VA Diagnostic Code 6843Traumatic chest wall defect, pneumothorax, hernia, etc.

Traumatic Chest Wall Defect, Pneumothorax, Hernia, etc. (VA Diagnostic Code 6843)

Respiratory System · 38 CFR § 4.97

Understanding This Condition

Diagnostic Code 6843 covers traumatic chest wall defects, pneumothorax (a collapsed lung caused by air leaking into the space around the lung), hernias affecting the chest, and similar conditions. Because these injuries can affect how well your lungs work, the VA evaluates them under the General Rating Formula for Restrictive Lung Disease, which is shared across diagnostic codes 6840 through 6845.

Restrictive lung conditions can limit how fully your lungs expand and how efficiently they move air and oxygen. To measure this, the VA relies on standardized breathing (pulmonary function) tests and other clinical findings.

Available Rating Levels

The VA assigns a disability rating based on your test results and clinical findings. Under the General Rating Formula for Restrictive Lung Disease, the levels are:

100%

Assigned when any of the following are 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 of the following are present:

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

30%

Assigned when any of the following are present:

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

10%

Assigned when any of the following are present:

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

What the VA Looks For

When rating this condition, the VA focuses on objective measures of lung function and related clinical findings, including:

• FEV-1 (Forced Expiratory Volume in one second) as a percentage of predicted value
• FEV-1/FVC ratio (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 value
• Maximum exercise capacity / oxygen consumption, particularly where there is cardiac or respiratory limitation
• Signs of cardiac involvement such as cor pulmonale, right ventricular hypertrophy, or pulmonary hypertension (confirmed by echo or cardiac catheterization)
• Episodes of acute respiratory failure or a need for outpatient oxygen therapy

Important Notes for This Diagnostic Code

• 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 a bullet or missile retained in the lung, pain or discomfort on exertion, or with scattered rales or some limitation of excursion of the 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.

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This information is drawn from the VA rating schedule under 38 CFR § 4.97, Diagnostic Code 6843. It is provided for general educational purposes and does not guarantee any particular rating outcome.