Nocardiosis — VA Disability Rating Criteria (DC 6823)
Diagnostic Code 6823 · 38 CFR §4.97
What Is It?
Nocardiosis is an infection caused by Nocardia bacteria found in soil and water. Pulmonary nocardiosis primarily affects the lungs and can cause pneumonia, lung abscesses, and chronic respiratory impairment. It is more common in immunocompromised individuals. Veterans may develop nocardiosis from environmental exposures during service, particularly in tropical or subtropical deployments.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Disseminated nocardiosis or severe pulmonary destruction causing chronic respiratory failure. |
| 50% | Moderate to severe residual lung damage with significantly reduced PFT values. May require ongoing or repeated antibiotic therapy. |
| 30% | Residual pulmonary scarring or mild PFT impairment following treatment. Occasional respiratory symptoms. |
| 0% | Infection resolved with no measurable residual lung impairment. |
Evidence Needed
Culture or biopsy confirming Nocardia infection. Service records showing environmental exposure opportunities. Imaging documenting pulmonary involvement. Current PFTs showing residual impairment. Treatment records.
C&P Exam Tips
Document the full treatment course and any relapses. Ensure current PFTs and imaging are obtained. Note any immunosuppression that may have predisposed you to the infection.
How to File
File for pulmonary nocardiosis citing the in-service exposure or onset. Include microbiological confirmation, treatment records, and current evidence of residual impairment.
Common Mistakes
Not obtaining proper microbiological confirmation. Failing to document relapses which are common with Nocardia. Not connecting environmental exposure to service locations.
Frequently Asked Questions
How does nocardiosis relate to military service?
Veterans exposed to soil and dust in tropical or subtropical environments may inhale Nocardia organisms. Those with immunosuppression from other service-connected conditions are at higher risk. The connection between deployment location and exposure is key for service connection.
Can nocardiosis recur after treatment?
Yes, relapses are common even after prolonged antibiotic therapy. Document every recurrence as it supports a higher disability rating and ongoing service connection.