Acromegaly — VA Disability Rating (DC 7908)
Diagnostic Code 7908 · 38 CFR §4.119
What Is It?
Acromegaly is caused by excessive growth hormone production, usually from a pituitary tumor. It causes gradual enlargement of hands, feet, and facial features, along with joint pain, headaches, vision problems, diabetes, heart disease, and sleep apnea. The changes develop slowly, so many veterans are not diagnosed for years after symptoms begin. While rare, the condition has wide-ranging effects on multiple body systems and can significantly reduce quality of life.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Evidence of increased intracranial pressure (such as visual field defect), arthropathy, glucose intolerance, and either hypertension or cardiomegaly. All four elements must be present: intracranial pressure signs, joint disease, glucose intolerance, and cardiovascular involvement. |
| 60% | Arthropathy, glucose intolerance, and hypertension. These three clinical findings must be documented together. |
| 30% | Enlargement of acral parts (hands, feet, facial features) or overgrowth of long bones. This is the entry-level rating based on the characteristic physical changes of acromegaly. |
Evidence Needed
Blood tests showing elevated growth hormone and IGF-1 levels confirm the diagnosis. Pituitary MRI showing the tumor documents the cause. For the 100% rating, you need documentation of increased intracranial pressure (visual field testing showing defects), arthropathy (joint disease on exam or imaging), glucose intolerance (blood sugar testing), and hypertension or cardiomegaly (blood pressure records or cardiac imaging). Photographs over time showing physical changes demonstrate the progression.
C&P Exam Tips
The rating depends on specific clinical findings, so make sure each one is documented. For the 30% level, the examiner should note enlargement of hands, feet, or facial features. For 60%, you need documented arthropathy (joint disease), glucose intolerance, and hypertension. For 100%, you additionally need evidence of increased intracranial pressure such as visual field defects — request visual field testing if you have not had it recently. Mention shoe size or ring size increases as concrete evidence of acral enlargement.
How to File
File VA Form 21-526EZ listing acromegaly under DC 7908. Include hormone levels, pituitary MRI, and evidence of each clinical finding needed for your rating level. File each complication as a separate secondary condition if not already captured in the DC 7908 criteria. Provide evidence connecting the pituitary tumor onset to the period of military service.
Common Mistakes
Not getting visual field testing to document intracranial pressure effects needed for the 100% rating Not documenting glucose intolerance and joint disease, which are needed for the 60% and 100% levels Failing to document the timeline of physical changes that began during service Not filing separately for complications like sleep apnea and carpal tunnel that are not captured in the DC 7908 criteria
Frequently Asked Questions
How can I prove acromegaly started during service?
Comparing photographs from before, during, and after service can show the progression of physical changes. Military ID photos, promotion photos, and unit photos serve as documented evidence of when changes began. Combining these with medical records showing when symptoms first appeared builds the timeline.
What clinical findings do I need for each rating level?
For 30%: enlargement of hands, feet, or facial features, or overgrowth of long bones. For 60%: arthropathy (joint disease), glucose intolerance, and hypertension. For 100%: evidence of increased intracranial pressure (like visual field defects), plus arthropathy, glucose intolerance, and either hypertension or cardiomegaly.