VA Diagnostic Code 6351HIV-related illness
Rated from 0% to 100% under § 4.88b. Here is what the VA requires at each level.
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What each rating requires
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- 100%
AIDS with recurrent opportunistic infections (see Note 3) or with secondary diseases afflicting multiple body systems; HIV-related illness with debility and progressive weight loss
- 60%
Refractory constitutional symptoms, diarrhea, and pathological weight loss; or minimum rating following development of AIDS-related opportunistic infection or neoplasm
- 30%
Recurrent constitutional symptoms, intermittent diarrhea, and use of approved medication(s); or minimum rating with T4 cell count less than 200
- 10%
Following development of HIV-related constitutional symptoms; T4 cell count between 200 and 500; use of approved medication(s); or with evidence of depression or memory loss with employment limitations
- 0%
Asymptomatic, following initial diagnosis of HIV infection, with or without lymphadenopathy or decreased T4 cell count
Notes on this code
These notes are part of the regulation. They change how the levels above are applied.
- Note 1: In addition to standard therapies and regimens, the term “approved medication(s)” includes treatment regimens and medications prescribed as part of a research protocol at an accredited medical institution.
- Note 2: Diagnosed psychiatric illness, central nervous system manifestations, opportunistic infections, and neoplasms may be rated separately under the appropriate diagnostic codes if a higher overall evaluation results, provided the disability symptoms do not overlap with evaluations otherwise assignable above.
- Note 3: The following list of opportunistic infections are considered AIDS-defining conditions, that is, a diagnosis of AIDS follows if a person has HIV and one more of these infections, regardless of the CD4 count—candidiasis of the bronchi, trachea, esophagus, or lungs; invasive cervical cancer; coccidioidomycosis; cryptococcosis; cryptosporidiosis; cytomegalovirus (particularly CMV retinitis); HIV-related encephalopathy; herpes simplex-chronic ulcers for greater than one month, or bronchitis, pneumonia, or esophagitis; histoplasmosis; isosporiasis (chronic intestinal); Kaposi's sarcoma; lymphoma; mycobacterium avium complex; tuberculosis; pneumocystis jirovecii (carinii) pneumonia; pneumonia, recurrent; progressive multifocal leukoencephalopathy; salmonella septicemia, recurrent; toxoplasmosis of the brain; and wasting syndrome due to HIV.
VA Disability Ratings for HIV-Related Illness (Diagnostic Code 6351)
Understanding how the VA evaluates HIV-related illness can help you make sense of where your condition may fall on the rating schedule. Below is a plain-language breakdown of the criteria the VA uses.
What Is HIV-Related Illness?
HIV-related illness is rated by the VA under Diagnostic Code 6351, found in 38 CFR § 4.88b. It falls within the body system for Infectious Diseases, Immune Disorders and Nutritional Deficiencies.
Ratings for this condition can range widely depending on your symptoms, lab results (such as T4 cell counts), the presence of opportunistic infections, and whether the illness has progressed to AIDS. The VA looks at factors like constitutional symptoms, weight loss, diarrhea, use of approved medications, and the overall impact on your body systems.
Available Rating Levels
The VA assigns ratings for HIV-related illness at the following levels:
100%
AIDS with recurrent opportunistic infections (see the list of AIDS-defining conditions below) or with secondary diseases afflicting multiple body systems; or HIV-related illness with debility and progressive weight loss.
60%
Refractory constitutional symptoms, diarrhea, and pathological weight loss; or the minimum rating following development of an AIDS-related opportunistic infection or neoplasm.
30%
Recurrent constitutional symptoms, intermittent diarrhea, and use of approved medication(s); or the minimum rating with a T4 cell count less than 200.
10%
Following development of HIV-related constitutional symptoms; a T4 cell count between 200 and 500; use of approved medication(s); or evidence of depression or memory loss with employment limitations.
0%
Asymptomatic, following an initial diagnosis of HIV infection, with or without lymphadenopathy or decreased T4 cell count.
What the VA Looks For
When rating HIV-related illness, the VA considers several key elements:
- Constitutional symptoms — whether they are absent, recurrent, or refractory (resistant to treatment).
- T4 (CD4) cell counts — specific thresholds (less than 200, between 200 and 500) factor into certain ratings.
- Weight loss and diarrhea — including whether weight loss is pathological or progressive, and whether diarrhea is intermittent.
- Use of approved medication(s).
- Progression to AIDS, including opportunistic infections and neoplasms.
- Depression or memory loss with associated employment limitations.
About "Approved Medication(s)"
In addition to standard therapies and regimens, the term "approved medication(s)" includes treatment regimens and medications prescribed as part of a research protocol at an accredited medical institution.
Separate Ratings for Certain Conditions
Diagnosed psychiatric illness, central nervous system manifestations, opportunistic infections, and neoplasms may be rated separately under the appropriate diagnostic codes if a higher overall evaluation results — provided the disability symptoms do not overlap with evaluations otherwise assignable above.
AIDS-Defining Opportunistic Infections
The VA considers the following opportunistic infections to be AIDS-defining conditions. A diagnosis of AIDS follows if a person has HIV and one or more of these infections, regardless of the CD4 count:
- Candidiasis of the bronchi, trachea, esophagus, or lungs
- Invasive cervical cancer
- Coccidioidomycosis
- Cryptococcosis
- Cryptosporidiosis
- Cytomegalovirus (particularly CMV retinitis)
- HIV-related encephalopathy
- Herpes simplex — chronic ulcers for greater than one month, or bronchitis, pneumonia, or esophagitis
- Histoplasmosis
- Isosporiasis (chronic intestinal)
- Kaposi's sarcoma
- Lymphoma
- Mycobacterium avium complex
- Tuberculosis
- Pneumocystis jirovecii (carinii) pneumonia
- Recurrent pneumonia
- Progressive multifocal leukoencephalopathy
- Recurrent salmonella septicemia
- Toxoplasmosis of the brain
- Wasting syndrome due to HIV
This information is drawn from the VA rating schedule under Diagnostic Code 6351 (38 CFR § 4.88b). Your individual rating depends on the specific medical evidence in your case.
These criteria are a rendering of § 4.88b, diagnostic code 6351. The official version is the one that governs your rating.
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