Hyperparathyroidism — VA Disability Rating (DC 7904)
Diagnostic Code 7904 · 38 CFR §4.119
What Is It?
Hyperparathyroidism occurs when one or more parathyroid glands produce too much parathyroid hormone, causing elevated calcium levels in the blood. This leads to bone weakening, kidney stones, abdominal pain, fatigue, depression, and cognitive problems. Veterans may develop this from radiation exposure during service, as a secondary effect of kidney disease, or from vitamin D deficiency during prolonged deployments. The condition can cause significant long-term damage if untreated.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Assigned for six months from the date of discharge following surgery. After six months, the VA rates residuals under the appropriate diagnostic codes based on a VA examination. Where surgical intervention is indicated, this evaluation continues until the day of surgery. |
| 60% | Hypercalcemia indicated by at least one of the following: total calcium greater than 12 mg/dL, ionized calcium greater than 5.6 mg/dL, creatinine clearance less than 60 mL/min, bone mineral density T-score worse than negative 2.5 at any site, or previous fragility fracture. Where surgical intervention is not indicated, this evaluation continues for six months after pharmacologic treatment begins, then residuals are rated under appropriate codes. |
| 10% | Symptoms such as fatigue, loss of appetite, nausea, or constipation that occur despite surgery, or in individuals who are not candidates for surgery but require continuous medication for control. |
| 0% | Asymptomatic hyperparathyroidism with no symptoms and no complications requiring treatment. |
Evidence Needed
Blood tests showing elevated calcium and parathyroid hormone levels confirm the diagnosis. Specific lab values matter for the 60% rating: total calcium above 12 mg/dL, ionized calcium above 5.6 mg/dL, or creatinine clearance below 60 mL/min. Bone density scans showing a T-score worse than negative 2.5 or documentation of fragility fractures also support the 60% level. Surgical records document treatment. Post-surgical labs and symptom documentation support the 10% rating if symptoms persist. Service records connecting onset to radiation exposure or other service factors establish eligibility.
C&P Exam Tips
Bring your most recent calcium, PTH, and creatinine clearance lab results — the specific values directly determine the rating level. If you have had bone density testing, bring those results showing your T-score. Report all symptoms: fatigue, loss of appetite, nausea, constipation, bone pain, kidney stones. If you had surgery, describe any persistent symptoms afterward. Report any complications such as kidney stones, fractures, vision problems, or cardiovascular issues, as these are rated separately as chronic residuals.
How to File
File VA Form 21-526EZ listing hyperparathyroidism under DC 7904. Include blood test results with specific calcium and PTH values, imaging, and bone density scans. After surgery or the initial rating period, file secondary claims for each chronic residual — kidney stones, decreased renal function, fractures, vision problems, and cardiovascular complications — as the CFR specifically directs these be rated under their own codes.
Common Mistakes
Not providing the specific lab values (calcium, creatinine clearance) needed to meet the 60% criteria Not claiming each chronic residual (kidney stones, osteoporosis, kidney damage, vision problems) separately after the initial rating period Attributing fatigue and other symptoms to other causes when they are actually from hyperparathyroidism Not getting bone density scans to document skeletal damage and T-scores
Frequently Asked Questions
What are the specific lab values needed for the 60% rating?
The CFR lists specific thresholds: total calcium greater than 12 mg/dL (or 3-3.5 mmol/L), ionized calcium greater than 5.6 mg/dL (or 2-2.5 mmol/L), creatinine clearance less than 60 mL/min, bone mineral density T-score worse than negative 2.5 at any site, or a previous fragility fracture. Meeting any one of these qualifies for the 60% level.
What happens after the initial rating period?
After six months post-surgery or post-pharmacologic treatment, the VA rates chronic residuals under their own diagnostic codes. Kidney stones, decreased renal function, fractures, vision problems, and cardiovascular complications are each evaluated separately. Filing claims for every residual is critical to maintaining your overall rating.