{"data":{"id":"us/38-cfr-4.97","jurisdiction":"us","citation":"38 CFR 4.97","heading":"Schedule of ratings—respiratory system.","body":"Rating\nDISEASES OF THE NOSE AND THROAT\n6502 Septum, nasal, deviation of:\nTraumatic only,\nWith 50-percent obstruction of the nasal passage on both sides or complete obstruction on one side 10\n6504 Nose, loss of part of, or scars:\nExposing both nasal passages 30\nLoss of part of one ala, or other obvious disfigurement 10\nNote: Or evaluate as DC 7800, scars, disfiguring, head, face, or neck.\n6510 Sinusitis, pansinusitis, chronic.\n6511 Sinusitis, ethmoid, chronic.\n6512 Sinusitis, frontal, chronic.\n6513 Sinusitis, maxillary, chronic.\n6514 Sinusitis, sphenoid, chronic.\nGeneral Rating Formula for Sinusitis (DC's 6510 through 6514):\nFollowing radical surgery with chronic osteomyelitis, or; near constant sinusitis characterized by headaches, pain and tenderness of affected sinus, and purulent discharge or crusting after repeated surgeries 50\nThree or more incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; more than six non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting 30\nOne or two incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; three to six non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting 10\nDetected by X-ray only 0\nNote: An incapacitating episode of sinusitis means one that requires bed rest and treatment by a physician.\n6515 Laryngitis, tuberculous, active or inactive.\nRate under §§ 4.88c or 4.89, whichever is appropriate.\n6516 Laryngitis, chronic:\nHoarseness, with thickening or nodules of cords, polyps, submucous infiltration, or pre-malignant changes on biopsy 30\nHoarseness, with inflammation of cords or mucous membrane 10\n6518 Laryngectomy, total. 1 100\nRate the residuals of partial laryngectomy as laryngitis (DC 6516), aphonia (DC 6519), or stenosis of larynx (DC 6520).\n6519 Aphonia, complete organic:\nConstant inability to communicate by speech 1 100\nConstant inability to speak above a whisper 60\nNote: Evaluate incomplete aphonia as laryngitis, chronic (DC 6516).\n6520 Larynx, stenosis of, including residuals of laryngeal trauma (unilateral or bilateral):\nForced expiratory volume in one second (FEV-1) less than 40 percent of predicted value, with Flow-Volume Loop compatible with upper airway obstruction, or; permanent tracheostomy 100\nFEV-1 of 40- to 55-percent predicted, with Flow-Volume Loop compatible with upper airway obstruction 60\nFEV-1 of 56- to 70-percent predicted, with Flow-Volume Loop compatible with upper airway obstruction 30\nFEV-1 of 71- to 80-percent predicted, with Flow-Volume Loop compatible with upper airway obstruction 10\nNote: Or evaluate as aphonia (DC 6519).\n6521 Pharynx, injuries to:\nStricture or obstruction of pharynx or nasopharynx, or; absence of soft palate secondary to trauma, chemical burn, or granulomatous disease, or; paralysis of soft palate with swallowing difficulty (nasal regurgitation) and speech impairment 50\n6522 Allergic or vasomotor rhinitis:\nWith polyps 30\nWithout polyps, but with greater than 50-percent obstruction of nasal passage on both sides or complete obstruction on one side 10\n6523 Bacterial rhinitis:\nRhinoscleroma 50\nWith permanent hypertrophy of turbinates and with greater than 50-percent obstruction of nasal passage on both sides or complete obstruction on one side 10\n6524 Granulomatous rhinitis:\nWegener's granulomatosis, lethal midline granuloma 100\nOther types of granulomatous infection 20\nDISEASES OF THE TRACHEA AND BRONCHI\n6600 Bronchitis, chronic:\nFEV-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\nFEV-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\nFEV-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\nFEV-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\n6601 Bronchiectasis:\nWith incapacitating episodes of infection of at least six weeks total duration per year 100\nWith incapacitating episodes of infection of four to six weeks total duration per year, or; near constant findings of cough with purulent sputum associated with anorexia, weight loss, and frank hemoptysis and requiring antibiotic usage almost continuously 60\nWith incapacitating episodes of infection of two to four weeks total duration per year, or; daily productive cough with sputum that is at times purulent or blood-tinged and that requires prolonged (lasting four to six weeks) antibiotic usage more than twice a year 30\nIntermittent productive cough with acute infection requiring a course of antibiotics at least twice a year 10\nOr rate according to pulmonary impairment as for chronic bronchitis (DC 6600).\nNote: An incapacitating episode is one that requires bedrest and treatment by a physician.\n6602 Asthma, bronchial:\nFEV-1 less than 40-percent predicted, or; FEV-1/FVC less than 40 percent, or; more than one attack per week with episodes of respiratory failure, or; requires daily use of systemic (oral or parenteral) high dose corticosteroids or immuno-suppressive medications 100\nFEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; at least monthly visits to a physician for required care of exacerbations, or; intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids 60\nFEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; daily inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication 30\nFEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; intermittent inhalational or oral bronchodilator therapy 10\nNote: In the absence of clinical findings of asthma at time of examination, a verified history of asthmatic attacks must be of record.\n6603 Emphysema, pulmonary:\nFEV-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\nFEV-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\nFEV-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\nFEV-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\n6604 Chronic obstructive pulmonary disease:\nFEV-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\nFEV-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\nFEV-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\nFEV-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\nDISEASES OF THE LUNGS AND PLEURA—TUBERCULOSIS\nRatings for Pulmonary Tuberculosis Entitled on August 19, 1968\n6701 Tuberculosis, pulmonary, chronic, far advanced, active 100\n6702 Tuberculosis, pulmonary, chronic, moderately advanced, active 100\n6703 Tuberculosis, pulmonary, chronic, minimal, active 100\n6704 Tuberculosis, pulmonary, chronic, active, advancement unspecified 100\n6721 Tuberculosis, pulmonary, chronic, far advanced, inactive\n6722 Tuberculosis, pulmonary, chronic, moderately advanced, inactive\n6723 Tuberculosis, pulmonary, chronic, minimal, inactive\n6724 Tuberculosis, pulmonary, chronic, inactive, advancement unspecified\nGeneral Rating Formula for Inactive Pulmonary Tuberculosis: For two years after date of inactivity, following active tuberculosis, which was clinically identified during service or subsequently 100\nThereafter for four years, or in any event, to six years after date of inactivity 50\nThereafter, for five years, or to eleven years after date of inactivity 30\nFollowing far advanced lesions diagnosed at any time while the disease process was active, minimum 30\nFollowing moderately advanced lesions, provided there is continued disability, emphysema, dyspnea on exertion, impairment of health, etc 20\nOtherwise 0\nNote (1): The 100-percent rating under codes 6701 through 6724 is not subject to a requirement of precedent hospital treatment. It will be reduced to 50 percent for failure to submit to examination or to follow prescribed treatment upon report to that effect from the medical authorities. When a veteran is placed on the 100-percent rating for inactive tuberculosis, the medical authorities will be appropriately notified of the fact, and of the necessity, as given in footnote 1 to 38 U.S.C. 1156 (and formerly in 38 U.S.C. 356, which has been repealed by Public Law 90-493), to notify the Veterans Service Center in the event of failure to submit to examination or to follow treatment.\nNote (2): The graduated 50-percent and 30-percent ratings and the permanent 30 percent and 20 percent ratings for inactive pulmonary tuberculosis are not to be combined with ratings for other respiratory disabilities. Following thoracoplasty the rating will be for removal of ribs combined with the rating for collapsed lung. Resection of the ribs incident to thoracoplasty will be rated as removal.\nRatings for Pulmonary Tuberculosis Initially Evaluated After August 19, 1968\n6730 Tuberculosis, pulmonary, chronic, active 100\nNote: Active pulmonary tuberculosis will be considered permanently and totally disabling for non-service-connected pension purposes in the following circumstances:\n(a) Associated with active tuberculosis involving other than the respiratory system.\n(b) With severe associated symptoms or with extensive cavity formation.\n(c) Reactivated cases, generally.\n(d) With advancement of lesions on successive examinations or while under treatment.\n(e) Without retrogression of lesions or other evidence of material improvement at the end of six months hospitalization or without change of diagnosis from “active” at the end of 12 months hospitalization. Material improvement means lessening or absence of clinical symptoms, and X-ray findings of a stationary or retrogressive lesion.\n6731 Tuberculosis, pulmonary, chronic, inactive:\nDepending 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). Rate thoracoplasty as removal of ribs under DC 5297.\nNote: A mandatory examination will be requested immediately following notification that active tuberculosis evaluated under DC 6730 has become inactive. Any change in evaluation will be carried out under the provisions of § 3.105(e).\n6732 Pleurisy, tuberculous, active or inactive:\nRate under §§ 4.88c or 4.89, whichever is appropriate.\nNONTUBERCULOUS DISEASES\n6817 Pulmonary Vascular Disease:\nPrimary pulmonary hypertension, or; chronic pulmonary thromboembolism 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\nChronic pulmonary thromboembolism requiring anticoagulant therapy, or; following inferior vena cava surgery without evidence of pulmonary hypertension or right ventricular dysfunction 60\nSymptomatic, following resolution of acute pulmonary embolism 30\nAsymptomatic, following resolution of pulmonary thromboembolism 0\nNote: 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.\n6819 Neoplasms, malignant, any specified part of respiratory system exclusive of skin growths 100\nNote: 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.\n6820 Neoplasms, benign, any specified part of respiratory system. Evaluate using an appropriate respiratory analogy.\nBacterial Infections of the Lung\n6822 Actinomycosis.\n6823 Nocardiosis.\n6824 Chronic lung abscess.\nGeneral Rating Formula for Bacterial Infections of the Lung (diagnostic codes 6822 through 6824):\nActive infection with systemic symptoms such as fever, night sweats, weight loss, or hemoptysis 100\nDepending 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).\nInterstitial Lung Disease\n6825 Diffuse interstitial fibrosis (interstitial pneumonitis, fibrosing alveolitis).\n6826 Desquamative interstitial pneumonitis.\n6827 Pulmonary alveolar proteinosis.\n6828 Eosinophilic granuloma of lung.\n6829 Drug-induced pulmonary pneumonitis and fibrosis.\n6830 Radiation-induced pulmonary pneumonitis and fibrosis.\n6831 Hypersensitivity pneumonitis (extrinsic allergic alveolitis).\n6832 Pneumoconiosis (silicosis, anthracosis, etc.).\n6833 Asbestosis.\nGeneral Rating Formula for Interstitial Lung Disease (diagnostic codes 6825 through 6833):\nForced 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\nFVC of 50- to 64-percent predicted, or; DLCO (SB) of 40- to 55-percent predicted, or; maximum exercise capacity of 15 to 20 ml/kg/min oxygen consumption with cardiorespiratory limitation 60\nFVC of 65- to 74-percent predicted, or; DLCO (SB) of 56- to 65-percent predicted 30\nFVC of 75- to 80-percent predicted, or; DLCO (SB) of 66- to 80-percent predicted 10\nMycotic Lung Disease\n6834 Histoplasmosis of lung.\n6835 Coccidioidomycosis.\n6836 Blastomycosis.\n6837 Cryptococcosis.\n6838 Aspergillosis.\n6839 Mucormycosis.\nGeneral Rating Formula for Mycotic Lung Disease (diagnostic codes 6834 through 6839):\nChronic pulmonary mycosis with persistent fever, weight loss, night sweats, or massive hemoptysis 100\nChronic pulmonary mycosis requiring suppressive therapy with no more than minimal symptoms such as occasional minor hemoptysis or productive cough 50\nChronic pulmonary mycosis with minimal symptoms such as occasional minor hemoptysis or productive cough 30\nHealed and inactive mycotic lesions, asymptomatic 0\nNote: 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.\nRestrictive Lung Disease\n6840 Diaphragm paralysis or paresis.\n6841 Spinal cord injury with respiratory insufficiency.\n6842 Kyphoscoliosis, pectus excavatum, pectus carinatum.\n6843 Traumatic chest wall defect, pneumothorax, hernia, etc.\n6844 Post-surgical residual (lobectomy, pneumonectomy, etc.).\n6845 Chronic pleural effusion or fibrosis.\nGeneral Rating Formula for Restrictive Lung Disease (diagnostic codes 6840 through 6845):\nFEV-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\nFEV-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\nFEV-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\nFEV-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\nOr rate primary disorder.\nNote (1): A 100-percent rating shall be assigned for pleurisy with empyema, with or without pleurocutaneous fistula, until resolved.\nNote (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.\nNote (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.\n6846 Sarcoidosis:\nCor pulmonale, or; cardiac involvement with congestive heart failure, or; progressive pulmonary disease with fever, night sweats, and weight loss despite treatment 100\nPulmonary involvement requiring systemic high dose (therapeutic) corticosteroids for control 60\nPulmonary involvement with persistent symptoms requiring chronic low dose (maintenance) or intermittent corticosteroids 30\nChronic hilar adenopathy or stable lung infiltrates without symptoms or physiologic impairment 0\nOr rate active disease or residuals as chronic bronchitis (DC 6600) and extra-pulmonary involvement under specific body system involved\n6847 Sleep Apnea Syndromes (Obstructive, Central, Mixed):\nChronic respiratory failure with carbon dioxide retention or cor pulmonale, or; requires tracheostomy 100\nRequires use of breathing assistance device such as continuous airway pressure (CPAP) machine 50\nPersistent day-time hypersomnolence 30\nAsymptomatic but with documented sleep disorder breathing 0\n1 Review for entitlement to special monthly compensation under § 3.350 of this chapter.","path":["Title 38—Pensions, Bonuses, and Veterans' Relief","CHAPTER I—DEPARTMENT OF VETERANS AFFAIRS","PART 4—SCHEDULE FOR RATING DISABILITIES","Subpart B—Disability Ratings"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-38.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:25:50Z","sha256":"cd81a8d2d422304d17ee9052f6857e5b05cddcec2f0582f007579e1bcc2a5d26","source_id":"us-cfr","stale":true,"prev":"us/38-cfr-4.96","next":"us/38-cfr-4.100"},"notice":"GroundRules: Original legal text. Not legal advice."}