Rhinitis is rated under diagnostic code 6522 at 10 or 30 percent based on the presence and severity of nasal polyps and obstruction.
Complete organic aphonia is rated under diagnostic code 6519: 100 percent for constant inability to communicate by speech, and 60 percent for constant inability to speak above a whisper. Lesser voice impairment is rated as chronic laryngitis (diagnostic code 6516) at 10 or 30 percent.
Asbestosis is rated under diagnostic code 6833 using the restrictive lung formula, from 10 to 100 percent based on FVC, DLCO, exercise capacity, and complications such as cor pulmonale or oxygen use. It is not presumptive, but VA has special development procedures for asbestos claims, and Navy ratings, shipyard work, and construction trades are recognized exposure settings.
Asthma is rated under diagnostic code 6602 at 10, 30, 60, or 100 percent based on PFT findings and need for medication.
Bronchiectasis is rated under diagnostic code 6601 at 10, 30, 60, or 100 percent based on incapacitating episode frequency and pulmonary findings.
Chronic obstructive pulmonary disease is rated under diagnostic code 6604 at 10, 30, 60, or 100 percent based on PFT findings and exercise tolerance.
Chronic bronchitis is rated under diagnostic code 6600 at 10, 30, 60, or 100 percent based on PFT findings and exercise tolerance.
Chronic laryngitis is rated under 38 CFR 4.97, DC 6516, at 10 or 30 percent based on hoarseness and the condition of the vocal cords.
Constrictive bronchiolitis does not yet have its own diagnostic code, so VA rates it by analogy, usually under the respiratory formula at diagnostic code 6600, from 10 to 100 percent based on pulmonary function testing. It is on the PACT Act presumptive list for veterans with qualifying burn pit era service. VA has announced rulemaking to give it a dedicated code.
A deviated nasal septum is rated under diagnostic code 6502 at 10 percent when both nasal passages are blocked 50 percent or more, or with complete obstruction of one nasal passage.
Emphysema is rated under diagnostic code 6603 at 10, 30, 60, or 100 percent based on PFT findings and exercise tolerance.
Granulomatous disease appears on the PACT Act presumptive list as its own entry. Granulomatous rhinitis is rated under 38 CFR 4.97, diagnostic code 6524: 100 percent for granulomatosis with polyangiitis (Wegener's granulomatosis) or lethal midline granuloma, and 20 percent for other types of granulomatous infection. Systemic involvement (kidney, lung) is rated separately under the codes for those organs.
Interstitial lung disease is rated under the restrictive lung formula (diagnostic codes 6825 to 6833) from 10 to 100 percent based on FVC, DLCO, exercise capacity, and complications such as pulmonary hypertension or oxygen use. ILD is on the PACT Act presumptive list for veterans with qualifying service.
Stenosis of the larynx is rated under diagnostic code 6520 from 10 to 100 percent based on FEV-1 with flow volume loop confirmation of upper airway pathology: 10 percent for FEV-1 of 71 to 80 percent predicted, 30 percent for 56 to 70, 60 percent for 40 to 55, and 100 percent for FEV-1 below 40 percent predicted or a permanent tracheostomy.
Chronic fungal lung infections, including coccidioidomycosis (Valley Fever, diagnostic code 6835), histoplasmosis (6834), blastomycosis (6836), cryptococcosis (6837), aspergillosis (6838), and mucormycosis (6839), share one formula: 100 percent for persistent fever, weight loss, night sweats, or massive hemoptysis; 50 percent when chronic infection requires suppressive therapy; 30 percent for minimal symptoms such as occasional minor hemoptysis or productive cough; and 0 percent for healed, inactive lesions.
Chronic rhinitis with nasal polyps is rated under diagnostic code 6522 at 30 percent. Without polyps, the rating is 10 percent when there is greater than 50 percent obstruction of the nasal passages on both sides or complete obstruction on one side.
Injuries to the pharynx are rated under diagnostic code 6521 at 50 percent for stricture or obstruction of the pharynx or nasopharynx, absence of the soft palate from trauma, chemical burn, or granulomatous disease, or paralysis of the soft palate with swallowing difficulty and speech impairment.
Pleurisy residuals (chronic pleural disease) are rated under 38 CFR 4.97 DC 6845 (chronic pleural effusion or fibrosis) at 30 to 100 percent based on FEV-1, FVC, and DLCO.
Chronic pleural effusion or fibrosis is rated under diagnostic code 6845 using the restrictive lung formula, from 10 to 100 percent based on FVC, DLCO, exercise capacity, and complications. Pleuritis is on the PACT Act presumptive list for veterans with qualifying service.
Pulmonary fibrosis and other interstitial lung disease are rated under diagnostic code 6825 at 10, 30, 60, or 100 percent based on PFT findings and exercise tolerance.
Inactive pulmonary tuberculosis residuals are rated under diagnostic code 6731 by routing to the code that fits the damage: interstitial lung disease, restrictive lung disease, or chronic bronchitis (diagnostic code 6600) when obstruction predominates, all of which rate 10, 30, 60, or 100 percent on pulmonary function testing. Thoracoplasty is rated as rib removal under diagnostic code 5297.
Active pulmonary tuberculosis is rated 100 percent under diagnostic code 6730 for as long as the disease is active. Once the disease is inactive, a mandatory examination follows and the residuals are rated under diagnostic code 6731, which routes to the interstitial, restrictive, or obstructive lung criteria based on pulmonary function testing.
Recurrent pneumonia is rated under diagnostic code 6604 by analogy to chronic bronchitis based on PFT findings and episode frequency.
Restrictive lung disease is rated under 38 CFR 4.97 DC 6845 at 30 to 100 percent based on PFT values (FVC, FEV-1, DLCO).
Sarcoidosis is rated under diagnostic code 6846 at 0, 30, 60, or 100 percent based on radiographic and clinical findings.
Silicosis and other pneumoconioses (dust diseases of the lung) are rated under diagnostic code 6832 using the restrictive lung formula, from 10 to 100 percent based on FVC, DLCO, exercise capacity, and complications. Service connection turns on documented dust exposure: sandblasting, mining, demolition, burn pits, and desert particulate matter are recognized settings.
Chronic sinusitis is rated under diagnostic code 6513 at 0, 10, 30, or 50 percent based on the frequency and severity of incapacitating episodes.
Pneumothorax residuals are rated under 38 CFR 4.97 DC 6843 at 30 to 100 percent based on PFT findings and recurrence pattern.
Vocal cord paralysis is rated under 38 CFR 4.97 by its effect on speech: complete organic aphonia under diagnostic code 6519 is 100 percent when the veteran constantly cannot communicate by speech and 60 percent when unable to speak above a whisper; paralysis that leaves hoarseness rather than aphonia is rated as chronic laryngitis under DC 6516 at 10 or 30 percent. A permanent tracheostomy is rated separately under DC 6518 (laryngectomy) or as stenosis of the larynx (DC 6520).