Diabetic Retinopathy VA Benefits—What You Can’t See Can Cause Blindness

Of the more than 250,000 U.S. veterans who receive disability benefits from the VA for eye problems, nearly a third resulted from the Gulf War. In addition, 75 percent of veterans with traumatic brain injuries (TBI) have vision issues, mostly without recognizing it or receiving coverage for the vision condition due to the TBI.

Injuries, exposure-related damage, and illnesses or diseases acquired while serving all contribute to eye problems. Diabetes is a significant contributor to serious eye problems, particularly diabetic retinopathy. Along with other eye conditions that are secondary to other medical conditions, diabetic retinopathy can qualify for VA disability benefits.

Diabetes is a common chronic condition among U.S. adults, and it is even more common among U.S. veterans. In 2017, the United States National Library of Medicine National Institute of Health published a study showing the prevalence of diabetes among veterans. Using data from the National Health and Nutrition Examination Survey (NHANES), research confirmed that diabetes is more common among U.S. veterans. Veterans account for 9 percent of cases compared to the general population, and the disease affects approximately 25 percent of U.S. Department of Veterans Affairs (VA) patients.

What Is Diabetes Mellitus?

The chronic condition known as Diabetes mellitus interferes with the body’s ability to absorb and process glucose (sugar). The pancreas either ceases producing insulin altogether or produces below normal blood sugar levels. As a result, glucose levels rise, causing damage to various parts of the body.

Why Is Diabetes So Prevalent Among The Veteran Population?

For starters, Type 2 Diabetes is one of the presumptive diseases linked to herbicide exposure during the Vietnam War. But Vietnam veterans aren’t the only ones who have developed diabetes as a result of their service. The VA has also established a connection to type 2 diabetes mellitus for veterans who served in the following areas and time periods:

• Veterans with “boots on the ground” and those serving on inland waterways in Vietnam between January 9, 1962 and May 7, 1975;

• “Blue Water” Navy Veterans who served within 12 nautical miles seaward of the demarcation line of Vietnam between January 9, 1962 and May 7, 1975;

• Veterans “who flew on or worked on C-123 aircraft” during the Vietnam War era;

• Veterans who served along the Korean Demilitarized Zone (Korean DMZ) between September 1, 1967 and August 31, 1971;

• Veterans who served on or near Thailand military bases between February 28, 1961 and May 7, 1975 and can prove they were near the perimeter of the base where Agent Orange was used.

If a veteran was diagnosed with diabetes while serving or resulting from an in-service disease, accident, or incident, they could be eligible for disability benefits via direct service association.

However, it is worth noting that the disproportionate number of veterans who develop diabetes is primarily due to the high prevalence of obesity in this population. While the VA doesn’t have a rating for obesity, there are other ways to get VA disability if you have service-connected issues related to obesity.

Is Obesity a VA Disability?

What Is The Link Between Diabetes Mellitus And Eye Conditions?

Diabetes is linked to a number of disorders, including kidney disease, peripheral neuropathy, hypertension, and a variety of eye conditions. In fact, the September 2019 VA Diabetes Fact Sheet reports that, for VA patients, diabetes is the leading cause of vision loss, blindness, amputation, and end-stage renal disease.

Diabetes can severely damage blood vessels. When elevated blood glucose levels damage blood vessels, diabetic eye disease can be the unfortunate result. Diabetic macular edema, glaucoma, cataracts, retinal detachment, and diabetic retinopathy are the most common eye health issues related to diabetes.

Your chances of developing eye problems or an eye disease increase the longer you have diabetes, and diabetic retinopathy develops in 40 percent of people with diabetes, according to the National Eye Institute.

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What Is Diabetic Retinopathy?

Diabetic retinopathy is a complication of diabetes that affects the eyes. It is caused by damage to the blood vessels in the tissue at the back of the eye (retina) that occur from elevated blood glucose levels. Because the sensitive retina is made up of thin tissue, blood vessels become swollen, leaking fluid until they eventually rupture. The blood vessels, which detect light and transmit information to the brain through the optic nerve, can no longer effectively communicate information to the brain through the optic nerve. The retina’s job is to deliver clear and sharp vision, but it can no longer do so.

Who Is At Risk For Developing Diabetic Retinopathy?

Anyone with type 1 or type 2 diabetes is at risk of acquiring diabetic retinopathy. There is a greater risk for those who have had diabetes for an extended period of time and for those who consistently have high blood sugar levels. Pregnant women, Afro-Caribbean and Asian people, and anyone with high blood pressure or high cholesterol are also at a higher risk.

Here one of our VA disability lawyers talks about how SMC (Special Monthly Compensation) works to help you get more money for extra expenses related to your disabling condition every month.

What Are The Symptoms Of Diabetic Retinopathy?

Diabetic retinopathy typically goes unnoticed until it is in the advanced stages, so you will likely not recognize it early on. People usually discover the disease during a diabetic eye screening when photos of the eyes are taken to detect early symptoms.

Early symptoms include:

• Progressively worsening vision
• Dark areas of vision
• Floaters: shapes, lines, rings, streaks, or spots floating in your field of vision caused by blood vessels bleeding into other parts of the eye
• Difficulty perceiving colors
• Patchy vision or blurriness making it difficult to read or see faraway objects
• Eye pain or redness
• Sudden loss of sight

These symptoms do not necessarily indicate diabetic retinopathy. However, they should be taken seriously, and you should see your doctor immediately if you notice any of them. Early treatment can prevent more symptoms from occurring and ward off scarring that causes retinal detachment. Early detection and treatment will also give you the best chance at preventing more serious eye conditions, such as diabetic macular edema and blindness.

Medications, injections, laser therapies, and surgery can all be used to treat these conditions. Your particular therapy will depend on your disorder’s prognosis, progression, and nature. For people with diabetes at risk for glaucoma, the American Optometric Association recommends getting a dilated eye examination annually. All of the above signs and any vision changes should be reported to your health care provider right away.

Here one of our VA disability lawyers goes over the questions Woods and Woods, The Veteran’s Firm, is often asked about veterans’ disability claims and appeals.

Can Diabetic Retinopathy Be Prevented?

By controlling your diabetes through diet, exercise, and sticking to your health care provider’s treatment plan, you will reduce your risk of developing diabetic retinopathy and other eye diseases. A healthy diet should be maintained and include a reduction in salt, fat, and sugar. If weight is an issue, reducing your Body Mass Index (BMI) to between 18.5 and 24.9 will also help.

Moderate-intense exercise of a minimum of 150 minutes daily can also help prevent diabetic retinopathy. “Moderate-intense” activity refers to activities such as walking or bicycling. You can further reduce your risk of the disease by quitting smoking and limiting alcohol use.

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Does Diabetic Retinopathy Qualify For VA Benefits?

You may be eligible for secondary service coverage if you think you experienced vision issues or an eye disorder as a result of your diabetes. It doesn’t matter if your condition was caused by exposure, injury, or illness. The VA rates many eye conditions like conjunctivitis, tumors, and ptosis of one or both eyes. If a service-connected disease or accident triggers a new condition or aggravates a non-service-connected impairment, secondary service coverage is available.

Suppose a veteran is service-connected or seeking service link for diabetes, either by presumption or direct service connection, and subsequently develops an eye disorder like diabetic retinopathy. In that case, they may file a claim for diabetic retinopathy secondary to diabetes mellitus. A current diagnosis of an eye disorder or disease is required to obtain coverage for this secondary condition. Evidence is required to support a suggestion of a connection between diabetes mellitus and an associated diabetic eye disorder. This secondary claim can be supported by private medical records, records of treatment while in service, and VA medical records documenting the condition. Medical studies and literature that address the connection between diabetes and specific diabetic eye disease will also help you with your disability claim.

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A supporting medical opinion from a doctor describing how your eye condition is either a complication of or caused by diabetes mellitus may also help your argument. Your claim may be even stronger if the supporting statement comes from an ophthalmologist or endocrinologist. A thorough eye test will help determine the seriousness of your condition and give you an idea of the rating percentage the VA will likely apply to your claim if a secondary service link for your eye disorder is granted.

Direct contact injuries, exposure-related injuries, and illnesses or diseases acquired while serving all contribute to eye problems. Eye conditions that are secondary to other medical conditions can also qualify for VA disability benefits. If eligible, the VA Healthcare system also offers eyeglasses or eye care to veterans who meet specific criteria.

How Does The VA Rate Eye Conditions?

The rating formula used by the VA for general eye conditions is outlined in detail under 38 CFR 4.79.

• 10%: With documented incapacitating episodes requiring at least one but less than three treatment visits for an eye condition during the past 12 months

• 20%: With documented incapacitating episodes requiring at least three but less than five treatment visits for an eye condition during the past 12 months

• 40%: With documented incapacitating episodes requiring at least five but less than seven treatment visits for an eye condition during the past 12 months

• 60%: With documented incapacitating episodes requiring seven or more treatment visits for an eye condition during the past 12 months

The VA also rates specific eye diseases using various VASRD codes. For diabetic retinopathy (also called diabetic retinitis), the diagnostic code is 6006 and corresponds to the ratings listed under 38 CFR 4.84. For diabetic retinopathy, VA ratings range from 10 to 100 percent. These ratings are determined using three primary measurements: central visual acuity, visual field, and muscle function.

Central Visual Acuity

Central visual acuity measures how sharp or distorted images are at different distances. The classic eye chart from our eye doctor’s office is often used to measure this. The central visual acuity ranges from 20/20 to 5/200, with VA rates dependent on corrected vision if it is possible. Anything less than a 5/200 vision acuity is considered blind. Since the VA considers both eyes, a veteran who is blind in one eye but has 20/20 vision in the other would likely only earn a 40 percent ranking.

Visual Field

The visual field is a calculated measurement of the visible region of the eye. Eye charts typically have 16 meridians for each eye that are measured outward from the center. Although it is a somewhat complicated process, this test can find problems with your field of vision. This measurement reveals whether or not there are losses in peripheral vision, central vision, upper or lower vision, or other areas.

Muscle Dysfunction

Measured in the same way as the visual field, an eye chart indicates how well the eye muscles move and if there is any muscle dysfunction. Eye muscle activity that restricts upward and downward vision, for instance, but allows it to pass side to side would be an example of muscle dysfunction.

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Diabetic Retinopathy Will Continue to Be a Problem for Veterans

While VA researchers and the medical field in general work toward the prevention and treatment of diabetic-related diseases, diabetic retinopathy remains a significant challenge. The prevalence of the disease among U.S. veterans combined with the fact that it often goes undetected until its latest stages are particularly concerning. Veterans with diabetes should stay informed, seek the advice of their doctor, and seek all VA disability benefits currently readily available.

For more information about diabetic retinopathy and VA benefits, contact our team today to schedule a free no-obligation legal consultation. Our experts are happy to talk about your specific situation and develop a strategy that meets your requirements. We look forward to assisting our heroes in receiving the best possible treatment so that they can flourish and prosper after serving our country.

At Woods and Woods, the Veteran’s Firm, we’ve helped thousands of veterans with their VA disability applications and appeals. We’ve been adding staff and lawyers during the Covid pandemic to serve disabled veterans better in difficult times.

Call us today to discuss your VA disability appeal or your first application. The call is free and we won’t charge you a single fee until we win your case. We even pay for the postage for all of the documentation you send to our office. You can look for a VA disability attorney near you or call us and join the thousands of veterans living off of VA disability thanks to Woods and Woods.

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