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6520
§ 4.97 Schedule of ratings—respiratory system.

Larynx narrowing or stenosis

Narrowing of the larynx that may obstruct breathing or voice production.

What the rating means

VA rates stenosis of the larynx, including residuals of laryngeal trauma, under Diagnostic Code 6520. The rating reflects how much the narrowing limits your airflow, measured by breathing tests. Four percentage ratings are possible. A 10% rating applies when your FEV-1 (the amount of air you can force out in one second) is 71 to 80 percent of the predicted value, combined with a Flow-Volume Loop result compatible with upper airway obstruction. A 30% rating applies when FEV-1 is 56 to 70 percent of predicted. A 60% rating applies when FEV-1 is 40 to 55 percent of predicted. A 100% rating applies when FEV-1 is below 40 percent of predicted, with a compatible Flow-Volume Loop, or when you have a permanent tracheostomy. The regulation also allows VA to instead evaluate this condition as aphonia under Diagnostic Code 6519 if that approach better captures your disability.

Evidence that helps

The most important evidence for this condition comes from pulmonary function testing. Your medical records should include spirometry results showing your FEV-1 value and what percentage it represents of the predicted value for someone of your age, height, and sex. A Flow-Volume Loop is a separate part of that same pulmonary function test; the report must state that the loop pattern is compatible with upper airway obstruction for most rating levels to apply. If you have a permanent tracheostomy, records documenting that the tracheostomy is permanent — such as operative notes, discharge summaries, or treating physician statements — support the 100% level. Statements from you or people who know you describing how breathing difficulty affects your ability to work, speak, or perform daily activities can help give context to the test results, though the ratings themselves turn on the objective measurements. Records from any follow-up visits with a pulmonologist or otolaryngologist that repeat or confirm these findings over time also strengthen the picture of your condition.

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.