§ 4.97 Schedule of ratings—respiratory system.

Interstitial lung disease (ILD)

Group of disorders causing progressive scarring of lung tissue (interstitium)

What the rating means

Diffuse interstitial fibrosis — also called interstitial pneumonitis or fibrosing alveolitis — is rated under the General Rating Formula for Interstitial Lung Disease, which covers diagnostic codes 6825 through 6833. VA uses pulmonary function test results and certain clinical findings to set the rating level.

A 100% rating applies when your Forced Vital Capacity (FVC) is less than 50% of the predicted value, or your Diffusion Capacity for Carbon Monoxide by Single Breath (DLCO (SB)) is less than 40% predicted, or your maximum exercise capacity is below 15 ml/kg/min oxygen consumption with cardiorespiratory limitation, or you have cor pulmonale or pulmonary hypertension, or you require outpatient oxygen therapy.

A 60% rating applies when FVC is 50% to 64% predicted, DLCO (SB) is 40% to 55% predicted, or maximum exercise capacity is 15 to 20 ml/kg/min oxygen consumption with cardiorespiratory limitation. A 30% rating applies when FVC is 65% to 74% predicted or DLCO (SB) is 56% to 65% predicted. A 10% rating applies when FVC is 75% to 80% predicted or DLCO (SB) is 66% to 80% predicted.

Evidence that helps

Because the rating criteria center on measurable lung function, pulmonary function test reports are the most directly relevant evidence. Look for spirometry results showing your FVC as a percentage of the predicted value, and DLCO (SB) test results showing diffusion capacity as a percentage of predicted. These numbers map directly to the rating levels described above.

If your condition is severe, records documenting a diagnosis of cor pulmonale or pulmonary hypertension — such as echocardiogram reports or right heart catheterization results — support the 100% level. A prescription or treatment record showing that you have been prescribed outpatient oxygen therapy also supports the 100% level. Records from a cardiopulmonary exercise test showing your maximum oxygen consumption and noting cardiorespiratory limitation are relevant to both the 100% and 60% levels.

Statements from you or people who know you describing how breathing difficulty affects your ability to work, carry out physical tasks, or manage daily activities can round out the picture, particularly when test results fall near a threshold between rating levels.

Secondary conditions

Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.

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What the rating means

Evidence that helps

Secondary conditions

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