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Did you know that you could receive a rating for nutritional deficiencies? There are multiple ways to do this, but we will be going over what can be claimed and the process one must go through. It is important to note, the VA is currently undergoing its most comprehensive update of the VASRD since 1945. In fact, the entire VASRD is being considered during this time.
This means changes are continually being rolled out. Recently this included changes to the rating schedule for nutritional deficiencies. This article will reflect the most recent changes, effective as of August 11, 2019.
What is considered a Nutritional Deficiency?
Nutritional deficiencies, or malnutrition, occurs when the body does not absorb or receive from food the necessary amount of a nutrient. Many different vitamins and minerals are necessary for healthy body development and disease prevention. These are referred to as micronutrients, and they are not naturally produced in the body but can only be received by eating a proper diet.
Being deficient in any important nutrient can lead to a variety of health issues and diseases. This includes digestion issues, skin problems, defective bone growth, and even dementia.
What type of deficiency will the VA rate for disability compensation?
Nutritional deficiencies can take many different forms. Currently, the VA officially recognizes 3 types of nutritional deficiency and leaves the rest to the interpretation of analogous ratings.
The following three are given specific ratings by the VA:
- Avitaminosis
Avitaminosis is a general term applying to multiple diseases occurring due to a lack of one or more than one vitamin.
These conditions can result in a number of different side effects and symptoms.
Included under the banner is scurvy (caused by a long-term deficiency of vitamin C), rickets (caused by a long-term deficiency of vitamin D), and night blindness (caused by an insufficient amount of vitamin A).
Those suffering from avitaminosis may be rated as follows:- 10%- confirmed diagnosis but with nonspecific symptoms such as; decreased appetite, weight loss, abdominal discomfort, weakness, inability to concentrate, and irritability
- 20%- confirmed with stomatitis (inflammation of the mouth and lips), achlorhydria (absence of hydrochloric acids in gastric secretions), or diarrhea
- 40%- confirmed with stomatitis, diarrhea, and symmetrical dermatitis (skin rash)
- 60%- all previous symptoms plus mental symptoms and impaired bodily vigor
- 100%- marked mental changes, moist dermatitis, inability to retain adequate nourishment, and cachexia (weakness and the wasting away of the body)
- BeriBeri
While Beriberi can fit under the banner of avitaminosis, it is also specifically recognized by the VA for the sake of disability rating.
Beriberi is caused by a deficiency of the vitamin B-1, also referred to as a thiamine deficiency. The disease presents itself in two types; wet beriberi and dry beriberi. Wet beriberi affects the heart and circulatory system. In extreme cases, it can cause heart failure. Dry beriberi damages the nerves and may lead to a decrease in muscle strength or even muscle paralysis.
Symptoms can include a loss of feeling and difficulty walking.
If left untreated beriberi can be life-threatening.
Beriberi may qualify for the following ratings from the VASRD:- 30%- Confirmed with peripheral neuropathy with absent knee or ankle jerks and loss of sensation, or; with symptoms such as weakness, fatigue, anorexia, dizziness, heaviness, and stiffness of legs, headache or sleep disturbance
- 60%- confirmed with cardiomegaly (abnormal enlargement of the heart), or; with peripheral neuropathy with footdrop or atrophy of thigh or calf muscles
- 100%- confirmed with congestive heart failure, anasarca (general swelling of the whole body), or Wernicke-Korsakoff syndrome (brain disorder, two conditions occurring at the same time as a result of vitamin B1 deficiency)
- Pellagra
Pellagra also fits under the greater banner of avitaminosis but, like beriberi, has been specifically recognized for its own schedule ratings under the VASRD.
Pellagra is caused by a significant deficiency of Niacin (also known as Vitamin B3). It also results from a lack of tryptophan (an essential amino acid).
Pellagra has been found to develop due to gastrointestinal diseases, weight loss (bariatric) surgery, anorexia, excessive alcohol use, carcinoid syndrome, and the use of certain medicines (isoniazid, 5-fluorouracil, 6-mercaptopurine, etc…).
The following disability ratings may be determined for Pellagra according to the VASRD:- 10%- Confirmed diagnosis with nonspecific symptoms such as; decreased appetite, weight loss, abdominal discomfort, weakness, inability to concentrate and irritability.
- 20%- confirmed with stomatitis (inflammation of the mouth and lips), achlorhydria (absence of hydrochloric acids in gastric secretions), or diarrhea
- 40%- confirmed with stomatitis, diarrhea, and symmetrical dermatitis (skin rash)
- 60%- all previous symptoms plus mental symptoms and impaired bodily vigor
- 100%- marked mental changes, moist dermatitis, inability to retain adequate nourishment, and cachexia (weakness and the wasting away of the body)
(If the ratings seem similar to Avitaminosis that’s because they are determined according to the same factors under 38 CFR Book C 4.88B)
What if I’m suffering from another form of nutritional deficiency?
There are a number of nutritional deficiencies not specifically recognized by the VASRD. The most common are deficiencies of iron, calcium, or folate. Depending on the symptoms exhibited, these may fit under the Avitaminosis diagnosis.
If your nutritional deficiency is the result of an eating disorder (such as anorexia or bulimia) it will be rated separately from those caused by infirmities or diseases.
All others will be rated analogously, under the Analogous and Equivalent Codes of the VASRD. The VASRD principle is to rate any condition under a code that best describes it whether it is exact or not.
Remember…
If you are seeking a rating for disability compensation from the VA for nutritional deficiency, you will still be required to link it to your time in service. Be sure to have all the records needed when going in for examination.
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