Systemic Lupus Erythematosus (SLE, Disseminated) VA Disability Rating

Yes. The VA rates Lupus Erythematosus, Systemic (Disseminated) under VASRD diagnostic code 6350 (Infectious Diseases and Immune Disorders). DC 6350 grades systemic lupus on exacerbations — how often they come and how long they last — and not on which organs the disease has reached. That is why its note matters more th…

Possible VA ratings for Lupus Erythematosus, Systemic (Disseminated) are 100%, 60%, 10%. Examples: 100%: Acute disease with frequent flares that leave overall health severely impaired.; 60%: Flares that last a week or longer, two or three times a year.; 10%: Flares once or twice a year, or symptoms at any point in the…

Strong evidence for a Lupus Erythematosus, Systemic (Disseminated) claim includes: A record of exacerbations with dates and durations. Every tier of this code is a count and a length — two or three a year lasting a week or more is 60 percent, once or twice a year is 10 percent — so a chart that describes lupus in gene…

Common pitfalls when filing for Lupus Erythematosus, Systemic (Disseminated): Accepting the DC 6350 evaluation without asking what the residuals combine to. The note makes that comparison part of the rating, not an appeal argument.; Claiming discoid lupus and systemic lupus as two ratings. DC 6350 and DC 7809 are not…

Whichever pays more, and the schedule says so rather than leaving it to be argued. DC 6350's note directs that the condition be evaluated either by combining the evaluations for residuals under the appropriate system, or by evaluating DC 6350, whichever method results in a higher evaluation. That matters because this code's own ladder is built entirely out of exacerbations - 100 percent for acute disease with frequent exacerbations producing severe impairment of health, 60 percent for exacerbations lasting a week or more two or three times a year, and 10 percent for exacerbations once or twice a year or symptoms during the past two years - and says nothing at all about which organs are involved. A veteran with kidney involvement, inflammatory arthritis and a blood abnormality may combine to well above 10 percent under those systems' own codes. The comparison can only be made if each residual has actually been evaluated, which is the practical thing to ask for.

No. The schedule bars it in DC 6350's own entry: ratings under this code are not to be combined with ratings under diagnostic code 7809, which is discoid lupus erythematosus in the skin schedule. Where both diagnoses are in the record, one evaluation is assigned rather than two. That is separate from the note about residuals - skin involvement can still be part of the combined-residuals route under DC 6350's note, but a standalone DC 7809 evaluation alongside a DC 6350 evaluation is what the schedule forbids.