Infectious Diseases

TOC

Overview of VA Infectious Disease Ratings

Infectious diseases involve disorders caused by organisms such as bacteria, viruses, fungi, or parasites. Military service can expose veterans to various infectious diseases through deployment to regions with endemic diseases, exposure to contaminated water or food, insect bites, or close living quarters that facilitate disease transmission. This section explains how the VA rates infectious diseases and provides detailed guidance for the most common conditions.

General Rating Principles for Infectious Diseases

The VA rates infectious diseases based on several factors:

• Active infection: Presence of active disease and its severity
• Residual effects: Lasting damage or symptoms after the acute infection resolves
• Frequency of relapses: How often the disease recurs
• Systemic impact: Effects on multiple body systems
• Treatment requirements: Medications, hospitalizations, or other interventions needed
• Functional impact: How the condition affects your ability to work and perform daily tasks

Gulf War Presumptive Infectious Diseases

Veterans who served in the Southwest Asia theater of operations (including Iraq, Kuwait, Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, Oman, the Gulf of Aden, the Gulf of Oman, the Persian Gulf, the Arabian Sea, and the Red Sea) during the Persian Gulf War, or in Afghanistan on or after September 19, 2001, may qualify for presumptive service connection for certain infectious diseases.

Qualifying Infectious Diseases for Gulf War Veterans

The following infectious diseases qualify for presumptive service connection if they manifest to a compensable degree within the specified time period:

• Brucellosis: Within one year of separation
• Campylobacter jejuni: Within one year of separation
• Coxiella burnetii (Q fever): Within one year of separation
• Malaria: Within one year of separation, or at a later date in certain circumstances
• Mycobacterium tuberculosis: Active disease at any time after service
• Nontyphoid Salmonella: Within one year of separation
• Shigella: Within one year of separation
• Visceral leishmaniasis: At any time after service
• West Nile virus: Within one year of separation

VA Rating Criteria for Brucellosis

Brucellosis is a bacterial infection that can affect various body systems. It is rated under Diagnostic Code 6316:

Rating	Criteria
100%	Active disease

For inactive brucellosis, the condition is rated based on residuals such as liver or spleen damage, meningitis, endocarditis, or other chronic manifestations.

VA Rating Criteria for Q Fever

Q fever is a bacterial infection caused by Coxiella burnetii. It is rated under Diagnostic Code 6325:

Rating	Criteria
100%	For acute Q fever during active disease

For chronic Q fever, the condition is rated based on residuals such as endocarditis, vascular infections, chronic hepatitis, or other chronic manifestations.

VA Rating Criteria for Malaria

Malaria is a parasitic infection transmitted by mosquitoes. It is rated under Diagnostic Code 6304:

Rating	Criteria
100%	Active disease

For inactive malaria, the condition is rated based on residuals such as liver or spleen damage. The diagnosis of malaria depends on the identification of the parasites in blood smears or other specific diagnostic tests.

VA Rating Criteria for Tuberculosis

Tuberculosis (TB) is a bacterial infection that primarily affects the lungs but can affect other parts of the body. The rating criteria depend on whether the TB is pulmonary (affecting the lungs) or extrapulmonary (affecting other parts of the body).

For pulmonary TB (Diagnostic Code 6730 for active disease or 6731 for inactive disease):

Rating	Criteria
100%	Active disease

After active pulmonary TB has been inactive for 6 months, the 100% rating continues for 12 months after inactivity. Then, the condition is rated based on residuals such as interstitial lung disease, restrictive lung disease, or obstructive lung disease.

For extrapulmonary TB, the condition is rated based on the affected body system (e.g., genitourinary, musculoskeletal, etc.).

Tropical Infectious Diseases

Military service often involves deployment to tropical regions where certain infectious diseases are endemic. These diseases can have long-term health effects even after the acute infection resolves.

Leishmaniasis

Leishmaniasis is a parasitic disease transmitted by the bite of infected sand flies. There are several forms of leishmaniasis, including cutaneous (affecting the skin), mucosal (affecting the mucous membranes), and visceral (affecting internal organs).

Visceral Leishmaniasis (Kala-azar)

Visceral leishmaniasis is rated under Diagnostic Code 6301:

Rating	Criteria
100%	During active disease or for 6 months following cessation of treatment

After the 100% rating period, the condition is rated based on residuals such as liver or spleen damage.

Cutaneous Leishmaniasis

Cutaneous leishmaniasis is typically rated based on the resulting skin condition, often under Diagnostic Code 7806 (dermatitis or eczema) or 7805 (scars).

West Nile Virus

West Nile virus is transmitted by mosquitoes and can cause a range of symptoms from mild fever to severe neurological disease. It is rated based on its residual effects, which may include:

• Neurological manifestations (rated under the appropriate neurological diagnostic codes)
• Fatigue and weakness (often rated by analogy to chronic fatigue syndrome)
• Joint pain (rated under the appropriate musculoskeletal diagnostic codes)

Dengue Fever

Dengue fever is a viral infection transmitted by mosquitoes. Acute dengue fever is typically rated at 100% during active disease. After the acute phase, the condition is rated based on residuals, which may include:

• Joint pain and arthritis
• Fatigue
• Neurological manifestations
• Liver damage

Parasitic Infections

Various parasitic infections can be contracted during military service, including:

• Schistosomiasis
• Filariasis
• Onchocerciasis (river blindness)
• Intestinal parasites

These conditions are typically rated based on the affected body system and the resulting impairment.

Other Infectious Diseases

In addition to the presumptive infectious diseases for Gulf War veterans and tropical diseases, veterans may develop other infectious diseases during or after military service.

HIV/AIDS

Human Immunodeficiency Virus (HIV) infection and Acquired Immune Deficiency Syndrome (AIDS) are rated under Diagnostic Code 6351:

Rating	Criteria
100%	AIDS with recurrent opportunistic infections or with secondary diseases afflicting multiple body systems; HIV-related illness with debility and progressive weight loss, without remission, or few or brief remissions
60%	Refractory constitutional symptoms, diarrhea, and pathological weight loss; or minimum rating following development of AIDS-related opportunistic infection or neoplasm
30%	Recurrent constitutional symptoms, intermittent diarrhea, and on approved medication(s); or minimum rating with T4 cell count less than 200
10%	Following development of definite medical symptoms, T4 cell count of 200 or more and less than 500, and on approved medication(s); or with evidence of depression or memory loss with employment limitations
0%	Asymptomatic, following initial diagnosis of HIV infection, with or without lymphadenopathy or decreased T4 cell count

Hepatitis

Hepatitis is inflammation of the liver, often caused by viral infections. The rating criteria depend on the type of hepatitis (A, B, C, etc.) and whether it is acute or chronic.

Chronic hepatitis B and C are rated under Diagnostic Code 7354:

Rating	Criteria
100%	Near-constant debilitating symptoms (such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain)
60%	Daily fatigue, malaise, and anorexia, with substantial weight loss (or other indication of malnutrition), and hepatomegaly, or; incapacitating episodes (with symptoms such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain) having a total duration of at least six weeks during the past 12-month period, but not occurring constantly
40%	Daily fatigue, malaise, and anorexia, with minor weight loss and hepatomegaly, or; incapacitating episodes (with symptoms such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain) having a total duration of at least four weeks, but less than six weeks, during the past 12-month period
20%	Daily fatigue, malaise, and anorexia (without weight loss or hepatomegaly), requiring dietary restriction or continuous medication, or; incapacitating episodes (with symptoms such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain) having a total duration of at least two weeks, but less than four weeks, during the past 12-month period
10%	Intermittent fatigue, malaise, and anorexia, or; incapacitating episodes (with symptoms such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain) having a total duration of at least one week, but less than two weeks, during the past 12-month period
0%	Nonsymptomatic

Lyme Disease

Lyme disease is a bacterial infection transmitted by ticks. It is typically rated based on its residual effects, which may include:

• Arthritis and joint pain
• Neurological manifestations
• Cardiac manifestations
• Chronic fatigue

Meningitis

Meningitis is inflammation of the membranes surrounding the brain and spinal cord. It is rated under Diagnostic Code 8019 (meningitis, cerebrospinal, epidemic):

Rating	Criteria
100%	Active febrile disease

After the active phase, the condition is rated based on residuals, with a minimum rating of 10%.