Diagnostic Code 6006 · 38 CFR §4.79
Diagnostic code 6006 covers retinopathy and maculopathy not otherwise specified, meaning conditions affecting the retina and macula that do not fall under a more specific diagnostic code. This includes diabetic retinopathy (damage to retinal blood vessels from diabetes), toxic retinopathy from medications or chemical exposures during service, hypertensive retinopathy from service-connected high blood pressure, and direct retinal damage from blast injuries or intense light exposure. Diabetic retinopathy is one of the most common secondary conditions claimed by veterans with service-connected diabetes. These conditions range from mild visual disturbance to severe vision loss or blindness. The VA rates under the General Rating Formula for Diseases of the Eye, based on incapacitating episodes or visual impairment, whichever is higher.
| Rating | Criteria |
|---|---|
| 60% | Seven or more incapacitating episodes requiring treatment visits during the past 12 months, or visual impairment equivalent to this level. |
| 40% | At least five but fewer than seven treatment visits for incapacitating episodes during the past 12 months. |
| 20% | At least three but fewer than five treatment visits for incapacitating episodes during the past 12 months. |
| 10% | At least one but fewer than three treatment visits for incapacitating episodes during the past 12 months. |
Retinal examination findings including fundus photographs or OCT imaging are essential. Visual acuity and visual field testing results document the functional impact. You need documentation of the underlying cause (diabetes, toxic exposure, trauma) and treatment records including injections, laser procedures, or surgeries. Progression documentation showing changes over time strengthens claims for higher ratings. For diabetic retinopathy, a nexus linking the condition to service-connected diabetes is important, though the connection is so well-established that it may be conceded.
If your diabetes is service-connected, diabetic retinopathy is claimed as secondary to the diabetes. The retinopathy is then rated based on its own severity under DC 6006 or based on the resulting visual impairment, whichever provides the higher rating. The medical connection is so well-established that the VA generally concedes the nexus.
Yes. Diabetic retinopathy is rated separately from diabetes itself because it affects a different body system (eyes vs. endocrine). Your diabetes percentage reflects metabolic management, while retinopathy is rated based on actual visual impairment or treatment frequency.
The VA evaluates retinal conditions either by the disease process (incapacitating episodes under DC 6006) or by the resulting visual impairment (visual acuity or visual field loss), whichever method yields the higher rating. They will use the more favorable approach.