Claim Raven explanation
What this means
This section discusses nephritis, or kidney inflammation, and explains why an isolated urine finding is not necessarily that diagnosis. It also addresses the relationship between kidney and cardiovascular disability evaluations.
The rule limits separate evaluations in some circumstances and identifies exceptions, including certain cases involving an absent kidney or regular dialysis. The complete medical picture determines which provision is relevant.
How this helps your claim
This helps you understand a decision involving both kidney disease and heart or blood-pressure problems. Look for the diagnoses and the reason VA combined or separated the evaluations.
What to check in your records
Use your decision, examination reports, and relevant records to check the following points.
- Find the clinical kidney diagnosis and supporting laboratory history.
- Review whether dialysis, kidney removal, or other relevant circumstances are documented.
- Compare the treatment of related heart and blood-pressure conditions with this rule.
Separate a laboratory finding from the kidney diagnosis
A urine abnormality can prompt investigation without establishing chronic nephritis. The regulation emphasizes the broader medical picture. Read the specialist assessment, repeated findings and explanation of the condition rather than treating an isolated test value as a complete diagnosis.
Kidney and cardiovascular impairments can also have a relationship affecting how they are evaluated. Keep the actual diagnoses and the applicable exception identifiable. The presence of both conditions does not automatically establish either a prohibition on every separate rating or permission to combine them without limits.
Does an abnormal urine test automatically establish a compensable kidney disability?
No. The medical diagnosis, relevant service relationship and severity criteria remain separate requirements. A test result can be evidence, but it does not answer all of them. The full assessment is needed to understand what the finding means and which rating provisions apply.
Official regulatory text
38 CFR § 4.115
eCFR snapshot: September 3, 2026. Layout and spacing are adapted for reading. The full section and its tables are included below.
§ 4.115 Nephritis.
Albuminuria alone is not nephritis, nor will the presence of transient albumin and casts following acute febrile illness be taken as nephritis. The glomerular type of nephritis is usually preceded by or associated with severe infectious disease; the onset is sudden, and the course marked by red blood cells, salt retention, and edema; it may clear up entirely or progress to a chronic condition. The nephrosclerotic type, originating in hypertension or arteriosclerosis, develops slowly, with minimum laboratory findings, and is associated with natural progress. Separate ratings are not to be assigned for disability from disease of the heart and any form of nephritis, on account of the close interrelationships of cardiovascular disabilities. If, however, absence of a kidney is the sole renal disability, even if removal was required because of nephritis, the absent kidney and any hypertension or heart disease will be separately rated. Also, in the event that chronic renal disease has progressed to the point where regular dialysis is required, any coexisting hypertension or heart disease will be separately rated.
[41 FR 34258, Aug. 13, 1976, as amended at 59 FR 2527, Jan. 18, 1994]
Related references
- 38 CFR § 4.1: What a VA disability rating measures
- 38 CFR § 3.159: VA duty to assist: records and examinations
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