What is the VA rating for Restrictive Lung Disease?

DC 6840 (diaphragm paralysis/paresis), 6841 (spinal cord injury with respiratory insufficiency), 6842 (kyphoscoliosis/pectus excavatum/pectus carinatum), 6843 (traumatic chest wall defect), 6844 (post-surgical residual), and 6845 (chronic pleural effusion/fibrosis) all use the textually identical 4-tier General Rating Formula for Restrictive Lung Disease.

• The 100/60/30/10 percent tier language is word-for-word identical across all 6 labels -- RatingScope's evaluateRestrictiveLungSharedTier function is written once and reused via label dispatch, never sextupled.
• This does not mean the underlying diagnoses are medically interchangeable -- it means VA rates their long-term severity the same way.
• Unlike Trachea/Bronchi or Heart Conditions, none of these 6 labels carries its own distinct temporary-window override in the CFR text -- the formula's three Notes (below) are attached to the whole table, not to any single diagnosis.
• This formula's PFT parameters (FEV-1, FEV-1/FVC, DLCO, maximum exercise capacity) genuinely differ from Interstitial Lung Disease's own formula (FVC and DLCO only, no FEV-1 or FEV-1/FVC ratio criterion).

Records to review: Respiratory Conditions DBQ; pulmonary function test results.

A 100 percent rating is assigned for pleurisy with empyema, with or without pleurocutaneous fistula, until resolved -- regardless of diagnosis label or any pulmonary function value.

• This override applies label-independently: it is checked first, ahead of every other fact, for all 6 diagnosis labels equally.
• "Until resolved" means this is not a fixed-duration temporary window like Note (2)'s pneumothorax provision -- it continues for as long as the empyema remains unresolved.
• RatingScope models this as its own distinct atomic fact and its own distinct registry criterion, separate from the shared ladder's own 100 percent path, so the specific basis for a 100 percent result stays traceable.

Records to review: Respiratory Conditions DBQ; treatment records documenting empyema resolution status.

Following episodes of total spontaneous pneumothorax, a 100 percent rating is assigned as of the date of hospital admission and continues for 3 months from the first day of the month after hospital discharge -- regardless of diagnosis label.

• This is a fixed temporary window tied to a specific event (unlike Note (1)'s open-ended "until resolved" language) -- checked second, after Note (1) resolves false.
• The window's end date is calculated from the first day of the month following discharge, not the discharge date itself -- a specific administrative detail disclosed here, not silently simplified.
• RatingScope models this as its own distinct atomic fact and its own distinct registry criterion, separate from both Note (1) and the shared ladder's own 100 percent path.

Records to review: Hospital admission and discharge records.

Gunshot wounds of the pleural cavity with a retained bullet or missile in the lung, exertional pain or discomfort, or scattered rales/limited diaphragm or chest expansion are rated at least 20 percent, even if the shared pulmonary-function ladder would otherwise resolve lower. A separate provision addresses shoulder-girdle muscle-group injuries.

• The 20 percent floor is implemented explicitly in RatingScope's evaluator logic (a direct comparison raising the shared formula's result to at least 20 percent when this fact applies), not merely disclosed as a note -- the same computational discipline already used for Heart Conditions' DC 7019 transplant floor.
• 20 percent is not one of the shared ladder's own named tiers (100/60/30/10) -- it required its own distinct registry row and criterion flag, correctly outranking the standard 10 percent row when it is the binding constraint.
• The separate muscle-group provision -- shoulder-girdle Muscle Groups I to IV are separately rated and combined with the respiratory rating, while Muscle Group XXI (DC 5321) is specifically excluded from separate rating -- cross-references the entirely distinct Muscle Groups schedule (38 CFR 4.73) and is disclosed only, never automated.

Records to review: Respiratory Conditions DBQ; surgical/imaging records documenting retained bullet or missile; records documenting shoulder-girdle muscle involvement, if applicable.

Directly below the 10 percent tier of the shared General Rating Formula, the regulation text reads exactly: "Or rate primary disorder." This offers an alternative to the shared PFT-based ladder: evaluating the underlying disorder that caused the restrictive lung condition under its own separate diagnostic code, instead of this formula.

• This line sits structurally between the 10 percent tier and Note (1) -- attached to the whole shared formula, the same way Notes (1), (2), and (3) are, not to any single one of the 6 diagnosis labels.
• The regulation text does not further specify how or when this alternative is selected (for example, it does not state whether the higher of the two results controls) -- RatingScope discloses the instruction's existence and exact wording but does not automate a comparison or selection between the shared formula and a primary-disorder rating.
• This is a distinct provision from section 4.96(a)'s predominant-disability combination rule (also disclosed on this hub) -- that rule addresses combining this range with other respiratory diagnostic codes, while this instruction addresses rating the separate underlying disorder that caused the restrictive lung condition in the first place.

Records to review: Respiratory Conditions DBQ; treatment records documenting the underlying/primary disorder.

38 CFR 4.96(a) states that ratings under diagnostic codes 6600 through 6817 and 6822 through 6847 will not be combined with each other; a single rating is assigned under whichever code reflects the predominant disability, with possible elevation to the next higher tier. RatingScope does not automate this rule.

• This is the exact same disclosure already established for Trachea and Bronchi (COND-022) -- reused verbatim here, not rewritten, since section 4.96(a) explicitly names DC 6840-6845 among the covered range.
• If a veteran has more than one respiratory diagnosis documented at once (for example, both a Trachea/Bronchi diagnosis and a Restrictive Lung Disease diagnosis), this rule determines which single code is used, not RatingScope.

Records to review: treatment records documenting each diagnosis; clinician assessment of predominant disability.

Section 4.96(d) lists special provisions governing how pulmonary function tests are administered and interpreted for DC 6600, 6603, 6604, 6825-6833, and 6840-6845 -- explicitly naming this hub's own DC range.

• These provisions cover post-bronchodilator test preference, which PFT result to trust when several are available, and when DLCO testing is not required -- examiner-side test-administration mechanics, not veteran-facing rating criteria.
• RatingScope does not model these test-selection mechanics as evaluator logic -- it takes whatever final band value is documented, the same boundary already used for Trachea/Bronchi and Heart Conditions.

Records to review: Respiratory Conditions DBQ; pulmonary function test results.