Diagnostic Code 6828 · 38 CFR §4.97
Eosinophilic granuloma of the lung, now more commonly called pulmonary Langerhans cell histiocytosis (PLCH), is a rare lung disease characterized by the formation of granulomas that damage lung tissue. It is strongly associated with smoking and may affect veterans who smoked during service. The disease can cause cysts, nodules, and progressive lung destruction.
| Rating | Criteria |
|---|---|
| 10% | Stable disease with minimal PFT impairment. Scattered nodules or small cysts on imaging without significant functional limitation. |
| 30% | Moderate disease with measurable PFT reduction. Multiple cysts visible on imaging with mild to moderate dyspnea. |
| 60% | Progressive disease with significant PFT impairment and exercise limitation. Extensive cystic changes on imaging. |
| 100% | End-stage disease with severe respiratory failure, pulmonary hypertension, or requiring lung transplant evaluation. |
Biopsy confirming Langerhans cell histiocytosis or characteristic CT findings. Current PFTs including DLCO. High-resolution CT showing nodules and/or cysts. Documentation of smoking history during service if applicable.
While there is a statutory bar on direct service connection for disability based on tobacco use after June 1998, if you can show nicotine dependence began during service (for claims filed before that date) or if other service exposures contributed, there may still be a path. Consult a veterans service organization for current guidance on your specific situation.
PLCH can stabilize, especially after smoking cessation. However, some cases progress to end-stage lung disease. Regular monitoring with PFTs and imaging is important both for your health and your VA claim, as progression supports a rating increase.