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6313
§ 4.88b Schedule of ratings—infectious diseases, immune disorders and nutritional deficiencies.

Malnutrition with vision loss

Severe nutritional deficiency causing weight loss, weakness, and vision loss (optic nerve degeneration)

What the rating means

VA rates avitaminosis — malnutrition and vitamin deficiency with associated vision loss — under diagnostic code 6313. Five rating levels are possible: 10%, 20%, 40%, 60%, and 100%.

A 10% rating applies when you have a confirmed diagnosis with nonspecific symptoms such as decreased appetite, weight loss, abdominal discomfort, weakness, inability to concentrate, and irritability. A 20% rating requires at least one of these: stomatitis, achlorhydria, or diarrhea. A 40% rating requires all three — stomatitis, diarrhea, and symmetrical dermatitis together. A 60% rating requires all of those symptoms plus mental symptoms and impaired bodily vigor. The highest level, 100%, applies when you have marked mental changes, moist dermatitis, inability to retain adequate nourishment, exhaustion, and cachexia.

Each step up requires additional or more severe symptoms, so the distinction between levels turns on which specific symptoms are present and how severely they affect you.

Evidence that helps

Medical records that document a confirmed diagnosis of avitaminosis or nutritional deficiency are the starting point for the 10% level. Records showing nonspecific symptoms — such as documented weight loss, appetite changes, weakness, difficulty concentrating, or irritability — support that level as well.

For the 20% level, clinical notes or examination findings that record stomatitis (mouth inflammation), achlorhydria (absence of stomach acid), or diarrhea are relevant. Moving to the 40% level requires evidence of all three: stomatitis, diarrhea, and symmetrical dermatitis documented together.

At the 60% level, records showing mental symptoms and signs of impaired bodily vigor — in addition to the symptoms above — are needed. For the 100% level, evidence of marked mental changes, moist dermatitis, inability to retain adequate nourishment, exhaustion, and cachexia (severe muscle and weight loss) would be central. Statements from you or those who know you describing how symptoms affect eating, daily functioning, and mental state can also help show the severity of your condition.

Secondary conditions

Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.