- Diagnostic Code
- 6521
- CFR Section
- §4.97 — Respiratory
Rating Tiers
50%
Stricture 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
Rated Under Formula
This condition is rated using the §4.97 general rating formula.
What Raters Look For
Based on M21-1 adjudication criteria for Respiratory conditions. These are the factors a VA rater evaluates when assigning a rating percentage.
M21-1 III.iv.4.B- •Pulmonary function test results: FEV1 (% of predicted), FVC, FEV1/FVC ratio, and DLCO
- •Exercise tolerance in METs (metabolic equivalents) if cardiac limitation is also relevant
- •Frequency of exacerbations requiring medical visits, oral steroids, or hospitalization
- •Oxygen therapy use — whether prescribed and under what conditions
- •Sleep study results and AHI score if sleep apnea is claimed
- •Medication regimen: inhalers, systemic steroids, biologics
- •Smoking history (noted but not used to reduce rating)
NoteFor sleep apnea, raters look specifically at whether a CPAP/BiPAP is required — that alone meets the 50% rating criteria under DC 6847.