How Medications and Treatments Affect Your VA Disability Rating

If you’re wondering whether your medications or treatments impact your VA disability rating, this guide will walk you through how to find out, step by step. We’ll explore specific conditions, dive into the 38 CFR criteria, and show you how to check if medications or treatments affect your rating. This article covers migraines, hypertension, plantar fasciitis, and mental health as examples, but the process applies to any condition.

Important Note: Deciding whether to take medications for conditions like depression, migraines, or hypertension is a conversation for you and your healthcare provider. This article focuses solely on how medications and treatments factor into your VA disability rating, not whether you should take them.

Step-by-Step: Checking Medication Effects on Your VA Rating

The simplest way to determine if medications or treatments affect your VA disability rating is to check the 38 CFR Schedule of Ratings for your condition. The Electronic Code of Federal Regulations (eCFR) is your go-to resource. Here’s how to do it:

1. Identify Your Condition or Diagnostic Code: Each VA-rated condition has a diagnostic code. If you know your code, use it for precision. If not, you can search by condition name (e.g., “migraines”) or contact a Veteran Service Officer (VSO) for help. You can also access your codes via the VA’s eBenefits portal in about three minutes.
2. Search the 38 CFR: Go to the 38 CFR on eCFR, search for your diagnostic code or condition, and review the rating criteria.
3. Look for Medication or Treatment Mentions: If the criteria mention medications or treatments (e.g., “requires continuous medication for control”), they may impact your rating. If not, they likely don’t.

Medications as Evidence

Medications can serve as strong evidence for your VA claim. According to the M21-1 Adjudication Procedures Manual, prescribed medications are considered valid evidence of a condition’s severity or existence. This can support your claim, even if medications don’t directly affect the rating percentage.

Example 1: Migraines (Diagnostic Code 8100)

Let’s start with migraines. Search for Diagnostic Code 8100 in the 38 CFR under neurological conditions. You can do this by visiting the eCFR, pressing Ctrl+F, and typing “8100” or “migraine.” The criteria for migraines focus on the frequency and severity of attacks, with no mention of medications. This means taking migraine medications won’t lower your VA rating. However, your prescriptions can be used as evidence to support your claim.

Example 2: Hypertension (Diagnostic Code 7101)

Hypertension is different. Search for Diagnostic Code 7101 under cardiovascular conditions. The criteria explicitly state that a 10% rating applies to individuals with a history of diastolic pressure predominantly 100 or more “who require continuous medication for control.” If your blood pressure is controlled by medication, you’re likely to receive a 10% rating—or even 0% if readings are consistently normal. Higher ratings (e.g., 40% or 60%) require significantly elevated readings, indicating poor health.

Key Point: Don’t stop taking hypertension medication to chase a higher rating—it’s dangerous and unnecessary. Always consult your healthcare provider. Also, read any notes in the 38 CFR criteria, as they may clarify terms like “isolated systolic hypertension” or specify how readings are measured (e.g., taken multiple times over different days).

Example 3: Plantar Fasciitis (Diagnostic Code 5269)

Plantar fasciitis introduces the concept of treatments, not just medications. Search for Diagnostic Code 5269 under musculoskeletal conditions. The criteria mention “no relief from both non-surgical and surgical treatment.” If treatments like insoles or surgery provide relief, and the condition is bilateral (both feet), you may receive a 10% rating instead of 30%. For unilateral cases, effective treatment could mean 20% instead of 30%. Treatment effectiveness directly impacts the rating here.

Example 4: Mental Health (e.g., Major Depressive Disorder, Diagnostic Code 9434)

For mental health conditions, search for the General Rating Formula for Mental Disorders (e.g., Diagnostic Code 9434 for major depressive disorder). Medications are mentioned only at the 10% level, where symptoms are “controlled by continuous medication.” If your symptoms persist despite medication, you’re more likely to qualify for higher ratings (e.g., 50% or 70%), based on the severity of symptoms like social or occupational impairment.

Many veterans on daily mental health medications still receive 50% or 70% ratings because their symptoms align with those criteria, not the milder 10% level. Medications alone won’t automatically lower your rating unless your symptoms are fully controlled.

Case Law: Jones v. Shinseki

For legal context, the case Jones v. Shinseki clarifies how the VA considers medications in disability ratings. It emphasizes that the VA must evaluate the condition’s severity, factoring in medication effects only when explicitly mentioned in the 38 CFR criteria.

Negative Side Effects of Medications

Medications can sometimes cause side effects that qualify for separate ratings. For example, erectile dysfunction caused by mental health medications may be rated separately. Discuss these with your healthcare provider and VSO to explore additional claims.

Final Thoughts

Don’t avoid medications or treatments just to maintain a higher VA rating. Your health comes first, and the VA’s rating system is designed to reflect your condition’s severity, not punish you for seeking care. By using the 38 CFR and diagnostic codes, you can understand exactly how medications or treatments factor into your rating.

If you made it this far, let me know in the comments: Do you like Chick-fil-A sweet tea? Yes or no!

Resources

• 38 CFR on eCFR
• M21-1 Adjudication Procedures Manual
• Find a Veteran Service Officer
• VA eBenefits Portal