Evidence Checklist: Sarcoidosis

Tissue biopsy showing non-caseating granulomasCritical

Pathology report confirming the diagnosis of sarcoidosis with characteristic non-caseating granulomas. Bronchoscopy with transbronchial biopsy is most common; lymph node or skin biopsy may also be used.

Pulmonary function tests (PFTs) with DLCOCritical

Spirometry and diffusion capacity documenting the degree of restrictive impairment or gas exchange abnormality. VA rates pulmonary sarcoidosis using the same criteria as other chronic lung diseases.

Nexus opinion linking sarcoidosis to service ("at least as likely as not")Critical

A medical opinion connecting your sarcoidosis to military service, including environmental exposures, organic dust, beryllium, or other known sarcoidogenic agents encountered during service.

Documentation of extrapulmonary involvement (skin, eyes, cardiac, neurological)

Records documenting involvement of other organ systems — cardiac sarcoidosis, ocular sarcoidosis, neurosarcoidosis, or cutaneous involvement — which may support separate ratings or a higher combined rating.

Chest imaging (CT or X-ray showing mediastinal and pulmonary findings)

CT chest or chest X-ray documenting hilar adenopathy, parenchymal infiltrates, or fibrotic changes. Scadding stages I-IV on imaging correlate with prognosis and disease severity.

Treatment records (corticosteroids, immunosuppressants)

Records documenting systemic corticosteroid therapy (prednisone) and any steroid-sparing immunosuppressants (methotrexate, azathioprine), including treatment response over time.

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.

Completed DBQ Respiratory ConditionsCritical

Standardized form capturing PFT results, imaging stage, treatment requirements, and functional impact of sarcoidosis.

Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.