Tracheostomy Residuals

DC 6520Respiratory38 CFR 4.97, DC 6520

Lasting problems from having a tracheostomy (a surgical opening in the throat for breathing). Even after the tracheostomy is closed, you may have scarring, voice changes, or breathing problems. The VA rates it based on how much it affects your speech and breathing.

How the VA rates this condition

The VA rates this condition based on how much it affects your ability to work and carry out daily activities. The examiner will focus on the functional limitations your condition causes, not just the diagnosis itself.

Diagnostic code

DC 6520

Rating range

0% – 100%

Rating levels

Rating criteria are defined in 38 CFR 4.97, DC 6520. 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 still have a permanent tracheostomy in place, or you have complete voice loss and severe breathing impairment requiring ongoing medical management.

What the VA looks for

Permanent tracheostomy still in place
Complete voice loss (aphonia)
Severe respiratory impairment on PFT
Dependence on tracheostomy for breathing
Inability to work due to combined impairments

Common Pitfalls

⚠Not claiming the tracheostomy scar separately — painful or restrictive scars can be rated under the scar rating criteria for an additional rating.
⚠Not getting a PFT after tracheostomy closure — even after the opening heals, tracheal narrowing can restrict airflow, and a PFT documents this objectively.
⚠Not documenting speech impairment with a speech-language pathology evaluation — a formal voice assessment provides objective evidence of how much your voice is affected.
⚠Not connecting the tracheostomy to the original service-connected injury or surgery — the VA needs to see the chain of events from service to tracheostomy.

Related DBQ Forms

DBQ Respiratory Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

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

Tracheostomy Residuals

How the VA rates this condition

Diagnostic code

DC 6520

Rating range

0% – 100%

Rating levels

Rating Levels

You still have a permanent tracheostomy in place, or you have complete voice loss and severe breathing impairment requiring ongoing medical management.

What the VA looks for

Permanent tracheostomy still in place
Complete voice loss (aphonia)
Severe respiratory impairment on PFT
Dependence on tracheostomy for breathing
Inability to work due to combined impairments

Common Pitfalls

⚠Not claiming the tracheostomy scar separately — painful or restrictive scars can be rated under the scar rating criteria for an additional rating.

⚠Not getting a PFT after tracheostomy closure — even after the opening heals, tracheal narrowing can restrict airflow, and a PFT documents this objectively.

⚠Not documenting speech impairment with a speech-language pathology evaluation — a formal voice assessment provides objective evidence of how much your voice is affected.

⚠Not connecting the tracheostomy to the original service-connected injury or surgery — the VA needs to see the chain of events from service to tracheostomy.