Granulomatous disease

• 100% — Cor pulmonale, or; cardiac involvement with congestive heart failure, or; progressive pulmonary disease with fever, night sweats, and weight loss despite treatment
• 60% — Pulmonary involvement requiring systemic high dose (therapeutic) corticosteroids for control
• 30% — Pulmonary involvement with persistent symptoms requiring chronic low dose (maintenance) or intermittent corticosteroids
• 0% — Chronic hilar adenopathy or stable lung infiltrates without symptoms or physiologic impairment

The evidence that matters most will depend on which rating level applies to you. For the 100% level, records documenting cor pulmonale, congestive heart failure, or a pattern of fever, night sweats, and weight loss that has continued despite active treatment are central. Cardiology and pulmonology notes, echocardiograms, and hospitalization records would reflect findings at this level.

For the 60% level, treatment records showing that your doctor prescribed systemic high-dose corticosteroids to control pulmonary disease are key. Prescription histories and physician notes explaining why therapeutic dosing was necessary directly support this criterion.

For the 30% level, records showing persistent respiratory symptoms alongside a prescription for chronic low-dose or intermittent corticosteroids are most relevant. Clinic notes describing ongoing symptoms and the reasoning for maintenance therapy connect directly to this standard.

For the 0% level, imaging such as chest X-rays or CT scans showing hilar adenopathy or stable infiltrates, combined with records confirming the absence of symptoms or measurable physiologic impairment, reflect findings at this level. Your own statements describing how symptoms affect daily activities and work can also help show severity at any level.

• PACT Act — 38 U.S.C. § 1120