Silicosis — VA Disability Rating (DC 6832)

Diagnostic Code 6832 · 38 CFR §4.97

What Is It?

Silicosis is a permanent, progressive lung disease caused by inhaling fine crystalline silica dust. The dust particles lodge in the alveoli, trigger a chronic inflammatory response, and over years produce nodular scarring that stiffens the lungs and reduces their ability to transfer oxygen. Symptoms creep in slowly — shortness of breath on exertion that gets worse year over year, dry cough, chest tightness, fatigue — and the disease often is not diagnosed until imaging is done for another reason. Veterans at elevated risk include combat engineers, demolition specialists, sandblasters, military masons and construction trades, vehicle and aircraft maintainers who worked with abrasive blasting, and infantry exposed to repeated dust storms or improvised explosive device debris. Silicosis is rated under DC 6832. 38 CFR § 4.97 titles that code "Pneumoconiosis (silicosis, anthracosis, etc.)" — the schedule names the disease outright. DC 6832 is one of nine codes, DC 6825 through DC 6833, that share the General Rating Formula for Interstitial Lung Disease. DC 6834 is a different disease: § 4.97 assigns it to histoplasmosis of the lung, a fungal infection rated on the separate General Rating Formula for Mycotic Lung Disease. The distinction matters beyond the number, because the interstitial formula scores Forced Vital Capacity, diffusion capacity and maximum exercise capacity and contains no FEV-1 clause at all — FEV-1 belongs to the obstructive codes, DC 6600 through DC 6604.

Rating Criteria

Evidence Needed

A high-resolution CT scan of the chest is the most useful imaging — it shows the characteristic small nodular opacities, often concentrated in the upper lobes, and any progressive massive fibrosis if the disease has advanced. Pulmonary function tests with spirometry, lung volumes, and a DLCO measurement establish the rating tier directly. Under § 4.96(d), PFTs are required for DC 6825 through 6833 except in four situations the regulation names: a maximum exercise capacity test of record at 20 ml/kg/min or less, a diagnosis of pulmonary hypertension documented by echocardiogram or cardiac catheterization, cor pulmonale or right ventricular hypertrophy, one or more episodes of acute respiratory failure, or a requirement for outpatient oxygen therapy. A six-minute walk test or formal cardiopulmonary exercise testing supports the higher tiers when symptoms outpace what the PFT numbers show alone. Occupational history from service treatment records, DD-214 MOS history, command-statement records of dust exposure, and lay statements from fellow service members describing the exposure events all build the nexus. A pulmonologist diagnosis differentiating silicosis from other dust diseases and ruling out competing causes closes the case.

C&P Exam Tips

Bring all PFT reports, the CT imaging, and any cardiology workup showing pulmonary hypertension or cor pulmonale. The rating tier is set by FVC, DLCO (SB) or maximum exercise capacity — FEV-1 does not appear anywhere in the interstitial formula, so a report that shows only spirometry ratios cannot establish a tier. Make sure FVC and DLCO are both in the record. Where two tests point at different levels, § 4.96(d)(6) tells the rater to use the result the examiner states most accurately reflects the level of disability, so ask the examiner to say which one that is. If exercise tolerance is severely limited but the resting PFTs do not reflect that, request a formal cardiopulmonary exercise test — the VO2 max number opens the 60% and 100% tiers. Describe what activities you can no longer do that you used to do (climbing stairs, walking the dog around the block, carrying groceries up to a second floor) and quantify how many breaks you need. Mention oxygen use, whether continuous or only at night. Bring the exposure history in writing so the examiner does not have to reconstruct it from memory.

How to File

File VA Form 21-526EZ listing silicosis under DC 6832 and reference 38 CFR § 4.97. Attach the chest CT, the PFT report, any exercise testing, the pulmonologist diagnosis, and the service exposure history with MOS records and lay statements. If the exposure occurred during deployment to a high-particulate environment (burn pit operations, demolition theaters, dust-storm exposure), reference the PACT Act presumptives where the registered conditions overlap. File tuberculosis, lung cancer, and cor pulmonale as separate secondary claims when those develop.

Common Mistakes

Filing without a DLCO measurement, which often drives the rating tier even when spirometry numbers look near-normal Not requesting formal exercise testing when symptoms are worse than resting PFTs suggest Missing the secondary-claim window for TB, lung cancer, and cor pulmonale Treating silicosis as if it were simple chronic bronchitis (DC 6600) — silicosis has progressive scarring and a higher long-term rating ceiling Filing under DC 6834, which § 4.97 assigns to histoplasmosis of the lung, rather than DC 6832, the pneumoconiosis code that names silicosis in its own title

Frequently Asked Questions

Can dust exposure during deployment cause silicosis?

Silicosis from deployment is recognized when the exposure history involves work with crystalline silica — sandblasting, demolition, masonry, blast-pit operations, vehicle maintenance with abrasive media — or extreme repeated exposure to silica-rich desert dust over a sustained period. The disease typically takes years to develop, so a current diagnosis in a post-deployment veteran is consistent with exposure during service even when the symptoms first appeared after separation. A pulmonologist nexus opinion connecting the exposure pattern to the current imaging and PFT findings is the key piece of evidence.

How is silicosis different from asbestosis?

Both are dust diseases that produce interstitial scarring, they are rated under DC 6832 and DC 6833 respectively, and because both codes sit inside the General Rating Formula for Interstitial Lung Disease the tiers are literally identical. The differences are in the imaging pattern (silicosis tends to show small upper-lobe nodules, asbestosis shows lower-lobe interstitial markings with pleural plaques), the time course (silicosis can progress for decades after exposure stops), and the secondary risks (silicosis raises TB and lung cancer risk; asbestosis raises mesothelioma risk). A high-resolution CT and pulmonologist read distinguishes them.

Will my rating drop if my PFT numbers improve?

Silicosis is a progressive, irreversible scarring disease — PFT numbers do not typically improve. They can fluctuate slightly with effort and technique, but the underlying lung fibrosis does not reverse. A short-term improvement is not a basis for rating reduction under 38 CFR §3.344. If a re-evaluation produces a temporarily better number, the protection rules generally prevent a reduction unless the improvement is sustained and material.