Mycotic Lung Disease — VA Disability Rating Criteria (DC 6821 Retired)
Diagnostic Code 6821 · 38 CFR §4.97
What Is It?
DC 6821 no longer exists, and the criteria it is usually quoted with were never the right ones. When VA rewrote the respiratory schedule effective October 7, 1996 it replaced the single mycotic-lung-disease entry with six organism-specific codes — DC 6834 histoplasmosis of lung, 6835 coccidioidomycosis, 6836 blastomycosis, 6837 cryptococcosis, 6838 aspergillosis, 6839 mucormycosis — all governed by one General Rating Formula for Mycotic Lung Disease. That formula does not score pulmonary function tests at all; it reads fever, weight loss, night sweats, hemoptysis and whether suppressive antifungal therapy is required. This page previously published a PFT-based ladder for DC 6821. That was wrong, and the table below is the schedule as it actually reads. 38 CFR § 3.951(a) is the provision to know: a readjustment to the rating schedule "shall not be grounds for reduction of a disability rating in effect on the date of the readjustment unless medical evidence establishes that the disability to be evaluated has actually improved." Under § 3.951(b), an evaluation continuously held at or above its level for 20 years or more cannot be reduced at all except on a showing of fraud, and under § 3.957 service connection in effect 10 years or more cannot be severed except for fraud or a defect in the record of service. The page keeps the retired code in its address and its heading because the reader it is written for is the one holding a decision that cites DC 6821.
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. These three rows are the General Rating Formula for Mycotic Lung Disease, which governs DCs 6834 through 6839. The formula has no 0 percent row; where the criteria for a compensable evaluation are not met, 38 CFR § 4.31 provides for a 0 percent evaluation, which is still a grant of service connection. |
Evidence Needed
Serology, culture or histopathology identifying the organism, because the code is assigned by organism. The antifungal prescription record — the 50 percent row turns on whether suppressive therapy is required, not on how much lung function is lost. Documented fever, night sweats, weight trend and any hemoptysis, since those four findings are the 100 percent row. Chest imaging showing cavitation, nodules or fibrosis. Evidence of where exposure occurred: histoplasmosis is endemic to the Ohio and Mississippi River valleys, coccidioidomycosis to the desert Southwest and parts of Central and South America, and duty stations and deployment dates are what tie exposure to service.
C&P Exam Tips
Bring the organism identification and the antifungal record; both drive the table more than any breathing test will. Describe fever, night sweats and weight loss in dates and numbers rather than impressions. If you cough blood, say how often and how much — "occasional minor hemoptysis" and "massive hemoptysis" are two different rows. If the examiner focuses on spirometry, it is reasonable to note that the mycotic formula is not PFT-based, though residual fibrosis from the infection can be separately relevant under the interstitial and restrictive lung disease codes.
How to File
File VA Form 21-526EZ naming the specific fungal infection — histoplasmosis, Valley fever, blastomycosis, cryptococcosis, aspergillosis, mucormycosis — rather than "mycotic lung disease," because the current schedule codes it by organism. Attach the organism identification, the treatment record, and evidence of where and when you were exposed. Note that § 4.96(a) bars combining ratings under DC 6600 through 6817 and 6822 through 6847 with each other: VA assigns one evaluation under the predominant code and elevates it a step where the overall severity warrants.
Common Mistakes
Building the claim around pulmonary function testing. The mycotic formula does not use PFTs. Filing as "mycotic lung disease" when the current schedule wants the organism. Assuming a retired code on an old decision means the award is unstable — § 3.951(a) says a schedule change alone is not grounds for a reduction. Trying to stack a mycotic rating with another respiratory rating, which § 4.96(a) forbids.
Frequently Asked Questions
My rating decision says DC 6821. What do I do?
Nothing is required of you. The code was retired on October 7, 1996 and replaced by the organism-specific codes DC 6834 through 6839. Your award stands: 38 CFR § 3.951(a) provides that a readjustment to the rating schedule is not grounds for reducing an evaluation in effect unless medical evidence establishes actual improvement, and a rating held continuously for 20 years or more is protected outright under § 3.951(b). If you file for an increase, the new decision is made on the current formula.
Which code applies to Valley fever?
Coccidioidomycosis is DC 6835. It shares the General Rating Formula for Mycotic Lung Disease with the other five organisms, so the code identifies the fungus and the formula sets the percentage.
Is there a 0 percent level?
The formula itself runs 100, 50 and 30 with no 0 percent row. Where the criteria for a compensable evaluation are not met, 38 CFR § 4.31 supplies a 0 percent evaluation, which is still a grant of service connection and still fixes an effective date.