The Key to Winning a VA Disability Rating for Pulmonary Fibrosis 

Many veterans face serious breathing problems after military service – particularly from burn pits, whose toxic fumes cause lasting lung damage. One condition often linked to toxic exposure is pulmonary fibrosis, which causes scar tissue to build up in the lungs, making it harder to breathe and reducing oxygen in the blood.  

Pulmonary fibrosis has no cure, but treatment can slow the disease and ease symptoms. That makes VA disability benefits especially important. A high disability rating provides monthly compensation and access to VA healthcare, which may include medications, oxygen therapy, and pulmonary rehabilitation. These resources can improve quality of life and help veterans manage the condition more effectively. At Hill & Ponton, we aim to give you the information and the support you need to claim and maximize your benefits. 

How to Service Connect Pulmonary Fibrosis

To receive VA disability benefits, you must first prove service connection. This means showing that your pulmonary fibrosis was caused by your time in uniform, or was made worse because of your service. There are several ways to establish this link: 

• Exposure to hazards in service: Many veterans breathed in burn pit smoke, asbestos, or toxic chemicals that damaged their lungs. 
• Diagnosis soon after discharge: If you were diagnosed within one year of leaving the military, that timing may strengthen your case. 
• Worsening symptoms after service: If your breathing problems grew worse after you left active duty, a doctor’s opinion tying the decline to your service can support your claim. 

Pulmonary fibrosis can also be rated secondarily. This happens when another service-connected condition like autoimmune disease, tuberculosis, or even past cancer treatment causes or aggravates lung scarring.

Presumptive Service Connection: Pulmonary Fibrosis and the PACT Act

The PACT Act of 2022 made it easier for many veterans with pulmonary fibrosis to qualify for benefits. Under this law, pulmonary fibrosis is now considered a presumptive condition for those exposed to burn pits and certain airborne hazards. A presumptive condition means the VA assumes your illness is connected to your service if you meet specific criteria. You don’t have to spend years trying to prove the direct link yourself. Veterans qualify if they served in: 

• Southwest Asia, Afghanistan, or nearby regions after September 11, 2001 
• Designated Gulf War areas after August 2, 1990 

To file under this presumption, you generally need only two things: proof of service in one of the listed locations (deployment orders, service records) and a medical diagnosis of pulmonary fibrosis. Although the burden of proof is lighter, it still helps to submit additional evidence, such as: 

• A nexus letter from your doctor. 
• In-service medical records showing respiratory issues. 
• Current treatment records documenting your condition. 

If your claim is approved, your monthly compensation is based on your disability rating and family status. You can use our VA disability calculator to get an estimate of your benefits. 

Agent Orange and Pulmonary Fibrosis

Unlike some cancers and respiratory conditions, pulmonary fibrosis is not on the VA’s presumptive list for Agent Orange exposure. That means the VA does not automatically assume the disease was caused by herbicide exposure during service. 

Even so, research suggests that Agent Orange may increase the risk of idiopathic pulmonary fibrosis, a type of the disease without a clear cause. Veterans who were exposed to Agent Orange may still be able to make a case for benefits but will require strong medical support. A pulmonologist or specialist can review your history and provide an opinion that your pulmonary fibrosis is “at least as likely as not” linked to Agent Orange. This type of evidence, combined with service and medical records, could give your claim a solid foundation. 

While this path can be more challenging than a presumptive claim under the PACT Act, it is still possible. With the right medical opinion and supporting documents, some veterans have successfully shown that Agent Orange exposure contributed to their pulmonary fibrosis. If your case has been denied, our lawyers experienced in Agent Orange cases may be able to handle and win the appeal.  

Asbestos Exposure 

Another pathway to pulmonary fibrosis is asbestos exposure. When tiny asbestos fibers are inhaled, they can lodge in the lungs and cause scarring over time. This scarring is called asbestosis, which is a form of pulmonary fibrosis. Military service carried especially high risks of asbestos exposure: 

• Veterans who served in the 1940s through the 1960s were among the most heavily exposed. 
• Navy veterans and shipyard workers faced high risk since asbestos was widely used on ships for insulation and fireproofing. 
• Coast Guard cutters containing asbestos stayed in service until 1991. 

Because of this long history of exposure, many veterans may qualify for VA benefits if they can connect their pulmonary fibrosis to asbestos. However, one challenge with asbestos-related diseases is their delayed onset. Symptoms like shortness of breath, chest pain, or a lingering cough may not appear until 10 to 40 years after exposure. For many veterans, the damage only becomes clear decades after service. If you can document exposure and provide a medical diagnosis of asbestos-related pulmonary fibrosis, your case for VA benefits becomes much stronger. You can get a free case evaluation here. 

Service-Connected Conditions That Can Cause Pulmonary Fibrosis

Pulmonary fibrosis sometimes develops because of another illness or treatment that is already service-connected. In those cases, it may be claimed as a secondary condition. Showing how one service-related problem led to another will raise your overall disability rating and ensure you receive treatment for the full impact of your health issues. 

Autoimmune Diseases

Several autoimmune diseases are known to affect the lungs. These include rheumatoid arthritis, systemic lupus erythematosus (SLE), scleroderma, polymyositis, dermatomyositis, and mixed connective tissue disease (MCTD). These conditions can cause interstitial lung disease, which often progresses to pulmonary fibrosis over time. 

For example, rheumatoid arthritis can cause chronic inflammation in the lung tissue. If that inflammation continues, scarring may form, leading to fibrosis. Because the autoimmune disease is already recognized by the VA, the fibrosis caused by it can also be service-connected. 

Tuberculosis and Other Lung Infections 

Chronic infections are another pathway to pulmonary fibrosis. Diseases such as tuberculosis (TB) or certain fungal infections can leave behind lasting scarring even after the infection clears. This is called post-inflammatory fibrosis. Veterans who contracted TB or other lung infections while deployed, especially in overseas or high-risk environments, may later develop fibrosis as a result. If the infection is already service-connected, then the fibrosis tied to it can also be claimed. 

Gastroesophageal Reflux Disease (GERD) 

Although GERD is known as a digestive condition, it can cause aspiration-related damage to the lungs when stomach acid repeatedly flows back into the airway. Over years, this damage may scar the lower lobes of the lungs and develop into pulmonary fibrosis. If GERD is service-connected, a pulmonologist could provide the needed medical opinion linking it to pulmonary fibrosis. 

Radiation or Chemotherapy for Service-Connected Cancers

Cancer treatment can sometimes lead to pulmonary fibrosis. Radiation therapy to the chest may damage lung tissue in the treated area. Certain chemotherapy drugs, such as those used for Hodgkin’s disease, breast cancer, or testicular cancer, are also known to cause lung scarring as a side effect. 

If the cancer itself is service-connected, then the fibrosis caused by treatment is considered a secondary effect. Veterans in this situation should submit treatment records and, when possible, a doctor’s statement confirming that pulmonary fibrosis developed as a result of their therapy. 

What Is the VA Looking for? 

When the VA reviews a pulmonary fibrosis claim, they want to see both medical proof and evidence of how the disease affects daily life. A simple diagnosis is not enough on its own, the VA needs a full picture of your health. 

Doctors’ notes and treatment records show when your symptoms began, how they have progressed, and what medications or therapies you rely on. Imaging results, such as chest X-rays or CT scans, provide visual evidence of scarring in the lungs. The VA also gives significant weight to pulmonary function tests (PFTs). These tests measure how much air your lungs can hold, how quickly you can exhale, and how well oxygen passes from your lungs into your blood. Lower numbers on these tests usually mean a higher disability rating. 

The VA also looks at the impact on your daily life. They want to know if you struggle with simple activities like walking short distances, climbing stairs, or carrying groceries. Missed workdays, the need for oxygen therapy, or frequent medical visits are all factors that show the real-world limits caused by the disease. 

Finally, a Statement in Support of Claim can make a strong difference. In your own words, you should explain how pulmonary fibrosis affects you day to day. Specific examples, such as how often you run out of breath or how much you rely on oxygen, help the VA understand your disability beyond the medical charts. 

Required Documents and Evidence 

Building a strong VA claim for pulmonary fibrosis depends on the evidence you submit. The VA will not approve a claim unless you can show both a diagnosis and a clear link to your service. That means every piece of documentation matters. 

The most important records come from your medical history. Hospital files, test results, and doctors’ notes confirm the diagnosis and show how the disease has progressed. Imaging reports, such as CT scans or chest X-rays, provide physical proof of scarring in the lungs. Treatment records, whether they involve oxygen use, pulmonary rehab, or medications, demonstrate how much care your condition requires. 

You will also need service records that tie your illness to military duty. Deployment orders, duty station assignments, or records of working in high-risk environments, like burn pits or ships with asbestos, help establish exposure. 

To connect the dots, many veterans rely on a nexus letter. This is a medical opinion from a doctor explaining why your pulmonary fibrosis is “at least as likely as not” related to service or another service-connected condition. A strong nexus opinion can often make the difference between approval and denial. 

Other supporting documents can also strengthen your case. Buddy letters from fellow service members, family, or friends who witnessed your symptoms can provide powerful firsthand accounts. Some veterans also submit an independent medical opinion from a non-VA doctor to add weight and credibility to their claim. 

Because missing evidence is one of the most common reasons for denial, it’s important to prepare a complete file before filing or appealing. Our free ebook on VA benefits offers step-by-step guidance on gathering the right documents and submitting them.

The C&P Exam for Pulmonary Fibrosis 

Once you file a claim, the VA will likely schedule you for a Compensation and Pension (C&P) exam. This exam helps the VA confirm that your condition is connected to service and measure how severely it impacts your health. 

The exam is conducted by a VA doctor or a contracted examiner. Before meeting with you, they review your service records, medical history, and any evidence you’ve submitted. During the appointment, they focus on your military exposures such as burn pits or asbestos and the symptoms you experience now, like shortness of breath, fatigue, or cough. 

For pulmonary fibrosis, the VA relies heavily on Pulmonary Function Tests (PFTs). These tests measure how well your lungs move air and transfer oxygen into your blood. Three key results are: 

• Forced Vital Capacity (FVC): How much air you can exhale after taking the deepest breath possible. 
• Forced Expiratory Volume in one second (FEV1): How much air you can blow out in the first second of a forced breath. 
• Diffusion Capacity (DLCO (SB)): How efficiently oxygen moves from your lungs into your bloodstream. 

During the test, you blow into a mouthpiece attached to a machine that records your breathing. In some cases, light exercise such as walking on a treadmill are added to see how your lungs respond under stress. 

The VA compares your results to normal values for someone your age, height, and weight. Lower results usually mean more severe impairment, and they play a direct role in determining your disability rating. 

How to Prepare for a Pulmonary Function Test

The results of a Pulmonary Function Test (PFT) are critical in deciding your VA disability rating. To make sure the test reflects your true lung capacity, it’s important to follow preparation instructions carefully. Even small mistakes like smoking too close to the test can affect your results. Doctors usually recommend a few simple steps before a PFT:

• Rest well the night before. Fatigue can lower your performance and skew the numbers. 
• Avoid heavy meals for at least two hours before the test. A full stomach can make it harder to take deep breaths. 
• Skip caffeine for four hours before the test, since it may affect your airways. 
• Do not smoke for at least eight hours, as smoking interferes with lung function. 
• Hold bronchodilator medications for 12 hours before the test unless your doctor instructs otherwise. 

Following these steps helps ensure your results are accurate. The VA uses this information to measure your level of disability, so it’s worth taking the preparation seriously. 

How the VA Rates Pulmonary Fibrosis

The VA places pulmonary fibrosis under the broader category of interstitial lung diseases, and looks at pulmonary function test results, medical records, and functional limits to determine how much the condition restricts lung function. Types of pulmonary fibrosis the VA may rate include: 

• Idiopathic Pulmonary Fibrosis (DC 6825): The most common type, with no clear cause, progressive and irreversible. 
• Asbestosis-Related Pulmonary Fibrosis (DC 6833): Caused by asbestos exposure during service. 
• Autoimmune-Associated Pulmonary Fibrosis: Linked to autoimmune diseases; rated under DC 6825 or similar ILD codes. 
• Drug-Induced Pulmonary Fibrosis: Caused by medications such as chemotherapy, amiodarone, or nitrofurantoin; rated under DC 6825 or 6826. 
• Radiation-Induced Pulmonary Fibrosis: Develops after chest radiation for cancers like Hodgkin’s disease or breast cancer; rated under the general ILD formula. 
• Chronic Hypersensitivity Pneumonitis – Triggered by repeated exposure to allergens such as mold or birds; rated under DC 6825 or 6826. 

What Is the VA Disability Rating for Pulmonary Fibrosis? 

Under the General Rating Formula for Interstitial Lung Disease (Diagnostic Codes 6825-6833), the VA assigns pulmonary fibrosis ratings ranging from 10% to 100%, depending on how much the disease limits your breathing. The decision is guided by pulmonary function test results and how the illness affects your daily life. 

• 10% rating: FVC of 75- to 80-percent predicted, or; DLCO (SB) of 66- to 80-percent predicted 
• 30% rating: FVC of 65- to 74-percent predicted, or; DLCO (SB) of 56- to 65-percent predicted 
• 60% rating: FVC of 50- to 64-percent predicted, or; DLCO (SB) of 40- to 55-percent predicted, or; maximum exercise capacity of 15 to 20 ml/kg/min oxygen consumption with cardiorespiratory limitation 
• 100% rating: Forced Vital Capacity (FVC) less than 50-percent predicted, or; Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO (SB)) less than 40-percent predicted, or; maximum exercise capacity less than 15 ml/kg/min oxygen consumption with cardiorespiratory limitation, or; cor pulmonale or pulmonary hypertension, or; requires outpatient oxygen therapy 

These ratings reflect both the medical evidence and the functional impact of pulmonary fibrosis. A higher rating means greater monthly compensation as well as expanded access to VA healthcare benefits. Find out how to increase your rating.

Getting Up to 100% VA Disability 

Pulmonary fibrosis is a progressive disease, which means symptoms often get worse over time. Many veterans start with a lower rating but later qualify for a higher one as their condition advances. If your rating does not match the severity of your illness, there are several ways to pursue an increase. 

One option is to appeal a decision if the VA underrated your condition. Updated pulmonary function tests, new medical records, or a strong nexus letter can strengthen your appeal. Another option is to request an increase if your health has declined since your last review. Because pulmonary fibrosis can progress quickly, it’s important to keep the VA updated with current evidence. 

Veterans can also reach 100% through combined ratings. Pulmonary fibrosis often leads to secondary conditions, such as pulmonary hypertension or right-sided heart failure, with their own ratings. When added together, they may push your overall percentage to 100%, which ensures the highest monthly compensation and access to full VA healthcare benefits.

What Conditions Are Secondary to Pulmonary Fibrosis?

Pulmonary fibrosis affects more than just the lungs. Because it reduces oxygen levels and strains the body, it can lead to several secondary conditions. Veterans may be able to claim these conditions as service-connected if pulmonary fibrosis is the underlying cause. Common secondary conditions include: 

• Pulmonary Hypertension – High blood pressure in the lung arteries due to chronic low oxygen. 
• Right-Sided Heart Failure (Cor Pulmonale) – A form of heart strain caused by pulmonary hypertension. 
• Sleep Apnea – Fibrosis can worsen breathing problems during sleep. 
• Chronic Respiratory Failure – Severe loss of lung function requiring oxygen therapy. 
• Anxiety and Depressive Disorders – Mental health conditions linked to living with chronic illness and breathlessness. 
• Chronic Fatigue Syndrome – Extreme tiredness caused by low oxygen and poor sleep quality. 
• Cognitive Impairment (“Brain Fog”) – Trouble concentrating due to reduced oxygen supply to the brain. 
• Weight Loss or Muscle Wasting (Cachexia) – Advanced disease may cause loss of muscle and body weight. 
• Osteoporosis – Often related to long-term corticosteroid use for managing lung inflammation. 
• Gastroesophageal Reflux Disease (GERD) – Can develop or worsen from persistent coughing and chest pressure. 
• Respiratory Infections – Lung scarring reduces the body’s ability to clear infections. 
• Secondary Polycythemia – An increased red blood cell count triggered by chronic low oxygen. 

Recognizing and filing for these conditions can significantly increase a veteran’s total VA disability rating and ensure they receive treatment for all related health issues. For many veterans, this support is vital, since the disease can limit mobility, cause fatigue, and require constant medical care or oxygen therapy. 

TDIU: Another Path to 100% Benefits 

Not every veteran with pulmonary fibrosis will qualify for a standard 100% rating, but many may still be eligible for Total Disability based on Individual Unemployability. TDIU allows veterans to be paid at the 100% disability rate if their service-connected conditions prevent them from maintaining steady work. 

Pulmonary fibrosis can make even simple tasks like walking, standing for long periods, or lifting light objects extremely difficult. Veterans often need oxygen therapy, frequent rest breaks, or regular medical appointments, all of which interfere with holding a full-time job. To qualify for TDIU under the VA’s standard rules, you must meet one of the following: 

• Have one service-connected disability rated at 60% or higher, or 
• Have two or more service-connected disabilities, with at least one rated at 40% and a combined rating of 70% or more. 

Even if you don’t meet these numbers, you may still qualify for TDIU if your health prevents you from earning what the VA considers “substantial gainful employment.”

TDIU provides the same monthly compensation and healthcare benefits as a 100% disability rating, without needing to meet the strict medical thresholds. For veterans with pulmonary fibrosis whose condition makes working impossible, this can be a life-changing option. If your claim was denied or underrated, our TDIU attorneys know exactly how to build a winning case on your behalf.