Diagnostic Code 6046 · 38 CFR §4.79
Anatomical loss of both eyes — surgical enucleation, evisceration, or complete destruction of both globes — produces total schedular disability at 100% under DC 6046 and triggers the highest tiers of Special Monthly Compensation under 38 USC 1114. The classic veteran mechanisms are catastrophic combat trauma (blast injury, penetrating shrapnel or gunshot wounds destroying both eyes), severe thermal or chemical burns, and rarely the surgical management of bilateral end-stage disease (uncontrollable infection, sympathetic ophthalmia, or bilateral malignant ocular tumors). Beyond the 100% schedular evaluation, the SMC ladder applies based on the specific functional losses: SMC-L at minimum for total blindness with no functional vision, with higher SMC tiers (M, N, O) when additional impairments coexist — loss of use of an upper extremity, requirement for aid and attendance, paraplegia, or other compound impairments. The SMC framework is essential for veterans in this situation because the additional monthly compensation often substantially exceeds the schedular 100% payment.
| Rating | Criteria |
|---|---|
| 100% | Anatomical loss of both eyes by enucleation, evisceration, or complete destruction. The 100% rating is mandatory under DC 6046 and is paid in addition to Special Monthly Compensation at the appropriate SMC tier. SMC-L is the minimum SMC level applicable; higher tiers (M, N, O, P) apply when additional impairments are present (loss of use of a hand or foot, paraplegia, requirement for the regular aid and attendance of another person, or other compound losses). |
Surgical records documenting the enucleation, evisceration, or surgical removal of both globes are the central evidence. Photographs and current ophthalmology examination document the anatomical state. Original trauma records — emergency department reports, operative notes from the initial wound management, any subsequent reconstructive surgery — establish the in-service event. Records of prosthetic eye fitting and ongoing prosthetic care document the post-operative state. A current statement from the treating ophthalmologist confirming the anatomical loss and characterizing any complications (chronic socket infection, orbital implant issues, contracture) supports the case. For SMC evaluation, a comprehensive functional assessment covering activities of daily living, mobility limitations, and the need for assistance from another person establishes the appropriate SMC tier.
SMC-L under 38 USC 1114(l) is the minimum applicable for anatomical loss of both eyes — it is paid for blindness in both eyes with no light perception, anatomical loss of both eyes, or the requirement for regular aid and attendance. SMC-L is paid on top of the schedular 100% rating, not in place of it. Higher SMC tiers apply when additional impairments coexist: SMC-M for loss of use of one upper extremity in addition to the bilateral blindness, SMC-N for loss of use of both upper extremities or both lower extremities, SMC-O for both blindness and bilateral upper-and-lower extremity loss, and so on up the ladder.
Veterans rated for anatomical loss of both eyes qualify for: (1) the Automobile and Adaptive Equipment Allowance under 38 USC 3902, which pays a one-time lump sum plus adaptive equipment costs; (2) the Specially Adapted Housing (SAH) grant under 38 USC 2101 for modifying or purchasing a home with accessibility features; (3) Service-Disabled Veterans Insurance (S-DVI) at an elevated coverage level; (4) Aid and Attendance benefits as part of the SMC framework; (5) eligibility for the Vocational Rehabilitation & Employment program at the higher need level. Each of these requires a separate application but all are essentially automatic upon the DC 6046 rating.
The VA Blind Rehabilitation Service provides guide dogs, white canes, electronic mobility aids, screen-reading software, Braille training, and other assistive technology at no cost to eligible blind veterans. DC 6046 ratings qualify; eligibility is also extended to veterans with bilateral vision loss meeting the legal blindness threshold under other codes. The benefits are administered through VA Blind Rehabilitation Centers and through specialized clinical teams rather than through the disability rating itself, so the application is to those programs directly.