Respiratory System§ 4.97Updated
Rating criteria

VA Diagnostic Code 6842Kyphoscoliosis, pectus excavatum, pectus carinatum

Rated from 10% to 100% under § 4.97. Here is what the VA requires at each level.

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What each rating requires

The VA assigns the highest level your evidence actually supports. Read up the stack until your records stop matching.

  1. 100%

    FEV-1 less than 40 percent of predicted value, or; the ratio of Forced Expiratory Volume in one second to Forced Vital Capacity (FEV-1/FVC) less than 40 percent, or; Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO (SB)) less than 40-percent predicted, or; maximum exercise capacity less than 15 ml/kg/min oxygen consumption (with cardiac or respiratory limitation), or; cor pulmonale (right heart failure), or; right ventricular hypertrophy, or; pulmonary hypertension (shown by Echo or cardiac catheterization), or; episode(s) of acute respiratory failure, or; requires outpatient oxygen therapy

  2. 60%

    FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; DLCO (SB) of 40- to 55-percent predicted, or; maximum oxygen consumption of 15 to 20 ml/kg/min (with cardiorespiratory limit)

  3. 30%

    FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; DLCO (SB) 56- to 65-percent predicted

  4. 10%

    FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; DLCO (SB) 66- to 80-percent predicted

How it is applied

General rating formula

General Rating Formula for Restrictive Lung Disease (diagnostic codes 6840 through 6845)

From the schedule

Notes on this code

These notes are part of the regulation. They change how the levels above are applied.

  • Note (1): A 100-percent rating shall be assigned for pleurisy with empyema, with or without pleurocutaneous fistula, until resolved.
  • Note (2): Following episodes of total spontaneous pneumothorax, a rating of 100 percent shall be assigned as of the date of hospital admission and shall continue for three months from the first day of the month after hospital discharge.
  • Note (3): Gunshot wounds of the pleural cavity with bullet or missile retained in lung, pain or discomfort on exertion, or with scattered rales or some limitation of excursion of diaphragm or of lower chest expansion shall be rated at least 20-percent disabling. Disabling injuries of shoulder girdle muscles (Groups I to IV) shall be separately rated and combined with ratings for respiratory involvement. Involvement of Muscle Group XXI (DC 5321), however, will not be separately rated.

Kyphoscoliosis, Pectus Excavatum & Pectus Carinatum (VA Diagnostic Code 6842)

Respiratory System · 38 CFR § 4.97

Understanding the Condition

Kyphoscoliosis, pectus excavatum, and pectus carinatum are structural conditions of the spine and chest wall. Kyphoscoliosis refers to an abnormal curvature of the spine, while pectus excavatum ("sunken chest") and pectus carinatum ("protruding chest") involve the shape of the breastbone and rib cage. Because these conditions can affect the space and mechanics of the chest, the VA evaluates them for their impact on breathing.

The VA rates this condition (Diagnostic Code 6842) under the General Rating Formula for Restrictive Lung Disease, which applies to diagnostic codes 6840 through 6845.

How the VA Assigns a Rating

Ratings are based primarily on the results of pulmonary function tests and related clinical findings. The available rating levels are:

100%

Assigned when any one of the following is present:

  • FEV-1 less than 40% of predicted value, or
  • FEV-1/FVC ratio less than 40%, or
  • DLCO (SB) less than 40% predicted, or
  • Maximum exercise capacity less than 15 ml/kg/min oxygen consumption (with cardiac or respiratory limitation), or
  • Cor pulmonale (right heart failure), or
  • Right ventricular hypertrophy, or
  • Pulmonary hypertension (shown by Echo or cardiac catheterization), or
  • Episode(s) of acute respiratory failure, or
  • Requires outpatient oxygen therapy

60%

Assigned when any one of the following is present:

  • FEV-1 of 40% to 55% predicted, or
  • FEV-1/FVC of 40% to 55%, or
  • DLCO (SB) of 40% to 55% predicted, or
  • Maximum oxygen consumption of 15 to 20 ml/kg/min (with cardiorespiratory limit)

30%

Assigned when any one of the following is present:

  • FEV-1 of 56% to 70% predicted, or
  • FEV-1/FVC of 56% to 70%, or
  • DLCO (SB) of 56% to 65% predicted

10%

Assigned when any one of the following is present:

  • FEV-1 of 71% to 80% predicted, or
  • FEV-1/FVC of 71% to 80%, or
  • DLCO (SB) of 66% to 80% predicted

What the VA Looks For

The VA relies on objective measurements to determine the appropriate rating level. Key measurements include:

  • FEV-1 — Forced Expiratory Volume in one second, expressed as a percentage of predicted value.
  • FEV-1/FVC — the ratio of Forced Expiratory Volume in one second to Forced Vital Capacity.
  • DLCO (SB) — Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method, as a percentage of predicted.
  • Maximum exercise / oxygen consumption capacity, measured in ml/kg/min.

In addition, the VA considers certain clinical findings — such as cor pulmonale, right ventricular hypertrophy, pulmonary hypertension, episodes of acute respiratory failure, or the need for outpatient oxygen therapy — which can support the highest (100%) rating level.

Important Additional Rules

  • Note (1): A 100% rating is assigned for pleurisy with empyema, with or without pleurocutaneous fistula, until resolved.
  • Note (2): Following episodes of total spontaneous pneumothorax, a 100% rating is assigned as of the date of hospital admission and continues for three months from the first day of the month after hospital discharge.
  • Note (3): Gunshot wounds of the pleural cavity with a bullet or missile retained in the lung, pain or discomfort on exertion, scattered rales, or some limitation of excursion of the diaphragm or lower chest expansion are rated at least 20% disabling. Disabling injuries of shoulder girdle muscles (Groups I to IV) are separately rated and combined with ratings for respiratory involvement. Involvement of Muscle Group XXI (DC 5321), however, is not separately rated.

This information is provided for general educational purposes and is based on the VA rating schedule under 38 CFR § 4.97. It is not legal advice, and individual results depend on the specific evidence in each case.

These criteria are a rendering of § 4.97, diagnostic code 6842. The official version is the one that governs your rating.

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What next

How to claim this

Knowing the criteria is the first half. Getting your file to show them is the second.

  1. Find your level in the stack

    Read each rung against what your medical records already say. The level your records document today is the one the VA can support today.

  2. Name the gap

    Look at the rung above yours and write down exactly what it asks for that your file does not show yet — a diagnosis, a measurement, a prescribed brace, a doctor’s opinion linking it to service.

  3. Claim it by code

    File under diagnostic code 6842 and attach the evidence for the level you are asking for. Other Respiratory System codes may cover your secondary conditions.

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