Are you a veteran living with lung nodules? If so, you could be eligible to receive VA disability benefits.
One in every 500 chest X-rays reveals the presence of a lung nodule. One is also detected in every 100 CT scans performed. In all, approximately 150,000 such nodules are detected every year in the United States.
Today, we’re taking a look at how the VA rates lung nodules, as well as the health conditions most commonly associated with them.
What We Cover in this Article on Lung Nodule VA Disability:
- What Are Lung Nodules?
- Symptoms of Lung Nodules
- Establishing a Service Connection for Lung Nodules
- Lung Nodules as a Secondary Condition
- VA Disability Ratings for Lung Nodules
- What is an Appropriate Respiratory Analogy?
- The Role of a Pulmonary Function Test
- Pulmonary Testing Metrics
- Applying These Metrics to Your Lung Condition
- Understanding Your Rights to VA Compensation
What Are Lung Nodules?
A lung nodule is defined as a spot on your lung that measures no more than three centimeters (or 1.2 inches) in diameter. It can also be called a coin lesion on an imaging test. It will usually be round or oval-shaped in appearance.
To be detected on an X-ray, most nodules have to be at least one centimeter in size. Conversely, smaller spots (as tiny as one to two millimeters) can show up on a CT scan. Any lesion that measures beyond three centimeters is considered to be a lung mass.
Any time your physician detects an undetermined spot on your lungs, it can be cause for concern. However, as noted, lung nodules are fairly common. While they are often found in people who smoke, this isn’t always the case, nor do lung nodules always mean cancer.
In fact, there are several factors that can cause a nodule to develop on your lungs. These include:
- Other cancers that have metastasized
- Tumors (benign and malignant)
- The presence of other benign nodules
Due to the many possible underlying conditions, it’s critical for your doctor to take a close look at any unusual spot detected in an X-ray or CT scan.
If you have a history of smoking or if the nodule contains calcification, these can point a more serious condition. Ultimately, however, a biopsy is required to determine if the nodule is malignant or benign. Thankfully, the majority of lung nodules (60%) are found to be non-cancerous.
Symptoms of Lung Nodules
Interestingly, most lung nodules are asymptomatic. This means you could have them on your lungs and not be in any discomfort. You might not even notice anything different at all!
In many cases, they are not even detected until an imaging test is performed for another condition. For instance, you may have chest tightness and request an X-ray, and your physician could notice the nodules at that time. Or, they could be identified during a normal, routine lung cancer screening.
If you do have symptoms, they are normally mild to moderate in nature. Some of the most common ones can include:
- Persistent cough
- Shortness of breath
- Coughing up blood
If the nodule is located near a major airway, its presence could cause a more serious respiratory infection.
In this video, one of our VA Disability lawyers talks about service-connecting your Persian Gulf syndrome to the symptoms in your lungs.
Establishing a Service Connection for Lung Nodules
To receive VA disability benefits for lung nodules, you must be able to show a direct service connection between the presence of the nodules and your time in the military.
To determine eligibility, the VA will look at several documents and records. These include:
- Medical records related to your lung health (CT scans and chest X-rays) during your time in service
- Medical records detailing your lung health after military discharge
Your doctor can help prove a nexus or connection between your lung health and your military service. To do so, they must be able to supply evidence that your condition is current and active at the time of the claim submission.
In addition, they must be able to trace the development or exacerbation of your lung nodules back to an event that occurred during your time in the military. A common culprit is air pollution, specifically the exposure to smoke, fuel, soot or fumes that veterans were required to sustain.
Lung Nodules as a Secondary Condition
According to the VA, a secondary service-connected condition is one that stems off of another condition that is already determined to be service-connected.
For example, you might already be receiving VA disability benefits for a knee injury you sustained while in service. Later, if you develop arthritis in that knee, you could apply to receive separate benefits for this condition by claiming that it is secondary to the injury you sustained years ago.
In the case of lung nodules, it’s important to understand that they can occur as a result of other lung conditions, including:
As a veteran, are you currently experiencing breathing problems, shortness of breath, or a nagging cough? If so, you may have a service-connected lung disability for which you could be eligible to receive VA benefits. Lung nodules could be associated with a range of these conditions, and could add to your overall disability payout.
Our guide to Veteran Disability Benefits for Lung Conditions explains these medical conditions in greater detail, such as the allergic rhinitis with polyps VA disability rating. Here, you’ll also find more information related to the VA disability rating for lung cancer, the VA disability rating for COPD, and the VA disability rating for exercise induced asthma, and others.
In addition, you can also find information on sleep-related disorders that can negatively affect your lung condition. This includes the VA rating sleep apnea can produce.
VA Disability Ratings for Lung Nodules
The VA provides a rating schedule for lung nodules under Diagnostic Code (DC) 6820, which covers a malignant neoplasm of the respiratory system. By definition, neoplasm is any new or abnormal growth of tissue that occurs in any part of your body.
While a neoplasm can be characteristic of cancer, this is not always the case.
If such tissue growth occurs in your respiratory system, you’ll reference the ratings in DC 6820 to understand your potential compensation. Yet, you’ll find that in lieu of individual ratings, the conditions under this code are ranked by an “appropriate respiratory analogy”.
What is an Appropriate Respiratory Analogy?
In short, it means that lung nodules are evaluated as other respiratory conditions are assessed. Put simply, it’s assumed that lung nodules will not simply occur on their own. Instead, they will be intricately linked to another respiratory condition, which the VA does rank with specific percentages.
The greater ratings schedule under which DC 6820 appears is 38 CFR § 4.97: Schedule of Ratings: Respiratory System. Within this schedule, you will also find other conditions that could affect a veteran’s respiratory system, including:
All of these conditions are ranked in severity from 10% to 100% by the VA, with eligible compensation rising as the severity increases. To determine your rating, the VA will assess the medical documents provided by your physician, which can help answer key questions, including:
- Is the nodule stable or is it changing?
- Are you actively receiving treatment for the nodule?
- Is the nodule causing any symptoms or interfering with your daily life?
- Are your lung and chest exams and imaging tests normal?
- Has your nodule caused you to lose work in the past year?
- What are the results of your pulmonary function tests?
That last bullet holds more significance than you might realize. Let’s discuss what a pulmonary function test entails and why it’s so important.
The Role of a Pulmonary Function Test
Also called a lung function test, a pulmonary function test is a critical way that the VA can measure how severely your life is impacted by your lung condition, including any lung nodules present.
These tests are designed to measure how well your lungs are working. Each test measures the amount of air you breathe out, or exhale, as well as how long it takes for you to empty your lungs and exhale completely.
Why are these tests performed? They can help physicians diagnose certain lung conditions, including asthma and COPD, both of which are rated under 38 CFR § 4.97.
If you are taking any medication to treat your condition, the test may be performed before or after you begin treatment to determine any effects that the medication may have. In addition, they can also help doctors understand if your condition gets worse as you exercise.
If you are seeking to file a claim for lung nodules as a secondary service-connected condition, you may be required to complete a pulmonary function test to help the VA determine your rating. A complete test has three parts and can take up to 90 minutes to complete. The three testing sections include:
During a spirometry test, you will be required to hold your breath and blow it out quickly, with force. You’ll repeat this test at least three times to measure your best results.
During your diffusion test, you will need to hold your breath for 10 seconds. This test will measure how efficiently your lungs are able to move air into your blood.
Lung Volume Test
For your lung volume test, you will be required to breathe in different mixtures of air. Your physician will measure how much air you can inhale and exhale with each mixture. They’ll also measure how much air remains in your lungs.
Here are some tips on your C&P exam from one of our VA disability lawyers.
Pulmonary Testing Metrics
The above three tests work together to reveal a variety of metrics, all of which the VA can reference to better understand how your lung nodules are affecting your respiratory function. These metrics include:
Forced vital capacity (FVC) measures the total amount of air that you can exhale. It’s based on the amount exhaled in one extended breath.
You may also notice FEV1 in your test results. This is your forced expiratory volume in one second. In other words, it’s the amount of air that you can release in the first second of your exhale. Usually, you’ll see FEV1 expressed as a percentage of your greater FVC.
The FEV1/FVC metric measures how much air you can exhale in the first second, compared with the total amount of air you exhale in full. You’ll usually see it written as a ratio or percentage. The higher this ratio, the better functioning your lungs are considered to be.
PEF stands for peak expiratory flow. This metric measures how quickly you can exhale. It’s tested with a peak flow meter or spirometry.
Applying These Metrics to Your Lung Condition
Once you’ve determined which primary lung condition your nodules are associated with, you can use the metrics listed within 38 CFR § 4.97 to understand how your condition is rated.
For instance, consider chronic bronchitis. This condition is listed under DC 6600 and includes the following ratings:
A 100% rating applies if any of the following are true:
- FEV-1 less than 40% predicted
- FEV-1/FVC less than 40% predicted
- Diffusion capacity of the lung for carbon monoxide (DLCO) of the single-breath method (SB) less than 40% predicted
- Maximum exercise capacity less than 15 ml/kg/min oxygen consumption
- Right heart failure
- Right ventricular hypertrophy
- Pulmonary hypertension
- Episode(s) of acute respiratory failure
- Outpatient oxygen therapy required
A 60% rating applies if any of the following are true:
- FEV-1 40% to 55% predicted
- FEV-1/FVC 40% to 55% predicted
- DLCO (SB) 40% to 55% predicted
- Maximum oxygen consumption 15 to 20 ml/kg/min
A 30% rating applies if any of the following are true:
- FEV-1 56% to 70% predicted
- FEV-1/FVC 56% to 70% predicted
- DLCO (SB) 56% to 65% predicted
A 10% rating applies if any of the following are true:
- FEV-1 71% to 80% predicted
- FEV-1/FVC 71% to 80% predicted
- DLCO (SB) 66% to 80% predicted
While these ratings are specific for chronic bronchitis, you’ll find that many respiratory conditions use the same metrics to rate their disability compensations accordingly. Your ultimate rating will depend on how much the nodule is affecting your life. If you do not have any symptoms and are able to continue life as normal, you’re more likely to receive a 0% rating than someone whose FEV-1 or FEV-1/FVC ratios are much lower.
Your physician can help you understand which primary condition your lung nodules are related to, and how it measures according to these restraints. You can also access the sleep conditions under Schedule 38 CFR sleep disorders if your respiratory condition is related to a sleep issue.
It may be difficult to get 100% TDIU from one disability, but here one of our VA disability lawyers talks about common disabilities that add up to a 100% combined rating.
Understanding Your Rights to VA Compensation
If you’re a veteran with lung nodules, you could be eligible to receive VA disability benefits for your condition. As stated, your rating will increase depending on how the nodules affect your daily life. Even if you aren’t experiencing any symptoms right now, it’s always smart to keep an eye on your condition in case it worsens in the future.
Looking for additional assistance as you navigate your VA disability benefits? We’re here to help. Contact us to learn more about the services we provide.
No, lung nodules can occur for a lot of harmless reasons and never show any symptoms. They are often found and cause worry, but they are not always cancer.
Not likely. If you have any other lung conditions, that will take precedence over the lung nodules. Since they are rated by respiratory analogy and not their own condition, you would get a rating for COPD with the mention of nodules but no additional rating for them.