Interstitial lung disease (ILD) and idiopathic pulmonary fibrosis (IPF) are rated under 38 CFR § 4.97 based on FVC and DLCO pulmonary function test results. At 60% FVC, the VA assigns a 60% rating worth $1,395.93/month. The PACT Act has dramatically expanded access for burn pit veterans — no nexus letter required if you qualify.
Interstitial lung disease (ILD) is an umbrella term covering more than 200 distinct lung conditions characterized by progressive scarring (fibrosis), inflammation, or both in the lung parenchyma — the tissues between and surrounding the air sacs (alveoli). The most common form in veterans is idiopathic pulmonary fibrosis (IPF), a progressive fibrosing ILD with a median survival of 3–5 years from diagnosis. Other forms relevant to veterans include hypersensitivity pneumonitis (from chemical or organic dust exposure), asbestosis (from asbestos exposure), and constrictive bronchiolitis (linked to burn pit smoke inhalation).
ILD reduces the lungs' ability to transfer oxygen into the bloodstream, leading to exertional dyspnea, progressive exercise intolerance, chronic dry cough, and eventually respiratory failure. The ICD-10 codes most commonly seen in veteran ILD claims include J84.112 (idiopathic pulmonary fibrosis), J84.10 (pulmonary fibrosis, unspecified), and J68.0 (chemical pneumonitis from fumes/vapors — common in burn pit exposure cases).
Interstitial lung diseases are rated under 38 CFR § 4.97, Diagnostic Codes 6825 through 6833, which cover various specific ILD diagnoses. The rating methodology is based primarily on pulmonary function test (PFT) results — specifically FVC (forced vital capacity) and DLCO (diffusing capacity of the lungs for carbon monoxide). These objective measurements translate directly into rating percentages under a standardized table.
| Rating | FVC (% of Predicted) | DLCO (% of Predicted) | Monthly Pay (2026) |
|---|---|---|---|
| 100% | FVC ≤ 50% | DLCO ≤ 40% — OR requires daily oxygen | $3,737.85 |
| 60% | FVC 51–60% | DLCO 41–55% | $1,395.93 |
| 30% | FVC 61–70% | DLCO 56–65% | $537.42 |
| 10% | FVC 71–80% | DLCO 66–80% | $175.51 |
| 0% | FVC > 80% with symptoms controlled | DLCO > 80% | Service connected, no pay |
Note that the VA uses whichever measurement — FVC or DLCO — produces the highest rating in your favor. If your FVC indicates a 30% rating but your DLCO indicates a 60% rating, you receive the 60%. This is consistent with the VA's duty to apply the most favorable interpretation of the evidence under 38 CFR § 3.102.
| DC | Condition |
|---|---|
| 6825 | Diffuse interstitial fibrosis (idiopathic pulmonary fibrosis) |
| 6826 | Desquamative interstitial pneumonitis |
| 6827 | Pulmonary alveolar proteinosis |
| 6828 | Eosinophilic granuloma of the lung |
| 6829 | Drug-induced pulmonary pneumonitis and fibrosis |
| 6830 | Radiation-induced pulmonary pneumonitis and fibrosis |
| 6831 | Hypersensitivity pneumonitis |
| 6832 | Pneumoconiosis (NOS) |
| 6833 | Asbestosis |
Your VA rating for ILD will be determined almost entirely by your PFT results, so understanding these tests is essential for managing your claim strategically.
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Get Free Claim Help →FVC measures the total volume of air you can forcefully exhale after a full inhalation. In ILD, the lung tissue stiffens (reduced compliance), which restricts how much air you can take in — producing a restrictive pattern on PFTs (reduced FVC, relatively preserved FEV1/FVC ratio). The FVC result is expressed as a percentage of the predicted normal for your age, sex, height, and race. A result below 80% of predicted suggests significant restriction; below 50% is severe restriction associated with the 100% VA rating.
DLCO (also called DLCO or carbon monoxide diffusing capacity) measures how efficiently the lungs transfer gas from the air sacs into the bloodstream. In ILD, fibrosis thickens the alveolar-capillary membrane, impairing gas exchange and reducing DLCO. Because DLCO reflects the actual functional impairment of gas exchange — not just the mechanical restriction — it often provides a more sensitive indicator of ILD severity than FVC alone. A low DLCO explains why ILD patients are breathless even when their FVC is not severely reduced.
PFTs should be performed on a day that reflects your typical respiratory function — not after a respiratory infection, during an acute exacerbation, or after bronchodilator use that artificially inflates results. For VA C&P purposes, the examiner should use PFT results obtained close in time to the exam. If your most recent PFTs are more than one year old, request updated testing before your C&P exam.
Constrictive bronchiolitis and related ILD patterns have been documented in veterans who deployed to Southwest Asia and were exposed to the massive open-air burn pits used to dispose of military waste in Iraq, Afghanistan, and other locations. Burn pit smoke contains particulate matter, heavy metals, volatile organic compounds, and dioxins — all of which can cause chronic lung injury. The VA has documented this connection, and the PACT Act of 2022 specifically addressed burn pit-related respiratory conditions as presumptives.
Asbestosis (DC 6833) is a specific fibrotic ILD caused by inhalation of asbestos fibers. Military service in the Navy (particularly ship repair and shipyard work), the Army Corps of Engineers, and various industrial military occupations involved extensive asbestos exposure through the 1970s and 1980s. Asbestosis typically has a latency period of 20–30 years between exposure and clinical manifestation, meaning veterans who served in asbestos-heavy occupations in the 1960s–1980s may be developing the disease now in their 60s–80s.
Hypersensitivity pneumonitis (DC 6831) results from repeated inhalation of organic antigens or chemicals — including in military environments (moldy aircraft parts, agricultural chemicals on military bases, industrial solvents). Chemical pneumonitis (DC 6829) can result from inhalation of chemical fumes during industrial military work. Veterans working in occupational environments with poorly ventilated chemical exposure should explore these specific codes when filing.
The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act of 2022 established presumptive service connection for several respiratory conditions in veterans with qualifying toxic exposure. For ILD specifically:
Review the full PACT Act presumptive conditions guide to confirm your eligibility before filing.
High-Resolution CT Scan (HRCT): The definitive imaging modality for ILD diagnosis. HRCT can identify the pattern of lung involvement (honeycombing, ground-glass opacities, reticular pattern) and help differentiate ILD subtypes. The radiology report should include the radiologist's interpretation of the pattern and, ideally, a statement about the likely diagnosis.
Chest X-Ray: Less sensitive than HRCT for early ILD, but often the first imaging obtained. Bilateral lower-lobe reticular opacities or honeycombing on chest X-ray support the ILD diagnosis.
As detailed above, your PFT results directly determine your rating. Obtain a complete set including spirometry (FVC, FEV1, FEV1/FVC ratio), lung volumes (TLC, RV), and DLCO. Make sure the report includes the percent-predicted values, not just raw numbers. The VA rater uses percent-predicted to apply the rating table.
A pulmonologist's records documenting your diagnosis, disease severity, treatment, and trajectory of illness are essential. If a lung biopsy has been performed (open lung biopsy or VATS biopsy), the pathology report is powerful objective evidence of the specific ILD subtype.
For non-PACT Act claims, document your in-service exposures: asbestos exposure through MOS codes and locations, burn pit exposure through deployment records, or chemical exposure through hazmat records or work orders. The VA's Defense Occupational and Environmental Health Readiness System (DOEHRS) may contain exposure records for some veterans.
If you are not claiming under the PACT Act presumptive or asbestosis framework, you will likely need a nexus letter from a pulmonologist or occupational medicine physician. The letter should:
For asbestosis specifically, the nexus letter should reference the known latency period and the veteran's specific asbestos-exposure occupational history. A pulmonologist or occupational medicine physician with experience in asbestos-related lung disease is the ideal author. Review the VA nexus letter guide and the comparison between a nexus letter and Independent Medical Opinion (IMO) to determine the right approach for your situation.
Severe ILD frequently causes secondary complications that are independently ratable under VA's combined ratings framework. Veterans with ILD should evaluate and claim these secondary conditions simultaneously:
Chronic hypoxia from ILD causes pulmonary vasoconstriction and, over time, structural remodeling of the pulmonary vasculature — resulting in pulmonary arterial hypertension. PAH secondary to service-connected ILD is ratable under DC 7008 (hypertensive heart disease) or DC 6817 (secondary pulmonary hypertension). The presence of PAH on right heart catheterization or echocardiogram should trigger a secondary claim immediately.
Prolonged pulmonary hypertension from ILD leads to right ventricular hypertrophy and eventually right heart failure (cor pulmonale). This is a serious, separately ratable condition that significantly increases your overall disability rating. Right heart catheterization data, echocardiogram findings, and cardiology records documenting right heart dysfunction should all be submitted with the secondary condition claim.
Veterans who require supplemental oxygen — either on exertion or continuously — qualify for the 100% VA rating under the ILD rating framework. If you have been prescribed supplemental oxygen, this alone triggers the maximum rating regardless of your FVC or DLCO values.
Use the VA rating estimator to understand how ILD plus its secondary conditions combine to produce your total disability rating, and get free help with your VA claim to ensure all conditions are properly documented and submitted.
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