Radiation Pneumonitis Residuals

DC 6604Respiratory38 CFR 4.97, DC 6604

Lung damage caused by radiation therapy, typically for cancer treatment. Radiation can cause inflammation and scarring of the lung tissue, leading to chronic breathing problems. The VA rates radiation pneumonitis 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 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 residual lung damage from radiation 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
Severe radiation fibrosis with significant lung volume reduction

Common Pitfalls

⚠Not establishing that the radiation therapy was for a service-connected cancer — the lung damage must be linked to treatment of a condition that itself is service-connected.
⚠Not getting DLCO testing — radiation primarily damages gas exchange, so DLCO is often the most sensitive PFT measure and may be significantly more abnormal than FEV-1.
⚠Not documenting progressive worsening — radiation fibrosis can worsen for years after radiation therapy ends, so serial PFTs showing decline strengthen the claim.
⚠Not claiming the original cancer and the radiation pneumonitis as separate conditions — the cancer and its treatment residuals can receive independent 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…

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
Cor pulmonale or pulmonary hypertension
Severe radiation fibrosis with significant lung volume reduction

Common Pitfalls

⚠Not establishing that the radiation therapy was for a service-connected cancer — the lung damage must be linked to treatment of a condition that itself is service-connected.

⚠Not getting DLCO testing — radiation primarily damages gas exchange, so DLCO is often the most sensitive PFT measure and may be significantly more abnormal than FEV-1.

⚠Not documenting progressive worsening — radiation fibrosis can worsen for years after radiation therapy ends, so serial PFTs showing decline strengthen the claim.

⚠Not claiming the original cancer and the radiation pneumonitis as separate conditions — the cancer and its treatment residuals can receive independent ratings.