Secondary Pulmonary Hypertension — VA Disability Rating Criteria (DC 6839)

Diagnostic Code 6839 · 38 CFR §4.97

What Is It?

Secondary pulmonary hypertension develops as a consequence of another underlying condition—most commonly COPD, interstitial lung disease, sleep apnea, chronic blood clots, or left heart disease. For veterans, this is often a secondary service connection claim linked to an already service-connected respiratory or cardiac condition. The elevated pulmonary pressures strain the right heart and progressively limit exercise capacity.

Rating Criteria

RatingCriteria
30%Secondary pulmonary hypertension confirmed with mild functional limitation. Underlying condition identified and treated. Some exercise intolerance noted.
60%Moderate to severe secondary pulmonary hypertension requiring specific treatment beyond managing the underlying cause. Significant exercise limitation and right ventricular changes on imaging.
100%Severe secondary pulmonary hypertension with right heart failure despite treatment. WHO Functional Class III-IV. May require oxygen therapy or advanced pulmonary hypertension medications.

Evidence Needed

Echocardiogram or right heart catheterization showing elevated pulmonary pressures. Documentation of the underlying cause and its service connection. Six-minute walk test. Current treatment records. Medical opinion linking the PH to the underlying service-connected condition.

Frequently Asked Questions

Can I get a separate rating for secondary pulmonary hypertension?

Generally yes, if the pulmonary hypertension causes disability beyond what your underlying lung condition rating covers. However, be aware of pyramiding rules—the VA cannot rate the same symptoms twice. If your PH causes distinct additional symptoms (right heart failure, additional exercise limitation), a separate rating is appropriate.

My sleep apnea is service-connected—can that cause pulmonary hypertension?

Yes. Chronic untreated or undertreated sleep apnea is a well-recognized cause of secondary pulmonary hypertension. A medical opinion explaining this connection can support a secondary service connection claim for DC 6839.