Understanding Voiding Dysfunction VA Disability Ratings

You probably never think about how many steps our bodies must go through to conduct a normal, successful trip to the bathroom. That is, until one of those steps isn’t working correctly and you wind up with a voiding dysfunction. 

Voiding dysfunction can impact your daily comfort and sleep, and make simply leaving the house more difficult. In this article, we’ll explain more about dysfunctional voiding and how the VA rates this condition.

What is voiding dysfunction?

Voiding dysfunction is an umbrella term for conditions affecting how the bladder stores and releases urine. It is basically a broad term for reasons you may not be urinating normally. 

Causes can be neurological or anatomical. Your voiding dysfunction may be related to a condition like urinary incontinence or may be linked to an overactive or underactive bladder. 

Ultimately, if your bladder muscles and urethra are not coordinating or communicating properly, you may experience some form of voiding dysfunction. 

When your bladder stops following its usual patterns, you often start planning your day around bathroom access. This is why voiding dysfunctions can also interfere with sleep, routines, travel, social plans, work, and overall confidence. Constant awareness or fear around urination can be draining and impact your quality of life.

Voiding dysfunction VA rating

As we mentioned above, voiding dysfunction is treated as an umbrella term, so the VA has multiple ratings for this condition. 

Your rating depends on the specific pattern of symptoms you experience. The Schedule of Ratings of the Genitourinary System splits these patterns into urine leakage, urinary frequency, or obstructed voiding. 

Voiding dysfunctions that primarily cause urine leakage can be rated as follows:

Description	VA Rating	Monthly payment (vet only)
Continual Urine Leakage, Post Surgical Urinary Diversion, Urinary Incontinence, or Stress Incontinence:
Requiring the use of an appliance or the wearing of absorbent materials which must be changed more than 4 times per day	60%	$1,434.02
Requiring the wearing of absorbent materials which must be changed 2 to 4 times per day	40%	$795.84
Requiring the wearing of absorbent materials which must be changed less than 2 times per day	20%	$356.66

Voiding dysfunctions that primarily cause frequent urination are rated as follows:

Description	VA Rating	Monthly payment (vet only)
Urinary frequency:
Daytime voiding interval less than one hour, or; awakening to void five or more times per night	40%	$795.84
Daytime voiding interval between one and two hours, or; awakening to void three to four times per night	20%	$356.66
Daytime voiding interval between two and three hours, or; awakening to void two times per night	10%	$180.42

And voiding dysfunctions that obstruct urination are rated as follows:

Description	VA Rating	Monthly payment (vet only)
Obstructed voiding:
Urinary retention requiring intermittent or continuous catheterization	30%	$552.47
Marked obstructive symptomatology (hesitancy, slow or weak stream, decreased force of stream) with any one or combination of the following:
1. Post void residuals greater than 150 cc. 2. Uroflowmetry; markedly diminished peak flow rate (less than 10 cc/sec). 3. Recurrent urinary tract infections secondary to obstruction. 4. Stricture disease requiring periodic dilatation every 2 to 3 months	10%	$180.42
Obstructive symptomatology with or without stricture disease requiring dilatation 1 to 2 times per year	0%	None

Voiding dysfunction and other related conditions

The bladder muscles, pelvic floor, nerves, and outlet all need to coordinate for urination to happen, and any disruption in that chain can lead to problems. 

Potential causes of voiding dysfunction include weak bladder muscles, blockages in the urinary tract, constipation, an enlarged prostate, urinary tract infections, habits that place too much stress on the bladder, and other health conditions that are shared below. 

Diabetes and voiding dysfunction

Diabetic bladder dysfunction, a type of voiding dysfunction, affects nearly half of all people living with diabetes. This makes it one of the most common complications of the disease. Studies have found diabetes raises the risk of urinary incontinence somewhere between 30% and 70%, and urge incontinence in women by nearly 50%.

Veterans with diabetes that can be tied to their service who also experience voiding dysfunction may be eligible for VA disability for both conditions.

Neurological disorders and voiding dysfunction

Neurological disorders can have a powerful effect on bladder control because the bladder depends on clear signals traveling to the pelvic nerves. 

More than 80% of people with multiple sclerosis experience urinary or voiding dysfunction, and that number rises to 96% when the disease has lasted more than 10 years. 

Spinal cord injuries can also cause neurological issues which ultimately lead to incontinence, urinary tract infections, and other urinary-related symptoms.

Veterans with neurological conditions that can be connected to their military service who experience voiding dysfunction may be eligible for VA disability for both conditions.

Prostate cancer and voiding dysfunction

Prostate cancer and its treatments can lead to long-term changes in bladder control. 

In many men, symptoms begin with obstruction from an enlarged prostate. Following a prostatectomy, 10% to 15% of men reported frequent leakage or no control and a need to use absorbent pads at six months after treatment. A significant number of patients also experienced increased urgency.

Radiation can irritate the bladder and urethra, and nearly 45% of men reported irritative voiding symptoms at six months. Though many cases resolve within a year, some veterans may continue to experience issues.

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Mental health and voiding dysfunction

Dysfunctional voiding has the ability to cause significant mental health issues. Frequent urination may make going to social gatherings, attending events, and traveling  especially difficult. Urinary leakage may also lead to issues with confidence and self esteem.

These feelings of shame and embarrassment mixed with isolation have the potential to lead to depression and anxiety.

Veterans with voiding dysfunctions that can be tied to their service who develop mental health concerns may want to speak to a doctor or psychiatrist about whether the two are linked. If there is a connection, you could be owed additional VA disability.

TDIU for voiding dysfunction

In some cases, a veteran may be awarded total disability based on individual unemployability (TDIU) for voiding dysfunction, particularly those experiencing urinary leakage. 

TDIU is also known as individual unemployability or simply IU. Veterans are eligible for these benefits if they can’t hold down “substantially gainful” employment due to their service-connected conditions.

Veterans with other service-connected conditions may be more likely to receive TDIU due to the combination of their symptoms.

Veterans who receive TDIU benefits are compensated at the same level as those with a 100% disability rating, even though their combined rating is below 100%.

Veterans will typically be eligible for TDIU if they have:

• At least one service-connected disability rated at 60% or more disabling OR
• Two or more service-connected disabilities with at least one rated at 40% or more disabling and a combined rating of 70% or more.

How Woods & Woods can help

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