Pterygium — VA Disability Rating Criteria (DC 6034)
Diagnostic Code 6034 · 38 CFR §4.79
What Is It?
Diagnostic Code 6034 assigns no percentage of its own. The entry in 38 CFR 4.79 reads, in full, "Pterygium: Evaluate under the General Rating Formula for Diseases of the Eye, disfigurement (diagnostic code 7800), conjunctivitis (diagnostic code 6018), etc., depending on the particular findings, and combine in accordance with § 4.25." Your evaluation is built from whichever of those codes your findings reach, and the results are combined. The General Rating Formula is one of those routes. Its opening line reads "Evaluate on the basis of either visual impairment due to the particular condition or on incapacitating episodes, whichever results in a higher evaluation." Documented incapacitating episodes requiring 7 or more treatment visits for an eye condition during the past 12 months are 60 percent; at least 5 but less than 7 are 40 percent; at least 3 but less than 5 are 20 percent; and at least 1 but less than 3 are 10 percent. Note (1) defines an incapacitating episode as "an eye condition severe enough to require a clinic visit to a provider specifically for treatment purposes." Visual impairment is measured under 38 CFR 4.75 through 4.78 and the visual codes at the end of 4.79. Pterygium is a wedge-shaped growth of fleshy tissue on the conjunctiva that extends onto the cornea. It is strongly associated with chronic UV exposure and dry, dusty environments, which makes it relevant to veterans who served in desert or tropical deployments. A pterygium can cause irritation and redness, and if it grows over the central cornea, it can distort or block vision.
Rating Criteria
| Rating | Criteria |
|---|---|
| See pathways | DC 6034 carries no percentage column. The schedule directs VA to evaluate pterygium under the General Rating Formula for Diseases of the Eye, disfigurement (DC 7800), conjunctivitis (DC 6018), etc., depending on the particular findings, and to combine the results under 38 CFR 4.25. Every percentage on a DC 6034 decision therefore comes from one of those other routes. |
Evidence Needed
Ophthalmology examination documenting the pterygium location and size, photographs showing corneal involvement, visual acuity measurements if the visual axis is affected, service records showing deployment to high-UV environments (desert, tropical), and documentation of outdoor duties during service. Because the schedule sends pterygium to several codes, bring evidence for each route your findings reach: a dated list of treatment visits during the past 12 months for the General Rating Formula, best-corrected acuity and visual fields for visual impairment, records of chronic conjunctival inflammation for DC 6018, and clinical photographs for disfigurement under DC 7800.
C&P Exam Tips
Ask the examiner to document the exact size and location of the pterygium and whether it crosses the visual axis. If it causes dry eye symptoms or astigmatism, ensure these are noted. Describe your service in hot, sunny, or dusty environments and any prolonged outdoor exposure.
How to File
File under DC 6034 with documentation of chronic UV and environmental exposure during service. Deployment records showing time in desert or tropical environments support the claim. Expect the decision to name other codes: DC 6034 assigns no percentage itself, so the evaluation is written under the General Rating Formula, DC 7800, DC 6018 or another code that fits the findings, and the results are combined under 38 CFR 4.25.
Common Mistakes
Not connecting the pterygium to environmental exposure during service is the most common error. Veterans who served in Iraq, Afghanistan, or other desert environments have strong cases but often fail to document the UV exposure. Not requesting a visual acuity evaluation if the growth crosses the visual axis is another mistake. A third is expecting a fixed percentage for the growth itself: DC 6034 has none, so the decision should show which codes were applied to the findings and how they were combined.
Frequently Asked Questions
What percentage does DC 6034 pay?
None by itself. The schedule directs VA to evaluate pterygium under the General Rating Formula for Diseases of the Eye, disfigurement (DC 7800), conjunctivitis (DC 6018), etc., depending on the particular findings, and to combine the results under 38 CFR 4.25. The percentages in your decision come from those codes.
Is pterygium common in veterans?
Pterygium is linked to chronic sun, wind and dust exposure, so veterans who served in desert, tropical, or maritime environments are among the people who develop it. Deployment records that show that exposure support the service-connection side of the claim.
Can pterygium come back after surgery?
Yes. Recurrence rates after surgical removal range from 5 to 40 percent depending on the technique used. A recurrence supports a claim for ongoing disability and may indicate the need for continued medical care.