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Lung Cancer Residuals

Lasting effects after lung cancer treatment. This is rated in two stages. While the cancer is active and through treatment, DC 6819 pays 100%. Six months after treatment ends a mandatory VA examination is held, and from then on you are rated on your residuals — most often under DC 6844 (post-surgical residual, lobectomy or pneumonectomy) using the General Rating Formula for Restrictive Lung Disease, which turns on FEV-1, the FEV-1/FVC ratio, and DLCO (SB).

Code: 6819
Criteria: 38 CFR 4.97, DC 6819 (residuals rated under DC 6840–6845)
Exam length: ~30-45 minutes
Form: Respiratory Conditions DBQ

Rating steps

0%
10%
30%
60%
100%

The percentages this diagnostic code can be rated at. Which one applies depends on the findings — no tool here can tell you in advance.

What happens at the appointment

The examiner will review your complete cancer history including the type of lung cancer, stage at diagnosis, treatment received (surgery, chemotherapy, radiation), and current disease status.
If your cancer is in active treatment or recurrence, the VA assigns a 100% rating; this exam focuses on determining residual disability once treatment has ended.
Pulmonary Function Tests (PFTs) will be performed to measure post-treatment lung capacity including FVC, FEV-1, and DLCO, especially if you had surgical resection.
The examiner will evaluate residual symptoms such as chronic cough, shortness of breath, chest pain, fatigue, and any complications from surgery or radiation therapy.
Imaging results (CT scans, PET scans) will be reviewed to confirm remission status and document any structural changes to the lungs from treatment.

What the examiner is actually filling in

01The examiner documents cancer type, stage, treatment history, and current disease status to determine whether the 100% active disease rating or residual rating applies.
02Post-treatment PFT values (FVC, FEV-1, DLCO) are recorded and rated under the respiratory conditions criteria — the most favorable value to the veteran is used.
03Residual conditions from surgery are assessed including reduced lung capacity from lobectomy or pneumonectomy, surgical scar pain, and chest wall defects.
04Radiation-induced lung damage (fibrosis, pneumonitis) is evaluated separately from the surgical residuals and may warrant its own rating consideration.
05The examiner provides a functional impact statement assessing how residuals affect your ability to perform both physical and sedentary occupational tasks.

Rated under 38 CFR 4.97, DC 6819 (residuals rated under DC 6840–6845). The examiner records findings on the DBQ; a rating specialist makes the decision.

A complete answer sounds like

If you are within six months of completing treatment, ensure your oncologist provides a clear statement about expected residuals, as the rating reduction review will come quickly.
During PFTs, give maximum effort even though it may be uncomfortable — these results directly determine your residual rating percentage under 38 CFR § 4.97.
Describe your worst days in detail, including how far you can walk before becoming winded, how many times you must rest during normal activities, and any oxygen requirements.
If you experience cancer-related fatigue, emphasize how it differs from normal tiredness — describe its severity, unpredictability, and how it prevents sustained work activity.
Request that the examiner document all secondary conditions separately (neuropathy, scarring, mental health) so each can be individually rated rather than lumped under one residual rating.

What costs veterans points

Not filing for residuals promptly after treatment ends — the VA will reduce from 100% six months after treatment cessation, so having residuals documented before that point is critical.
Focusing only on whether cancer has returned rather than describing ongoing residual symptoms like breathing difficulties, fatigue, and pain from surgical or radiation damage.
Failing to claim secondary conditions caused by cancer treatment such as peripheral neuropathy from chemotherapy, hypothyroidism from radiation, or depression from the cancer experience.
Assuming that clear scans mean you won't receive a compensable rating — residual lung damage from surgery or radiation often warrants significant ratings based on PFT results alone.
Not reporting the functional impact on employment, as the examiner specifically assesses whether residuals prevent you from performing physical or sedentary work.

The rating criteria, in plain language

Rating levels for Lung Cancer Residuals under 38 CFR 4.97, DC 6819 (residuals rated under DC 6840–6845)
Rating	Rating criteria	What that means for you
0%	In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met.	Your lung cancer has been treated and you have no lasting effects on your lung function. A 0% rating establishes service connection. The lowest compensable level under this code is 10 percent.
0%	What supports this level Cancer in remission confirmed by oncology Normal pulmonary function tests after treatment Normal chest imaging with no active disease Clearance from treating oncologist
10%	FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; DLCO (SB) 66- to 80-percent predicted.	After treatment, your breathing tests show FEV-1 of 71 to 80 percent predicted, or FEV-1/FVC of 71 to 80 percent, or DLCO (SB) of 66 to 80 percent predicted.
10%	What supports this level FEV-1 of 71-80% predicted on post-bronchodilator PFT FEV-1/FVC ratio of 71-80% DLCO (SB) of 66-80% predicted Post-treatment pulmonary function testing
30%	FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; DLCO (SB) 56- to 65-percent predicted.	After treatment, your breathing tests show FEV-1 of 56 to 70 percent predicted, or FEV-1/FVC of 56 to 70 percent, or DLCO (SB) of 56 to 65 percent predicted.
30%	What supports this level FEV-1 of 56-70% predicted on PFT FEV-1/FVC ratio of 56-70% DLCO (SB) of 56-65% predicted on PFT Cancer remission documented
60%	FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; DLCO (SB) of 40- to 55-percent predicted, or; maximum oxygen consumption of 15 to 20 ml/kg/min (with cardiorespiratory limit).	After treatment, your breathing tests show FEV-1 of 40 to 55 percent predicted, or FEV-1/FVC of 40 to 55 percent, or DLCO (SB) of 40 to 55 percent predicted, or maximum oxygen consumption of 15 to 20 ml/kg/min.
60%	What supports this level FEV-1 of 40-55% predicted on PFT DLCO (SB) of 40-55% predicted on PFT Maximum oxygen consumption of 15 to 20 ml/kg/min on exercise testing Shortness of breath with moderate activity Evidence of surgical lung tissue loss (lobectomy/pneumonectomy)
100%	A rating of 100 percent shall continue beyond the cessation of any surgical, X-ray, antineoplastic chemotherapy or other therapeutic procedure. Six months after discontinuance of such treatment, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of § 3.105(e) of this chapter. If there has been no local recurrence or metastasis, rate on residuals.	Your cancer is active or under treatment, in which case DC 6819 assigns 100% and continues it past the end of treatment until a mandatory VA examination six months later. Separately, post-treatment residuals reach 100% when breathing tests show FEV-1 or DLCO (SB) less than 40 percent predicted, or you have cor pulmonale, an episode of acute respiratory failure, or require outpatient oxygen therapy.
100%	What supports this level Lung cancer diagnosis confirmed by biopsy or pathology Active treatment records (surgery, chemotherapy, radiation) Date of last treatment, for the six-month examination clock FEV-1 or DLCO (SB) less than 40% predicted on post-treatment PFT Cor pulmonale, right ventricular hypertrophy, or pulmonary hypertension Outpatient oxygen therapy prescription

The middle column is our transcription of the criteria at 38 CFR 4.97, DC 6819 (residuals rated under DC 6840–6845), condensed for reading. Read the section itself on eCFR before relying on the exact wording. The items under each level are the kinds of evidence that document it — not a VA checklist, and not a prediction of which level applies to you.

Mistakes we see most often

Not knowing about the mandatory 100% rating during treatment — if you have active lung cancer or are in treatment, you are entitled to 100% for the duration of treatment and 6 months after your last treatment ends. File immediately upon diagnosis.

Missing the post-treatment re-evaluation — the VA will schedule a mandatory exam 6 months after treatment ends. Prepare by getting pulmonary function tests beforehand so you know your baseline. If the VA does not schedule this exam, request it yourself.

Not connecting lung cancer to in-service exposures — burn pits (PACT Act), Agent Orange, asbestos, radiation, and other toxic exposures are common causes. The PACT Act expanded presumptive coverage for many toxic exposure cancers.

Not filing for all residuals separately — lung surgery can cause chronic pain, reduced lung capacity, neuropathy from chemotherapy, depression, anxiety, and fatigue. File for each residual as a separate condition.

Not getting both FVC and DLCO tested — after surgery that removes part of your lung, both tests may show different levels of impairment. The VA uses whichever gives the higher rating.

Before & after your exam

These apply to every C&P exam, whatever the condition.

Do not miss the appointment: Missing your C&P exam without a good reason can cost you. Under 38 CFR § 3.655, a missed exam can cause a claim for an increased rating or a reopened claim to be denied, and can cause an original claim to be decided on the evidence already in your file. If you cannot make it, call the VA or the exam company right away to reschedule — a documented good reason (illness, work conflict, no transportation, a family emergency) protects your claim.
Your examiner may be a contractor: Many C&P exams are performed by VA-contracted companies — QTC, Optum Serve (LHI), VES, or MSLA — not at a VA hospital. They will call, text, or mail you to schedule. Do not ignore an unknown number or letter while your claim is pending, and confirm the exam location and time before you go.
The examiner does not decide your claim: The examiner's job is to record findings on the Disability Benefits Questionnaire (DBQ). A rating specialist at the Regional Office makes the actual decision, using the exam together with your full record — service records, medical records, and lay statements. One appointment does not settle everything.
Get a copy of your exam report: After the exam you can request the report (often called the DBQ or C&P exam results) through VA.gov, the Blue Button tool, or your accredited representative. Reading it lets you catch errors while you still have time to respond.
If the exam was inadequate, you have options: If the examiner rushed you, evaluated the wrong condition, or the report is inaccurate, you can submit a statement and new evidence, and — after a decision — request a review (a Supplemental Claim or Higher-Level Review). A single bad exam is not the end of your claim.

View condition guide →View evidence checklist →

Folder readiness

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Print the whole guide — what the examiner records, the folder list with your ticks, the criteria table and the mistakes to avoid — and bring it to the appointment.

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C&P Exam Preparation Guides

The VA orders this exam to verify your diagnosis and measure how severe it is right now. It can shape your rating and your monthly compensation — but it does not decide your claim. A rating specialist weighs it against your full record, and if the exam does not reflect your condition, you can say so and ask the VA to correct it.

Source forms
Coverage

Lung Cancer Residuals

Rating steps

What happens at the appointment

What the examiner is actually filling in

A complete answer sounds like

What costs veterans points

The rating criteria, in plain language

What supports this level

What supports this level

What supports this level

What supports this level

What supports this level

Mistakes we see most often

Before & after your exam

Lung Cancer Residuals

Rating steps

What happens at the appointment

What the examiner is actually filling in

A complete answer sounds like

What costs veterans points

The rating criteria, in plain language

What supports this level

What supports this level

What supports this level

What supports this level

What supports this level

Mistakes we see most often

Before & after your exam