Nocturia VA Rating Explained: How Veterans Can Qualify for Up to 40% for Nighttime Urination

If you’re waking up multiple times every night to use the bathroom, you already know the toll it takes. Interrupted sleep leads to chronic fatigue, poor concentration, irritability, and reduced quality of life.

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Many veterans dismiss nocturia as “just aging” or something they have to live with. But under VA rules, frequent nighttime urination is a ratable disability and thousands of veterans already receive 10%, 20%, or even 40% VA compensation for it every month.

“Veterans are often shocked to learn that nocturia alone can support a compensable VA rating,” said by Brian Reese, VA disability expert.

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What Is Nocturia?

Nocturia is defined as waking up one or more times during the night to urinate, with sleep occurring both before and after each episode.

From a VA disability perspective, two or more nighttime awakenings are compensable.

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VA Rating Thresholds for Nocturia

Although nocturia does not have its own diagnostic code, the VA rates it under urinary frequency within the genitourinary system.

VA Rating Levels for Nighttime Urination

• 2 times per night → 10%
• 3–4 times per night → 20%
• 5 or more times per night → 40% (maximum)

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These ratings apply even if nocturia is a symptom of another condition, such as sleep apnea or PTSD.

“The VA doesn’t care what you call it medically what matters is how often you’re waking up,” explains Reese.

How the VA Rates Nocturia?

Applicable VA Regulation

The VA evaluates nocturia under 38 CFR § 4.115a, which governs urinary frequency within the Schedule for Rating Disabilities.

Nocturia is rated based on frequency, not diagnosis.

VA Ratings for Urinary Frequency

VA Rating	Nighttime Voiding	Daytime Voiding Interval
10%	Awakening to void 2 times per night	Every 2–3 hours
20%	Awakening to void 3–4 times per night	Every 1–2 hours
40%	Awakening to void 5+ times per night	Less than 1 hour

Higher Ratings When Incontinence Is Present

If nocturia includes urinary leakage requiring absorbent materials, ratings may increase up to 60%, depending on how many pads must be changed daily.

This makes careful documentation critical.

Common Causes of Nocturia in Veterans

Nocturia rarely exists in isolation. In many cases, it is caused or aggravated by another service-connected condition, which opens the door to secondary service connection.

Most Common VA-Linked Causes

Sleep Apnea

Up to 50% of veterans with obstructive sleep apnea experience nocturia. Oxygen drops during sleep trigger hormonal changes that increase urine production at night.

PTSD and Anxiety Disorders

Chronic stress, hyperarousal, and fragmented sleep are strongly associated with increased nighttime urination.

Diabetes Mellitus

Elevated blood sugar levels increase urine production and are a frequent cause of nocturia.

Prostate Conditions

Benign prostatic hyperplasia (BPH), prostatitis, or prostate cancer residuals commonly lead to nighttime voiding.

“Secondary service connection is where many nocturia claims succeed,” said by Reese.

Proving Service Connection for Nocturia

Direct Service Connection

To establish direct service connection, you must show:

1. A current diagnosis of nocturia or urinary frequency
2. An in-service event, injury, or illness, such as dehydration, infections, chemical exposure, or field conditions
3. A medical nexus linking the two

Secondary Service Connection (Most Common Path)

Nocturia can be granted as secondary to an already service-connected disability.

Common primary conditions include:

• Sleep apnea
• PTSD or anxiety
• Diabetes mellitus
• Prostate conditions

A nexus opinion stating the nocturia is “at least as likely as not” caused or aggravated by the primary condition is often decisive.

Service Connection by Aggravation

If nocturia existed before service or before a service-connected condition, you may still qualify if military service or another disability made it worse.

Nocturia VA Claim Evidence Checklist

Filing without preparation is one of the biggest reasons claims fail.

Required Evidence

• Current diagnosis (urology or primary care)
• Medical nexus opinion (C&P examiner or private provider)

Strong Supporting Evidence (Highly Recommended)

• Voiding diary tracking nighttime urination over 2–3 days
• Lay statement (VA Form 21-4138) describing sleep disruption and fatigue
• Buddy statements from a spouse or family member who observes nighttime awakenings

“A simple voiding diary can be the difference between 0% and 40%,” explains Reese.

How Nocturia Impacts VA Compensation?

Because nocturia often stacks with other disabilities, even a 10% or 20% rating can significantly increase your combined VA rating.

For example:

• 50% sleep apnea + 20% nocturia = higher combined compensation
• PTSD + nocturia may strengthen unemployability arguments
• Severe nocturia may support secondary mental health claims

Final Thought

Nocturia isn’t just inconvenient it’s a recognized VA disability symptom with real compensation attached. The VA rates it clearly under urinary frequency, with 10%, 20%, and 40% thresholds that are achievable when symptoms are properly documented.

Veterans who track their symptoms, secure a nexus opinion, and file strategically often succeed even when nocturia is secondary to another condition.

“If you’re waking up multiple times every night, the VA expects to compensate you for that,” concludes Reese.

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