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Lyme Disease VA Disability Rating
DC 6319 | 38 C.F.R. § 4.88b | M21-1, Part IV.ii.2.A
OVERVIEW
Lyme disease is rated under DC 6319 at 38 C.F.R. § 4.88b, directing evaluation under the General Rating Formula and rating residual disabilities under the appropriate body system. The VA rates Lyme primarily on residuals: arthritis, Bell's palsy, radiculopathy, ocular dysfunction, and cognitive dysfunction — each rated under the relevant diagnostic codes. Veterans may contract Lyme during field exercises or training in tick-endemic areas.
RATING CRITERIA (4 LEVELS)
100% — Severe systemic active Lyme disease
Active Lyme with severe multisystem involvement requiring hospitalization or inability to perform ADLs.
60% — Significant multisystem residual disability
Multiple system involvement with significant functional limitation — rate each residual under appropriate body system codes.
30% — Moderate residual disability
Bell's palsy incomplete severe (DC 8207, 20%); OR moderate radiculopathy; OR arthritis with significant limitation.
10% — Mild residual disability
Confirmed Lyme with residual symptoms — Bell's palsy incomplete moderate (10%); OR mild radiculopathy; OR mild arthritis.
KEY EVIDENCE TO GATHER
-Two-tier serological testing: ELISA positive followed by Western blot confirmation
-CDC-confirmatory Western blot results (IgG and/or IgM bands)
-Service records documenting tick exposure in endemic training areas
-Treatment records (doxycycline, IV ceftriaxone for late disease)
-Objective testing for residuals: EMG/NCS for neuropathy, MRI for neurological Lyme
SECONDARY CONDITIONS (4 MAPPED)
DC 5010/5002
Lyme arthritis is a direct complication — rate under musculoskeletal codes.
DC 8207
Lyme disease is the most common cause of bilateral Bell's palsy.
DC 8520
Lyme neuroborreliosis causes peripheral radiculopathy.
DC 9326
Late Lyme encephalopathy causes cognitive impairment.
C&P EXAM TIPS (4)
1.Lyme is rated primarily on residuals — file separately for each residual condition (arthritis, Bell's palsy, radiculopathy, cognitive dysfunction).
2.The value is in the combined rating of all residuals, not the Lyme diagnosis itself.
3.Objective Western blot confirmation is required — the CDC two-tier testing standard applies.
4.Bell's palsy from Lyme rates under DC 8207 — complete palsy rates 30%.
RELEVANT CASE LAW
38 C.F.R. § 4.88b, DC 6319 Note
Rate under the appropriate body system any residual disability including but not limited to arthritis, Bell's palsy, radiculopathy, ocular, or cognitive dysfunction.
DOLLAR IMPACT
Residuals combined: Bell's palsy 20% + arthritis 20% + radiculopathy 20% can reach 50% combined. Active multisystem Lyme: 60-100%.
EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026