VASRD Schedule —respiratory system - Nontuberculous diseases

Discussion in 'Linked VA Schedule for Rating Disabilities (VASRD)' started by Jason Perry, Jan 20, 2008.

  1. Jason Perry

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    Nontuberculous diseases
    Rating

    6817 Pulmonary Vascular Disease:



    Primary pulmonary hypertension, or; chronic pulmonary thrombo-
    embolism with evidence of pulmonary hypertension, right
    ventricular hypertrophy, or cor pulmonale, or; pulmonary
    hypertension secondary to other obstructive disease of pulmonary
    arteries or veins with evidence of right ventricular hypertrophy or
    cor pulmonale 100

    Chronic pulmonary thromboembolism requiring anticoagulant therapy,
    or; following inferior vena cava surgery without evidence of
    pulmonary hypertension or right ventricular dysfunction 60

    Symptomatic, following resolution of acute pulmonary embolism 30

    Asymptomatic, following resolution of pulmonary thromboembolism 0

    Note: Evaluate other residuals following pulmonary embolism under the most appropriate diagnostic code, such as chronic bronchitis (DC 6600) or chronic pleural effusion or fibrosis (DC 6844), but do not combine that evaluation with any of the above evaluations.

    6819 Neoplasms, malignant, any specified part of respiratory system exclusive
    of skin growths 100

    Note: A rating of 100 percent shall continue beyond the cessation of any surgical, X-ray, antineoplastic chemotherapy or other therapeutic procedure. Six months after discontinuance of such treatment, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of §3.105(e) of this chapter. If there has been no local recurrence or metastasis, rate on residuals.

    6820 Neoplasms, benign, any specified part of respiratory system. Evaluate
    using an appropriate respiratory analogy.



    Bacterial Infections of the Lung


    6822 Actinomycosis.

    6823 Nocardiosis.

    6824 Chronic lung abscess.

    General Rating Formula for Bacterial Infections of the Lung (diagnostic codes 6822 through 6824):

    Active infection with systemic symptoms such as fever, night sweats,
    weight loss, or hemoptysis 100

    Depending on the specific findings, rate residuals as interstitial lung
    disease, restrictive lung disease, or, when obstructive lung disease is
    the major residual, as chronic bronchitis (DC 6600).


    Interstitial Lung Disease


    6825 Diffuse interstitial fibrosis (interstitial pneumonitis, fibrosing alveolitis).

    6826 Desquamative interstitial pneumonitis.

    6827 Pulmonary alveolar proteinosis.

    6828 Eosinophilic granuloma of lung.

    6829 Drug-induced pulmonary pneumonitis and fibrosis.

    6830 Radiation-induced pulmonary pneumonitis and fibrosis.

    6831 Hypersensitivity pneumonitis (extrinsic allergic alveolitis).

    6832 Pneumoconiosis (silicosis, anthracosis, etc.).

    6833 Asbestosis.

    General Rating Formula for Interstitial Lung Disease (diagnostic codes
    6825 through 6833):

    Forced Vital Capacity (FVC) less than 50-percent predicted,
    or; Diffusion Capacity of the Lung for Carbon Monoxide by the
    Single Breath Method (DLCO (SB)) less than 40-percent predicted,
    or; maximum exercise capacity less than 15 ml/kg/min oxygen
    consumption with cardiorespiratory limitation, or; cor pulmonale
    or pulmonary hypertension, or; requires outpatient oxygen therapy 100

    FVC of 50- to 64-percent predicted, or; DLCO (SB) of 40- to 55-percent
    predicted, or; maximum exercise capacity of 15 to 20 kg/min oxygen
    consumption with cardiorespiratory limitation 60

    FVC of 65- to 74-percent predicted, or; DLCO (SB) of 56- to
    65-percent predicted 30

    FVC of 75- to 80-percent predicted, or; DLCO (SB) of 66- to
    80-percent predicted 10



    Mycotic Lung Disease


    6834 Histoplasmosis of lung.

    6835 Coccidioidomycosis.

    6836 Blastomycosis.

    6837 Cryptococcosis.

    6838 Aspergillosis.

    6839 Mucormycosis.

    General Rating Formula for Mycotic Lung Disease (diagnostic codes
    6834 through 6839):

    Chronic pulmonary mycosis with persistent fever, weight loss,
    night sweats, or massive hemoptysis 100

    Chronic pulmonary mycosis requiring suppressive therapy with
    no more than minimal symptoms such as occasional minor
    hemoptysis or productive cough 50

    Chronic pulmonary mycosis with minimal symptoms such as
    occasional minor hemoptysis or productive cough 30

    Healed and inactive mycotic lesions, asymptomatic 0

    Note: Coccidioidomycosis has an incubation period up to 21 days, and the disseminated phase is ordinarily manifest within six months of the primary phase. However, there are instances of dissemination delayed up to many years after the initial infection which may have been unrecognized. Accordingly, when service connection is under consideration in the absence of record or other evidence of the disease in service, service in southwestern United States where the disease is endemic and absence of prolonged residence in this locality before or after service will be the deciding factor.



    Restrictive Lung Disease


    6840 Diaphragm paralysis or paresis.

    6841 Spinal cord injury with respiratory insufficiency.

    6842 Kyphoscoliosis, pectus excavatum, pectus carinatum.

    6843 Traumatic chest wall defect, pneumothorax, hernia, etc.

    6844 Post-surgical residual (lobectomy, pneumonectomy, etc.).

    6845 Chronic pleural effusion or fibrosis.

    General Rating Formula for Restrictive Lung Disease
    (diagnostic codes 6840 through 6845):

    FEV-1 less than 40 percent of predicted value, or; the ratio of
    Forced Expiratory Volume in one second to Forced Vital
    Capacity (FEV-1/FVC) less than 40 percent, or; Diffusion Capacity
    of the Lung for Carbon Monoxide by the Single Breath Method
    (DLCO (SB)) less than 40-percent predicted, or; maximum
    exercise capacity less than 15 ml/kg/min oxygen consumption
    (with cardiac or respiratory limitation), or; cor pulmonale (right
    heart failure), or; right ventricular hypertrophy, or; pulmonary
    hypertension (shown by Echo or cardiac catheterization), or;
    episode(s) of acute respiratory failure, or; requires outpatient
    oxygen therapy 100

    FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to
    55 percent, or; DLCO (SB) of 40- to 55-percent predicted, or;
    maximum oxygen consumption of 15 to 20 ml/kg/min (with
    cardiorespiratory limit) 60

    FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to
    70 percent, or; DLCO (SB) 56- to 65-percent predicted 30

    FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to
    80 percent, or; DLCO (SB) 66- to 80-percent predicted 10

    Or rate primary disorder.

    Note (1): A 100-percent rating shall be assigned for pleurisy with empyema, with or without pleurocutaneous fistula, until resolved.

    Note (2): Following episodes of total spontaneous pneumothorax, a rating of 100 percent shall be assigned as of the date of hospital admission and shall continue for three months from the first day of the month after hospital discharge.

    Note (3): Gunshot wounds of the pleural cavity with bullet or missile retained in lung, pain or discomfort on exertion, or with scattered rales or some limitation of excursion of diaphragm or of lower chest expansion shall be rated at least 20-percent disabling. Disabling injuries of shoulder girdle muscles (Groups I to IV) shall be separately rated and combined with ratings for respiratory involvement. Involvement of Muscle Group XXI (DC 5321), however, will not be separately rated.

    6846 Sarcoidosis:

    Cor pulmonale, or; cardiac involvement with congestive heart failure,
    or; progressive pulmonary disease with fever, night sweats, and
    weight loss despite treatment 100

    Pulmonary involvement requiring systemic high dose (therapeutic)
    corticosteroids for control 60

    Pulmonary involvement with persistent symptoms requiring chronic
    low dose (maintenance) or intermittent corticosteroids 30

    Chronic hilar adenopathy or stable lung infiltrates without symptoms
    or physiologic impairment 0

    Or rate active disease or residuals as chronic bronchitis (DC 6600) and extra- pulmonary involvement under specific body system involved

    6847 Sleep Apnea Syndromes (Obstructive, Central, Mixed):

    Chronic respiratory failure with carbon dioxide retention or cor
    pulmonale, or; requires tracheostomy 100

    Requires use of breathing assistance device such as continuous
    airway pressure (CPAP) machine 50

    Persistent day-time hypersomnolence 30

    Asymptomatic but with documented sleep disorder breathing 0
     

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