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6721
§ 4.97 Schedule of ratings—respiratory system.

Pulmonary tuberculosis, inactive, far advanced

Inactive tuberculosis infection of the lungs with evidence of prior extensive disease.

What the rating means

Pulmonary tuberculosis, chronic, far advanced, inactive is rated under the General Rating Formula for Inactive Pulmonary Tuberculosis. The rating depends on how much time has passed since the disease became inactive, and on the severity of the lesions while the disease was active.

For two years after the date of inactivity, following active tuberculosis that was clinically identified during service or afterward, the rating is 100%. For the next four years — up to six years after the date of inactivity — the rating is 50%. For the following five years, through eleven years after the date of inactivity, the rating is 30%.

Separate from that time-based schedule, if far advanced lesions were diagnosed at any point while the disease was active, the minimum rating is 30%. If lesions were moderately advanced and you have continued disability, emphysema, dyspnea on exertion, or impairment of health, the rating is 20%. Otherwise the rating is 0%.

Two important rules apply. First, the 100% rating will be reduced to 50% if you fail to submit to examination or follow prescribed treatment. Second, ratings under this formula cannot be combined with ratings for other respiratory disabilities.

Evidence that helps

To support a rating under this code, the most important evidence is documentation of when your tuberculosis was clinically identified and when it became inactive. Medical records that establish the date active disease was identified during or after service, and records that confirm the date of inactivity, directly tie your claim to the time-based rating levels.

For the far advanced minimum rating of 30%, records from any point while the disease was active — such as imaging studies, pathology reports, or physician notes — showing that lesions were far advanced are key. For the 20% level, records showing moderately advanced lesions combined with evidence of continued disability matter; this includes pulmonary function test results, notes documenting emphysema, records of dyspnea on exertion, or physician observations about impairment of health.

Your own statements, and statements from people who know you, describing how breathing difficulty or reduced physical capacity affects your work and daily activities can help show continued disability. If you had a thoracoplasty, records documenting rib removal are relevant because that procedure is rated separately as removal of ribs combined with collapsed lung rather than under this formula.

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.