Diaphragmatic Paralysis

DC 6840Respiratory38 CFR 4.97, DC 6840

Paralysis of the diaphragm, the main muscle used for breathing, usually caused by damage to the phrenic nerve. This can result from surgery, trauma, or neurological conditions. The VA rates diaphragmatic paralysis based on lung function tests and respiratory impairment.

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 6840

Rating range

10% – 100%

Rating levels

Rating criteria are defined in 38 CFR 4.97, DC 6840. 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 diaphragmatic paralysis with FEV-1 less than 40 percent predicted, or DLCO (SB) less than 40 percent predicted, or you require supplemental oxygen or ventilatory support, or you have cor pulmonale.

What the VA looks for

FEV-1 less than 40% predicted
DLCO less than 40% predicted
Supplemental oxygen or ventilatory support required
Bilateral diaphragm paralysis
Cor pulmonale or respiratory failure

Common Pitfalls

⚠Not getting a fluoroscopic sniff test — this is the gold standard for diagnosing diaphragm paralysis and is essential for establishing the diagnosis for VA purposes.
⚠Not documenting the cause of the phrenic nerve injury — if it was from surgery, trauma, or a medical condition during service, the causal link must be clearly established.
⚠Not reporting orthopnea (difficulty breathing when lying flat) — this is a hallmark symptom of diaphragmatic paralysis that significantly impacts sleep quality and daily function.
⚠Not claiming the underlying nerve injury separately — phrenic nerve damage may warrant a separate rating under the peripheral nerve diagnostic codes in addition to the respiratory rating.

Related DBQ Forms

DBQ Respiratory Conditions (other than Tuberculosis and Sleep Apnea)

View evidence checklist →See secondary conditions →

Condition Rating Guides

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Diaphragmatic Paralysis

How the VA rates this condition

Diagnostic code

DC 6840

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 or ventilatory support required
Bilateral diaphragm paralysis
Cor pulmonale or respiratory failure

Common Pitfalls

⚠Not getting a fluoroscopic sniff test — this is the gold standard for diagnosing diaphragm paralysis and is essential for establishing the diagnosis for VA purposes.

⚠Not documenting the cause of the phrenic nerve injury — if it was from surgery, trauma, or a medical condition during service, the causal link must be clearly established.

⚠Not reporting orthopnea (difficulty breathing when lying flat) — this is a hallmark symptom of diaphragmatic paralysis that significantly impacts sleep quality and daily function.

⚠Not claiming the underlying nerve injury separately — phrenic nerve damage may warrant a separate rating under the peripheral nerve diagnostic codes in addition to the respiratory rating.