Gynecological Issues and Ratings

According to the VA, there are over 2 million women Veterans in the United States right now. In fact, females are the fastest-growing group in the Veteran population.

Over 580,000 female Veterans have a VA rating due to a service-connected disability. And, about 10,000 women receive a VA disability rate due to gynecological conditions.

VA rates gynecological conditions under 38 CFR § 4.116, Schedule of Ratings, “Gynecological Conditions and Disorders of the Breast.” Ratings range from 0 to 100%, with individual rating criteria for each disability. 

Gynecological issues are among the most common disabilities among women Veterans, trailing only back pain and PTSD. Considering this, it’s surprising that gynecological issues were only added to the VA Rating Schedule in 2018!

Here we’ll talk about: 

  • Why have gynecological conditions become such a pressing issue among female military personnel?
  • Which disabilities belong to this group?
  • How does the VA rate gynecological conditions and how can you make sure you get your VA disability benefits!

Service Connection for Gynecological Conditions

Gynecological conditions can be more common among female military personnel for several reasons:

  1. Hygiene Challenges 
    When deployed or in training, access to proper hygiene facilities might be limited. It inevitably increases the risk of infections like urinary tract infections (UTIs) or vaginal infections, leading to more serious gynecological problems if left untreated.
  2. Stress and Physical Demands
    Military life can be very stressful and demanding. Both mentally and physically. The stress and strain from intense training, deployments, and long working hours can disrupt your body’s hormonal balance. It can lead to irregular menstrual cycles, fertility issues, or exacerbating existing gynecological conditions.
  3. Sexual Harassment and Assault
    Sexual harassment and assault can occur within the military. These traumatic experiences can have long-lasting effects on physical and mental health, including gynecological issues like pelvic pain, sexually transmitted infections (STIs), or post-traumatic stress disorder (PTSD).
  4. Limited Access to Healthcare
    Depending on where stationed, female service members might have limited access to gynecological healthcare. This can make it harder to get regular check-ups, screenings, or treatment for gynecological conditions, leading to undiagnosed or untreated issues.

If you have a service-connected gynecological problem, a disability that developed due to the conditions of your military service as a result of an accident or injury while in service, you can be entitled to VA disability benefits.

To establish the connection between your current disability and military service, you need to provide:

  • Medical records with a diagnosis of an existing gynecological condition
  • Evidence of an injury or in-service event that could lead to these health issues
  • A medical nexus that links your disability to the conditions of your military service or a particular event.

It is important to consult a professional while collecting the necessary documents and evidence while filing for any kind of VA disability benefits. It can save you a great deal of time and effort, minimize the possibility of mistakes and miscommunication, and guarantee that you receive the maximum in the VA disability benefits you deserve.

VA Rates for Gynecological Conditions

The Schedule for Rating disabilities rates gynecological conditions under diagnostic codes 7610 to 7632. These conditions include disorders of breasts and organs in the abdominal and pelvic area.

Let’s go over the most common gynecological conditions, their diagnostic codes, and VA disability rates.

Menstrual Disorders 

Menstrual disorders usually express themselves in heavy and prolonged menstrual bleeding (dysfunctional uterine bleeding.) It is one of the most common gynecological conditions among female Veterans, which can greatly affect every aspect of your everyday life including the ability to work.

VA classifies menstrual disorders as “Ovary, disease, injury, or adhesions of”, under Code 7615. Depending on the severity of symptoms and treatment efficiency those conditions are rated:

  • 0% – Symptoms do not require continuous treatment
  • 10% – Symptoms require continuous treatment
  • 30% – Symptoms are irresponsive to continuous treatment

In case the treatment becomes efficient even after you have received a 30% rate, it may go down to 10%.

Infertility 

The VA does not provide a disability rating for infertility itself. However, loss of reproductive organ function is a notoriously common disability caused by military service. 

Nevertheless, if you provide evidence that your infertility is a result of non-functioning ovaries, it will fall into the category of “Ovaries, atrophy of both, complete” (Code 7620) which comes with a 20% VA disability rate.

In case infertility is a result of an ovaries removal surgery, it is rated under Code 7619 “Ovary removal of” with the VA rates:

  • 0% – Removal of one with or without partial removal of the other
  • 30% – Complete removal of both ovaries
  • 100% – For 3 months after surgery if one or both ovaries are removed

Infertility may also be a result of surgical uterus removal, which has a diagnostic Code 7619 and gives you VA rates of:

  • 100% – For 3 months after surgery
  • 30% – Thereafter

In case both ovaries and uterus were surgically removed, this case falls under the diagnostic Code 7617 “Uterus and both ovaries, removal of, complete”, which has the rates:

  • 100% – For 3 months after the surgery
  • 50% – Thereafter

In case your infertility was not caused by either of those cases, you can still be entitled to VA benefits through VA Healthcare that provides special treatments and procedures including infertility and genetic counseling, blood testing, surgery, IVF and more.

Mastectomy (Breast surgery)

If mastectomy is medically determined to be secondary to, or necessary to treat, a service-connected condition, it falls under the diagnostic Code 7626, which is also included in the section that describes gynecological conditions in the Schedule of Ratings.

In this case, you can be entitled to the following VA rates:

  • Radical mastectomy (removing the breast and its underlying chest muscle) – 80% for both, 50% for one
  • Modified mastectomy (removal of the entire breast and axillary lymph nodes) – 60% for both, 40% for one
  • Simple mastectomy (removal of all of the breast tissue, nipple, and a small portion of the overlying skin) – 50% for both, 30% for one
  • Wide local excision without significant alteration of size or form (removal of a portion of the breast tissue) – 0%

Endometriosis

Endometriosis is a disease in which tissue similar to the lining of the uterus grows outside the uterus. It can cause severe pain in the pelvis and make it harder to get pregnant. In fact, it is another gynecological condition that can be connected to infertility.

It is another common gynecological condition among female Veterans. You will need to provide complete medical records about the condition as well as a thorough description of therapies and treatments, their effect, and their connection to the military service in order to receive a VA rating for endometriosis.

This gynecological condition is rated under the Code 7629 and has the following rates:

  • 10% – Pelvic pain or heavy or irregular bleeding requiring continuous treatment for control
  • 30% – Pelvic pain or heavy or irregular bleeding not controlled by treatment
  • 50% – Lesions involving bowel or bladder confirmed by laparoscopy, pelvic pain or heavy or irregular bleeding not controlled by treatment, and bowel or bladder symptoms

Reproductive Cancers

As the name suggests, reproductive cancers are cancers that originate in reproductive organs. If the development of your cancer is connected to the conditions of your military service, you may be entitled to VA Disability Benefits. 

The VA automatically assigns a 100% disability rate to Veterans with service-connected active cancer, including reproductive cancers. This rate is relevant for as long as the cancer is active and then for 6 more months after successful treatment. After that, your condition will be evaluated once again, and the VA will give you a new rate depending on the residuals of the disease and its treatment.

When talking about gynecological cancer, it is important to highlight the case that usually causes the most confusion: Abnormal Pap Smear.

A pap smear is a standard diagnostic procedure, that checks for cervical cancer. An Abnormal Pap Smear may mean that the test found abnormal cells or the Human Papillomavirus (HPV). These results are usually connected to the development of Cervical Cancer.

HPV itself does not necessarily mean that you have cancer. It is also not considered a ratable condition. However, once an HPV develops into a cancerous condition, you can receive the 100% VA disability rate typical for service-connected cancers.

Claiming VA Disability Benefits for Gynecological Conditions

To ensure that you are eligible for VA disability compensation for gynecological conditions, you will need to go through the Compensation and Pension Examination (C&P).

It is a medical examination performed by a VA healthcare provider or a VA-contracted provider. The VA uses the C&P Exam to gather more information about your condition, its nature and development as well as its connection to your military service.

The goal of this medical testing is to receive an official conclusion that your gynecological condition is “at least as likely as not” resulted from your military service or another service-connected disability.

After ensuring your eligibility, you’ll need to complete VA Form 21-526EZ, collect the necessary evidence, and follow the standard procedure of claiming VA disability benefits.

Throughout the whole process, it’s essential to stay informed and proactive. Consider seeking assistance from a professional specializing in VA benefits, who will help navigate the process and ensure your rights are protected.

Final Thoughts – How Can We Help?

Due to its sensitive nature and the fact that the proportion of women in the military, though rapidly increasing, is still relatively low, gynecological conditions are not discussed as often when we speak about VA disability benefits.

VCU helps female Veterans seek and claim their VA disability benefits using our wide network of independent medical professionals, who provide medical examinations and nexus statements needed for a successful VA disability claim. Contact us today to schedule your free 30-minute call. Together we’ll make sure you and your family make informed decisions through the process and receive your compensation in full.

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