Aspergillosis — VA Disability Rating Criteria (DC 6838)
Diagnostic Code 6838 · 38 CFR §4.97
What Is It?
Aspergillosis is a lung condition caused by Aspergillus mold, which is found worldwide in soil, decaying vegetation, and building materials. Veterans may develop pulmonary aspergillosis from inhaling spores in moldy barracks, field conditions, or during construction and demolition work. The forms differ sharply in severity: allergic bronchopulmonary aspergillosis (ABPA), aspergilloma (a fungal ball colonising an existing cavity), and invasive aspergillosis. The diagnostic code is DC 6838. 38 CFR § 4.97 lists it by name in the Mycotic Lung Disease block — DC 6834 histoplasmosis, 6835 coccidioidomycosis, 6836 blastomycosis, 6837 cryptococcosis, 6838 aspergillosis, 6839 mucormycosis — and all six share one General Rating Formula for Mycotic Lung Disease. DC 6824 is not this condition: § 4.97 assigns that number to chronic lung abscess. Note what the mycotic formula does not do. It does not score pulmonary function tests. It counts fever, weight loss, night sweats, hemoptysis, productive cough, and whether suppressive antifungal therapy is required.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Chronic pulmonary mycosis with persistent fever, weight loss, night sweats, or massive hemoptysis. |
| 50% | Chronic pulmonary mycosis requiring suppressive therapy with no more than minimal symptoms such as occasional minor hemoptysis or productive cough. |
| 30% | Chronic pulmonary mycosis with minimal symptoms such as occasional minor hemoptysis or productive cough. |
| 0% | Healed and inactive mycotic lesions, asymptomatic. |
Evidence Needed
Positive Aspergillus serology, cultures, or biopsy results. Chest imaging showing an aspergilloma, cavitation, or infiltrates. Records of antifungal treatment, and specifically whether suppressive therapy is required — that single fact separates the 50 percent row from the 30. Documentation of fever, measured weight loss, night sweats and hemoptysis, because those are the words of the 100 percent row. Documentation of the exposure circumstances during service.
C&P Exam Tips
Say which form of aspergillosis you have — allergic, aspergilloma, or invasive — and bring imaging showing progression. The criteria that decide the rating are symptom-based, not spirometric, so describe fever, night sweats, weight loss and any hemoptysis in specific terms, with dates and amounts where you have them, and confirm on the record whether you are on suppressive antifungal therapy. Bring PFTs anyway: § 4.96(a) directs a single rating under the predominant disability where more than one respiratory condition is present, so if lung function is the larger problem the rater needs the numbers to see it.
How to File
File for pulmonary aspergillosis with documentation of the specific type and its connection to service. Include evidence of mold exposure during service (housing conditions, deployment environments) and current pulmonary impairment.
Common Mistakes
Not specifying the type of aspergillosis. Failing to document exposure conditions during service. Not getting regular imaging to show progression. Missing the ABPA connection to pre-existing asthma.
Frequently Asked Questions
What forms of aspergillosis can be service-connected?
All forms can potentially be service-connected if you can demonstrate exposure during service. ABPA, the allergic form, is most common and often develops in veterans with pre-existing asthma. An aspergilloma can form in a lung cavity left by prior tuberculosis or other lung damage, which is a secondary-service-connection route worth naming explicitly in the claim. Whatever the form, the code is DC 6838 and the criteria are the mycotic formula.
I have an aspergilloma—should I get surgery?
Surgical decisions are medical, not rating-related. However, if you have surgery, the VA should rate your post-surgical residuals. Document your condition both before and after any procedure.