Rating Schedule for the Genitourinary System
The parts of the body that remove liquid waste from the body. This also includes the male sex organs.
PYRAMIDING NOTES:
If the Veteran has a single condition that affects both the kidney AND urinary functions the Veteran can only receive a single rating for either being affected! - whichever would give the Veteran the highest rating.
However, if the Veteran has more than one condition that could affect both set of functions the Veteran CAN receive a singular ratings for the kidney and the urinary functions being affected!
Kidney
Removes wastes from the blood and urine.
Hello Kidney!
Kidney Failure (Renal Disease, Renal Dysfunction)
When your kidney is not being the best it can be.The following conditions may also be known broadly as Nephropathy. Which are conditions that impair renal function:
Atheroembolic renal disease
Atherosclerotic renal disease
Cystic diseases of the kidney:
Polycystic disease
Medullary sponge kidney
Uremic medullary cystic disease
etc.
Disseminated intravascular coagulation with renal cortical necrosis (Renal cortical loss)
Glomerulonephritis
Interstitial nephritis
Papillary necrosis
Renal amyloid disease
Renal artery stenosis
Renal Involvement (due to Diabetes mellitus, Sickle cell anemia, Systemic lupus erythematosus, Vasculitis, or other systemic disease processes)
Toxic nephropathy
IMPORTANT NOTE:
Conditions can be rated under this schedule OR under the Urinary Rating System; whichever will provide the highest rating!
| Rating |
Description |
|---|---|
| 0% |
Glomerular Filtration Rate (GFR) from 60 to 89 mL/min/1.73m2 AND albumin/creatinine ratio (ACR) ≥30 mg/g for at least 3 consecutive months during the past 12 months; or GFR from 60 to 89 mL/min/1.73m2 |
| 30% | Chronic kidney disease with GFR from 45 to 59 mL/min/1.73m2 for at least 3 consecutive months during the past 12 months. |
| 60% | Chronic kidney disease with GFR from 30 to 44 mL/min/1.73m2 for at least 3 consecutive months during the past 12 months. |
| 80% |
Chronic kidney disease with GFR from 15 to 29 mL/min/1.73m2 for at least 3 consecutive months during the past 12 months. |
| 100% | Chronic kidney disease with GFR less than 15 mL/min/1.73m2 for at least 3 consecutive months during the past 12 months; or requiring regular routine dialysis; or eligible kidney transplant recipient. |
RATER NOTES:
Three consecutive months does NOT mean continuous - readings that are confirmed at least once every month!
It means abnormal finding with another repeated abnormal finding 3 or more months later during a 12-month period.
If there is evidence to suggest a chronic condition exists BUT there is only one abnormal reading of record a rater CAN grant an increase. However, an At once examination 3 months into the future MUST be established!
GFR, estimated GFR (eGFR), and creatinine-based approximations of GFR will be accepted for evaluation purposes under this section when determined to be appropriate and calculated by a medical professional.
Common Secondaries
7500 Removal of One Kidney (Nephrectomy)
IMPORTANT NOTES:
If the kidney removal is related to a donation, it CANNOT be service-connected!
HOWEVER, if the donation results in unexpected/abnormal complications those complications CAN be service-connected!
| Rating |
Description |
|---|---|
| ?% |
If still experiencing Kidney failure and it rates higher than the minimum; Veteran gets the higher of the 2 ratings. |
| 30% | Minimum rating. |
| Rating |
Description |
|---|---|
| ?% |
If still experiencing Kidney failure and it rates higher than the minimum; Veteran gets the higher of the 2 ratings. |
| 30% | Minimum rating. |
| 100% | For 1 year following the surgery. |
7531 Kidney Transplant
7502 Nephritis
Swelling of the kidney.
Rated under Kidney failure.
PYRAMIDING NOTES:
As nephritis is often connected to Heart diseases (this does include Hypertension). If the Veteran has both and they can be determined to be caused by the same general condition. Then the Veteran will only receive a singular rating for either the nephritis or the heart disease - whichever is higher.
EXCEPTIONS to receiving the singular ratings for the heart and kidneys:
If the nephritis was so advanced that it required regular dialysis. Then the Veteran CAN get both ratings even if they were caused by the same general condition.
Veteran only has a single kidney, EVEN IF removal was required because of nephritis.
RATER NOTES:
Albuminuria alone is NOT nephritis.
Do NOT accept the presence of transient symptoms, such as elevated albumin and the presence of casts following febrile illness as establishing nephritis.
7507 Hardening of the Kidney (Nephrosclerosis)
Damage done by high blood pressure.
PYRAMIDING NOTE:
As this condition is a symptom of High blood pressure or Heart disease. The Veteran can only receive a singular rating under Kidney failure, high blood pressure, or heart disease; Whichever is highest.
IMPORTANT NOTES:
The Veteran is entitled to have their high blood pressure or heart disease rating bumped 1 compensational degree! If rated under those schedules INSTEAD of kidney failure!
IE. if heart disease would have been rated at 30% then it would be bumped to the next higher rating which is 60%!
This 1 degree compensational bump is NOT applied to the kidney failure schedule!
This bump is NOT applied in consideration of “whichever is highest”. it is applied only AFTER it is determined that high blood pressure or heart disease would rate higher!
7532 Renal Tubular Disorders (Renal Glycosurias, Aminoacidurias, Renal Tubular Acidosis, Fanconi's Syndrome, Bartter's Syndrome, related disorders of Henle's Loop and Proximal or Distal Nephron Function, etc.)
| Rating |
Description |
|---|---|
| ?% |
If experiencing Kidney failure and it rates higher than the minimum; Veteran gets the higher of the 2 ratings. |
| 20% | Minimum rating (if there are obvious symptoms). |
7504 Kidney Infection (Pyelonephritis)
Can be rated under Kidney failure or Urinary tract infection. The Veteran will get a singular rating under whichever schedule provides the highest rating.
7508 Kidney Stones (Nephrocalcinosis, Nephrolithiasis, Ureterolithiasis)
Will be rated under Hydronephrosis unless the Veteran meets the following criteria:
| Rating |
Description |
|---|---|
| 30% |
Frequent stones requiring invasive or non-invasive procedures more than 2 times a year. |
Definitions:
Frequent stones - more than one a year.
Invasive procedures:
Open surgical lithotomy;
Percutaneous nephrolithotomy (PCNL);
Retrograde intrarenal surgery (RIRS); or
Other minimally invasive endourological treatments.
Non-invasive procedures:
Shockwave lithotripsy (SWL); or
Ureteroscopic fragmentation and retrieval.
7509 Hydronephrosis
Excess fluid in a kidney due to a backup of urine.
| Rating |
Description |
|---|---|
| 10% |
Occasional kidney stones, does not result in infection or need for catheter. |
| 20% | Frequent kidney stones, requires catheter drainage. |
| 30% | Frequent kidney stones, with infection (pyonephrosis), and kidney function is impaired. |
| ?% | If severe kidney impairment is present, condition will be rated under Kidney failure instead (if it provides a higher rating). |
Definition:
Frequent stones - more than 1 a year.
7511 Ureter Stricture
Will be rated under Hydronephrosis unless the Veteran meets the following criteria:
| Rating | Description |
|---|---|
| 30% | Frequent stones requiring 1. diet therapy, 2. drug therapy, or 3. invasive or non-invasive procedures more than 2 times a year. |
Definitions:
Frequent stones - more than one a year.
Invasive procedures:
Open surgical lithotomy;
Percutaneous nephrolithotomy (PCNL);
Retrograde intrarenal surgery (RIRS); or
Other minimally invasive endourological treatments.
Non-invasive procedures:
Shockwave lithotripsy (SWL); or
Ureteroscopic fragmentation and retrieval.
1. Urinary Frequency
Condition causes you to urinate more often than normal.
| Rating |
Description |
|---|---|
| 10% |
Must urinate every 2-3 hours, during the day; or must urinate 2 times, during the night. |
| 20% | Must urinate every 1-2 hours, during the day; or must urinate 3-4 times, during the night. |
| 40% | Must urinate less than an every hour, during the day; or must urinate 5 or more times during the night. |
| Rating |
Description |
|---|---|
| 0% |
There are only symptoms (hesitancy to start urinating, slow or weak stream, or low force of stream). With or without needing stretching treatments 1-2 times a year. |
| 10% | There are obvious symptoms (hesitancy to start urinating, slow or weak stream, or low force of stream) with 1 or more of the following: 1) Greater than 150cc of urine remains in bladder after you finish urinating; 2) Less than a 10cc/sec peak flow rate; 3) Regular urinary tract infections due to the obstruction; 4) Requires stretching treatments at least once every 2-3 months. |
| 30% | Requires the intermittent or continuous use of a catheter. |
2. Obstructed Urination (Voiding)
Condition makes it hard to urinate.
3. Voiding Dysfunction
When the urinary condition just does not quite fit under frequency or obstructed urination measures.
This usually boils down to conditions that cause loss of bladder control resulting in continual urine leakage (urinary incontinence).
| Rating |
Description |
|---|---|
| 20% |
Requires the wearing of absorbent materials (such as pads or diapers) which must be changed once a day. |
| 40% | Requires the wearing of absorbent materials which must be changed 2-4 times a day. |
| 60% | Requires the use of an appliance (such as a catheter); or the wearing of absorbent materials which must be changed more than 4 times a day. |
RATER NOTE:
When a catheter is used primarily as a tool to retain urine then the Veteran should be rated under the Obstructed urination schedule and NOT this one. Unless, this schedule better captures the predominant disability.
7512 Chronic Cystitis and Painful Bladder Syndrome (Interstitial Cystitis)
Inflammation of the bladder, most often due to infections.
Rated under the Urinary rating system.
7515 Bladder Stones (Calculus in the Bladder)
Rated under the Urinary rating system.
7545 Bladder Diverticulum
When the bladder develops pouches within its walls.
Rated under the Urinary tract infection schedule; OR
Rated under the Urinary rating system. Whichever best covers the symptoms.
7516 Bladder Fistula (Fistula of the Bladder) and Suprapubic Cystotomy
An abnormal passageway that connects the bladder to other areas of the body that would not normally connect.
If symptoms are mostly associated with a UTI, it is rated under the Urinary tract infection schedule. Otherwise it is rated under the Urinary rating system.
| Rating |
Description |
|---|---|
| 100% | After suprapubic cystotomy - surgery that creates a passageway from the bladder to the skin, allowing a person to urinate. |
7517 Injury of the Bladder
Rated under the Urinary rating system.
7542 Neurogenic Bladder
Loss of bladder control due to nerve or brain.
Rated under the Urinary rating system.
7518 Stricture of the Urethra (Narrow Urethra)
Propane and propane accessories!When the passageway through the urethra becomes narrowed.
Rated under the Urinary rating system.
7519 Fistula in the Urethra
An abnormal passageway from the urethra to other areas of the body that would not normally connect.
| Rating |
Description |
|---|---|
| ?% | Rated under the Urinary rating system, unless there are multiple fistulas. |
| 100% | If there are multiple fistulas. |
Urinary Tract Infection Schedule (UTI, Bladder Infection, Kidney Infection)
A urinary tract infection is a bacterial infection be it in your kidneys, ureters, bladder, or urethra.
| Rating |
Description |
|---|---|
| 0% |
Regular infections NOT requiring hospitalizations, but DO require suppressive drug therapy for less than 6 months. |
| 10% | Regular infections that require 1-2 hospitalizations a year; or requires occasional intensive treatment; or regular continuous use of medication to treat. |
| 30% | Regular infections that require 3 or more hospitalizations a year; or requires intensive and continuous treatment. |
Definitions:
Suppressive drug therapy - use of prolonged suppressive antibiotic therapy OR medications.
Continuous intensive management - treatment beyond the use of antibiotic or other medications or hospitalizations. Examples of this level of care include but are NOT to limited surgical management of the nephrostomy and/or stent, intravenous antibiotics, or treatment that is otherwise required for the maintenance of the nephrostomy tube or stent.
Catheters are NOT considered to require intensive and continuous treatment.
NOTE:
UTIs can cause kidney issues. If so, the Veteran can be rated under Kidney failure instead, if it would produce a higher rating.
7501 Abscess of the Kidney (Renal Abscess)
A puss-filled pocket in the kidney.
Rated under the Urinary tract infection schedule.
7525 Chronic Epididymitis (Epididymo-orchitis, Urethritiis Prostatitis)
Inflammation of the tube at the back of the testicle.
Rated under the Urinary tract infection schedule; OR
Rated under Nonpulmonary tuberculosis if caused by tuberculosis.
NOTE:
The Veteran will still only get a singular rating if both testicles are affected.
7527 Prostate Gland Conditions - Injuries, Infections, Enlargement (hypertrophy), or after Surgery Residuals
Rated under the Urinary tract infection schedule; OR
Rated under the Urinary rating system. Whichever best covers the symptoms
Common secondaries
Retrograde ejaculation can result from some types of BPH treatment, especially transurethral resection of the prostate (TURP).
Erectile dysfunction (ED) as a result of treatment or if hormone therapy.
7505 Tuberculosis of the Kidney
Rated as Nonpulmonary tuberculosis.
The Penis and Testes
The wounds you don't brag about.
IMPORTANT NOTE:
Veterans with these conditions are likely entitled to SMC K.
7520/7521 Loss of the Penis (Penis Deformity)
Can be rated under the Urinary rating system instead of this schedule, if it produces a higher rating.
| Rating |
Description |
|---|---|
| 20% |
Just the tip. |
| 30% | Half or more. |
7522 Erectile Dysfunction (ED)
IMPORTANT NOTES:
The ability to sometimes achieve an erection or impregnate someone does NOT prevent you from getting service-connection OR SMC K
If ED is the result of Diabetes mellitus, you won't get a separate rating ED. Administratively, it will look like: diabetes type II with erectile dysfunction. That said, you ARE still entitled to SMC K.
| Rating |
Description |
|---|---|
| 0% |
Difficulty/inability achieving or maintaining an erection. |
7524 Removal of Testicle (Removal of the Testis, Orchiectomy)
RATER NOTE:
In the event that one testicle is removed due to a non service-connected event and the other was removed due to a service-connected event (or vice versa) the Veteran will receive a 30% rating.
| Rating |
Description |
|---|---|
| 0% |
One. |
| 30% | Both. |
The VA will conduct regular Reevaluations every 6 months (unless otherwise stated) to determine if your cancer is still active. UNLESS, there is medical evidence that your cancer is terminal. In which case, the VA will consider the cancer to be permanent and your 100% rating will continue till death.
IMPORTANT NOTES:
A diagnosis of prostate cancer is made only on the basis of a prostate biopsy. An elevated prostate-specific antigen (PSA) test is NOT diagnostic of prostate cancer.
HOWEVER, a prostate biopsy is NOT required to support a medical diagnosis that prostate cancer has returned after a radical prostatectomy; or after prostate cancer has been confirmed once before via a biopsy.
Common secondaries
| Type of Treatment | Common Secondaries | RATER NOTES: |
|---|---|---|
| Chemotherapy | Varies. | Rate residuals based upon the impacted Body system(s). |
| Cryotherapy (cryosurgery or cryoablation) | Erectile Dysfunction and Urinary incontinence | Grant SMC K as needed. |
| Hormone therapy | Erectile Dysfunction | If the Testicles are removed, award the appropriate ratings. |
| Radical prostatectomy | Erectile Dysfunction, Scars, and Urinary incontinence | Grant SMC K in ALL CASES! |
| Radiation | Bowel problems, Erectile Dysfunction and Urinary incontinence | Low dose radiation (LDR) treatment is designed to last a year, as such do NOT assign a Reevaluation till 6 months after this year of treatment ends! |
| Watchful waiting (conservative management, observation, or surveillance) | None. | While cancer is active the 100% rating will continue. |
7529 Tumor (Benign Neoplasm)
Can be rated under Kidney failure; or
Under the Urinary rating system.
Depending which better captures the Veteran's impairment.
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