Arteriolar Nephrosclerosis — VA Disability Rating (DC 7507)
Diagnostic Code 7507 · 38 CFR §4.115b
What Is It?
Arteriolar nephrosclerosis is the hardening and narrowing of the small arteries inside the kidney that long-standing high blood pressure produces. As those vessels stiffen, filtration falls, and the same vascular process is usually at work in the heart at the same time. For veterans it most often arrives as a secondary claim behind service-connected hypertension. DC 7507 assigns no percentage of its own: its rating cell in 38 CFR 4.115b is empty, and the entry reads "Rate according to predominant symptoms as renal dysfunction, hypertension or heart disease. If rated under the cardiovascular schedule, however, the percentage rating which would otherwise be assigned will be elevated to the next higher evaluation." That is a three-way election on predominant symptoms, not a ladder — and it carries a bonus that is easy to miss. If the predominant picture is cardiovascular, the evaluation that would otherwise apply is elevated one step. So the analysis is: work out the renal figure, work out the hypertension or heart figure, apply the one-step elevation to the cardiovascular result, then take whichever predominates. Note also that the renal criteria themselves were rewritten in 2021 (86 FR 54086) around glomerular filtration rate, replacing the older albuminuria-and-BUN language that many summaries still quote.
Rating Criteria
| Rating | Criteria |
|---|---|
| See pathways | DC 7507 carries no percentage column — the rating cell in 38 CFR 4.115b is empty. Three destinations, chosen on predominant symptoms. (1) Renal dysfunction under 38 CFR 4.115a: 100 percent for GFR below 15 mL/min/1.73 m2 for at least 3 consecutive months in the past 12, or regular routine dialysis, or eligible kidney transplant recipient; 80 percent for GFR 15 to 29; 60 percent for GFR 30 to 44; 30 percent for GFR 45 to 59; and 0 percent for GFR 60 to 89 with recurrent red-cell, white-cell or granular casts, or structural kidney abnormalities, or an albumin/creatinine ratio of 30 mg/g or more — each sustained 3 consecutive months in the past 12. (2) Hypertension under DC 7101: 60 percent for diastolic predominantly 130 or more; 40 for diastolic predominantly 120 or more; 20 for diastolic predominantly 110 or more or systolic predominantly 200 or more; 10 for diastolic predominantly 100 or more, or systolic predominantly 160 or more, or as a minimum where there is a history of diastolic predominantly 100 or more requiring continuous medication. (3) Heart disease under 38 CFR 4.104. Where the rating comes from the cardiovascular schedule, DC 7507 elevates it to the next higher evaluation. |
Evidence Needed
Because the code is an election, build all three files. Renal: serial GFR or estimated GFR values — 38 CFR 4.115a expressly accepts GFR, eGFR and creatinine-based approximations when calculated by a medical professional — with enough results to show a value sustained for three consecutive months within the past twelve, plus urinalysis showing casts, imaging showing structural abnormality, or an albumin/creatinine ratio. Hypertension: blood-pressure readings that satisfy DC 7101 Note (1), which requires confirmation by readings taken two or more times on at least three different days, and the continuous-medication history that supports the 10 percent minimum. Cardiac: echocardiogram, any measured or estimated METs level, and left-ventricular ejection fraction. Add a renal biopsy if one was done, and a nexus opinion tying the nephrosclerosis to service-connected hypertension if you are claiming it as secondary.
C&P Exam Tips
Say explicitly that DC 7507 is a routing code and ask that all three pathways be developed, because a rater who evaluates only the kidney may never see that the cardiac route plus the one-step elevation produces more. Bring the laboratory trend rather than a single value — the renal rows require a GFR sustained for three consecutive months during the past twelve, so one low result does not establish a row and one normal result does not defeat one. For hypertension, bring readings from separate days; the note requires two or more readings on at least three different days. If you have cardiac symptoms, ask for a METs assessment, since the cardiovascular criteria are largely METs-driven and that is the route the elevation applies to.
How to File
File under DC 7507 and state in the claim that you are seeking evaluation under all three pathways the code names — renal dysfunction, hypertension, and heart disease — with the cardiovascular elevation applied where that route predominates. Attach the GFR trend, the multi-day blood-pressure record, and any cardiac testing. If nephrosclerosis follows service-connected hypertension, file it as secondary with a nexus opinion. Watch the pyramiding line: 38 CFR 4.14 bars rating the same manifestations twice, so hypertension cannot be paid separately when the hypertension readings are the basis of the DC 7507 evaluation — but genuinely distinct manifestations under different body systems, such as anemia or retinopathy, are rated on their own and combined under 38 CFR 4.25.
Common Mistakes
Reading DC 7507 as a ladder with its own tiers. It has none; the figures belong to 38 CFR 4.115a, DC 7101 and the cardiovascular schedule. Forgetting the elevation clause, which is the single most valuable sentence in the entry and applies only when the rating comes from the cardiovascular schedule. Quoting pre-2021 renal criteria: 38 CFR 4.115a was rewritten around glomerular filtration rate effective in 2021, so albuminuria-and-BUN language is superseded. Submitting one laboratory value where the criteria require a level sustained for three consecutive months within the past twelve. And submitting blood pressures from a single visit, when DC 7101 Note (1) requires readings on at least three different days.
Frequently Asked Questions
What percentage does DC 7507 pay?
None on its own. The rating cell in 38 CFR 4.115b is empty. The code directs VA to rate according to predominant symptoms as renal dysfunction, hypertension or heart disease, and the percentage comes from whichever of those applies.
What is the one-step elevation?
The entry says that if the disability is rated under the cardiovascular schedule, the percentage that would otherwise be assigned is elevated to the next higher evaluation. So a cardiovascular result of 30 percent becomes 60, the next higher evaluation in that code’s ladder — it is a step up the destination code’s own tiers, not a fixed number of points.
How do the renal figures work now?
They are GFR-based since the 2021 revision of 38 CFR 4.115a. GFR below 15, or regular routine dialysis, or eligible kidney transplant recipient is 100 percent; 15 to 29 is 80; 30 to 44 is 60; 45 to 59 is 30; and 60 to 89 with abnormal urinary findings or structural abnormality or an albumin/creatinine ratio of 30 mg/g or more is 0. Each requires the value sustained 3 consecutive months during the past 12.
Can I be rated for both hypertension and nephrosclerosis?
Not on the same manifestations. 38 CFR 4.14 bars evaluating the same symptoms twice, and DC 7507 is expressly an election on the predominant picture. Distinct conditions in other body systems — anemia, retinopathy — are rated separately and combined under 38 CFR 4.25.
Which pathway should I ask for?
Ask for all three to be calculated, then for the predominant one to be assigned. That is what the regulation requires, and it is the only way to see whether the cardiovascular route plus the elevation beats the renal figure.
My kidney function is only mildly reduced. Is it worth filing?
Yes. A 0 percent evaluation establishes service connection and preserves the effective date, and nephrosclerosis is progressive. Establishing the connection while GFR is still 60 to 89 means a later decline supports an increase rather than a new claim.