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7904
§ 4.119 Schedule of ratings—endocrine system.

Overactive parathyroid

A condition where the parathyroid glands produce too much hormone, affecting calcium and bone health.

What the rating means

Hyperparathyroidism (diagnostic code 7904) is rated based on how active the condition is, whether surgery or other treatment has been done, and what symptoms or lab findings remain.

If you have had surgery, VA assigns a 100% rating for six months from the date you are discharged after that surgery. If surgery is indicated but has not happened yet, VA applies the criteria below until the day of surgery, then the 100% rate begins. After the six-month post-surgery period, VA rates you on whatever residual conditions remain, using the diagnostic codes for those body systems.

A 60% rating applies when your condition causes hypercalcemia, shown by at least one of these measured findings: total calcium above 12 mg/dL, ionized calcium above 5.6 mg/dL, creatinine clearance below 60 mL/min, bone mineral density T-score below 2.5 SD at any site, or a previous fragility fracture. If surgery is not appropriate for you and pharmacologic treatment is used instead, this 60% evaluation continues for six months after treatment begins, after which residuals are rated separately.

A 10% rating applies if you still have symptoms such as fatigue, loss of appetite, nausea, or constipation despite surgery, or if you are not a candidate for surgery and require continuous medication. A 0% rating applies when the condition is asymptomatic.

Evidence that helps

For the 100% post-surgery rating, medical records documenting that surgery was performed and the date you were discharged afterward are the core evidence needed.

For the 60% rating, lab reports and imaging are central. Records showing a total calcium level above 12 mg/dL or an ionized calcium level above 5.6 mg/dL directly support this level. So do records showing a creatinine clearance below 60 mL/min, a bone mineral density scan with a T-score below 2.5 SD at any measured site, or documentation of a previous fragility fracture. Dates of these results matter because they can also establish when pharmacologic treatment began, which affects how long the 60% evaluation continues.

For the 10% rating, treatment records showing ongoing or continuous medication use are important, along with physician notes or VA examination findings that document symptoms such as fatigue, nausea, anorexia, or constipation after surgery or during non-surgical management. Your own statements describing how these symptoms affect your daily life and work can support what the medical records show.

For any residual conditions after treatment, such as kidney stones, reduced kidney function, fractures, vision problems, or cardiovascular complications, records specific to those conditions under their own diagnostic codes will be relevant.

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.