Chronic Pleurisy

DC 6845Respiratory38 CFR 4.97, DC 6845

Chronic inflammation of the pleura (the membrane surrounding the lungs) causing sharp chest pain with breathing. Can result from in-service infections, injuries, or toxic exposures. Rated based on lung function tests.

Rating Levels

Your lung function tests show FVC of less than 50 percent predicted, or DLCO (SB) of less than 40 percent predicted, or you require outpatient oxygen therapy.

What the VA looks for

FVC less than 50% predicted
DLCO less than 40% predicted
Outpatient oxygen therapy prescribed
Cor pulmonale documented
Severe restrictive defect from pleural disease

Common Pitfalls

⚠Not getting DLCO testing in addition to spirometry — DLCO may show worse impairment than FVC alone in pleural disease and can yield a higher rating.
⚠Not connecting pleurisy to in-service pneumonia, chest trauma, or toxic exposures — establish the nexus between the service event and chronic pleural inflammation.
⚠Not documenting chronic pleuritic chest pain — ongoing pain with deep breathing is a key symptom that supports the diagnosis even when PFTs are borderline.
⚠Not getting chest CT showing pleural thickening — imaging evidence of chronic pleural changes strengthens the claim beyond just PFT numbers.

Related DBQ Forms

DBQ Respiratory Conditions (Other Than Tuberculosis and Sleep Apnea)

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

Rating Levels

Your lung function tests show FVC of less than 50 percent predicted, or DLCO (SB) of less than 40 percent predicted, or you require outpatient oxygen therapy.

What the VA looks for

FVC less than 50% predicted
DLCO less than 40% predicted
Outpatient oxygen therapy prescribed
Cor pulmonale documented
Severe restrictive defect from pleural disease

Common Pitfalls

⚠Not getting DLCO testing in addition to spirometry — DLCO may show worse impairment than FVC alone in pleural disease and can yield a higher rating.

⚠Not connecting pleurisy to in-service pneumonia, chest trauma, or toxic exposures — establish the nexus between the service event and chronic pleural inflammation.

⚠Not documenting chronic pleuritic chest pain — ongoing pain with deep breathing is a key symptom that supports the diagnosis even when PFTs are borderline.

⚠Not getting chest CT showing pleural thickening — imaging evidence of chronic pleural changes strengthens the claim beyond just PFT numbers.