Evidence Checklist: Lung Cancer Residuals
DC 6819
Significant gaps — claim likely to be denied or underrated
Specialist Opinion (Highest Value)
Pathology report confirming lung cancer diagnosis and histologyCritical
Biopsy or surgical pathology report documenting the cancer type (non-small cell: adenocarcinoma, squamous cell, large cell; or small cell), stage, and grade. This is the foundation of the claim.
Nexus opinion or presumptive documentation linking lung cancer to serviceCritical
A medical opinion connecting lung cancer to service, OR documentation of presumptive service connection under the PACT Act (burn pit/toxic exposure registry), Agent Orange exposure, or radiation exposure. Active malignancy is rated 100%.
Post-treatment PFTs documenting residual pulmonary functionCritical
Spirometry and DLCO following surgery, radiation, or chemotherapy documenting the degree of residual functional impairment. Post-lobectomy or post-pneumonectomy PFTs are critical for rating after active malignancy.
Treatment Records
Surgical and treatment records (resection, radiation, chemotherapy)Critical
Operative reports for lung resection (wedge, lobectomy, pneumonectomy), radiation therapy records, and chemotherapy treatment summaries documenting the extent of treatment.
Post-treatment imaging (CT chest, PET scan) for surveillance
Surveillance CT or PET-CT imaging documenting the post-treatment state, any recurrence, or residual structural changes including pleural or parenchymal changes following resection or radiation.
Lay Statements & Personal Documentation
Buddy statement from spouse, family, or fellow service member
A written statement from someone who can describe observable symptoms and how your condition affects daily life.
Disability Benefits Questionnaire (DBQ)
Completed DBQ Respiratory ConditionsCritical
Standardized form capturing post-treatment PFT values, imaging findings, treatment history, and functional impact following lung cancer.
Service Records
PACT Act toxic exposure registry or Agent Orange documentation
Enrollment in the VA Airborne Hazards and Open Burn Pit Registry, ILER report, or documentation of qualifying Agent Orange or radiation exposure to establish presumptive service connection.
Service treatment records (STRs)Critical
Military medical records showing in-service treatment, complaints, or injuries related to this condition.