Diagnostic Code 7904 · 38 CFR §4.119
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 |
|---|---|
| 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. |
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.
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.
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.