VA Disability Rating for Trachomatous Conjunctivitis (DC 6017)
Diagnostic Code 6017 · 38 CFR §4.79
What Is It?
DC 6017 splits in two. The entry in 38 CFR 4.79 reads "Trachomatous conjunctivitis: Active: Evaluate under the General Rating Formula for Diseases of the Eye, minimum rating — 30. Inactive: Evaluate based on residuals, such as visual impairment and disfigurement (diagnostic code 7800)." Whether your disease is active or inactive therefore decides not just the percentage but which rating machinery applies at all. Active disease takes the General Rating Formula with a floor of 30 percent. The formula counts documented incapacitating episodes as treatment visits over the past twelve months — 60 percent at seven or more visits, 40 percent at five or six, 20 percent at three or four, 10 percent at one or two — and its opening line directs evaluation on either visual impairment or those episodes, whichever is higher. The 30 percent minimum then lifts the bottom of that range: for active trachoma the formula's 10 and 20 percent rows cannot produce the final figure, because the floor is higher than both. In practice the reachable evaluations for active disease are 30, 40 and 60 percent, plus whatever visual impairment yields if it exceeds them. Inactive disease is a different exercise. Nothing is evaluated on the infection; the evaluation is built on what the infection left behind — visual impairment under 38 CFR 4.75 through 4.78 and the visual codes at the end of 4.79, and disfigurement under DC 7800. That structure matters because trachoma's damage is mostly mechanical and arrives late. Repeated infection scars the tarsal conjunctiva, the scar contracts, the lid margin turns inward, and the lashes then abrade the cornea for years. Corneal opacification follows, and it follows long after the organism is gone. Trachoma is chronic ocular infection with Chlamydia trachomatis, transmitted by contact with infected secretions and by flies, and it remains the world's leading infectious cause of blindness. It is endemic across parts of sub-Saharan and North Africa, the Middle East, South and South-East Asia, and remote Australia. Veterans exposed in field conditions with limited water for face-washing are the population this code was written for. Note that the entropion and trichiasis it produces have their own diagnostic code — DC 6021, entropion, is rated 20 percent bilateral and 10 percent unilateral — and that Note the schedule attaches to the neighbouring code 6018 shows the drafting pattern: chronic non-trachomatous conjunctivitis takes the same formula with a 10 percent minimum instead of 30.
Rating Criteria
| Rating | Criteria |
|---|---|
| 60% | Active trachomatous conjunctivitis with documented incapacitating episodes requiring 7 or more treatment visits for an eye condition during the past 12 months. Alternatively, evaluate on visual impairment if that produces a higher evaluation. |
| 40% | Active trachomatous conjunctivitis with documented incapacitating episodes requiring at least 5 but less than 7 treatment visits for an eye condition during the past 12 months. |
| 30% | Minimum evaluation for active trachomatous conjunctivitis. Because the schedule sets a 30 percent floor for active disease, the General Rating Formula's 10 percent and 20 percent rows cannot produce a lower figure while the disease remains active. Inactive disease is not evaluated under this row at all — it is evaluated on residuals, such as visual impairment and disfigurement under DC 7800. |
Evidence Needed
The record has to establish two things: exposure and current findings. For exposure, deployment orders, unit histories and dates placing you in an endemic region, together with any in-service treatment for conjunctivitis. For findings, a slit-lamp examination describing tarsal conjunctival scarring, whether the lid margin is inverted, and whether lashes are contacting the cornea. Photographs of the everted upper lid are the single most persuasive document for scarring, because a written grade is hard to check and an image is not. Where the cornea has been abraded, corneal staining and best-corrected acuity establish the visual consequence; formal perimetry matters where opacification is central. If the disease is being treated, a dated list of treatment visits over the past twelve months is what the formula table is scored against. Operative reports for lid rotation surgery or epilation document severity that has already been acted on.
C&P Exam Tips
Ask the examiner to evert the upper lids and describe the tarsal conjunctiva. Trachomatous scarring is not visible without that step, and an examination that does not do it will record a quiet-looking eye. Have any inturned lashes photographed. Make clear whether you are being treated now — the active and inactive branches of the code are decided on that, and an assumption either way changes the whole evaluation. Bring the deployment history rather than describing it, since the causal link is geographic and dates are what establish it. If the cornea has scarred, ask for best-corrected acuity and for perimetry where the opacity is central. Describe the chronic course honestly: trachoma's damage is cumulative, and symptoms that come and go over decades are the expected pattern rather than evidence of a mild condition.
How to File
File under DC 6017 with the ophthalmology findings and the deployment history that establishes exposure. State whether the disease is active or inactive, because that determines which branch applies — active takes the General Rating Formula with a 30 percent floor, inactive is evaluated on residuals. Where scarring has produced entropion or trichiasis, file those under DC 6021 as well; they are separate ratable consequences rather than descriptions of the same disease. Where corneal opacification has cost vision, make sure the visual codes are evaluated, since for inactive disease they are the entire basis of the rating.
Common Mistakes
The most consequential mistake is letting the claim be decided as inactive without the residuals being examined. Inactive trachoma is not a nil evaluation — it is an evaluation of scarring, lid position, corneal damage and disfigurement — and a decision that finds the infection resolved and stops there has not applied the code. Second, veterans do not establish the geographic exposure, so a condition that is essentially unknown in the domestic population is adjudicated as though it arose spontaneously. Third, entropion and trichiasis are described as symptoms rather than claimed under DC 6021, where they carry their own evaluation. Finally, veterans understate the timeline, assuming a treated infection is a closed matter; the corneal damage from inturned lashes accumulates for decades after the organism has gone.
Frequently Asked Questions
Is the 30 percent minimum automatic for anyone with trachoma?
It applies to active disease. The schedule sets 30 percent as the minimum for active trachomatous conjunctivitis evaluated under the General Rating Formula. Inactive disease is not covered by that floor at all — it is evaluated on residuals such as visual impairment and disfigurement, which can be higher or lower than 30 percent depending on the damage left behind.
Why does the table start at 30 rather than 10?
Because the floor swallows the lower rows. The General Rating Formula assigns 10 percent for one or two treatment visits and 20 percent for three or four, but active trachoma has a 30 percent minimum, so neither of those can be the final figure while the disease is active. The reachable evaluations are 30, 40 and 60 percent, plus whatever visual impairment produces if it is higher.
Can trachoma cause problems years after service?
That is its characteristic course. Antibiotics clear the organism, but the conjunctival scarring is permanent and contracts over time, turning the lid margin inward so the lashes abrade the cornea. The corneal opacification that results accumulates over decades. A veteran treated successfully during service can develop the blinding stage long afterwards.
Where were veterans exposed?
Trachoma is endemic across parts of sub-Saharan and North Africa, the Middle East, South and South-East Asia, and remote Australia. Risk concentrates in field conditions with limited water for face-washing and close living quarters. Deployment orders and dates are the evidence that matters, because the exposure argument here is entirely geographic.
Should I claim the inturned eyelashes separately?
Yes. Entropion has its own diagnostic code, DC 6021, evaluated at 20 percent bilateral and 10 percent unilateral. It is a distinct ratable consequence of the scarring rather than a symptom of the infection, and treating it as part of the trachoma narrative is a common way for a separate evaluation to go unmade.
What if the infection is gone but my vision is damaged?
Then you are in the inactive branch, and visual impairment is the basis of the evaluation. That sends the claim to 38 CFR 4.75 through 4.78 and the visual codes at the end of 4.79 — acuity, visual field, diplopia — plus disfigurement under DC 7800 for visible lid change. Ask specifically for those measurements; an inactive-disease decision made without them is incomplete.