Cushing's Syndrome — VA Disability Rating (DC 7907)
Diagnostic Code 7907 · 38 CFR §4.119
What Is It?
Cushing syndrome results from prolonged exposure to high levels of cortisol. It causes weight gain (especially in the face and trunk), thin skin that bruises easily, muscle weakness, high blood pressure, diabetes, bone loss, and mood changes. In veterans, it can be caused by long-term steroid medication prescribed during service, pituitary or adrenal tumors, or in rare cases by ectopic tumors. The syndrome has profound effects on nearly every body system.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Active, progressive disease including areas of osteoporosis, hypertension, and proximal upper and lower extremity muscle wasting that results in inability to rise from a squatting position, climb stairs, rise from a deep chair without assistance, or raise arms. This rating continues for six months following initial diagnosis, after which residuals are rated under appropriate codes. |
| 60% | Proximal upper or lower extremity muscle wasting that results in inability to rise from a squatting position, climb stairs, rise from a deep chair without assistance, or raise arms. This rating continues for six months following initial diagnosis, after which residuals are rated under appropriate codes. |
| 30% | Cushing syndrome with striae, obesity, moon face, glucose intolerance, and vascular fragility. This rating continues for six months following initial diagnosis, after which residuals are rated under appropriate codes. |
Evidence Needed
Lab tests showing elevated cortisol levels (24-hour urine cortisol, midnight salivary cortisol, dexamethasone suppression test) confirm the diagnosis. Imaging to identify the source (pituitary MRI, adrenal CT) guides treatment and documents the cause. Documentation of specific physical findings — striae, moon face, proximal muscle weakness — directly determines the rating level. Functional testing showing inability to rise from squatting, climb stairs, or raise arms supports the higher ratings. If caused by steroid medications prescribed during service, those prescription records are essential.
C&P Exam Tips
The specific rating levels depend on demonstrable physical findings. For the 100% level, you need documented osteoporosis, hypertension, and proximal muscle wasting with functional inability (cannot rise from squat, climb stairs, rise from deep chair, or raise arms). For 60%, you need the muscle wasting and functional limitations. For 30%, striae, obesity, moon face, glucose intolerance, and vascular fragility. Ask the examiner to test and document your ability to rise from a squatting position and from a deep chair, and to raise your arms overhead.
How to File
File VA Form 21-526EZ listing Cushing syndrome under DC 7907. Include lab results, imaging, and documentation of physical findings. After the initial six-month rating period, file each residual complication (diabetes, hypertension, osteoporosis, depression) as a separate condition under its own diagnostic code. If caused by steroids prescribed for a service-connected condition, explain that chain of causation clearly.
Common Mistakes
Not documenting the specific physical findings (striae, moon face, muscle wasting) that determine the rating level Not understanding that after six months, residuals must be claimed separately under their own codes Failing to connect steroid-induced Cushing syndrome to the underlying service-connected condition Not requesting functional testing during the C&P exam to document inability to rise from squat or climb stairs
Frequently Asked Questions
Can steroid medications cause Cushing syndrome?
Yes. Long-term use of corticosteroid medications (prednisone, dexamethasone, etc.) is actually the most common cause of Cushing syndrome. If you were prescribed steroids during service for a service-connected condition and developed Cushing features, the syndrome and all its complications are secondary to that original condition.
What happens after the six-month initial rating period?
After six months following initial diagnosis, the VA rates residuals under the appropriate diagnostic codes for each affected body system. Diabetes, hypertension, osteoporosis, depression, and other complications are each rated separately. The damage caused during the period of excess cortisol may be permanent and remains ratable even after cortisol levels normalize.