Chronic Aspiration Pneumonia

DC 6604Respiratory38 CFR 4.97, DC 6604

Recurrent lung infections caused by food, liquid, or stomach contents being breathed into the lungs. This often happens in veterans with swallowing problems, severe GERD, or neurological conditions. The VA rates chronic aspiration pneumonia based on lung function tests and treatment requirements.

How the VA rates this condition

The VA rates this condition based on objective clinical measurements and test results. The examiner will use standardized tests or lab values to determine the severity of your condition rather than relying primarily on subjective symptom reports.

Diagnostic code

DC 6604

Rating range

10% – 100%

Rating levels

Rating criteria are defined in 38 CFR 4.97, DC 6604. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

You have chronic aspiration pneumonia with FEV-1 less than 40 percent predicted, or DLCO (SB) less than 40 percent predicted, or you require supplemental oxygen, or you have recurrent episodes of respiratory failure.

What the VA looks for

FEV-1 less than 40% predicted
DLCO less than 40% predicted
Supplemental oxygen required
Recurrent hospitalizations for aspiration pneumonia
Feeding tube placement for aspiration prevention

Common Pitfalls

⚠Not documenting the underlying cause of aspiration — whether it is GERD, dysphagia from a neurological condition, or vocal cord dysfunction, the primary cause should also be claimed as service-connected.
⚠Not getting a video swallowing study (modified barium swallow) — this objective test documents aspiration risk and supports both the diagnosis and the service connection.
⚠Not tracking each episode of pneumonia with hospitalization records — the frequency of infections demonstrates disease severity and supports a higher rating.
⚠Not claiming secondary conditions — chronic aspiration damages the lungs over time and can cause bronchiectasis, pulmonary fibrosis, or other conditions that warrant separate ratings.

Related DBQ Forms

DBQ Respiratory Conditions (other than Tuberculosis and Sleep Apnea)

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

Chronic Aspiration Pneumonia

How the VA rates this condition

Diagnostic code

DC 6604

Rating range

10% – 100%

Rating levels

Rating Levels

What the VA looks for

FEV-1 less than 40% predicted
DLCO less than 40% predicted
Supplemental oxygen required
Recurrent hospitalizations for aspiration pneumonia
Feeding tube placement for aspiration prevention

Common Pitfalls

⚠Not documenting the underlying cause of aspiration — whether it is GERD, dysphagia from a neurological condition, or vocal cord dysfunction, the primary cause should also be claimed as service-connected.

⚠Not getting a video swallowing study (modified barium swallow) — this objective test documents aspiration risk and supports both the diagnosis and the service connection.

⚠Not tracking each episode of pneumonia with hospitalization records — the frequency of infections demonstrates disease severity and supports a higher rating.

⚠Not claiming secondary conditions — chronic aspiration damages the lungs over time and can cause bronchiectasis, pulmonary fibrosis, or other conditions that warrant separate ratings.