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6827
§ 4.97 Schedule of ratings—respiratory system.

Pulmonary alveolar proteinosis

A rare lung condition where protein builds up in the air sacs and may cause breathing difficulty.

What the rating means

Pulmonary alveolar proteinosis is rated under the General Rating Formula for Interstitial Lung Disease, which covers diagnostic codes 6825 through 6833. VA uses the results of breathing tests and other clinical findings to assign one of four ratings.

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

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

Evidence that helps

Because the ratings depend on specific breathing test numbers, pulmonary function test reports are the most direct evidence. These reports should clearly state your measured FVC and DLCO (SB) values alongside the predicted values, so the percentage of predicted can be calculated. If exercise testing was done, records showing your maximum oxygen consumption in ml/kg/min and whether a cardiorespiratory limitation was identified are relevant to the 100% and 60% levels.

For the 100% rating, records documenting a diagnosis of cor pulmonale or pulmonary hypertension, such as echocardiogram or right-heart catheterization results, are directly on point. A prescription or medical order for outpatient oxygen therapy also supports that level.

Statements from you or people who know you describing how breathlessness or fatigue limits your work, daily activities, or exertion can help show the real-world impact of the test findings. Treatment records, hospitalization notes, and pulmonologist visit summaries that track changes in your lung function over time round out the picture.

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.