Pleuritis, or pleurisy, is a condition characterized by inflammation around the lungs and can have a significant impact on the lives of veterans.
For those seeking compensation and benefits from the Department of Veterans Affairs (VA), understanding how the VA determines your VA rating for pleurisy is important in order to file your VA claim successfully.
In this post, we’ll uncover key aspects of obtaining a pleuritis VA rating, shedding light on how you can navigate the VA claims process and secure the VA compensation and benefits you deserve.
What is Pleuritis?
Pleuritis, also known as pleurisy, refers to the inflammation of the pleura, the double-layered membrane surrounding the lungs.
This inflammation can lead to sharp chest pain and discomfort, making it challenging for individuals to breathe.
Veterans experiencing pleuritis may find their daily lives affected, warranting compensation through the VA disability system.
Pleuritis VA Ratings
When assessing a pleurisy VA rating, the condition is categorized under Diagnostic Code 6732 in 38 CFR § 4.97, schedule of ratings for the respiratory system.
However, the VA raters follow instructions from either § 4.88c or 4.89, depending on the situation as follows:
Under § 4.88c:
- A 100% VA rating for pleurisy is assigned for one year after the date of inactivity following active tuberculosis, specifically for inactive nonpulmonary tuberculosis initially entitled after August 19, 1968.
- Residuals are rated under the specific body system(s) affected.
- Where there are existing residuals of pulmonary and nonpulmonary conditions, the evaluations for residual separate functional impairment may be combined.
Under § 4.89:
- A 100% VA disability rating for pleurisy is assigned for two years post-inactivity following active tuberculosis, clinically identified during service or subsequently.
- A 50% pleuritis VA rating is assigned for the subsequent four years (up to 6 years post-inactivity).
- A 30% pleuritis VA rating is assigned for the following five years (up to 11 years post-inactivity).
- A 0% pleuritis VA rating is assigned thereafter in the absence of a compensable permanent residual.
- Following the total rating for the 2-year period after the date of inactivity, the schedular evaluation for residuals of nonpulmonary tuberculosis, i.e., ankylosis, surgical removal of a part, etc., if in excess of 50% or 30%, will be assigned under the appropriate diagnostic code for the specific residual preceded by the diagnostic code for tuberculosis of the body part affected.
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Establishing VA Service Connection for Pleuritis
When pursuing a VA disability rating for pleurisy, veterans need to establish service connection. To do that you need to have the following:
A Current Diagnosis: Veterans initiate the process by providing a current diagnosis of pleuritis. This serves as the foundation for establishing the connection between their condition and military service.
An In-Service Event, Illness, or Stressor: Alongside the diagnosis, veterans must demonstrate a direct link between their pleuritis and an in-service event, illness, injury, or stressor. This establishes the connection between the veteran’s military service and the development of pleuritis.
A Nexus: A crucial component is establishing a nexus (or link), linking the veteran’s pleuritis to the identified in-service stressor via competent medical evidence. This connection solidifies the causation between the military experience and the development of the condition.
How to File a VA Claim for a VA Rating for Pleurisy
To file a VA claim to receive a pleurisy VA rating, follow these five steps:
- Gather Documentation: Collect medical records showing current diagnosis, test results, service records, and other evidence, such as Medical Nexus Letter or Independent Medical Opinion (IMO) linking your pleurisy to your military service.
- Complete VA Form 21-526EZ: Fill out this form to apply for disability compensation. Include details about your exposure, symptoms, and how it affects your daily life.
- Submit Your Claim: Send the completed form and supporting documents to the VA regional office handling your claim. You can submit it online through the VA website, by mail, or in person.
- Undergo Examinations: The VA might schedule you for medical examinations to evaluate the extent of your Pleuritis.
- Await the Decision: The VA will review your claim, considering the evidence provided.
The VA will notify you of their decision regarding your eligibility for a VA disability rating for pleurisy, including VA benefits and compensation.
The VA PACT Act
The 2022 Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act (PACT Act) marks an expansion of VA compensation, offering support to veterans, family members, and caregivers affected by exposure to burn pits and various toxic substances.
It also extends eligibility for VA health care for veterans with toxic exposures and veterans of the Vietnam, Gulf War, and post-9/11 eras. It also opened avenues for Gulf War Veterans and others who have developed illnesses resulting from exposure to burn pits, environmental toxins, and radiation.
This legislative initiative reflects a commitment to addressing the health challenges arising from toxic exposures and ensuring comprehensive support for those impacted by their service-related conditions, including pleuritis.
PACT Act and Presumptive Conditions: Pleuritis
With the recent enactment of the PACT ACT significant strides have been made in recognizing pleuritis as a presumptive disability for “covered veterans.”
These covered veterans typically include individuals exposed to toxins, notably those from military burn pits, during their military service.
Covered Veterans Criteria:
Under the PACT Act, a covered veteran is defined as someone who served:
- On or after August 2, 1990, in active military, naval, air, or space service while assigned to duty stations, including the airspace above specific regions such as Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, and the United States Emirates.
- On or after September 11, 2001, with active military, naval, air, or space service while assigned to duty stations, including the airspace above regions like Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen, and Uzbekistan.
Pleuritis as a Covered Condition
Pleuritis has been added to the list of covered conditions for veterans meeting the specified service requirements.
For veterans diagnosed with pleuritis who fulfill the criteria outlined in the Honoring Our PACT Act, their condition is presumed to have been caused or aggravated by burn pit exposure or other toxins.
Pleuritis as a Secondary Service Connection
Alternatively, veterans can explore a pleurisy VA rating through secondary service connection, a pathway for those whose conditions are caused or aggravated by another service-connected condition.
For instance, if you develop pleuritis due to service-connected lupus, you can pursue secondary service connection with pleuritis rated as secondary to lupus.
Conclusion
A VA disability rating for pleurisy can be 0%, 30%, 50%, or 100%. Additionally, related conditions have evolved significantly, providing veterans with expanded avenues for recognition and support.
As we explored the intricacies of pleuritis, its diagnosis, and the establishment of VA service connection, the recent enactment of the Honoring Our PACT Act has emerged as a transformative force.
The PACT Act not only acknowledges pleuritis as a presumptive disability for covered veterans but also signifies a broader commitment to addressing the health impacts of toxic exposures.
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Asaad Fakhir
A former US Army translator in Iraq (2006-2009) and an ex-commissioned Iraqi officer, Asaad graduated from the Royal Australian Military College (2010-2014). Asaad holds a Bachelor’s degree in English Arts and currently serves as a content writer at VACI, leveraging military experience with linguistic skills to create impactful content.
