VA Rating for Menorrhagia (Heavy Menstrual Bleeding): How Do I Qualify for Benefits?

Heavy, painful, or irregular menstruation can severely impair a veteran’s life. Abnormal periods interfere with a veteran’s ability to work and travel. Moreover, these symptoms are often accompanied by anemia and pelvic pain.

Whether abnormal menstruation occurs by itself or is caused by another medical problem, the VA provides disability benefits for heavy periods (menorrhagia), irregular periods, or other abnormal menstruation. The VA rating for menorrhagia can be combined with other conditions related to, or caused by, heavy periods resulting in a substantial overall disability rating.

How Does the VA Assign the Disability Rating for Menorrhagia?

The VA does not have a specific ratings table for menorrhagia or other abnormal menstruation. However, the VA does provide a schedule for gynecological conditions that can be used to arrive at a VA rating for menorrhagia, painful menstruation, and irregular menstruation.

The one wrinkle in obtaining a VA rating for menorrhagia or other forms of abnormal periods is that the VA’s rating schedules for gynecological conditions were revised in 1995, 2002, and 2018. Depending on your claim, you could receive different ratings under different schedules that were in effect at the time of your disability. For example, in one case, a veteran was rated differently based on the pre-1995 rating table and the post-1995 rating table when her claim straddled the 1995 revisions.

If you win your claim for menorrhagia disability, you want to make sure the VA gets the effective date and your backpay right. Backpay would be different from 1995, 1995-2002, 2002-2018, and 2018 to the present. So even if you win your claim, don’t stop there. Look at that award letter to see when your effective date should be and how your back pay is computed.

Is Menorrhagia a Disability?

Yes, regardless of when a veteran served and which ratings tables apply, menorrhagia is considered by the VA to be a ratable disability. Although it may seem odd, before 1995, menorrhagia was rated as analogous to a skin condition.

Since 1995, however, the VA rating for menorrhagia has been gleaned from the ratings table for endometriosis, which is characterized by pelvic pain and heavy or irregular bleeding. When a veteran suffers from heavy periods, irregular periods, and pelvic pain, the overall symptoms match the symptoms of endometriosis and, thus, can be rated using the same VA ratings table.

Keep in mind that this process applies regardless of whether the menorrhagia is caused by endometriosis or has some other cause. For example, heavy periods caused by a hormonal imbalance or uterine fibroids are rated using the endometriosis ratings table even though these conditions are unrelated to endometriosis.

What is the VA Rating for Menorrhagia?

Menorrhagia is rated based on the extent to which the condition can be controlled. If the veteran experiences symptoms despite treatment, the VA assigns a rating of 30%. If continuous treatment can control the symptoms, the VA assigns a rating of 10%.

For example, in one case, a veteran experienced cramping along with bleeding that was so heavy that she used 48 pads in half of a week. Moreover, her periods were highly irregular, occurring in cycles of anywhere between 15 and 30 days. The veteran reported that this had a profound effect on her earning ability because she was unable to do her job. As a result, she received a VA rating for abnormal menstruation of 30%.

However, after medical treatment, the veteran’s condition improved. The veteran had a regular period that occurred once every 30 days. Although the veteran reported heavy bleeding, it was less heavy than when she was not under treatment. Most importantly, the veteran indicated that she had not missed any work since starting treatment. As a result, the VA reduced her VA rating for heavy periods to 10%.

When combining multiple disability ratings, you have to use VA math, not conventional math. We explain how and why VA math is a thing in this post:

How to Do VA Math with the VA Combined Ratings Table

How Can Menorrhagia Be Service Connected?

Every VA disability claim must include a service connection. A service connection can be established by showing that the condition:

• Is part of a medically unexplained chronic multi-symptom illness in Gulf War veterans
• Manifested during your service
• Manifested after your discharge but was caused by your service
• Existed prior to your service but was worsened by your service

Menorrhagia can have many causes. As a result, any of these could provide a pathway for establishing a service connection to your case of menorrhagia.

Presumptive Service Connection for Gulf War Veterans

Gulf War veterans are entitled to a presumptive service connection for certain chronic disabilities. This means that if a disability falls under the definition of medically unexplained chronic multi-symptom illness, the veteran is not required to prove a service connection. Instead, the veteran must just establish that they:

• Served in the Southwest Asia theater of operations between August 2, 1990 and the present.
• Suffers from an illness that has manifested to at least 10% disability.
• Experiences a cluster of symptoms cannot be explained by any diagnosed illness.

Once these elements are established, the illness is presumed to be connected to the veteran’s service. For veterans who experience heavy, irregular, or painful periods, one of the symptoms included in the cluster can be menstrual disorders.

Thus, menstrual disorders would not be sufficient on their own to obtain the presumptive service connection. However, abnormal menstruation would be entitled to the presumptive service connection when it manifests in combination with chronic fatigue syndrome, fibromyalgia, functional gastrointestinal disorders, or any of the other symptoms typically associated with the Gulf War Syndrome.

How Can Veterans Get Benefits for Gulf War Syndrome?

Manifested During Service

Because the age of service members skews toward young, any manifestation of irregular, heavy, or painful menstruation would be noted in their service medical records. Moreover, because these symptoms can signify other problems like cancer, fibroids, and hormone imbalances, most service members experiencing abnormal periods would likely undergo testing to identify the cause.

As a result, service members who experienced these conditions during their service will likely have ample medical records showing the timing of their manifestation. These records would be sufficient to establish a service connection to receive a heavy menstrual bleeding VA rating.

This would be true even if your condition was misdiagnosed by military doctors. For example, suppose your heavy, irregular, or painful periods were diagnosed as being a side effect of anti-inflammatory drugs during your service but were diagnosed as endometriosis after you served. For purposes of establishing a service connection, the fact that you have records documenting those symptoms during your service will probably be sufficient to establish a connection between your service and your condition.

Conditions Manifested After Discharge

A veteran can also establish a service connection between menorrhagia and the veteran’s military service if the condition manifested after discharge but was caused by the veteran’s service. For example, menorrhagia can be caused by physical damage to the uterus. If you had an injury or underwent surgery during your service, it is possible that abnormal menstruation might not manifest until after your discharge. If you can connect the uterine damage to your menorrhagia, you should be able to establish a service connection and receive a VA rating for irregular periods.

Here, one of our VA disability lawyers gives tips and advice on what to do at your C&P Exam.

Worsened by Service

If you experienced irregular menstruation before you joined the service, but it was worsened by your time in the military, you might be able to establish a service connection. The difficulty with this pathway to establishing a service connection is that the VA does not need to compensate you for a “natural progression” of a condition. Thus, you will likely need to point to a specific event that occurred during your service that caused your menorrhagia.

Depending on your age and other things that have happened to you, the VA may blame those things on your condition. You only have to prove that your painful periods were as likely as not caused by your time in the service. If we can show the VA that there is a 51% chance that it was caused by something that happened to you while you were enlisted, we have a winning case.

The nexus letter is the missing link to many successful VA disability claims. One of our VA disability lawyers explains why in this video.

Secondary Service-Connected Menorrhagia

If you have a primary service-connected disability, you can establish a service connection to menorrhagia through the secondary service-connection doctrine. This allows you to claim VA disability benefits for any condition that results from a primary service-connected disability or the treatment of a primary service-connected disability.

For example, one potential cause of abnormal menstruation is a hormone imbalance. Hormone imbalances result from disruptions to the endocrine system caused by, among other factors, exposure to toxic chemicals. Thus, it may be possible to establish a service connection between a hormone imbalance, such as hyperthyroidism or hypothyroidism and your service if you were exposed to chemicals such as fire-retardant or missile fuel.

Both hyperthyroid and hypothyroid have been connected to menorrhagia. This means that once you establish a service connection for a thyroid disorder, you should be able to establish a service connection to menorrhagia as a secondary service-connected disability.

In another example, menorrhagia is a known side effect of anti-inflammatory drugs and anticoagulant drugs. If you have a service-connected disability that requires treatment with anti-inflammatories, such as a physical injury, or blood thinners, such as a stroke or heart attack, you have a basis to establish abnormal menstruation as a secondary service-connected disability.

How Veterans Qualify for VA Disability for Hyperthyroidism

How to Maximize Your VA Rating for Menorrhagia

Menorrhagia can also lead to other conditions. When combined with the disability rating for heavy, irregular, or painful menstruation, these other conditions can increase your overall VA disability rating. Specifically, each additional service-connected disability can be added to the VA disability rating for menorrhagia using VA math. The result could be an overall disability rating that vastly increases your VA disability benefits.

For example, heavy menstruation can lead to anemia. Anemia can be rated as a disability for purposes of VA disability benefits. If the anemia requires intravenous treatment four or more times per year, it is rated at 30%. If the anemia requires intravenous treatment fewer than four times per year or continuous oral treatment, it is rated at 10%. A 10% rating for menorrhagia and a 10% rating for anemia would double your overall VA disability rating to 20%.

Similarly, treatment for menorrhagia usually includes injections of Depo-Provera. This medication has several side effects including depression and osteoporosis. Once your abnormal menstruation is service-connected, side effects from treatment of your condition can qualify for VA disability benefits as well.

Additional Benefits for Menorrhagia VA Disability Rating

Another potential source of additional benefits includes special monthly compensation (SMC). SMC is available when a service-connected disability deprives a veteran of the use of a limb or organ. In this case, Depo-Provera is a contraceptive. As a result, treatment for menorrhagia with Depo-Provera deprives a veteran of the use of her reproductive organs. This qualifies the veteran to SMC to supplement the veteran’s VA disability benefits.

One of our VA disability lawyers explains SMC (Special Monthly Compensation) in this video:

Obstacles to Obtaining a VA Rating for Menorrhagia

The greatest obstacle to VA disability benefits for abnormal menstruation will be establishing a service connection. Unless you qualify for a presumptive service connection, you will need a medical opinion that connects your disability to either the timing or events of your service.

Even if you qualify for the Gulf War veteran presumptive service connection, you will need to document the cluster of symptoms that meet the definition of medically unexplained chronic multi-symptom illness.

This is where a VA attorney can help. A VA benefits lawyer is familiar with the evidence that can improve the chances of establishing either a service connection or, for Gulf War veterans, Gulf War Syndrome.

Let’s discuss the evidence that will assist you in getting the best possible VA rating for menorrhagia. Schedule a free consultation with a VA attorney online or call (866)232-5777.