HIV-related illness — VA Rating Criteria (38 CFR DC 6351)
The VA rates HIV-related illness under 38 CFR 38 CFR § 4.88b, Diagnostic Code 6351, from 0% to 100% based on the frequency and functional severity of symptoms. The maximum 100% rating requires AIDS with recurrent opportunistic infections (see Note 3) or with secondary diseases afflicting multiple body systems; HIV-related illness with debility and progressive weight loss. Related conditions in the Infectious Diseases body system share this rating framework.
What are the VA rating criteria for HIV-related illness?
Asymptomatic, following initial diagnosis of HIV infection, with or without lymphadenopathy or decreased T4 cell count
Following development of HIV-related constitutional symptoms; T4 cell count between 200 and 500; use of approved medication(s); or with evidence of depression or memory loss with employment limitations
Recurrent constitutional symptoms, intermittent diarrhea, and use of approved medication(s); or minimum rating with T4 cell count less than 200
Refractory constitutional symptoms, diarrhea, and pathological weight loss; or minimum rating following development of AIDS-related opportunistic infection or neoplasm
AIDS with recurrent opportunistic infections (see Note 3) or with secondary diseases afflicting multiple body systems; HIV-related illness with debility and progressive weight loss
“Recurrent constitutional symptoms, intermittent diarrhea, and use of approved medication(s); or minimum rating with T4 cell count less than 200”
How does the VA rate Infectious Diseases conditions?
Common Questions About HIV-related illness VA Ratings
What is the VA disability rating for HIV-related illness?
The VA rates HIV-related illness under Diagnostic Code 6351 at the following tiers: 0%, 10%, 30%, 60%, 100%. The minimum 0% rating requires: Asymptomatic, following initial diagnosis of HIV infection, with or without lymphadenopathy or decreased T4 cell count. The maximum 100% rating requires: AIDS with recurrent opportunistic infections (see Note 3) or with secondary diseases afflicting multiple body systems; HIV-related illness with debility and progressive weight loss.
What is Diagnostic Code 6351?
Diagnostic Code 6351 is the VA rating identifier for HIV-related illness within 38 CFR 38 CFR § 4.88b. It defines the specific symptom criteria and percentage thresholds a VA adjudicator uses to assign a disability rating. The diagnostic code is listed on a veteran's rating decision letter.
What is the highest rating for HIV-related illness?
The highest schedular rating for HIV-related illness under DC 6351 is 100%. This tier requires: AIDS with recurrent opportunistic infections (see Note 3) or with secondary diseases afflicting multiple body systems; HIV-related illness with debility and progressive weight loss. Veterans who cannot secure substantially gainful employment due to HIV-related illness alone or in combination with other service-connected conditions may also qualify for TDIU at the 100% compensation rate under 38 CFR § 4.16.
What 38 CFR section governs HIV-related illness ratings?
HIV-related illness is rated under 38 CFR 38 CFR § 4.88b, Diagnostic Code 6351. This section is part of the Schedule for Rating Disabilities (38 CFR Part 4) and can be read in full at the eCFR website.
Which conditions are commonly secondary to HIV-related illness?
Secondary conditions caused or aggravated by HIV-related illness may be ratable under 38 CFR § 3.310. Veterans should work with a VSO or accredited claims agent to document the medical relationship.
What evidence do I need to establish service connection for HIV-related illness?
Service connection for HIV-related illness requires three elements: (1) a current diagnosis of the condition, (2) an in-service event, injury, or disease that may have caused or aggravated it, and (3) a medical nexus connecting the current diagnosis to that in-service event. A nexus letter from a treating physician or independent medical examiner is the most reliable nexus evidence. C&P exam findings can also establish nexus if adequately documented.
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