Empyema Residuals

DC 6845Respiratory38 CFR 4.97, DC 6845

Residual lung damage from empyema, a collection of pus in the space between the lung and chest wall (pleural space). This serious infection often requires chest tube drainage or surgery and can leave permanent scarring that restricts lung expansion. The VA rates empyema residuals based on lung function tests.

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 6845

Rating range

10% – 100%

Rating levels

Rating criteria are defined in 38 CFR 4.97, DC 6845. 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 empyema residuals with FEV-1 less than 40 percent predicted, or DLCO (SB) less than 40 percent predicted, or you require supplemental oxygen, or you have cor pulmonale or pulmonary hypertension.

What the VA looks for

FEV-1 less than 40% predicted
DLCO less than 40% predicted
Supplemental oxygen required
Cor pulmonale or pulmonary hypertension
Severely restricted lung expansion from pleural fibrosis

Common Pitfalls

⚠Not documenting the original empyema and its treatment — surgical records showing chest tube placement, VATS, or decortication are essential for establishing the service connection and severity of residuals.
⚠Not getting a CT scan to document pleural thickening — chest X-rays may underestimate the extent of residual pleural disease, and CT provides detailed documentation of trapped lung and pleural fibrosis.
⚠Not requesting both PFTs and DLCO — empyema residuals cause restrictive lung disease that reduces lung volumes, and DLCO may be more impaired than FEV-1.
⚠Not claiming chest wall pain separately if present — surgical scars and pleural adhesions can cause chronic chest pain that may warrant an additional 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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Empyema Residuals

How the VA rates this condition

Diagnostic code

DC 6845

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
Cor pulmonale or pulmonary hypertension
Severely restricted lung expansion from pleural fibrosis

Common Pitfalls

⚠Not documenting the original empyema and its treatment — surgical records showing chest tube placement, VATS, or decortication are essential for establishing the service connection and severity of residuals.

⚠Not getting a CT scan to document pleural thickening — chest X-rays may underestimate the extent of residual pleural disease, and CT provides detailed documentation of trapped lung and pleural fibrosis.

⚠Not requesting both PFTs and DLCO — empyema residuals cause restrictive lung disease that reduces lung volumes, and DLCO may be more impaired than FEV-1.

⚠Not claiming chest wall pain separately if present — surgical scars and pleural adhesions can cause chronic chest pain that may warrant an additional rating.