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6842
§ 4.97 Schedule of ratings—respiratory system.

Laryngeal cancer

Malignant neoplasm of larynx (unspecified)

What the rating means

Kyphoscoliosis, pectus excavatum, and pectus carinatum are rated under the General Rating Formula for Restrictive Lung Disease, which covers diagnostic codes 6840 through 6845. The formula focuses on how much the condition limits your lung function, measured through breathing tests and other clinical findings.

A 100% rating applies if your FEV-1 is below 40% of the predicted value, or your FEV-1/FVC ratio is below 40%, or your DLCO (SB) is below 40% predicted, or your maximum exercise capacity is below 15 ml/kg/min, or you have cor pulmonale, right ventricular hypertrophy, pulmonary hypertension shown by echocardiogram or cardiac catheterization, episodes of acute respiratory failure, or require outpatient oxygen therapy. A 60% rating applies for FEV-1 of 40 to 55% predicted, FEV-1/FVC of 40 to 55%, DLCO (SB) of 40 to 55% predicted, or maximum oxygen consumption of 15 to 20 ml/kg/min. A 30% rating applies for FEV-1 of 56 to 70% predicted, FEV-1/FVC of 56 to 70%, or DLCO (SB) of 56 to 65% predicted. A 10% rating applies for FEV-1 of 71 to 80% predicted, FEV-1/FVC of 71 to 80%, or DLCO (SB) of 66 to 80% predicted. VA may also rate the primary disorder instead.

Evidence that helps

Because the rating levels turn almost entirely on objective breathing test results, pulmonary function test records are the most direct evidence. Spirometry reports showing your FEV-1 value and FEV-1/FVC ratio, as well as DLCO (SB) test results, correspond directly to the thresholds that separate one rating level from the next.

For the 100% level, records showing a cardiopulmonary exercise test with maximum oxygen consumption below 15 ml/kg/min, an echocardiogram or cardiac catheterization report documenting pulmonary hypertension or right ventricular hypertrophy, hospital records for episodes of acute respiratory failure, or a prescription and records of use for outpatient oxygen therapy would all be relevant.

Statements from you or people who know you about how your breathing limits physical activity, work tasks, or daily routines can help VA understand the real-world impact of your test results. Treatment records from pulmonologists or other treating providers, showing ongoing care and any changes in your condition over time, also support the overall picture of severity.

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.