Chronic Kidney Disease & Renal Failure: How VA Rates Kidney Function

The VA evaluates renal conditions using the objective renal dysfunction scale in 38 CFR 4.115a. The 100 percent row is GFR less than 15 mL/min/1.73 m2 for at least 3 consecutive months during the past 12 months; or requiring regular routine dialysis; or "eligible kidney transplant recipient". The 80 percent row is GFR 15 to 29. The 60 percent row is GFR 30 to 44. The 30 percent row is GFR 45 to 59. The 0 percent row is GFR 60 to 89 combined with recurrent casts, structural kidney abnormalities, or an albumin/creatinine ratio of 30 mg/g or more.

Each GFR row in 38 CFR 4.115a is stated "for at least 3 consecutive months during the past 12 months". Records potentially relevant to repeated GFR measurements include laboratory reports from different dates.

Specific surgical outcomes have dedicated rating rules under 38 CFR 4.115b. DC 7531 (kidney transplant) lists 100 percent following transplant surgery and, thereafter, residuals rated as renal dysfunction with a minimum rating of 30. Its Note says the 100 percent evaluation "shall be assigned as of the date of hospital admission for transplant surgery and shall continue with a mandatory VA examination one year following hospital discharge." DC 7500 (kidney, removal of one) lists a minimum evaluation of 30, "or rate as renal dysfunction if there is nephritis, infection, or pathology of the other." DC 7501 is "Kidney, abscess of": "Rate as urinary tract infection."

Chronic kidney disease frequently develops secondary to other service-connected systemic conditions. 38 CFR 3.310(a) says a disability proximately due to or the result of a service-connected disease or injury shall be service connected, and 3.310(b) addresses aggravation. 38 CFR 4.115b lists nephrosclerosis (DC 7507) as rated by predominant symptoms as renal dysfunction, hypertension or heart disease.

Advanced chronic kidney disease causes profound systemic fatigue, metabolic imbalances, and demanding treatment schedules. 38 CFR 4.16 describes total disability ratings based on individual unemployability, including the schedular percentage framework in 4.16(a) and the provisions in 4.16(b) for cases that do not satisfy those percentage standards.