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Nexus Letters for Glaucoma
Licensed Physician, MD | Patriot Path Medical Team
Specializing in VA vision and eye evaluations and independent medical opinions • Last updated: June 2026
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Glaucoma is sneaky. It usually does not hurt. It takes your side vision so slowly that you may not notice until a real amount is gone. By then the damage is permanent. Your glaucoma may be connected to your service. Or it may be connected to another condition the VA already covers, like type 2 diabetes. Either way, you may be owed disability compensation for it.
A claim turns on the medical evidence. Our doctors connect your glaucoma to your service, or to a service-connected cause. They record how it affects your vision, in the language the VA expects. One flat fee of $1,500, and the first consultation is free.
How VA Rates Glaucoma
The VA rates glaucoma under 38 C.F.R. § 4.79. There are two diagnostic codes, based on the type. DC 6013 covers open-angle glaucoma, the common, slow form. DC 6012 covers angle-closure glaucoma, the less common form, which can flare suddenly. Glaucoma is not rated on a single 'glaucoma score.' Instead, both codes are rated on the General Rating Formula for Diseases of the Eye. There is a minimum 10% if you need continuous medication (like daily eye drops) to control it. Here is the rule for each code, word for word.
"6012 Angle-closure glaucoma. Evaluate under the General Rating Formula for Diseases of the Eye. Minimum evaluation if continuous medication is required ... 10. 6013 Open-angle glaucoma. Evaluate under the General Rating Formula for Diseases of the Eye. Minimum evaluation if continuous medication is required ... 10."
| Rating | What it generally takes | Monthly pay (approx) |
|---|---|---|
| Minimum 10% | From DC 6012 / DC 6013. Assigned if you need continuous medication (such as daily eye drops) to control the glaucoma, even if your vision still tests well. | ~$180/mo |
| Visual impairment | From the General Rating Formula, Note (3), pointing to 38 CFR 4.76 to 4.78 (visual acuity) and 38 CFR 4.77 (visual fields), rated via DCs 6061 to 6091. Covers loss of sharpness and loss of side vision. Glaucoma damages side vision first, so the visual field rules under 4.77 often matter most. Usually the higher rating once damage sets in.Most Common | ~$180 to $3,939/mo |
| Incapacitating episodes | From the General Rating Formula. 10% to 60% based on documented treatment visits for the eye condition over the past 12 months (1 to 2 visits = 10%, up to 7 or more visits = 60%). | ~$180 to $1,435/mo |
Early on, drops may keep your pressure down, and your vision may still look normal on a chart. At that stage, glaucoma is usually a 10% minimum. As it damages your side vision, that loss is measured under 38 C.F.R. § 4.77. It can push the rating well above 10%. Loss of sharpness (visual acuity) is measured under 38 C.F.R. § 4.76 to 4.78. The VA uses whichever path gives the higher rating. That is why a current, full eye exam with visual field testing matters so much for a glaucoma claim. A chart-only acuity test can miss the side-vision loss that carries the rating.
Pay figures are approximate 2026 rates (effective December 1, 2025) for a single veteran with no dependents. Check VA.gov for current amounts.
How a glaucoma rating is decided
Glaucoma can be rated on three paths. The VA uses whichever gives the higher rating. Knowing which path fits your records tells you whether your rating is too low.
- 1
Minimum 10% for continuous medication
Both DC 6012 and DC 6013 assign a minimum 10% if you need continuous medication, such as daily eye drops, to control the glaucoma. This applies even if your vision still tests well. It is the floor for most veterans early on.
- 2
Visual impairment, usually the higher path
The General Rating Formula, Note (3), points to the visual-impairment rules. Visual acuity is rated under 38 C.F.R. § 4.76 to 4.78. Visual fields are rated under 38 C.F.R. § 4.77. The ratings come through DCs 6061 to 6091. Glaucoma takes side vision first, so the visual field rules under 4.77 often carry the rating. This is why a formal visual field test matters so much.
- 3
Incapacitating episodes
The formula can also rate documented incapacitating episodes. It counts treatment visits for the eye condition over the past 12 months: 10% for 1 to 2 visits, up to 60% for 7 or more. The VA takes whichever of the three paths is highest.
The visual-acuity tables (4.76 to 4.78, DCs 6061 to 6066) and the visual-field table (4.77, DC 6080) are long, number-keyed tables. They are not copied here. A current eye exam with visual field testing is what lets the VA apply them. A chart-only acuity test can miss the side-vision loss that carries the rating.
Making a VA Disability Claim for Glaucoma
A VA disability claim for glaucoma needs three things to line up:
A current diagnosis
A glaucoma diagnosis from an eye provider, with the testing that backs it (eye pressure, optic nerve findings, and visual field results).
A service connection
Glaucoma that began in service, or a link to a service-connected condition (see the secondary paths below).
A medical nexus
A qualified opinion that your glaucoma is 'at least as likely as not' connected to your service, or to a service-connected cause.
Glaucoma is not a presumptive condition. Most claims turn on a medical opinion linking it to your service, or to a service-connected cause like diabetes or steroid treatment. A current eye exam with visual field testing does the heavy lifting. The rating often turns on side-vision loss, not just a chart. The 'at least as likely as not' standard means a 50% or better chance. It comes from the benefit-of-the-doubt rule in 38 U.S.C. § 5107(b), carried out in 38 C.F.R. § 3.102. That medical opinion is what we write.
How to Connect Glaucoma to Service
There are a few paths to tie glaucoma to service. The secondary paths are common with glaucoma, so they are worth a close look.
Direct connection
Glaucoma that began in service, or eye trauma in service that led to it.
- A diagnosis in service. Being found to have high eye pressure or glaucoma on a service eye exam.
- Eye injury in service. A serious eye injury can lead to glaucoma later (sometimes called traumatic or secondary glaucoma). The in-service injury can support the link.
Secondary connection
Another service-connected condition, or its treatment, caused your glaucoma (38 C.F.R. § 3.310). Two paths come up often.
- Diabetic eye disease secondary to service-connected type 2 diabetes. Diabetes can damage the eyes (diabetic retinopathy) and is linked to certain types of glaucoma. If your type 2 diabetes is service-connected, glaucoma or other eye disease secondary to it is worth going after. The strength of the link depends on the type of glaucoma. That is why an opinion written for your case matters.
- Steroid-induced glaucoma. Long-term steroid use can raise eye pressure and cause glaucoma. That includes eye drops, oral steroids, and other forms. If you take steroids for a service-connected condition, such as a respiratory, skin, or autoimmune condition, the glaucoma that medication causes can be service-connected on a secondary theory.
Aggravation
You had glaucoma before service, and service made it permanently worse, beyond its normal course.
- Worse during service. Pressure that climbed, vision loss that got worse, or treatment that had to be stepped up during service, beyond the condition's normal course.
Secondary Conditions
The VA rates each condition on its own and adds it to your combined rating. So each one is worth documenting. The diabetes-to-glaucoma and steroid-to-glaucoma links are well known in medicine. But their strength depends on the type of glaucoma and the facts of the case. That is why a medical opinion written for your case matters.
Glaucoma may be secondary to
- Type 2 diabetes. Service-connected diabetes can drive diabetic eye disease and is linked to certain glaucomas.
- Service-connected eye injury or eye disease. Trauma or other eye conditions can lead to secondary glaucoma.
- Long-term steroid treatment. Steroids taken for another service-connected condition can raise eye pressure and cause glaucoma.
Conditions that may go along with glaucoma
- Visual field loss and visual acuity loss. These are how the glaucoma itself is rated above the 10% minimum, under 38 C.F.R. § 4.76 to 4.78 and § 4.77.
- Cataracts or other eye conditions. Other service-connected eye conditions are rated under their own diagnostic codes in 38 C.F.R. § 4.79 and combined.
- Depression or anxiety. Losing vision can contribute to a mental-health condition. That condition may itself be claimable as secondary to the vision loss.
What to Gather - Evidence Checklist
Gather these before you file or ask for a letter. For glaucoma, a current eye exam with visual field testing does the heavy lifting. The rating often turns on side-vision loss, not just a chart.
Frequently Asked Questions
How does the VA rate glaucoma?
Under 38 C.F.R. 4.79, using DC 6013 for open-angle glaucoma and DC 6012 for angle-closure glaucoma. Both are rated on the General Rating Formula for Diseases of the Eye. There is a minimum 10% rating if you need continuous medication to control it. Above that, the rating is based on your actual vision loss, or on documented incapacitating episodes, whichever is highest. Vision loss means visual acuity under 38 C.F.R. 4.76 to 4.78 and visual fields under 38 C.F.R. 4.77.
Can I get rated for glaucoma if my vision still tests fine?
Yes. The rule assigns a minimum 10% if you need continuous medication (such as daily eye drops) to control the glaucoma. That holds even when your vision still tests well. As any side-vision or sharpness loss develops, the rating can go higher under the visual-impairment rules.
Why does the visual field test matter so much for glaucoma?
Because glaucoma damages side (peripheral) vision first. A standard eye-chart test mostly measures central sharpness. The VA rates side-vision loss under 38 C.F.R. 4.77, using a formal visual field test. Without that test, the record can miss the very loss that would raise your rating above the 10% minimum.
Can glaucoma be secondary to my service-connected diabetes?
It can. Type 2 diabetes can cause diabetic eye disease and is linked to certain types of glaucoma. If your diabetes is service-connected, glaucoma or other diabetic eye disease secondary to it is worth going after with a medical opinion. The strength of the link depends on the type of glaucoma. That is why an opinion written for your case matters.
Can steroid eye drops or steroid medication cause glaucoma the VA will cover?
Sometimes, yes. Long-term steroid use can raise eye pressure and cause glaucoma. If you take steroids for another service-connected condition, glaucoma caused by that medication can be service-connected on a secondary theory. The records need to show the steroid use and tie it to the glaucoma.
Do I need a nexus letter for glaucoma?
Usually, yes, unless the glaucoma is already on record as service-connected. Glaucoma is not a presumptive condition. Most claims turn on a medical opinion linking it to your service, or to a service-connected cause like diabetes or steroid treatment. A nexus letter meeting the 'at least as likely as not' standard is what we write.
Glaucoma damage does not come back. The sooner your claim reflects the real loss, the better.
Let our doctors prepare a glaucoma nexus letter that meets the VA's evidence standards and supports the benefits you earned.
Sources & Regulatory References
- VA disability compensation (VA.gov) https://www.va.gov/disability/
- 2026 VA disability compensation rates (VA.gov) https://www.va.gov/disability/compensation-rates/veteran-rates/
- 38 CFR 4.79, Schedule of ratings, eye, including DC 6012 and DC 6013 and the General Rating Formula for Diseases of the Eye (eCFR) https://www.ecfr.gov/current/title-38/section-4.79
- 38 CFR 4.76, Visual acuity, how rated (eCFR) https://www.ecfr.gov/current/title-38/section-4.76
- 38 CFR 4.77, Visual fields (eCFR) https://www.ecfr.gov/current/title-38/section-4.77
- 38 CFR 4.78, Muscle function (eCFR) https://www.ecfr.gov/current/title-38/section-4.78
- 38 CFR 3.310, Secondary service connection (eCFR) https://www.ecfr.gov/current/title-38/section-3.310
- 38 CFR 3.102, Reasonable doubt (eCFR) https://www.ecfr.gov/current/title-38/section-3.102