VA C&P Exam for Kidney Disease: What to Expect and How to Prepare

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If you’ve filed a VA claim for kidney disease, you’ll likely be scheduled for a C&P exam with a third-party company contracted by the VA.

In this blog post, you’ll learn what to expect and how to prepare for this #1 most important day in the VA claim process to ensure you get the VA rating and compensation you deserve.

Kidney disease is rated under 38 CFR § 4.115a, Diagnostic Code (DC) 7530 for chronic renal disease, with ratings ranging from 0% to 100%, with breaks at 30%, 60%, and 80%, depending on the severity of symptoms as measured by the glomerular filtration rate (GFR).

The GFR measures how well your kidneys filter blood, with a GFR of 60 or higher being normal, below 60 indicating possible kidney disease, and 15 or below suggesting kidney failure.

Summary of Main Points

• Kidney Disease C&P Exam: If you’ve filed a VA claim for kidney disease, you’ll likely be scheduled for a C&P exam to evaluate the severity of your condition and whether it’s connected to your military service or another service-connected disability.

• Diagnostic Code and Rating Criteria: Kidney disease is rated under 38 CFR § 4.115a, Diagnostic Code (DC) 7530 for chronic renal disease, with ratings ranging from 0% to 100% and breaks at 30%, 60%, and 80%, depending on the severity of symptoms as measured by the glomerular filtration rate (GFR).

• Purpose of the Exam: The C&P exam aims to confirm your diagnosis, assess whether your kidney disease is service-connected, and evaluate the severity, frequency, and duration of your symptoms, along with their impact on your work, life, and social functioning.

• Exam Day Tips: To prepare for your exam, gather relevant medical records, keep a detailed symptoms diary, list the functional impacts of kidney disease on your daily activities, and review the Disability Benefits Questionnaire (DBQ) for Kidney Conditions to be ready to discuss the onset and progression of your condition.

The Purpose of a VA C&P Exam for Kidney Disease

A VA C&P exam for kidney disease is designed to evaluate three main areas:

• Diagnosis Confirmation: Determine if you have a diagnosis of kidney disease that conforms to medical standards and guidelines.

• Nexus for Service Connection: The examiner will provide their medical opinion on whether your kidney disease was caused or aggravated by your active-duty military service or another service-connected condition.

• Symptoms Assessment: Assess the severity of your kidney disease symptoms in terms of frequency, severity, and duration, and their negative impacts on your work, life, and social functioning.

What to Expect at Your C&P Exam for Kidney Disease

Here are six things you can expect during a VA C&P exam for kidney disease:

1. Review of Medical History

The C&P examiner will start by reviewing your medical records, including any previous diagnoses, medical history, treatments, and evaluations related to kidney disease. The examiner has access to the medical records and documents you submitted to the VA, so you don’t need to bring records with you to the exam. However, bringing any additional documents you believe are important can be helpful.

2. History and Onset

The examiner will ask about your military service history and any prior diagnoses of kidney disease. Certain factors encountered in military environments, such as exposure to toxins, physical exertion, and dehydration, can contribute to the development or exacerbation of kidney disease. For example, you might explain, “My kidney disease symptoms began during my deployment due to the harsh conditions and lack of adequate hydration.”

3. Discussion of Symptoms

The examiner will ask you about your kidney disease symptoms, including when you first noticed them and how often you experience them. Common symptoms of kidney disease include fatigue, swelling, and changes in urination. Remember, your final VA rating for kidney disease depends on the frequency, severity, and duration of symptoms and how those symptoms negatively affect your work, life, and social functioning.

4. Negative Impacts on Work, Life, and Social Functioning

You’ll be asked about how kidney disease affects your daily activities, such as sleeping, working, socializing, and overall quality of life. Be honest and provide specific examples of how kidney disease interferes with your ability to function normally. For instance, you might say, “My kidney disease causes severe fatigue and swelling, which affects my ability to concentrate and perform tasks at work.”

5. Physical Exam Plus Blood and Urine Tests

The C&P examiner might conduct a physical exam to check for signs and symptoms of kidney disease. They may evaluate your overall health and look for symptoms such as swelling, high blood pressure, and changes in urination. Kidney disease testing typically includes the estimated glomerular filtration rate (eGFR) blood test and the urine albumin-creatinine ratio (uACR) urine test, both are essential for assessing the severity of your kidney disease.

6. Completion of Disability Benefits Questionnaire (DBQ) for Kidney Disease

The examiner will document their findings on the DBQ for Kidney Disease, which then gets submitted to the VA Rater for further processing. Eventually, the VA Rater will either approve, deny, or defer your claim for kidney disease.

Questions You Might Be Asked During a C&P Exam for Kidney Disease

Based on the VA DBQ for Kidney Conditions, here are some questions you can expect during your C&P exam:

Evidence Review:

• Were any records reviewed before the exam? If so, which records (e.g., service treatment records, VA treatment records, private treatment records) and the date range?

Diagnosis:

• What are the claimed conditions that pertain to this questionnaire?
• Do you have a current diagnosis associated with the claimed conditions? If so, what is the diagnosis, ICD code, and date of diagnosis?

Medical History:

• Can you describe the history (including cause, onset, and course) of your kidney condition?
• Does your treatment plan include taking continuous medication for the diagnosed condition? If yes, what medications are you taking?
• Do you have hypertension and/or heart disease due to renal dysfunction or caused by any kidney condition?

Renal Dysfunction:

• Do you have renal dysfunction? If yes, complete the following:
• Do you require regular dialysis?
• Do you have a cystic, obstructive, or glomerular structural kidney abnormality for at least 3 consecutive months during the past 12 months? If yes, which type and what tests/evidence were used to confirm it?
• Is there a renal tubular disorder? If yes, is it symptomatic?
• Do you have any signs or symptoms of hydronephrosis due to obstruction other than upper urinary tract urolithiasis? If yes, indicate severity.
• Do you have attacks of renal colic due to obstruction other than upper urinary tract urolithiasis? If yes, indicate frequency.

Urolithiasis:

• Do you have or have you ever had kidney or ureteral calculi (urolithiasis)? If yes, complete the following:
• Indicate current/past location of calculi.
• Does the stone formation cause stricture of the ureter? If yes, discuss tests/evidence used to confirm it.
• Have you had treatment for recurrent stone formation in the kidney or ureter? If yes, indicate treatment.
• Do you have any signs or symptoms due to upper urinary tract urolithiasis? If yes, indicate severity.
• Do you have attacks of colic due to upper urinary tract urolithiasis? If yes, indicate frequency.

Urinary Tract/Kidney Infection:

• Do you have a history of recurrent symptomatic urinary tract or kidney infections? If yes, complete the following:
• What is the etiology of recurrent urinary tract or kidney infections?
• Indicate all treatment modalities used for recurrent urinary tract or kidney infections.

Kidney Removal or Transplant:

• Have you had a kidney removed, are eligible for a kidney transplant, or have had a kidney transplant? If yes, complete the following:
• Have you had a kidney removed? If yes, provide reason.
• Is your renal disease course such that it is medically determined that you warrant transplant consideration?
• Have you had a kidney transplant? If yes, complete the following: date of transplant, name of treatment facility, and date of admission and discharge for transplant.
• If you underwent kidney removal, is the remaining kidney affected by nephritis, infection, or other pathology?
• If you underwent a kidney transplant, is there nephritis, infection, or other pathology of the transplanted kidney?

Tumors and Neoplasms:

• Do you currently have, or have you had, a benign or malignant neoplasm or metastases related to any condition in the diagnosis section? If yes, complete the following:
• Is the neoplasm benign or malignant? If malignant, is it active or in remission? Indicate if it is primary or secondary (metastatic).
• Have you completed treatment or are you currently undergoing treatment for a benign or malignant neoplasm or metastases? If yes, indicate type of treatment.

Other Pertinent Physical Findings:

• Do you have any other pertinent physical findings, complications, conditions, signs, or symptoms related to any conditions listed in the diagnosis section? If yes, describe.
• Do you have any scars or other disfigurement related to any conditions or to the treatment of any conditions listed in the diagnosis section?

Diagnostic Testing:

• Are there laboratory or other diagnostic studies in the medical records? If yes, provide most recent results.
• Were laboratory or other diagnostic studies performed in conjunction with this examination? If yes, provide most recent results.
• Has the Veteran had albumin/creatinine ratio (ACR) greater than or equal to 30 mg/g, RBC casts, WBC casts, or hyaline casts present for at least 3 consecutive months during the past 12 months? If yes, check all that apply and discuss tests/evidence used to confirm their presence.
• Are there any other significant diagnostic test findings and/or results? If yes, provide a brief summary.

Functional Impact:

• Regardless of your current employment status, do the conditions listed in the diagnosis section impact your ability to perform any type of occupational task (such as standing, walking, lifting, sitting, etc.)? If yes, describe the functional impact of each condition, providing one or more examples.

How to Prepare for Your Kidney Disease C&P Exam

Here are some tips to help you prepare for a VA C&P exam for kidney disease:

1. Gather Records and Documents

Collect all relevant medical records, including diagnostic tests and reports, treatment history, medication lists, and any correspondence related to your kidney disease. This documentation will provide essential evidence to support your claim during the examination. Review the documents in detail and bring hard copies with you to the C&P exam for reference.

2. Create a Symptoms Diary

Keep a detailed log of your symptoms, noting the frequency, severity, and duration of episodes and flare-ups. Document any factors that exacerbate or alleviate your symptoms. This diary will help you explain the impact of kidney disease on your work, life, and social functioning during the C&P exam.

3. List Functional Impacts

Make a list of specific ways that kidney disease affects your ability to perform daily tasks and activities. For example:

• Fatigue and weakness due to impaired kidney function
• Difficulty concentrating and decreased productivity at work
• Restrictions on diet and fluid intake affecting daily routines
• Challenges in participating in physical activities or hobbies
• Emotional distress, including anxiety and depression, related to chronic symptoms

4. Review the DBQ for Kidney Conditions

Review the DBQ for Kidney Conditions before your exam. Be prepared to describe the onset and progression of your condition and symptoms over time, as well as any treatments you have pursued and their effectiveness (if any). It’s also important for you to know your numbers based on prior blood and urine tests regarding the severity of your kidney disease.

Examples of Common Work, Life, and Functional Impacts of Kidney Disease

Work Impacts

• Decreased Productivity: Kidney disease can cause significant fatigue and cognitive difficulties, reducing your ability to focus and complete tasks efficiently at work.

• Increased Absenteeism: Frequent medical appointments, dialysis sessions, and illness-related absences can result in more time off work, affecting job performance and reliability.

• Job Restrictions: Physical limitations due to kidney disease may prevent you from performing certain types of work, especially those that require heavy lifting, prolonged standing, or high levels of physical activity.

Life Impacts

• Social Isolation: The need for regular treatments and the physical toll of kidney disease can lead to withdrawing from social activities, impacting relationships and reducing social interactions.

• Emotional and Mental Health: Chronic kidney disease can lead to stress, anxiety, and depression due to the ongoing management of the condition and its impact on lifestyle and future outlook.

• Dietary and Lifestyle Changes: Necessary dietary restrictions and lifestyle adjustments can limit your ability to enjoy meals out, participate in social gatherings, or maintain previous hobbies and activities.

Functional Impacts

• Reduced Physical Stamina: Kidney disease often results in decreased physical stamina and energy levels, making everyday activities like climbing stairs, walking long distances, or carrying groceries more challenging.

• Impaired Daily Functioning: Symptoms such as swelling, muscle cramps, and shortness of breath can interfere with daily tasks, from household chores to personal care.

• Dependence on Medical Treatments: Regular dialysis or other treatments can significantly impact your daily schedule and overall lifestyle, requiring careful planning and accommodation to manage health effectively.

How Does the VA Rate Kidney Disease?

VA ratings for kidney disease range from 0% to 100% with breaks at 30%, 60%, and 80%, based on the glomerular filtration rate (GFR), length of time at a certain GFR, and the overall severity of your symptoms.

• 100% VA Rating for Kidney Disease: Awarded for chronic kidney disease with a GFR less than 15 mL/min/1.73 m² for at least 3 consecutive months during the past 12 months, or if regular routine dialysis is required, or if the individual is eligible for a kidney transplant.

• 80% VA Rating for Kidney Disease: Given for chronic kidney disease with a GFR between 15 and 29 mL/min/1.73 m² for at least 3 consecutive months during the past 12 months.

• 60% VA Rating for Kidney Disease: Assigned for chronic kidney disease with a GFR between 30 and 44 mL/min/1.73 m² for at least 3 consecutive months during the past 12 months.

• 30% VA Rating for Kidney Disease: Applicable for chronic kidney disease with a GFR between 45 and 59 mL/min/1.73 m² for at least 3 consecutive months during the past 12 months.

• 0% VA Rating for Kidney Disease: Used when the GFR is between 60 and 89 mL/min/1.73 m², coupled with either recurrent red blood cell (RBC) casts, white blood cell (WBC) casts, or granular casts for at least 3 consecutive months during the past 12 months, or structural kidney abnormalities (cystic, obstructive, or glomerular) for at least 3 consecutive months during the past 12 months, or an albumin/creatinine ratio (ACR) of 30 mg/g or higher for at least 3 consecutive months during the past 12 months.

Note: GFR, estimated GFR (eGFR), and creatinine-based approximations of GFR will be accepted for evaluation purposes when determined to be appropriate and calculated by a medical professional.

VA DBQ for Kidney Disease [Download]

The VA DBQ for Kidney Conditions will be completed electronically by the C&P examiner during your exam.

This form helps document the severity and impact of your kidney disease, providing essential information for your VA claim.

We’ve made a copy available for review and download below:

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