If you’re a veteran with PTSD that is service-connected, you may be at risk of developing diabetes later. Common symptoms of PTSD like depression, overeating, and lack of exercise may result in a veteran developing diabetes secondary to PTSD. Some veterans have been able to prove a connection between their PTSD and diabetes diagnoses, and earn VA benefits for both health conditions. Veterans may also be able to show other service-connected mental health conditions caused them to develop diabetes.
In this article, we detail how your diabetes could be secondary to your service-connected PTSD, so you can understand how to get the compensation you deserve.
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In this article about service connecting diabetes secondary to PTSD:
- PTSD and other mental health conditions in veterans
- Diabetes in veterans
- Diabetes secondary to PTSD
- Diabetes secondary to other mental health conditions
- How the VA rates PTSD and diabetes
- TDIU for diabetes secondary to PTSD
- How our veterans disability lawyers can help
PTSD and other mental health conditions in veterans
Mental health is an ongoing issue for many veterans due the enormous amount of stress and trauma they experience in service. Aside from combat stressors, the amount of strain veterans endure upon returning to their civilian lives after discharge doesn’t help.
Post-traumatic stress disorder (PTSD) and depression are two of the most commonly diagnosed mental health conditions among veterans. In fact, at least 500,000 veterans who served in modern wars have been diagnosed with PTSD. According to the VA’s 2022 Annual Report, of the 5.8 million veterans receiving VA disability, 1.3 million are receiving compensation for PTSD. This makes PTSD the fourth most common service-connected disability.
PTSD is characterized by symptoms such as depression, anxiety, hypervigilance, and recurring negative thoughts. Among the veteran population, PTSD can be caused by combat and non-combat stressors.
Examples of combat stressors include:
- Witnessing the death of a fellow service member
- Enemy ambush
- Military plane crash
- Personal injury from combat
Examples of non-combat stressors include:
- Military sexual trauma (MST)
- Training accident
- Vehicle accident
Overall, more than 2.3 million veterans are service connected through the VA for mental health conditions. That’s more than 8% of all VA disability compensation recipients.
Diabetes in veterans
Diabetes is a chronic illness in which your body doesn’t make enough insulin or doesn’t use it like it should. Over time, too much sugar builds up in your bloodstream. This can lead to vision loss, kidney disease, heart disease, numbness, tingling, and even amputations.
Diabetes affects 25% of the VA’s patient population. With a statistic like that, you must be wondering why so many veterans are affected by this illness. Let’s break down the possible causes of diabetes and how those can be closely tied to veterans.
Type 1 diabetes, also known as insulin-dependent diabetes, is often detected in children, but can develop in adults. If you have type 1 diabetes, your pancreas doesn’t make enough insulin, or may not make any at all. Your body needs insulin to convert blood sugar into energy. Type 1 diabetes can be caused by genetics, environmental factors, or exposure to viruses.
Type 2 diabetes is a problem with the way the body regulates sugar and uses it as energy, and is most common in older adults. This condition can develop over time from factors like poor diet, too little exercise, chronic stress, sleep issues, or genetics. Type 2 diabetes is also often associated with obesity.
Diabetes can be directly connected to a veteran’s service and type 2 diabetes is a presumptive condition of Agent Orange exposure. However, diabetes can also be secondary to another service-connected condition like PTSD. We explain below.
Diabetes secondary to PTSD
During active-duty service, you may have witnessed or experienced traumatic events that have stuck with you long after discharge. Those stressors may have led to a diagnosis of PTSD. As we discussed above, PTSD can severely impact your quality of life.
The constant anxiety and stress you carry may cause you to exercise less, develop a poor diet, and have trouble getting a good night’s sleep. Any combination of these risk factors can lead to diabetes.
If you are service connected for PTSD and later developed diabetes, you could also become service connected for diabetes. This is what the VA calls a secondary service connection. In this case, diabetes is secondary to PTSD if symptoms of PTSD caused you to develop diabetes.
Diabetes secondary to other mental health conditions
Because they often share similar symptoms and risk factors, veterans could also develop diabetes secondary to other mental health conditions like depression and bipolar disorder.
Diabetes secondary to bipolar disorder
Bipolar disorder is characterized by irritable or euphoric moods and drastic changes in energy levels. Often, veterans with bipolar disorder display manic behavior followed by low, depressive moods.
Studies show that patients with bipolar disorder have a higher risk of developing type 2 diabetes. In fact, diabetes occurs up to three times more often in patients with bipolar disorder than it does within the general population.
Some mood stabilizing medications used to treat bipolar disorder can also impair glucose metabolism in bipolar patients.
In addition, bipolar patients are at a higher risk of obesity and often live more sedentary lifestyles. Each of these are huge risk factors for diabetes.
Diabetes secondary to depression
Depression can be caused by various factors, including stressful or traumatic life events, genetics, and health problems like anemia and thyroid issues. People with depression experience intense sadness, feelings of hopelessness and general loss of interest.
Due to the stresses and trauma of combat, depression is commonly diagnosed in veterans. A 2008 study estimated that 1 in 3 veterans have symptoms of depression, 1 in 5 has serious symptoms that require treatment, and 1 in 8 to 10 has major depression.
Like bipolar disorder, depression can also lead to a more sedentary lifestyle, an unhealthy diet, smoking, and weight gain. Each of these is a known risk factor for developing diabetes.
Just like with PTSD, if you are service-connected for bipolar or depression, and later develop diabetes, you could receive a secondary service connection for diabetes.
How the VA rates PTSD and diabetes
The VA rates PTSD using the General Rating Formula for mental health conditions. This means you could earn a rating of 10%, 30%, 50%, 70%, or 100% based on the severity of your symptoms. Once you’ve been assigned a rating by the VA, they will consider any secondary conditions that may have been caused by your service-connected PTSD. In this case, diabetes. You will need to be prepared to provide a “medical nexus” which shows there is a medical link between your diabetes and PTSD. You can also claim your PTSD and diabetes at the same time. However, if you’ve already been assigned a rating for your PTSD and you develop diabetes later, there is no time limit on claiming diabetes secondary to PTSD.
The VA rates diabetes using diagnostic code 7913 as follows:
|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||100%|
|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||60%|
|Requiring one or more daily injection of insulin, restricted diet, and regulation of activities||40%|
|Requiring one or more daily injection of insulin and restricted diet, or; oral hypoglycemic agent and restricted diet||20%|
|Manageable by restricted diet only||10%|
TDIU for diabetes secondary to PTSD
Total disability based on individual unemployability (TDIU) is for veterans with service-connected conditions that prevent them from keeping substantially gainful employment.
You are eligible for TDIU if you have:
- At least one service-connected disability that is rated at least 60%, or
- Two or more service-connected disabilities with a combined rating of 70% or more. In this case, you must have one single disability rated at 40% or more.
In order to receive TDIU for diabetes secondary to PTSD, your PTSD must be service connected. Next, you’ll need to prove that your diabetes is service-connected on a secondary basis to your PTSD, meaning your PTSD symptoms caused your diabetes. Finally, your ratings will have to meet the VA’s TDIU eligibility criteria.
If the effects of your PTSD and diabetes make working difficult or impossible, you may want to consider seeking TDIU.
“They did good by me. I am sick, and the VA was stalling. They got me 100% permanent and total.“
How our veterans disability lawyers can help
It may be difficult for veterans to receive the benefits they deserve for diabetes secondary to PTSD. With help from an attorney, you can appeal decisions you disagree with and start working toward a better life.
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FREQUENTLY ASKED QUESTIONS
Research suggests that risk factors like obesity, lack of exercise, anxiety, depression, and poor diet, all symptoms of PTSD, can cause someone to develop diabetes. In order to receive benefits for your diabetes on a secondary basis to PTSD, you would need to show it is “as least as likely as not” that your service-connected PTSD caused you to develop diabetes.
You could be granted TDIU if you have at least one service-connected disability that is rated at least 60%, or two or more service-connected disabilities with a combined rating of 70% or more with one condition rated at least 40% disabling. PTSD, diabetes, or a combination of both conditions could qualify you for TDIU.