VA Disability Rating for Q Fever / Coxiella Burnetii Infection (DC 6331)
Diagnostic Code 6331 · 38 CFR §4.88b
What Is It?
Q fever is caused by Coxiella burnetii, a highly infectious bacterium found in livestock. Veterans who served near livestock in Iraq, Afghanistan, and other areas are at elevated risk. Q fever can become chronic, causing endocarditis and debilitating chronic fatigue syndrome. The VA uses the General Rating Formula. Residuals including chronic hepatitis, endocarditis, osteomyelitis, post-Q fever chronic fatigue syndrome, and vascular infections are rated under appropriate body system codes.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Active Q fever with confirmed serology and systemic symptoms during treatment, or chronic Q fever with ongoing complications. |
| 0% | Resolved. Residuals including chronic hepatitis, endocarditis, osteomyelitis, post-Q fever chronic fatigue syndrome, and vascular infections are rated under relevant body system codes. |
Evidence Needed
Serological testing showing Coxiella burnetii antibodies (phase I and phase II). Deployment records to livestock-endemic areas. Treatment records. Echocardiogram for chronic Q fever. Documentation of chronic fatigue.
C&P Exam Tips
Describe proximity to livestock during deployment. Report chronic fatigue, night sweats, or weight loss. Have serological results. If you have heart symptoms, bring echocardiogram results. Connect symptoms to deployment timeline.
How to File
File under DC 6331 with serology and deployment records. If you have chronic fatigue, also file under DC 6354. Get cardiac evaluation and file heart valve disease separately if found. For veterans with a qualifying period of service in the Southwest Asia theater of operations, or in Afghanistan on or after September 19, 2001, 38 CFR 3.317(c) presumes service connection for Coxiella burnetii (Q fever) that became manifest to a degree of 10 percent or more within one year of separation from that service — on that route you do not have to prove an in-service event, only the qualifying service and the diagnosis. Outside that service or that window, the evidence this page describes is what carries the claim. 38 CFR 3.317(d) adds a development duty on that route: it lists chronic hepatitis, endocarditis, osteomyelitis, post-Q-fever chronic fatigue syndrome and vascular infection as long-term health effects potentially associated with Coxiella burnetii, with no time period attached to any of them, so where a veteran presumed service connected under paragraph (c) is diagnosed with one of them at any time, VA will request a medical opinion as to whether it is at least as likely as not that the infection caused it.
Common Mistakes
Common mistakes include not testing for Q fever with unexplained chronic fatigue after Gulf War deployment, missing chronic Q fever endocarditis, not filing chronic fatigue syndrome separately, and failing to connect livestock exposure.
Frequently Asked Questions
Is Q fever related to Gulf War illness?
Q fever is associated with Gulf War service and post-Q fever fatigue syndrome shares many Gulf War illness symptoms. Testing for Q fever antibodies may strengthen a disability claim.
How is chronic Q fever different from acute?
Acute Q fever is flu-like and usually resolves. Chronic Q fever develops months or years later, most dangerously affecting heart valves. Different antibody patterns distinguish them.