Hypothyroidism VA Rating

Hypothyroidism became an Agent Orange presumptive condition on January 1, 2021, when Section 9109 of the National Defense Authorization Act for Fiscal Year 2021 added it to 38 U.S.C. § 1116. Before then, a veteran with hypothyroidism had to prove a direct or secondary link to service. The change opened a new path for veterans with herbicide-exposure service whose claims had been denied under the older framework.

Across 2,997 decided Board rulings on hypothyroidism from 2021 to 2026, 26.8% were granted, 27.6% denied and 45.6% remanded. A ruling is one issue the Board decided in one decision; one decision often rules on several issues. That grant rate is 2.1 percentage points above the 24.7 percent across all decided Board rulings. On service connection, claims that involved a presumption were granted somewhat more often than direct claims, and secondary claims less often; the Board section below shows all three.

This page covers the current rating criteria and what they pay, the herbicide presumption, the other paths to service connection, the evidence that wins, why VA denies hypothyroidism claims, and the questions veterans ask most.

TL;DR

• 2,997 decided Board rulings on hypothyroidism from 2021 to 2026: 26.8% granted, 27.6% denied, 45.6% remanded. Remand is the most common outcome.
• The symptom-tier ladder was repealed effective 2017-12-10. The current DC 7903 has exactly two rungs: 100% for hypothyroidism manifesting as myxedema, and 30% for hypothyroidism without myxedema. There is no 10% tier and no 60% tier, and no symptom constellation is required for either rung.
• Both rungs are time-limited. The 30% runs six months from initial diagnosis; the 100% runs six months past crisis stabilization. After that VA rates the residual effects under the appropriate diagnostic code in the appropriate body system, so the long-term rating lives in mental disorders, eye, digestive, or cardiovascular, not in the endocrine code.
• Note (3) allows a separate eye rating. Exophthalmos, corneal ulcer, blurred vision, or diplopia due to thyroid disease is evaluated separately under § 4.79, not folded into the thyroid evaluation.
• Hypothyroidism was added to the Agent Orange presumptive list under 38 USC § 1116 in 2021. VA's Agent Orange page says that if VA denied a hypothyroidism claim in the past, VA will automatically review the case again, and the veteran doesn't need to file another claim.
• Higher-rating appeals succeed less often than service connection appeals. Under the current code 30 percent comes with the diagnosis for six months and then gives way to residuals.
• When the Board denied service connection, it most often found no link between the hypothyroidism and service. Qualifying herbicide service, or a medical opinion that explains the link, is what carries the claim.
• "Severity insufficient" was a common denial pattern under the old symptom-checklist tiers. Under the current code the equivalent failure is a file that never names the residuals or places them in a body system.

Hypothyroidism VA rating criteria (DC 7903)

If you have read almost anything else about hypothyroidism ratings, you have read about a four-tier symptom ladder: 10 percent for fatigability or continuous medication, 30 percent for fatigability plus constipation plus mental sluggishness, 60 percent for muscular weakness plus mental disturbance plus weight gain, and 100 percent for a six-element constellation ending in bradycardia and sleepiness.

That ladder was repealed. VA rewrote the endocrine section effective December 10, 2017 (82 FR 50802), and the current DC 7903 in 38 CFR § 4.119 reads as follows.

Hypothyroidism manifesting as myxedema (cold intolerance, muscular weakness, cardiovascular involvement (including, but not limited to hypotension, bradycardia, and pericardial effusion), and mental disturbance (including, but not limited to dementia, slowing of thought and depression)), 100%

Note (1): This evaluation shall continue for six months beyond the date that an examining physician has determined crisis stabilization. Thereafter, the residual effects of hypothyroidism shall be rated under the appropriate diagnostic code(s) within the appropriate body system(s) (e.g., eye, digestive, and mental disorders).

Hypothyroidism without myxedema, 30%

Note (2): This evaluation shall continue for six months after initial diagnosis. Thereafter, rate residuals of disease or medical treatment under the most appropriate diagnostic code(s) under the appropriate body system (e.g., eye, digestive, mental disorders).

Note (3): If eye involvement, such as exophthalmos, corneal ulcer, blurred vision, or diplopia, is also present due to thyroid disease, also separately evaluate under the appropriate diagnostic code(s) in § 4.79, [the eye schedule] (such as diplopia (DC 6090) or impairment of central visual acuity (DCs 6061-6066)).

That is the entire code. Two rungs, and the notes matter more than the rungs.

There is no 10 percent tier and no 60 percent tier. Both were deleted. So was every symptom constellation. Fatigability, constipation, mental sluggishness, and weight gain appear nowhere in the current DC 7903, and a claim built on documenting them is documenting a repealed standard.

The 30 percent is close to automatic, and it expires. Hypothyroidism without myxedema rates 30 percent, full stop. No symptom showing is required. But Note (2) runs that evaluation for six months after initial diagnosis, and then it stops being the rating. After six months VA is directed to rate the residuals under whatever body system they fall in.

The 100 percent is narrow, and it also expires. It requires myxedema, which is a specific clinical picture: cold intolerance and muscular weakness and cardiovascular involvement and mental disturbance. Note (1) runs it for six months past crisis stabilization, then the same residual analysis takes over.

What this changes about how you build the claim

The whole center of gravity moved. Under the old rule the fight was about stacking three symptoms into a tier. Under the current rule the endocrine code is a placeholder that pays for roughly six months, and your long-term rating lives in other body systems entirely.

That makes the residual inventory the claim. The regulation names examples, and they are the places to look.

• Mental disorders. Depression, cognitive slowing, and memory complaints attributable to thyroid disease are rated under § 4.130, on the General Rating Formula for Mental Disorders. That formula reaches 100 percent.
• Eye. Note (3) is unusually generous and easy to miss. If exophthalmos, corneal ulcer, blurred vision, or diplopia is present due to thyroid disease, it is separately evaluated under § 4.79, in addition to the endocrine rating rather than folded into it.
• Digestive. Persistent constipation or other GI residuals are rated under § 4.114.
• Cardiovascular. Bradycardia, hypotension, or pericardial effusion that persists is rated under § 4.104 rather than counted as an element of a thyroid tier.

A veteran six months past diagnosis whose file contains only "hypothyroidism, on levothyroxine, stable" has nothing for a rater to work with, because the code itself has run out. The record has to name the residuals and place them in a body system.

Claims that span December 10, 2017

If your claim was pending across the change, the Board applies the old symptom-ladder criteria to the period before December 10, 2017. From that date it considers both the old and the current criteria and applies whichever is more favorable, though the current criteria cannot be applied to any period before their effective date (Board citations 25006817 and A25001713, citing 38 U.S.C. § 5110(g) and VAOPGCPREC 3-2000). A rating already in effect is not reduced just because the schedule changed, unless the condition actually improved (38 CFR § 3.951(a)), which is why some veterans still hold ratings assigned under the old ladder (Board citation A25003724).

How much VA pays for hypothyroidism

For a single veteran with no dependents at the 2026 rates (effective December 1, 2025), 30 percent pays $552.47 a month and 100 percent pays $3,938.58 a month. Each runs for six months. After that, what you receive depends on the ratings VA assigns to the residuals, combined with your other service-connected conditions.

Hypothyroidism and Agent Orange: the 2021 presumption

Section 9109 of the National Defense Authorization Act for Fiscal Year 2021 (Public Law 116-283, January 1, 2021) added hypothyroidism to the list of presumptive conditions for veterans exposed to Agent Orange. The presumption is written into the statute, at 38 U.S.C. § 1116(a)(2)(K); the current text of 38 CFR § 3.309(e) does not list hypothyroidism. VA's Agent Orange eligibility page lists it among the presumptive conditions.

For a veteran with qualifying service, hypothyroidism is presumed to be related to service. VA's Agent Orange page and 38 U.S.C. § 1116(d) list the qualifying service.

• Service in the Republic of Vietnam, aboard a vessel on its inland waterways, or on a vessel not more than 12 nautical miles seaward from the demarcation line of the waters of Vietnam and Cambodia, from January 9, 1962 through May 7, 1975
• Service at any U.S. or Royal Thai military base in Thailand from January 9, 1962 through June 30, 1976
• Service in Laos from December 1, 1965 through September 30, 1969
• Service in Cambodia at Mimot or Krek, Kampong Cham Province, from April 16 through April 30, 1969
• Service on Guam or American Samoa or in their territorial waters from January 9, 1962 through July 31, 1980, or on Johnston Atoll or a ship that called there from January 1, 1972 through September 30, 1977
• Service in or near the Korean DMZ from September 1, 1967 through August 31, 1971
• Regular and repeated contact with C-123 aircraft known to have carried Agent Orange, or involvement in transporting, testing, storing or otherwise using Agent Orange

VA says the PACT Act added the Thailand, Laos, Cambodia, Guam, American Samoa and Johnston Atoll locations. Once qualifying service is documented and the diagnosis is established, the link to service is presumed. The Board section below shows how presumptive claims fared against direct and secondary ones.

For veterans whose hypothyroidism claims were denied before the 2021 expansion, VA's Agent Orange page says VA will automatically review the case again and send a letter, and no new claim is needed.

Other paths: Camp Lejeune, radiation, Gulf War and secondary claims

Camp Lejeune. The Camp Lejeune presumption in 38 CFR § 3.307(a)(7) covers veterans with at least 30 days at Camp Lejeune between August 1, 1953 and December 31, 1987, but its disease list in § 3.309(f) does not include hypothyroidism. A Camp Lejeune hypothyroidism claim has to be argued directly, with the contaminated water as the in-service exposure and a medical opinion that explains the link.

Radiation exposure. 38 CFR § 3.311 lists thyroid cancer and non-malignant thyroid nodular disease as radiogenic diseases, but not hypothyroidism, and the § 3.309(d) presumptive list for radiation-exposed veterans names thyroid cancer only. Under § 3.311(b)(4), VA still considers a claim for an unlisted disease if you cite or submit competent scientific or medical evidence that it is radiogenic.

Gulf War service. 38 CFR § 3.317 covers undiagnosed illnesses and medically unexplained chronic multisymptom illnesses, meaning disability that cannot be attributed to any known clinical diagnosis. Hypothyroidism is a known clinical diagnosis, so it generally falls outside § 3.317, and fatigue or cognitive symptoms that a thyroid diagnosis explains do not qualify. The Gulf War illness page covers that framework.

Secondary service connection. Under 38 CFR § 3.310, hypothyroidism can be service connected when a service-connected condition or its treatment caused it, or aggravated it, meaning it would be less severe but for that condition. Lithium, a standard treatment for bipolar disorder, is a known cause: one review describes lithium-induced hypothyroidism as relatively common (PMID 27900734), and another puts it at 8 to 20 percent of lithium-treated patients (PMID 35074396). Radioactive iodine treatment for hyperthyroidism commonly leaves hypothyroidism as well (PMID 32471411). The opinion still has to tie the treatment to your hypothyroidism using your own records.

How to prove hypothyroidism for a VA claim

Documented qualifying service for the herbicide presumption. The DD-214 and personnel records have to place you in a covered location during a covered period. Once qualifying service is documented and the diagnosis is established, the presumption does the rest.

Thyroid labs and a clinical diagnosis. TSH and free T4 results, together with the treating clinician's diagnosis, establish the underlying condition and the date it was first diagnosed.

A named residual inventory, placed in a body system. This replaces the old symptom-constellation strategy entirely. Because both current rungs expire after six months, the records that decide the durable rating are the ones documenting residual effects and the body system they belong to: depression or cognitive slowing under § 4.130, eye involvement separately under § 4.79 per Note (3), GI residuals under § 4.114, persistent bradycardia or hypotension under § 4.104. The C&P examination should be asked to identify residuals by system, not to tick symptoms off a thyroid checklist.

Diagnosis documentation and the myxedema question. Under the current code a confirmed hypothyroidism diagnosis without myxedema is worth 30 percent for six months without any symptom showing, so the diagnosis date is what starts the clock. Where myxedema is clinically present, the record should say so in those terms and identify the date of crisis stabilization, because Note (1) runs the 100 percent evaluation for six months past that date.

A nexus opinion when the presumption does not apply. For veterans whose service doesn't qualify for the herbicide presumption, the opinion needs to engage with the specific exposure, in-service event or service-connected condition that caused the hypothyroidism. The Board section below shows how claims went when the Board relied on a favorable opinion, an opinion against the claim, or none.

Why VA denies hypothyroidism claims

When the Board denied hypothyroidism service connection, it most often found no link between the hypothyroidism and service, and higher-rating appeals were granted less often than service connection appeals. The Board section below shows how often each part of the claim failed, why the Board sent claims back, and results by what the appeal asked for.

No link to service. No herbicide-qualifying service, no in-service thyroid findings, and no opinion that explains a direct or secondary link.

Qualifying service not in the record. The diagnosis alone does not trigger the presumption. The service records have to show a covered location and period.

No named residuals after six months. A file that says only "stable on levothyroxine" gives a rater nothing to rate once the endocrine code runs out.

Old-ladder evidence under the new code. Under the pre-2017 criteria, a higher rating required each listed symptom: constipation and mental sluggishness on top of fatigability for 30 percent, or muscular weakness, mental disturbance and weight gain for 60 percent. Records that mentioned "fatigue and weight gain" generically were not enough, and "severity insufficient" was the common result. That analysis still applies to periods before December 10, 2017, but under the current code the same specificity has to go into naming residuals and placing them in a body system.

Questions veterans ask about hypothyroidism

What is the VA rating for hypothyroidism?

Under the current code, hypothyroidism without myxedema rates 30 percent for six months after diagnosis, and hypothyroidism with myxedema rates 100 percent for six months after crisis stabilization. After that, VA rates the residual effects under the body systems they affect.

Is hypothyroidism presumptive for Vietnam veterans?

Yes. Since January 1, 2021, hypothyroidism has been a presumptive condition for veterans with qualifying herbicide-exposure service, which includes Vietnam and also Thailand, Laos, Cambodia, Guam, American Samoa, Johnston Atoll and the Korean DMZ for set periods.

What happens to my hypothyroidism rating after six months?

The 30 or 100 percent evaluation ends, and VA rates the residuals instead, such as depression or cognitive slowing under the mental disorders formula, eye involvement under the eye schedule, or heart and digestive effects under those systems. A file that names no residuals leaves little to rate.

Can hypothyroidism be secondary to a service-connected condition?

Yes. If a service-connected condition or its treatment caused your hypothyroidism or made it worse, it can be service connected under 38 CFR § 3.310. Lithium for bipolar disorder and radioactive iodine for hyperthyroidism are two treatments known to cause it.

Is Hashimoto's thyroiditis rated as hypothyroidism?

When it causes hypothyroidism, yes. The note to DC 7906 says thyroiditis manifesting as hypothyroidism is evaluated as hypothyroidism under DC 7903, while thyroiditis with normal thyroid function rates 0 percent.

Does VA rate thyroid eye problems separately?

Yes. Note (3) to DC 7903 says eye involvement such as exophthalmos, corneal ulcer, blurred vision or diplopia due to thyroid disease is evaluated separately under the eye schedule in § 4.79.

Bottom Line

Hypothyroidism is rated under 38 CFR § 4.119 DC 7903, which since 2017-12-10 has exactly two rungs: 100 percent for hypothyroidism manifesting as myxedema, and 30 percent without it. No symptom constellation is required for either, the 10 and 60 percent tiers were deleted, and both surviving rungs expire after six months, at which point VA rates residual effects under other body systems. That makes the residual inventory the claim, and it is why the old advice to stack fatigability, constipation, and mental sluggishness is now wasted effort. Across 2,997 decided Board rulings on hypothyroidism from 2021 to 2026, some of which applied the repealed ladder to earlier periods, the grant rate is 26.8 percent. The Agent Orange presumption added hypothyroidism in 2021, and claims that involved a presumption were granted somewhat more often than direct claims. Camp Lejeune, radiation, and Gulf War rules do not presume hypothyroidism, but a direct or secondary claim can still succeed with the right opinion. For veterans with qualifying service whose hypothyroidism was denied before the 2021 expansion, VA says it will review those denials again on its own, which is the structural opening that wasn't available under earlier versions of the framework.

Methodology and Limitations

• Data source: 38 CFR § 4.119 DC 7903 and the note to DC 7906 (endocrine rule 82 FR 50802, effective December 10, 2017), 38 USC § 1116 (Agent Orange; hypothyroidism added by Section 9109 of Public Law 116-283), 38 CFR § 3.309(e) (regulatory Agent Orange list, which does not list hypothyroidism), VA's Agent Orange eligibility page, 38 CFR §§ 3.307(a)(7) and 3.309(f) (Camp Lejeune), 38 CFR §§ 3.309(d) and 3.311 (radiation), 38 CFR § 3.317 (Gulf War), 38 CFR §§ 3.310 and 3.951(a), checked against the eCFR text current to October 2, 2026, and Claim Raven's read of every Board decision from 2021 to 2026 that it holds. Board decisions cited are 2025 decisions from the Board's public archive.
• Sample size: 511,036 Board decisions from 2021 to 2026 containing 1,378,030 rulings, including 2,997 decided Board rulings on hypothyroidism (3,276 rulings in all, counting dismissed and withdrawn issues). Outcomes split granted 26.8% (804), denied 27.6% (826), remanded 45.6% (1,367). The Board section on this page breaks these down by denial reason, remand reason, appeal type, medical opinion, claim theory and era since 1992; those figures are computed from the data, not typed here. Rating tiers are not part of this data.
• Medical sources: PMID 27900734 and PMID 35074396 (lithium and hypothyroidism), PMID 32471411 (hypothyroidism after radioactive iodine for Graves' disease).
• Limitations: The 2021 Agent Orange presumption expansion is recent; the 2021 to 2026 window begins the year it took effect, so the presumption framework controls for the decisions in it. Some decisions in the window still applied the pre-2017 conjunctive symptom tiers to earlier periods of a claim, so their rating outcomes describe a mix of the old and current standards and are not a forecast under the current code. The current code also leaves open how VA identifies and stages residuals once the six-month rungs expire, which is now the main source of variation. These observations describe BVA patterns and are not predictions of individual outcomes, and Claim Raven is data analysis, not legal, medical, or VA-accredited advice.