VA Disability Rating for Hyperinfection Syndrome / Disseminated Strongyloidiasis (DC 6325)
Diagnostic Code 6325 · 38 CFR §4.88b
What Is It?
Hyperinfection syndrome and disseminated strongyloidiasis are life-threatening complications of Strongyloides stercoralis infection, a parasitic roundworm acquired through skin contact with contaminated soil. Veterans who served in tropical or subtropical regions may carry a chronic silent Strongyloides infection for decades, because the parasite auto-infects its host. Hyperinfection occurs when the immune system is suppressed, allowing explosive parasite multiplication. The VA rates active disease at 100 percent with a mandatory follow-up examination after treatment.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Active hyperinfection syndrome or disseminated strongyloidiasis during treatment. The 100 percent rating continues through active disease, followed by a mandatory VA examination. |
| 0% | Resolved with no relapse confirmed on follow-up. Residual organ damage is rated under appropriate body system codes. |
Evidence Needed
Stool examination, sputum analysis, or tissue biopsy confirming Strongyloides. Serological testing. Deployment records to endemic regions. Documentation of immunosuppressive trigger if applicable. Imaging documenting dissemination. Post-treatment organ evaluations.
C&P Exam Tips
Emphasize the life-threatening nature. Document all affected organs. Bring lab results. Describe any immunosuppressive treatment that triggered hyperinfection. Have post-treatment evaluations. Mention deployment to tropical regions.
How to File
File under DC 6325 with diagnostic confirmation and deployment records. If hyperinfection was triggered by immunosuppressive treatment for another service-connected condition, document that connection. File residual organ damage separately.
Common Mistakes
The biggest mistake is not knowing you carry Strongyloides. Veterans from endemic areas should be screened before starting immunosuppressive therapy. Other mistakes include not connecting hyperinfection to the original exposure, failing to claim organ damage separately, and not documenting the immunosuppressive trigger.
Frequently Asked Questions
How can I carry Strongyloides for decades without symptoms?
Strongyloides auto-infects its host, maintaining itself at low levels indefinitely. It only becomes dangerous when the immune system is suppressed.
Should veterans from tropical deployments be screened?
Yes, especially before starting corticosteroids or other immunosuppressive medications. A simple blood test can detect the chronic infection.
What triggers hyperinfection syndrome?
Most commonly corticosteroid therapy, chemotherapy, or organ transplant immunosuppression. If the triggering medication was for a service-connected condition, the hyperinfection may qualify for secondary service connection.