What is the VA rating for Pulmonary Vascular Disease and Bacterial Infections of the Lung?

DC 6817's 60 percent tier covers chronic pulmonary thromboembolism requiring anticoagulant therapy, or following inferior vena cava surgery without evidence of pulmonary hypertension or right ventricular dysfunction. The regulation's own text does not make clear whether that "without evidence" qualifier applies only to the inferior vena cava surgery alternative, or to both alternatives. RatingScope discloses this rather than picking a reading.

• DC 6817's 60 percent tier, verbatim: "Chronic pulmonary thromboembolism requiring anticoagulant therapy, or; following inferior vena cava surgery without evidence of pulmonary hypertension or right ventricular dysfunction -- 60 percent."
• One reading (Reading A) treats the "without evidence of pulmonary hypertension or right ventricular dysfunction" qualifier as attaching only to the inferior vena cava surgery alternative -- under this reading, chronic pulmonary thromboembolism requiring anticoagulant therapy reaches 60 percent regardless of whether pulmonary hypertension or right ventricular findings are also present, unless those findings are severe enough to independently satisfy the 100 percent tier's own separate criteria.
• A second reading (Reading B) treats the qualifier as attaching to both alternatives -- under this reading, chronic pulmonary thromboembolism requiring anticoagulant therapy would also need to be documented without evidence of pulmonary hypertension or right ventricular dysfunction to reach 60 percent, and it is less clear what tier applies to anticoagulant-therapy cases where such evidence is present but does not independently rise to the 100 percent tier's own threshold.
• This hub computes the 100 percent tier directly and independently whenever chronic pulmonary thromboembolism is documented together with evidence of pulmonary hypertension, right ventricular hypertrophy, or cor pulmonale -- that fact pattern is unambiguous on its own terms and does not depend on resolving the 60 percent tier's ambiguity.
• For the 60 percent tier's own fact pattern (chronic pulmonary thromboembolism requiring anticoagulant therapy, or following inferior vena cava surgery without evidence of pulmonary hypertension or right ventricular dysfunction) when it does not already independently satisfy the 100 percent tier's own clean criteria, RatingScope does not compute a 60 percent result. It discloses the ambiguity instead, so the veteran and their representative know to raise the reading question directly with the adjudicator.
• This is a genuine interpretive gap in currently in-force, fully sourced regulatory text -- not a missing-input sourcing gap like Addison's Disease's DC 7911 Note (3)/38 CFR 4.88b situation. 38 CFR 4.97 is fully sourced here; the ambiguity is in the sourced text itself.

Records to review: Records documenting chronic pulmonary thromboembolism and anticoagulant therapy; Records documenting inferior vena cava surgery, if applicable; Echocardiogram or catheterization findings documenting the presence or absence of pulmonary hypertension or right ventricular dysfunction.

Once active infection with systemic symptoms is no longer documented, DC 6822 through 6824's General Rating Formula directs evaluators to rate residuals as interstitial lung disease, restrictive lung disease, or, when obstructive lung disease is the major residual, as chronic bronchitis (DC 6600) -- an open dispatch RatingScope discloses but does not compute.

• The General Rating Formula's residual-dispatch text, verbatim: "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)."
• The regulation states a clear decision rule for one of the three destinations: chronic bronchitis (DC 6600) applies specifically "when obstructive lung disease is the major residual." It states no equivalent rule for choosing between interstitial lung disease and restrictive lung disease when the major residual is not obstructive -- this additional choice-gap is disclosed here as part of the same broader dispatch disclosure, not as its own separate blocking item.
• RatingScope does not compute or guess which of the three destination diagnostic codes applies, or what rating any of them would produce, for facts that do not meet the 100 percent tier's active-infection-with-systemic-symptoms threshold.
• This is the same open residual-dispatch pattern already used for DC 6819's post-treatment reassessment in the Respiratory Neoplasms hub, disclosed rather than computed.

Records to review: Records documenting resolution or control of the active bacterial lung infection; Pulmonary function testing or imaging documenting the specific residual findings, including whether obstructive lung disease is the major residual.

38 CFR 4.96(a) bars combining ratings under diagnostic codes 6600 through 6817 with each other, and separately bars combining ratings under diagnostic codes 6822 through 6847 with each other. DC 6817 sits at the top of the first range; DC 6822 sits at the start of the second. DC 6817's own Note separately bars combining its own tiers with whatever residual diagnostic code its Note dispatches to.

• Section 4.96(a), sentence 1, verbatim: "Ratings under diagnostic codes 6600 through 6817 and 6822 through 6847 will not be combined with each other."
• This means a veteran with documented findings under DC 6817 and also under another respiratory diagnostic code in the 6600-6817 range (such as trachea and bronchi, restrictive lung disease, interstitial lung disease, mycotic lung disease, tuberculosis, or sleep apnea) cannot have both ratings combined through the standard combined-ratings table -- a single predominant-disability rating applies instead, possibly elevated one step where the severity of the overall disability warrants it. The same bar applies separately to DC 6822-6824 and any other diagnostic code in the 6822-6847 range.
• DC 6817's own Note, verbatim: "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." This is a second, narrower, code-specific non-combination rule layered on top of the general 4.96(a) bar: even when DC 6817's own residual dispatch is evaluated under another diagnostic code, that separate evaluation is not combined with any of DC 6817's own tier ratings.
• RatingScope discloses both rules but does not automate the predominant-disability determination, the elevation decision, or the DC-6817-specific residual non-combination rule.

Records to review: Treatment records documenting each respiratory diagnostic code finding; Clinician assessment of predominant disability.

VA has proposed, but not finalized, a substantive rewrite of DC 6817 (renamed, relocated, and split into a new code) and a subheading-only rename for DC 6822-6824. This hub is built on the current, in-force text.

• For DC 6817, the proposed rule would rename it to "Pulmonary thromboembolic disease," relocate it to a new "Vascular Lung Diseases" subheading, split "primary pulmonary hypertension" out into a new standalone diagnostic code (proposed DC 6849), remove its cor pulmonale references, and add two new Notes whose exact replacement text was not fully retrievable in this hub's sourcing pass and remains unconfirmed.
• For DC 6822 through 6824, the proposed rule gives them only a subheading rename to "Bacterial Lung Diseases," with VA's own text stating explicitly that no substantive criteria changes are proposed for these three codes.
• This proposal has not been finalized as of this hub's build date. No final rule has published. RatingScope builds and rates on the current, in-force regulatory text and will update this hub in a future work order if and when this rule finalizes, including sourcing the two new DC 6817 Notes' exact text at that time.
• This is the same pending-rulemaking watch item already tracked for the Trachea and Bronchi, Tuberculosis, Interstitial Lung Disease, Mycotic Lung Disease, Restrictive Lung Disease, and Respiratory Neoplasms hubs, all part of the same broader RIN 2900-AQ72 respiratory-schedule proposal.

Records to review: .