VA Disability Rating for Spinal Cord Injury with Respiratory Insufficiency (DC 6841)
Diagnostic Code 6841 · 38 CFR §4.97
What Is It?
This condition covers respiratory insufficiency caused by spinal cord injuries that impair the nerves controlling the breathing muscles. The diaphragm and intercostal muscles depend on nerves from the cervical and thoracic spine, and injuries to these areas can partially or completely paralyze the breathing apparatus. High cervical injuries (C3-C5) can paralyze the diaphragm, while thoracic injuries affect the intercostal muscles that help with deep breathing and coughing. Veterans with combat spinal injuries, vehicular accidents, or training injuries that affect these nerve levels may develop respiratory insufficiency.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | FEV-1 less than 40 percent predicted, or need for mechanical ventilation, or oxygen therapy required. |
| 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. |
| 30% | FEV-1 of 56 to 70 percent predicted, or FEV-1/FVC of 56 to 70 percent. |
| 10% | FEV-1 of 71 to 80 percent predicted, or FEV-1/FVC of 71 to 80 percent. |
Evidence Needed
- MRI or CT of the spine showing the injury level and severity
- Pulmonary function tests showing restrictive pattern
- Neurological examination documenting the level of spinal cord injury
- Records of ventilator use or respiratory support
- Service records documenting the spinal cord injury event
- Respiratory therapy records
C&P Exam Tips
- Get both upright and supine PFT measurements, as spinal cord injury patients often have significantly worse breathing when lying down
- Make sure the examiner connects the respiratory impairment to the spinal cord injury level
- Document any respiratory support equipment you use — ventilator, BiPAP, cough-assist device
- Describe how your breathing is affected by position changes, exertion, and infections
- This rating is separate from the spinal cord injury rating itself
How to File
File on VA Form 21-526EZ with spinal imaging, PFT results, and service records of the injury. This should be filed in addition to the spinal cord injury itself.
Common Mistakes
Not claiming respiratory insufficiency separately from the spinal injury The respiratory impairment from a spinal cord injury can be rated separately under DC 6841 in addition to the neurological rating. Only getting upright PFTs Supine PFT values are important because breathing typically worsens significantly when lying down with spinal cord respiratory impairment.
Frequently Asked Questions
Is this rated separately from my spinal cord injury?
Yes. The respiratory insufficiency caused by the spinal cord injury can receive its own rating under the respiratory codes, in addition to the neurological rating for the spinal cord injury itself.
Can ventilator dependence from a spinal cord injury be rated?
Yes. Need for mechanical ventilation supports a 100 percent rating and may also qualify for Special Monthly Compensation.