Diaphragm paralysis or weakness

Diaphragm paralysis or paresis is rated under the General Rating Formula for Restrictive Lung Disease, which covers diagnostic codes 6840 through 6845. VA may also rate the primary disorder instead, whichever produces the higher evaluation.

The formula has four levels based on breathing test results and clinical findings. A 100% rating applies if your FEV-1 is below 40% of the predicted value, your FEV-1/FVC ratio is below 40%, your DLCO (SB) is below 40% predicted, your maximum exercise capacity is below 15 ml/kg/min oxygen consumption with cardiac or respiratory limitation, or you have cor pulmonale, right ventricular hypertrophy, pulmonary hypertension shown by echocardiogram or cardiac catheterization, episodes of acute respiratory failure, or a need for outpatient oxygen therapy. A 60% rating applies when FEV-1 is 40 to 55% predicted, FEV-1/FVC is 40 to 55%, DLCO (SB) is 40 to 55% predicted, or maximum oxygen consumption is 15 to 20 ml/kg/min with cardiorespiratory limitation. A 30% rating applies when FEV-1 is 56 to 70% predicted, FEV-1/FVC is 56 to 70%, or DLCO (SB) is 56 to 65% predicted. A 10% rating applies when FEV-1 is 71 to 80% predicted, FEV-1/FVC is 71 to 80%, or DLCO (SB) is 66 to 80% predicted.