Sarcoidosis

Sarcoidosis is a multi-system inflammatory disease, and the VA schedule reflects that. Diagnostic Code 6846 in 38 CFR § 4.97 rates pulmonary disease mainly through corticosteroid requirements and severe cardiopulmonary findings. The same code also allows VA to rate active disease or residuals as chronic bronchitis and to evaluate extra-pulmonary involvement under the affected body system.

Service connection is a separate question. Sarcoidosis is specifically listed in 38 U.S.C. § 1120 as presumptive for a covered veteran as defined in § 1119. The presumption can establish the connection to service; it does not choose the percentage.

TL;DR

• Sarcoidosis is DC 6846, with listed levels of 0, 30, 60, and 100 percent.
• 0%: chronic hilar adenopathy or stable lung infiltrates without symptoms or physiologic impairment.
• 30%: pulmonary involvement with persistent symptoms requiring chronic low-dose maintenance or intermittent corticosteroids.
• 60%: pulmonary involvement requiring systemic high-dose therapeutic corticosteroids for control.
• 100%: cor pulmonale, cardiac involvement with congestive heart failure, or progressive pulmonary disease with fever, night sweats, and weight loss despite treatment.
• VA may instead rate active disease or residuals as chronic bronchitis under DC 6600 and evaluate extra-pulmonary involvement under the affected body system.
• Sarcoidosis is a PACT Act presumptive disease for veterans who satisfy the statutory covered-service definition.
• No verified aggregate Board-outcome cut specific to sarcoidosis was available, so no grant-rate statistic is published.

DC 6846 Rating Criteria

0 percent

The noncompensable level applies to chronic hilar adenopathy or stable lung infiltrates without symptoms or physiologic impairment. Imaging alone can establish disease without establishing a compensable level.

30 percent

The 30-percent level requires pulmonary involvement with persistent symptoms requiring chronic low-dose maintenance corticosteroids or intermittent corticosteroids. The treatment record should identify the drug, dose, frequency, and reason it is being used.

60 percent

The 60-percent level requires pulmonary involvement controlled with systemic high-dose therapeutic corticosteroids. “High dose” is a medical and record-specific question; a medication name without dosage and treatment context leaves the criterion unresolved.

100 percent

The highest level applies with cor pulmonale; cardiac involvement with congestive heart failure; or progressive pulmonary disease accompanied by fever, night sweats, and weight loss despite treatment. The code requires the complete severe pattern, not one constitutional symptom in isolation.

Alternative Rating and Other Organ Involvement

DC 6846 permits active disease or residuals to be rated as chronic bronchitis under DC 6600. That route uses pulmonary-function and other respiratory criteria. It can matter when physiologic impairment describes the disability better than the corticosteroid ladder.

Sarcoidosis can also involve the eyes, skin, heart, nervous system, liver, joints, and other organs. DC 6846 directs extra-pulmonary involvement to the specific body system involved. The record should identify each diagnosed manifestation and distinguish it from symptoms that have another cause.

VA's anti-pyramiding rule still applies. Separate ratings require distinct manifestations, not different labels for the same respiratory impairment.

PACT Act Presumption

Section 1120 lists sarcoidosis as presumptively service connected when it becomes manifest in a “covered veteran.” Section 1119 defines covered service through specified locations and periods. This is more precise than saying that any burn-pit exposure or any deployment qualifies.

For the presumptive route, submit:

• service records establishing a qualifying location and period;
• a current sarcoidosis diagnosis; and
• records showing the current manifestations and treatment.

The presumption addresses nexus. VA still needs evidence to assign the percentage and any organ-specific evaluations.

Direct Service Connection

Veterans outside the statutory definition can still pursue direct service connection under 38 CFR § 3.303. That route requires a current diagnosis, an in-service event or onset, and a medical opinion linking the disease to service. A toxic-exposure risk activity memorandum can support the exposure history, but a clinician must still address causation when no presumption applies.

What the Medical Record Should Show

• How the diagnosis was established and what alternative infections or diseases were excluded.
• Chest imaging and pulmonary-function studies.
• Corticosteroid name, dose, schedule, duration, and treatment purpose.
• Whether disease is stable, active, or progressive despite treatment.
• Cardiology evidence for cor pulmonale, cardiac sarcoidosis, or heart failure.
• Diagnosed eye, skin, neurologic, or other extra-pulmonary involvement.
• Functional effects such as exertional limitation tied to objective disease.

Common Failure Modes

• Treating the PACT Act presumption as an automatic percentage.
• Saying “steroids” without documenting the systemic dose and duration.
• Ignoring extra-pulmonary organ involvement.
• Counting the same pulmonary impairment under both DC 6846 and DC 6600.
• Describing all fatigue or joint pain as sarcoidosis without medical attribution.

Bottom Line

Sarcoidosis claims have two maps. Section 1120 may establish presumptive service connection for a covered veteran. DC 6846 then rates pulmonary severity by treatment and severe findings, while permitting chronic-bronchitis or organ-specific routes when those better describe the residuals. A complete packet proves both the qualifying service and the current medical pattern.

Legal sources: 38 CFR § 4.97, 38 U.S.C. § 1119, 38 U.S.C. § 1120, and 38 CFR § 3.303, checked August 13, 2026.