VA Disability Rating for Desquamative Interstitial Pneumonitis (DC 6826)
Diagnostic Code 6826 · 38 CFR §4.97
What Is It?
Desquamative interstitial pneumonitis (DIP) is a rare form of interstitial lung disease characterized by the accumulation of macrophages (immune cells) in the tiny air sacs of the lungs. This buildup causes inflammation and progressive scarring that makes breathing increasingly difficult. DIP is strongly associated with cigarette smoking, but can also develop from occupational exposures to dusts, chemicals, or fumes common in military settings. Veterans exposed to burn pit smoke, industrial chemicals, or other inhaled irritants during service may develop this condition. Symptoms include progressive shortness of breath, dry cough, and declining exercise tolerance. The VA rates DIP under the General Rating Formula for Interstitial Lung Disease, which uses pulmonary function test results to determine the rating level.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | FEV-1 less than 40 percent predicted, or FEV-1/FVC less than 40 percent, or DLCO less than 40 percent, or maximum exercise capacity less than 15 ml/kg/min oxygen consumption, or need for oxygen therapy. |
| 60% | FEV-1 of 40 to 55 percent predicted, or FEV-1/FVC of 40 to 55 percent, or DLCO of 40 to 55 percent, or maximum oxygen consumption of 15 to 20 ml/kg/min. |
| 30% | FEV-1 of 56 to 70 percent predicted, or FEV-1/FVC of 56 to 70 percent, or DLCO of 56 to 65 percent. |
| 10% | FEV-1 of 71 to 80 percent predicted, or FEV-1/FVC of 71 to 80 percent, or DLCO of 66 to 80 percent. |
Evidence Needed
- Complete PFT results showing a restrictive pattern (reduced FVC with preserved or increased FEV-1/FVC ratio)
- Chest CT showing the cause of restriction — scarring, pleural disease, or chest wall abnormality
- Service records documenting the causative exposure or injury
- Treatment records showing progression of the condition
- Deployment records if related to environmental exposures
C&P Exam Tips
- PFTs should show a restrictive pattern — reduced total lung capacity and vital capacity
- Make sure DLCO is included in your PFT, as it is often the most abnormal value in restrictive disease
- Describe your exposure history: burn pits, radiation, chemicals, chest injury
- Report daily limitations: how far you can walk, what activities trigger breathlessness
- If you use supplemental oxygen, bring the prescription
How to File
File on VA Form 21-526EZ with complete PFT results, chest imaging, and evidence of the service-related cause of the restriction.
Common Mistakes
Not including DLCO in PFT testing DLCO (diffusion capacity) is often the most abnormal value in restrictive disease and can give a higher rating. Make sure it is part of your PFT. Not identifying the specific cause Restrictive lung disease is a broad category. The VA needs to know what caused it to assess service connection.
Frequently Asked Questions
What is the difference between restrictive and obstructive lung disease?
Restrictive disease limits how much air the lungs can hold (reduced lung volume). Obstructive disease limits how fast air can flow out (blocked airways). PFT patterns differ: restrictive shows reduced FVC with normal or high FEV-1/FVC ratio.
Can chest injuries cause restrictive lung disease?
Yes. Chest wall fractures, thoracic spine injuries, and surgical changes from combat or accidents can restrict lung expansion.