Glaucoma VA Rating Criteria: DC 6012 and DC 6013 General Formula Guide

Glaucoma is a group of eye conditions characterized by progressive optic neuropathy and visual field loss, frequently associated with elevated intraocular pressure. The VA disability rating schedule differentiates glaucoma into two primary diagnostic codes: Diagnostic Code 6012 for open-angle glaucoma (the most prevalent chronic form) and Diagnostic Code 6013 for angle-closure glaucoma (often presenting with acute ocular pain or narrow angles). Both diagnostic codes route raters directly into the General Rating Formula for Diseases of the Eye.

Under 38 CFR 4.79, the General Rating Formula evaluates ocular pathology on whichever provides the higher disability evaluation: documented visual impairment due to the condition or documented incapacitating episodes over the past 12 months. An incapacitating episode requires documented treatment visits or physician-prescribed rest. The rating tiers are: 10% for 1 to 2 treatment visits in the past 12 months; 20% for 3 to 4 visits; 40% for 5 to 6 visits; and 60% for 7 or more visits. If visual impairment computes higher, that visual impairment evaluation is assigned instead.

A vital statutory rule in both DC 6012 and DC 6013 is the continuous-medication minimum evaluation floor. The schedule explicitly states: 'Minimum evaluation if continuous medication is required -- 10.' If a veteran requires daily topical pressure-lowering drops (such as latanoprost, timolol, or brimonidine) or oral carbonic anhydrase inhibitors to maintain safe intraocular pressure, the veteran is entitled to a minimum 10% rating even if central visual acuity and peripheral visual fields remain entirely undamaged. This prevents penalizing veterans whose medical compliance successfully halts disease progression.

Because glaucoma causes painless, gradual peripheral vision loss before central vision is compromised, monitoring peripheral visual fields with Humphrey automated perimetry is critical. If glaucomatous optic nerve damage causes arcuate scotomas, nasal steps, or concentric contraction of the visual field, the veteran's visual impairment may exceed the 10% continuous medication floor. In such cases, the rater evaluates the peripheral loss under DC 6080, which can yield ratings of 10%, 20%, 30%, 50%, 70%, or 100% depending on the remaining field degrees.

A comprehensive glaucoma claim must include Goldman applanation tonometry records, optical coherence tomography (OCT) of the retinal nerve fiber layer, serial automated visual fields, and pharmacy logs documenting continuous medication. Glaucoma frequently occurs secondary to service-connected conditions, such as prolonged systemic corticosteroid treatment for service-connected asthma, rheumatoid arthritis, or skin disorders (steroid-induced glaucoma). Under 38 CFR 3.310, Association between conditions does not by itself establish secondary service connection. The evidence must support causation or aggravation in the individual claim.