- Diagnostic Code
- 6819
- CFR Section
- §4.97 — Respiratory
Rating Tiers
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.
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.