent and restricted diet
Rule: 38 CFR 4.119, DC 7913
40%
Insulin shots, diet, AND a doctor has told you to avoid hard physical work and hard exercise ('regulation of activities').
VA's exact words
Requiring one or more daily injection of insulin, restricted diet, and regulation of activities
Rule: 38 CFR 4.119, DC 7913
60%
All of the 40% items, PLUS dangerous high or low sugar episodes that put you in the hospital 1-2 times a year or make you see your diabetes provider twice a month, PLUS minor complications.
VA's exact words
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
Rule: 38 CFR 4.119, DC 7913
100%
More than one insulin shot a day, diet, activity limits, PLUS 3+ hospital stays a year or weekly diabetes visits for sugar emergencies, PLUS steady weight and strength loss or serious complications.
VA's exact words
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
Rule: 38 CFR 4.119, DC 7913
What to track before your exam
What to write down: Medicines and insulin, diet orders, any written activity limits, sugar readings, low-sugar episodes, ER or hospital visits, provider visits, and complications.
How: Get a printout of your medicines and A1C results. Ask your provider to put any activity limits in writing in your chart. For 30 days, log sugars and any lows or highs.
Your log: what to write each time
- Date
- Morning sugar
- Other sugars
- Insulin units / pills taken
- Low or high episode? what happened
- ER, hospital, or extra provider visit?
- Numbness/tingling in hands or feet?
- Notes
Tap Print this page to get a blank log sheet and your exam-day checklist on paper.
Exam-day checklist
Tick each one off. Nothing you tick is saved or sent anywhere.
What to bring: Bring a photo ID, your list of medicines and doses, your home log, and any new private records you have not sent to VA yet. VA says you don't have to bring anything, but your notes help you remember. A spouse or caregiver may come along. VA says you can ask the examiner if they can stay in the room. The examiner may ask them to wait outside.
Tell the examiner
Honest exam rules
- Tell the whole truth. Don't add to it. Don't shrink it.
- Describe a normal day AND your worst days. Say how often the worst days happen.
- Answer the question you were asked. Skip the habit of saying 'I'm fine' or 'it's not that bad' when it is.
- It's OK to read from your log or notes. Hand the examiner a copy if they will take it.
- Don't act out symptoms or guess at numbers. If you don't know or can't remember, say so.
- If something hurts or makes you worse during the exam, say so right then.
- Fraud warning: knowingly giving VA false information is a federal crime (18 U.S.C. 1001) and can cost you all your benefits (38 U.S.C. 6103). Honest, complete answers protect you.
Common mistakes
Expecting 40% without a provider's written activity limits. Your own choice to slow down isn't enough.
Where this comes from: Camacho v. Nicholson, 21 Vet. App. 360 (2007)
On a non-insulin injectable (like Byetta-type drugs)? Courts said 'insulin' means actual insulin.
Where this comes from: Middleton v. Shinseki, 727 F.3d 1172 (Fed. Cir. 2013)
Not claiming complications like neuropathy, eye, kidney, or ED.
Where this comes from: 38 CFR 4.119, DC 7913, Note (1)
Type 2 diabetes is presumptive for Agent Orange exposure in listed places and dates.
Where this comes from: 38 CFR 3.309(e)
Questions to ask together
A spouse, grown child or friend can read these out loud. Talk about each one before the exam, so nothing gets left out.
- What diabetes medicines and insulin do you take, and how many shots a day?
- Has your doctor told you to avoid hard work or exercise? Is it in writing?
- Have you had a low-sugar or high-sugar emergency this year? Hospital or ER?
- How often do you see your diabetes provider?
- Any numbness in your feet, vision changes, kidney problems, or ED?
Rule changes you may hear about
Today's rules (above) are what VA uses unless a change is final.
Cancelled, not in force
On Feb 17, 2026, VA put out a quick rule that would have rated you with the help your medicine gives you (38 CFR 4.10). VA cancelled it 10 days later. The old wording is back. Court case Jones v. Shinseki, 26 Vet. App. 56 (2012) still says: if the rating rule doesn't mention medicine, VA can't lower your rating because medicine helps.
Where it stands: Rescinded effective Feb 27, 2026. Not in force.
91 FR 7118 (Feb 17, 2026), interim final rule; 91 FR 9712 (Feb 27, 2026), rescission. RIN 2900-AS49
Sources
Helping The Brave doesn't file or prepare claims. This guide is free education, not medical or legal advice. The VA examiner measures and VA decides your rating.