VA Disability Rating for Chronic pleural effusion or fibrosis (DC 6845)

Rating levels

• 100% — You qualify for this rating if breathing tests show your lungs are working at less than 40% of what's expected for someone your age and size, or if you can only consume less than 15 ml/kg/min of oxygen during exercise due to heart or lung problems. You also qualify if you have serious heart complications from your lung condition like right heart failure (cor pulmonale), enlarged right heart chamber (right ventricular hypertrophy), or high blood pressure in your lungs (pulmonary hypertension), or if you've had episodes where you couldn't breathe well enough on your own (acute respiratory failure) or need to use oxygen at home.
• 60% — Your breathing tests must show FEV-1 (the air you can blow out in one second) at 40 to 55 percent of predicted, or an FEV-1/FVC ratio (the share of the air you blow out that comes out in the first second) of 40 to 55 percent, or a DLCO (how well your lungs move oxygen into your blood) at 40 to 55 percent of predicted. You also qualify if exercise testing shows a maximum oxygen consumption of 15 to 20 ml/kg/min with a cardiorespiratory limit. At this level, the chronic pleural effusion or fibrosis limits your breathing to about half of normal function.
• 30% — Your breathing tests must show FEV-1 (the air you can blow out in one second) at 56 to 70 percent of predicted, or an FEV-1/FVC ratio (the share of the air you blow out that comes out in the first second) of 56 to 70 percent, or a DLCO (how well your lungs move oxygen into your blood) at 56 to 65 percent of predicted. At this level, the chronic pleural effusion or fibrosis clearly limits your breathing, but you keep more than half of normal lung function.
• 10% — To qualify for this rating level, your lung function tests must show mild impairment in one of three key measurements. Either your FEV-1 (the amount of air you can forcefully exhale in one second) is 71-80% of what's expected for someone your age and size, or your FEV-1/FVC ratio (how much air you can blow out compared to your total lung capacity) is 71-80%, or your DLCO test (which measures how well oxygen moves from your lungs into your blood) shows 66-80% of normal function.
• Note — If you have pleurisy with empyema (a collection of pus in the pleural space around the lung), with or without a pleurocutaneous fistula (an abnormal channel from the pleural space to the skin), you receive a MANDATORY 100% rating that continues UNTIL THE EMPYEMA IS RESOLVED. This applies regardless of where the pulmonary function tests place you on the regular ladder, the empyema rule overrides the standard tiers as long as the empyema is active.
• Note — If you have a TOTAL SPONTANEOUS PNEUMOTHORAX (complete lung collapse not caused by trauma), the VA assigns 100% starting from the date of HOSPITAL ADMISSION for that episode. The 100% rating continues for THREE MONTHS from the first day of the month following hospital discharge. After that 3-month window, the rating shifts to whatever the regular pulmonary function tests warrant under the standard ladder tiers above. This rule applies to total spontaneous pneumothorax only; smaller pneumothoraces or traumatic pneumothoraces are rated on PFT findings under the regular ladder.
• Note — Instead of the lung-function levels above, the VA may rate the underlying condition itself (for example the spinal cord injury or the chest wall injury), whichever applies better.
• Note — A gunshot wound of the chest cavity with a bullet or fragment left in the lung, pain or discomfort on exertion, or rales or some limitation of chest or diaphragm movement, is rated at least 20%. Injuries to the shoulder girdle muscles (Groups I to IV) are rated separately and combined; Muscle Group XXI (DC 5321) is not rated separately.