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6817
§ 4.97 Schedule of ratings—respiratory system.

Pulmonary vascular disease

A condition affecting the blood vessels in the lungs that may cause breathing problems and reduced oxygen levels.

What the rating means

VA rates pulmonary vascular disease under Diagnostic Code 6817 based on the specific diagnosis and how severely it affects your heart and lungs. Four rating levels are possible. A 100% rating applies if you have primary pulmonary hypertension; chronic pulmonary thromboembolism with evidence of pulmonary hypertension, right ventricular hypertrophy, or cor pulmonale; or pulmonary hypertension caused by obstructive disease of the pulmonary arteries or veins with evidence of right ventricular hypertrophy or cor pulmonale. A 60% rating applies if you have chronic pulmonary thromboembolism that requires ongoing anticoagulant therapy, or if you have had inferior vena cava surgery without evidence of pulmonary hypertension or right ventricular dysfunction. A 30% rating applies if you remain symptomatic after an acute pulmonary embolism has resolved. A 0% rating applies if you are asymptomatic after resolution of pulmonary thromboembolism. If you have other residual conditions following a pulmonary embolism, VA rates those separately under the most appropriate diagnostic code and does not combine that rating with the ratings above.

Evidence that helps

For the 100% level, medical records documenting a diagnosis of primary pulmonary hypertension, or imaging and clinical findings showing right ventricular hypertrophy or cor pulmonale, are central. Right heart catheterization results, echocardiograms, and CT pulmonary angiography establishing elevated pulmonary arterial pressures or structural heart changes directly support this level. For the 60% level, records showing a diagnosis of chronic pulmonary thromboembolism along with current anticoagulant prescriptions, or operative and post-surgical records confirming inferior vena cava surgery without pulmonary hypertension or right ventricular dysfunction, are relevant. For the 30% level, records confirming that an acute pulmonary embolism has resolved but that you continue to have symptoms — such as shortness of breath, fatigue, or reduced exercise tolerance — support that rating. Statements from you describing how ongoing symptoms affect your work and daily activities can help document this. For the 0% level, records confirming resolution of thromboembolism and absence of symptoms reflect that criteria.

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.