Infectious Diseases and Immune Disorders

Topics:

Infectious Diseases
Sexually Transmitted Diseases
Immune Disorders
Other Infectious and Immune Conditions
DBQs for Infectious and Immune Conditions
Principles that Apply

Reminder: The VA will give a Military Disability Rating for each service-connected condition a service member has, but the DoD will only rate service-connected conditions that make a service member Unfit for Duty.

 


Infectious Diseases

All infectious diseases are rated 100% while they are active. After it is inactive, each one has its own rules to determine its rating.

Code 6300: Asiatic cholera is an infection in the small intestine that causes severe diarrhea and vomiting. The 100% rating for this condition continues for 3 months after the active infection. If there are symptoms left over after the 3-month period, then they are rated separately. These symptoms could include papillary necrosis, which is rated under code 7538.

Code 6301: Visceral leishmaniasis is a disease of parasites in the internal organs that can cause symptoms like weight loss, fever, and anemia. The 100% rating for this condition continues for the first 6 months after treatment for this disease ends. It is then reevaluated, and any remaining symptoms or side effects are rated separately. These symptoms could include liver damage, which is rated under code 7312.

Code 6302: Leprosy (or “Hansen’s Disease”) is a bacterial disease that attacks the skin, nerves and airways. It causes severe skin damage and can lead to many other conditions if left untreated. The 100% rating for this condition continues for the first 6 months after treatment for this disease ends. It is then reevaluated, and any remaining symptoms or side effects are rated separately. These symptoms could include skin damage, codes 7800–7805, or nerve damage. Nerve damage is a bit complicated to rate, and the code depends on which nerves are damaged. Thorough information on rating nerve damage can be found on The Central Nervous System page.

Code 6304: Malaria is a disease of parasites that infect red blood cells and cause severe fevers and other symptoms. For malaria to be properly diagnosed, it must be confirmed by blood smear tests unless it is clear that the veteran was in an area where contamination could be very likely. The 100% rating for this condition continues only while the condition is active. Afterwards, any remaining side effects are rated separately. These symptoms could include liver damage, which is rated under code 7312.

Code 6305: Lymphatic filariasis is a disease of parasites that infect the lymphatic system, including the lymph nodes. The 100% rating for this condition continues only while the condition is active. Afterwards, any remaining symptoms or side effects are rated separately. These symptoms could include epididymitis, which is rated under code 7525.

Code 6306: Bartonellosis is a bacterial infection which can cause many other diseases including trench fever, chronic bacteremia, endocarditis, neurological conditions, Carrion’s disease, cat-scratch disease, bacillary angiomatosis, peliosis hepatis, and chronic lymphadenopathy. All of these conditions are rated under this code. The 100% rating for this condition continues only while the condition is active. Afterwards, any remaining symptoms or side effects are rated separately. These symptoms could include skin damage, which is rated under codes 7800–7805.

Code 6307: Plague (any kind) is a bacterial infection that can attack different parts of the body. It can be treated if caught early. The 100% rating for this condition continues only while the condition is active. After that, any remaining side effects or symptoms are rated separately. These symptoms could include gangrene that could lead to amputation. It would then be rated on the amputation of the particular body part. See the Amputations page for a complete list of amputation ratings. In addition to gangrene, this condition could also cause nerve or brain damage. The code depends on the extent of the nerve or brain damage. All nerve and brain conditions are discussed on The Central Nervous System page.

Code 6308: Relapsing fever is a bacterial infection that causes fevers, chills, aches, and nausea that can last between 2 and 9 days. Every couple of weeks, these symptoms return if not treated with antibiotics. The 100% rating for this condition continues only while the condition is active. After that, any remaining side effects or symptoms are rated separately. These symptoms could include liver damage, code 7312, spleen damage, codes 7706-7707, or nerve damage. The code for nerve damage depends on which nerve is affected and the severity of the damage. Thorough information on rating nerve damage can be found on The Central Nervous System page.

Code 6309: Rheumatic fever is a disease that affects the tissues of the body, causing them to swell. It can damage the valves of the heart, which can cause congestive heart failure. Symptoms also include rashes, twitching in the face and arms, and fevers. The 100% rating for this condition continues only while the condition is active. After that, any remaining side effects or symptoms are rated separately. These symptoms could include heart damage, code 7020.

Code 6316: Brucellosis is a bacterial infection that causes fevers, headaches, depression, and weakness. The symptoms can come and go throughout the rest of your life if the disease is not properly treated with antibiotics. The 100% rating for this condition continues only while the condition is active. After that, any remaining side effects or symptoms are rated separately. These symptoms could include liver damage, code 7312, or meningitis, code 8019.

Code 6317: Scrub typhus is an infection caused by parasites that can be treated with antibiotics, although many strains are not responsive to treatments. The 100% rating for this condition continues while the condition is active and for the first 3 months following. After that, any remaining side effects or symptoms are rated separately. These symptoms could include skin damage, codes 7800–7805, and spleen damage, codes 7706-7707.

Code 6318: Melioidosis is a bacterial infection that causes pain, coughing, pneumonia and skin infections. The 100% rating for this condition continues only while the condition is active. After that, any remaining side effects or symptoms are rated separately. These symptoms could include arthritis, code 5003, lung tissue damage, code 6825, or meningitis, code 8019.

Code 6319: Lyme disease is a bacterial disease common in the US and spread by ticks. Symptoms include fever, skin rash, fatigue, and depression and can affect the joints, heart and nerves if it is not treated properly. The 100% rating for this condition continues only while the condition is active. After that, any remaining side effects or symptoms are rated separately. These symptoms could include arthritis, codes 5002-5003, heart damage, code 7020, chronic fatigue, code 6354, and nerve damage.

Code 6320: All other diseases caused by parasites are rated under this code. The 100% rating for this condition continues only while the condition is active. After that, any remaining side effects or symptoms are rated separately. These symptoms could include liver damage, code 7312.

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Sexually Transmitted Diseases

Code 6310: Syphilis and all other infections caused by treponemal bacteria (including bejel, pinta and yaws) are most commonly spread by sexual contact or from a mother to an unborn baby. There are numerous kinds of syphilis that can attack various bodily systems. Some of these have their own codes and rating systems:

7004, Syphilitic Heart Disease
8013, Cerebrospinal Syphilis
8014, Meningovascular Syphilis
8015, Tabes Dorsalis
9301, Dementia due to Central Nervous System Syphilis

If the syphilis is not one of these specific types, then it is rated under this code. This code does not have its own ratings, but the symptoms of the condition are all rated separately. These symptoms could include heart damage, damage of the eyes, which is rated on the Visual Impairment Rating System under the eye code that most closely describes the eye damage, ear damage, or nerve damage.

Code 6351: HIV (human immunodeficiency virus) is a virus mostly spread by sexual contact with an infected person, although it can also be spread from mother to child or by contact with infected blood. The virus attacks “T4” cells that support the immune system of the body, thus causing the body to be very vulnerable to infections, other diseases (“secondary diseases”), and cancers. The HIV virus can cause the disease AIDS (acquired immunodeficiency syndrome). It takes many years for an HIV infection to develop into AIDS. The presence of AIDS is confirmed if the T4 cell count is less than 200.

If a higher rating can be received by rating a secondary disease or infection than can be received by rating HIV or AIDS, then it can be rated under that secondary condition. A rating for both, however, is not allowed—only a rating for HIV or a rating for ONE of the secondary conditions, whichever can provide the higher rating. If it is rated on one of the secondary conditions, then the final code will look like this: 6351-4901. The first four-digit code defines the condition as HIV, and the second four-digit code tells how the condition is rated.

The ratings:

If there is an active AIDS disease with either regularly occurring infections/diseases or infections/diseases in numerous areas of the body, it is rated 100%. A 100% rating is also given for HIV if there is a secondary disease that is present the majority of the time and causes continual weight loss.

If there is a secondary disease, infection, or neoplasm as a result of AIDS, then the minimum rating is 60%. This rating is also given if there are significant symptoms throughout the body that cannot be controlled, diarrhea, and weight loss.

If the HIV is being treated by “approved” medication (medications that are prescribed for research by a qualified medical institution), but there are still regularly occurring symptoms throughout the body and intermittent diarrhea, then it is rated 30%. This rating is also the minimum rating given if the T4 cell count is less than 200, there is hairy cell leukoplakis, or oral candidiasis.

If the HIV is being treated by “approved” medication, there are at least definite symptoms present, and the T4 cell count is between 200 and 500, then it is rated 10%. If there are clear signs of depression or memory loss that interfere with the ability to work, a rating of 10% may also be given.

If there are no symptoms that affect the ability of the individual to function, then it is rated 0%, even if there is a decreased T4 cell count, disease in the lymph nodes, or diagnosed AIDS.

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Immune Disorders

There are other infectious conditions besides HIV that can affect the immune system.

Code 6350: Systematic lupus erythematosus (SLE or “lupus”) is a disease that causes the immune system to attack the good, healthy tissue cells of the body. This code is for lupus that attacks the tissues inside the body. Code 7809 is for lupus that attacks the skin. These codes cannot both be used for a lupus condition. If both tissues on the inside and the skin are affected, the code that gives the higher rating is assigned. Similarly, if the lupus attacks tissues that cause other symptoms and problems, like arthritis in the knee, then it can be rated under a single symptom if that rating would be higher than the rating under this code.

If the condition causes severe symptoms that significantly limit the functioning of the body, it is rated 100%. For example, if there was such severe disease in the knees that you were bed-ridden and couldn’t work or function, a 100% rating would be justified. If, however, severe episodes of symptoms that significantly limit the functioning of the body occur 2 or 3 times a year and last a week or more, then it is rated 60%. If there are episodes only once or twice a year or if there are at least any symptoms within the past 2 years, then it is rated 10%.

Code 6354: Chronic fatigue syndrome is a condition where there is a long-term severe loss of energy. Many different conditions can produce significant fatigue, so a diagnosis of chronic fatigue syndrome can only be made after proper testing for all other possible conditions is done. The fatigue also has to be severe enough to limit the ability to perform daily activities by half for at least 6 months. Finally, there must be at least 6 or more of the following symptoms present: fever, tender lymph nodes, muscle aches or weakness, sore throat, debilitating fatigue lasting 24 hours or more after exercise, headaches unique to the fatigue (different than headaches before the fatigue began), joint aches, and cognitive problems (bad concentration, forgetfulness, confusion, etc.).

Note: If the condition requires bed rest prescribed by the physician, then it is considered “incapacitating” during the period of bed rest.

If the symptoms are constant or so severe that it is impossible to perform daily activities, it is rated 100%.

If the symptoms do not completely limit activity, but your activity level is limited to at least half of what it was before the fatigue, or if the symptoms are not constant but there are periods of incapacitation that add up to at least 6 weeks within the past year, then it is rated 60%.

If the symptoms are fairly constant but you can still perform 50 to 75% of the normal daily activity, or if the symptoms are not constant but there are periods of incapacitation that add up to between 4 and 6 weeks within the past year, then it is rated 40%.

If the symptoms are fairly constant but you can perform 75% or more of your normal daily activity, or if the symptoms are not constant but there are periods of incapacitation that add up to between 2 and 4 weeks within the past year, then it is rated 20%.

If the symptoms are not constant but there are periods of incapacitation that add up to between 1 and 2 weeks within the past year, or if the symptoms are controlled by constant medication, then it is rated 10%.

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Other Infectious and Immune Conditions

Please see the Tuberculosis page for all conditions relating to tuberculosis and The Digestive System page for hepatitis conditions. All other infectious diseases and immune system conditions will be rated analogously (see the Analogous and Equivalent Codes page) with the above ratings. The bottom line rule is to rate any condition under the code that BEST describes it, even if it is not exact.

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DBQ for Infectious and Immune Conditions

Here are the Disability Benefits Questionnaires (DBQs) used for infectious and immune conditions: Gulf War Diseases DBQ, HIV DBQ, Lupus and Autoimmune DBQ, Chronic Fatigue Syndrome DBQ, and Infectious Diseases (other) DBQ.

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Principles that Apply

Pyramiding: A single condition can only be rated once! However, if another condition exists that is additional to the disease or immune disorder (not simply caused by it), then it can also be rated.

Probative Value: If two exams record the condition differently, the exam with the most thorough data and performed by the most qualified person in that specialty will be the exam the rating is based on.

A Tie Goes to the Veteran: If there are two equally strong exams with conflicting information, or if the condition can be equally rated under two different codes, then the one that gives the highest rating will be assigned. Every conflict should be resolved in favor of the higher rating.

Accurate Measurements: It is essential that the necessary information to rate your condition is recorded by the physician in your exam. With the information on this page, you should know what needs to be measured and recorded. Make sure this happens correctly to ensure that you receive a proper rating.

Hospital or Convalescent Ratings: Some conditions require periods of hospitalization or constant medical care (at-home nurse, etc.). Any condition that requires this is rated 100% during this intensive treatment. Once it ends, then the 100% rating will continue for a certain period. This period is 3 months unless another length (6 months, 1 year, etc.) is directly specified in the condition ratings. Some patients may need more time to recover than others, so the physician or Rating Authorities can lengthen this time period if they see fit.

Please see the VASRD Principles page for further guidance.

For tuberculosis conditions, see the Tuberculosis page.

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