Lung Nodules VA Disability Guide 

Every year, millions of people, including many veterans, are diagnosed with pulmonary (lung) nodules. If you developed lung nodules as a result of military service, you may be eligible for disability compensation through the United States Department of Veterans Affairs. This guide will outline some of the main ways to prove service connection for lung nodules, as well as how the VA rates this condition. 

Lung Nodules in Veterans

Lung nodules are small, round or oval-shaped growths in the lungs, typically less than 3 cm (1.2 inches) in diameter. While most lung nodules are benign and asymptomatic, they can sometimes be early indicators of more serious health issues. Veterans, particularly those exposed to airborne hazards during service, are at a higher risk of developing these nodules. 

According to the Department of Veterans Affairs and recent VA Airborne Hazards and Burn Pit Center of Excellence findings, a significant portion of post-9/11 veterans deployed to Southwest Asia and Afghanistan report respiratory symptoms consistent with airway and lung disorders. According to research published in the Annals of the American Thoracic Society, many lung nodules are found incidentally during imaging for other conditions, such as lung cancer screenings. 

Symptoms of lung nodules can vary, with many veterans having none (no significant effects on work or daily activities) and others having symptoms such as: 

• Shortness of breath 
• Chest pains 
• Functional limits at work or in daily life (if an underlying lung disease is present) 

Even though most lung nodules are asymptomatic, they may still qualify for a 0% rating, which is important for free VA health care or future disability claims. 

Service Connection for Lung Nodules

To prove entitlement to a service connection for lung nodules, you must establish a direct connection between military service and the diagnosed condition. This means, for lung nodules, you must show:

• A current disability related to lung nodules. This must include evidence of the disability, and it must be near the time of the claim to be timely. 
• Something that happened during the time of service that caused or aggravated the disability. Examples could include exposure to soot, fuel, smoke, or fumes during service (depending on the research that shows a connection with the pollution and lung nodules). 
• A medical connection between the current diagnosed disability to that occurrence or incident during service. As defined under federal law, this may include active duty or inactive duty for training. An example of making this connection would be a doctor’s opinion that the present lung nodules are connected with the veteran’s military service.  

A health care provider typically writes a nexus letter to present to the VA. The doctor should include a clear medical opinion that it is “at least as likely as not” that the condition is related to your military service. For example:  

In my medical opinion, it is at least as likely as not (50% or greater probability) that the veteran’s pulmonary nodules are due to exposure to [X] during active service. 

Other required evidence: 

• Medical records, such as computed tomography scans (CT scans) and chest x-rays, pertinent to lung health from the time in service. An example of evidence is a diagnostic test taken during the time of service, showing lung nodules. 
• The medical records after discharge, including, for example, the results of scans and pulmonary function tests to determine whether the Forced Expiratory Volume is affected 

Toxic Exposure and the PACT Act 

Toxic exposure is one of the most common environmental hazards tied to lung issues among veterans. Types of exposures related to lung nodules include: 

• Burn Pits – Found at many overseas bases in Iraq, Afghanistan, and surrounding areas 
• Airborne Hazards – Sand, dust, and particulates in the Middle East or Southwest Asia 
• Asbestos – Common in Navy ships and shipyards 
• Jet Fuel and Solvents – Common for aviation mechanics and fuel handlers 
• Industrial Fumes or Smoke – Such as from refueling stations or diesel exhaust  

In 2022, the Honoring Our PACT Act significantly expanded presumptives of exposure for certain locations and/timeframes for veterans exposed to burn pits and airborne hazards and adds presumptive diagnoses. If you served in any of the following locations during specific timeframes, VA presumes you were exposed- you dont need to prove the exposure:

• Iraq, Afghanistan, or surrounding areas (post-9/11)
• Southeast Asia during the Gulf War
• Any location listed under the PACT Act’s updated deployment maps 

The VA presumes service connection for specific listed conditions, such as asthma, chronic bronchitis, COPD, interstitial lung disease, and certain respiratory cancers. Lung nodules by themselves are not a PACT Act presumptive condition. If your nodule is due to, or progresses into, a diagnosable condition that is presumptive (e.g., chronic bronchitis/COPD or certain lung cancers), then the presumption can apply. Otherwise, you can still win via direct or secondary service connection with a medical nexus. 

How to Use the PACT Act in Your Claim

• Mention exposure locations clearly in your claim (e.g., “Served at FOB Falcon, Iraq, 2005-2006”) 
• Reference the PACT Act in your statement 
• Indicate symptoms or diagnoses that began during or shortly after service 

This act removes the burden of proof for exposure, meaning you don’t need to submit scientific evidence connecting your service to the toxic exposure – your presence in a qualifying location is often enough. 

Veterans with lung nodules who were previously denied a rating for a respiratory condition may now be eligible under the PACT Act and should consider filing a supplemental claim. Get a free case evaluation to see how we can assist you in obtaining your rightful benefits.

Secondary Service Connection for Lung Nodules

Disabilities can also be claimed if they are not directly connected to the veteran’s service in the Army, Navy, or Air Force, but are instead secondary service connections. In some cases, the Department of Veterans Affairs misses indirect connections that constitute valid claims. 

Lung nodules can be secondary to several underlying physical conditions, such as a chronic condition in the respiratory system. If, for example, you have chronic bronchitis (Diagnostic Code 6600), you may subsequently be diagnosed with lung nodules. A properly presented secondary disability claim may succeed in raising your level of benefits when a new condition results from a service-connected disability. 

If you have new symptoms, let your VSO or disability attorney know. Even if you did not experience any secondary conditions when you first filed, you can file a new claim for a secondary service connection that developed later on using VA Form 20-0995 (Supplemental Claim). 

How Does the VA Rate Lung Nodules?

Tumors of the lungs are rated using the Diagnostic Code 6820 (Neoplasms, benign, any specified part of the respiratory system), with ratings ranging from 0% to 100%. However, DC 6820 does not contain specific rating percentages. Instead, the VA must rate the condition by analogy to another respiratory condition. 

Rating by Analogy Examples

If rated as Chronic Bronchitis (DC 6600): 

• 10% rating: FEV-1 of 71–80% predicted, or FEV-1/FVC of 66–80%; or; DLCO (SB) 66- to 80-percent predicted 
• 30% rating: FEV-1 of 56–70% predicted, or FEV-1/FVC of 56–70%; or, DLCO (SB) 56- to 65-percent predicted 
• 60% rating: FEV-1 of 40–55% 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) 
• 100% rating: FEV-1 less than 40 percent of predicted value, or; the ratio of Forced Expiratory Volume in one second to Forced Vital Capacity (FEV-1/FVC) less than 40 percent, 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 cardiac or respiratory limitation), or; cor pulmonale (right heart failure), or; right ventricular hypertrophy, or; pulmonary hypertension (shown by Echo or cardiac catheterization), or; episode(s) of acute respiratory failure, or; requires outpatient oxygen therapy   

Other analogies:

• COPD (DC 6604) 
• Interstitial Lung Disease (DC 6825) 

A lung nodule’s impact on the veteran’s disability will be determined by medical questions, such as: 

• Whether the nodule is stable or changing 
• Whether the nodule is causing symptoms 
• Whether or not the vet is receiving treatment 
• Pulmonary function test (PFT) results (e.g., FEV-1, FVC) 
• Time lost from work and functional limits 
• Whether the nodule affects daily life or ability to work

Filing a VA Claim for Lung Nodules

1. Obtain a current diagnosis from your doctor
2. Gather service records showing potential exposure (deployment, MOS, burn pits, etc.)
3. Secure a medical nexus letter linking the condition to service
4. File VA Form 21-526EZ online or by mail
5. Attend your C&P exam and bring symptom notes
6. Follow up with the VA and be ready to appeal if denied

C&P Exams for Lung Nodules

Before authorizing disability benefits, the VA may require a veteran to undergo a C&P exam. The VA can require this test whenever it receives a disability claim. It is used to rate the disability and validate service connection. It’s the veteran’s job to demonstrate the claim, and if the evidence is considered 50-50, the veteran, by law, gets the benefit of the doubt. 

The examiners do not decide on the spot. Instead, they report to the VA Regional Office (RO), so a decision can be processed. First, the vet receives a notice in the mail to attend the exam. Preparation and knowledgeable advice can make a successful outcome more likely. The veteran’s medical expert can fill out the Disability Benefits Questionnaire to support the claim. On the day of the exam: 

• The veteran may bring a witness 
• They may take helpful reminders and notes about symptoms 
• Any daily limitations, even seemingly minor ones, should be shared 

After the exam, it helps to write down everything discussed in case the rating is unexpectedly low and will need to be appealed.

Common Pitfalls to Avoid

VA lung nodule claims are often denied for:

• No current diagnosis  
• No nexus letter or opinion 
• No documented in-service exposure or event 
• Missed C&P exams

You can avoid these by preparing early, documenting thoroughly, and seeking help from a VSO or legal representative. We also offer our own free guide to the VA claims process for veterans seeking disability benefits. Request our free book or get the online course for immediate access.