38 CFR Part 4 — 38 CFR § 4.88b

Pellagra — VA Diagnostic Code 6315

Infectious / immune

Diagnostic code

6315

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38 CFR § 4.88b lists Diagnostic Code 6315 as “Pellagra.” The percentage lines are 100, 60, 40, 20, and 10, in the same words as DC 6313. The code does not say to evaluate under the General Rating Formula for Infectious Diseases. Section 3.309(c)(2) lists “Pellagra” for a former prisoner of war interned or detained for not less than 30 days. Section 3.309(c)(1) does not list it.

Reviewed 2026-10-05. Text checked against the eCFR versioner full-text XML for 2026-10-01 on 2026-10-05. Title 38 was up to date as of 2026-10-01 and last amended on 2026-08-27. The § 4.88b source note prints 61 FR 39875, July 31, 1996, as amended at 84 FR 28230, June 18, 2019.

The rating criteria at each level

Pellagra — DC 6315

Rating %: 100

Criteria (verbatim). Marked mental changes, moist dermatitis, inability to retain adequate nourishment, exhaustion, and cachexia

Rating %: 60

Criteria (verbatim). With all of the symptoms listed below, plus mental symptoms and impaired bodily vigor

Rating %: 40

Criteria (verbatim). With stomatitis, diarrhea, and symmetrical dermatitis

Rating %: 20

Criteria (verbatim). With stomatitis, or achlorhydria, or diarrhea

Rating %: 10

Criteria (verbatim). Confirmed diagnosis with nonspecific symptoms such as: decreased appetite, weight loss, abdominal discomfort, weakness, inability to concentrate and irritability

Rating %	Criteria (verbatim)
100	Marked mental changes, moist dermatitis, inability to retain adequate nourishment, exhaustion, and cachexia
60	With all of the symptoms listed below, plus mental symptoms and impaired bodily vigor
40	With stomatitis, diarrhea, and symmetrical dermatitis
20	With stomatitis, or achlorhydria, or diarrhea
10	Confirmed diagnosis with nonspecific symptoms such as: decreased appetite, weight loss, abdominal discomfort, weakness, inability to concentrate and irritability

DC 6315 does not print a 0 percent line and does not say to evaluate under the General Rating Formula. 38 CFR § 4.31 says: “In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met.” 38 CFR § 4.7 assigns the higher rating when the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 CFR § 4.6 requires each element affecting the evidence to be studied so that decisions will be equitable and just.

The five criteria sentences match the five sentences under DC 6313. The titles do not match. Pellagra is not a parenthetical inside the avitaminosis title.

The code does not print a residual note. The 60 percent line still says “with all of the symptoms listed below,” and the 40, 20, and 10 percent lines are the lines printed under it.

The opening note of § 4.88b says to rate any residual disability of infection within the appropriate body system as indicated by the notes in the evaluation criteria. It then says, as applicable, to consider the long-term health effects potentially associated with infectious diseases as listed in § 3.317(d), specifically Brucellosis, Campylobacter jejuni, Coxiella burnetii (Q fever), Malaria, Mycobacterium Tuberculosis, Nontyphoid Salmonella, Shigella, Visceral Leishmaniasis, and West Nile virus. Pellagra is not one of those names.

Source: 38 CFR § 4.88b, Diagnostic Code 6315, eCFR full-text XML for 2026-10-01.

What the words mean in your records

The title is the list’s word

Section 3.309(c)(2) says “Pellagra.” The schedule title at DC 6315 is “Pellagra.”

Same lines as avitaminosis, separate name

Each line from 100 through 10 uses the same words as DC 6313. Section 3.309(c)(2) lists pellagra and avitaminosis separately. “Any other nutritional deficiency” is a third name in that paragraph. It is not the pellagra title.

Paragraph (c)(1) is a different list

Psychosis, anxiety states, dysthymic disorder, and the other paragraph (c)(1) names do not include pellagra. Paragraph (c)(1) does not use the 30-day internment sentence. Pellagra uses paragraph (c)(2).

Evidence that speaks to each level

100

What the rater needs to see. Marked mental changes, moist dermatitis, inability to retain adequate nourishment, exhaustion, and cachexia.

Where that usually lives. The examination that records those findings.

60, 40, or 20

What the rater needs to see. At 60, all of the symptoms listed below, plus mental symptoms and impaired bodily vigor. At 40, stomatitis, diarrhea, and symmetrical dermatitis. At 20, stomatitis, or achlorhydria, or diarrhea.

Where that usually lives. The clinical note that matches the line.

What the rater needs to see. A confirmed diagnosis with nonspecific symptoms such as decreased appetite, weight loss, abdominal discomfort, weakness, inability to concentrate and irritability.

Where that usually lives. The diagnosis and the symptom description.

Level	What the rater needs to see	Where that usually lives
100	Marked mental changes, moist dermatitis, inability to retain adequate nourishment, exhaustion, and cachexia.	The examination that records those findings.
60, 40, or 20	At 60, all of the symptoms listed below, plus mental symptoms and impaired bodily vigor. At 40, stomatitis, diarrhea, and symmetrical dermatitis. At 20, stomatitis, or achlorhydria, or diarrhea.	The clinical note that matches the line.
10	A confirmed diagnosis with nonspecific symptoms such as decreased appetite, weight loss, abdominal discomfort, weakness, inability to concentrate and irritability.	The diagnosis and the symptom description.

VA’s public DBQ list, checked October 5, 2026, names “Nutritional Deficiencies.” The file is Nutritional Deficiencies. The section heading of 38 CFR § 4.88b is “Schedule of ratings—infectious diseases, immune disorders and nutritional deficiencies.”

The exam form

DC 6315 prints five percentage lines and does not print a residual note. This page does not say the form replaces those lines.

Related codes and how they interact

Beriberi is the neighboring nutritional code with different lines

DC 6314 is beriberi. Its active-disease lines are 100, 60, and 30, and it then says to rate residuals under the appropriate body system. Those are not the pellagra lines. Both names are in § 3.309(c)(2).

Secondary conditions and presumptions

38 CFR § 3.309(c)(2) says: “If the veteran: (i) Is a former prisoner of war and; (ii) Was interned or detained for not less than 30 days, the following diseases shall be service connected if manifest to a degree of 10 percent or more at any time after discharge or release from active military, naval, air or space service even though there is no record of such disease during service, provided the rebuttable presumption provisions of § 3.307 are also satisfied.” “Pellagra” is in that list.

38 CFR § 3.307(a)(5) says the diseases listed in § 3.309(c) shall have become manifest to a degree of 10 percent or more at any time after discharge or release from active service. 38 CFR § 3.307(a)(1) says any period of service is sufficient for the purpose of establishing the presumptive service connection of a specified disease under the conditions listed in § 3.309(c) and (e). The 90-day sentence in that paragraph is not the sentence for § 3.309(c). Paragraph (c)(2) of § 3.309 is the paragraph that adds the 30-day internment or detention requirement. Paragraph (c)(1) does not list pellagra.

Section 3.309(a) does not name pellagra. Section 3.309(b) does not name it. The 2026-10-01 text of 38 CFR § 3.309(e) does not name pellagra. 38 CFR § 3.309(f) does not name pellagra. 38 CFR § 3.309(d) does not name pellagra. 38 CFR § 3.320 does not name pellagra. 38 CFR § 3.320a does not name pellagra. 38 CFR § 3.320b does not name pellagra. 38 CFR § 3.316 does not name pellagra. 38 CFR § 3.317 does not name pellagra.

A separate question, when a presumption does not decide it, is a medical question on the facts under 38 CFR § 3.310. Paragraph (a) covers disability proximately due to or the result of a service-connected disease or injury. Paragraph (b) covers increase in severity and requires a medical baseline.

Short answers

What is the VA rating for DC 6315?

Under 38 CFR § 4.88b, pellagra is rated 100, 60, 40, 20, or 10 percent on the printed lines. Those lines match DC 6313. The code does not print a 0 percent line. Education only. VA decides on the evidence.

Is pellagra a former-prisoner presumption?

Section 3.309(c)(2) lists “Pellagra” when the veteran is a former prisoner of war who was interned or detained for not less than 30 days, if the disease is manifest to a degree of 10 percent or more at any time after discharge or release, and the rebuttable presumption provisions of § 3.307 are also satisfied.

FAQ

How does VA rate pellagra under DC 6315?

The lines are 100, 60, 40, 20, and 10 percent, in the same words as avitaminosis. The code does not say to use the General Rating Formula for Infectious Diseases. Education only.

Why do two codes print the same lines?

The 2026-10-01 text of DC 6313 and DC 6315 prints the same five criteria sentences. The titles remain “Avitaminosis” and “Pellagra.” Section 3.309(c)(2) lists both.

What service fact does paragraph (c)(2) require?

The veteran is a former prisoner of war and was interned or detained for not less than 30 days. Manifestation is to a degree of 10 percent or more at any time after discharge or release. Section 3.307(a)(1) says any period of service is sufficient for a disease listed in § 3.309(c).

Next steps

Read the decision for DC 6315 and which of the five lines was used.
The free worksheet is a place to write the code, the findings, and the records you already have. It does not file a claim or protect a filing date. An accredited representative is at find a VSO.
Other codes in this schedule are on the infectious-disease diagnostic-code index.

Education only. Not legal or medical advice. My Claim Packet is not a VA-accredited representative and does not file claims. VA decides every claim on its own evidence.

Other codes in this body system

Nearby catalog entries in Infectious / immune, ordered by diagnostic code number. All Infectious / immune codes

Also: DC code lookup (tools) lists the same index in a compact layout.

Source: 38 CFR Part 4, Diagnostic Code 6315 • va.gov

⚠️ Important Disclaimer

This page provides general educational information based on public VA regulations and VA.gov resources. It is not legal or medical advice, and My Claim Packet is not a VA-accredited representative. Any worksheets or draft documents produced by the tools must be reviewed for accuracy and are not filed with VA for you. Ratings and service connection are decided case-by-case from the individual record. Consult a VA-accredited VSO, claims agent, attorney, or qualified clinician for help with your situation, and verify current rules using the linked official source.