38 CFR Part 4 — 38 CFR § 4.88b

Lyme disease — VA Diagnostic Code 6319

Infectious / immune

Diagnostic code

6319

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38 CFR § 4.88b lists Diagnostic Code 6319 as “Lyme disease:”. The title ends with a colon. The rating cell on that title is empty. The next cell says “Evaluate under the General Rating Formula.” A note follows. Appendix B to Part 4 indexes “Lyme disease.”

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

6319 Lyme disease — the row this code prints

Rating %: —

Criteria (verbatim). Evaluate under the General Rating Formula.

Rating %	Criteria (verbatim)
—	Evaluate under the General Rating Formula.

General Rating Formula for Infectious Diseases — DC 6319 says to evaluate under this formula

Rating %: 100

Criteria (verbatim). For active disease

Rating %: —

Criteria (verbatim). After active disease has resolved, rate at 0 percent for infection. Rate any residual disability of infection within the appropriate body system.

Rating %	Criteria (verbatim)
100	For active disease
—	After active disease has resolved, rate at 0 percent for infection. Rate any residual disability of infection within the appropriate body system.

Note: Rate under the appropriate body system any residual disability of infection, which includes, but is not limited to, arthritis, Bell's palsy, radiculopathy, ocular, or cognitive dysfunction.

The second line of the General Rating Formula does not print a number in the rating column. The words “rate at 0 percent” are inside the criteria cell.

DC 6319’s own row does not print a percentage. The formula’s 100 percent line is “For active disease.” The line does not say “As active disease.” 38 CFR § 4.31 says that 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. The zero percent words sit inside the formula’s second cell, for the infection after active disease has resolved. 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. 38 CFR § 4.14 says the evaluation of the same disability under various diagnoses is to be avoided, and that the evaluation of the same manifestation under different diagnoses is to be avoided.

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. Lyme disease is not one of those names. The 2026-10-01 text of 38 CFR § 3.309 does not contain “Lyme.” The 2026-10-01 text of 38 CFR § 3.317 does not contain “Lyme.”

The Lyme note names examples. It does not assign a diagnostic code to arthritis, Bell's palsy, radiculopathy, ocular dysfunction, or cognitive dysfunction. DC 6318 is “Melioidosis:” and also says to evaluate under the General Rating Formula. Its Note 2 names arthritis, lung lesions, or meningitis. Those examples are not the Lyme note. DC 6320 is “Parasitic diseases otherwise not specified:”. Its note says to rate any residual disability of infection and does not print the Lyme examples.

Source: 38 CFR § 4.88b, Diagnostic Code 6319 and the General Rating Formula for Infectious Diseases, eCFR full-text XML for 2026-10-01.

What the words mean in your records

The code points at the formula

The DC 6319 cell says “Evaluate under the General Rating Formula.” The 100 percent line of that formula is “For active disease.” After active disease has resolved, the formula says to rate at 0 percent for the infection and to rate any residual disability of infection within the appropriate body system.

The note’s examples are not codes

The note includes, but is not limited to, arthritis, Bell's palsy, radiculopathy, ocular, or cognitive dysfunction. It does not print a diagnostic code next to any of those words.

Lyme is outside the opening list

The opening note of § 4.88b names Brucellosis, Campylobacter jejuni, Coxiella burnetii (Q fever), Malaria, Mycobacterium Tuberculosis, Nontyphoid Salmonella, Shigella, Visceral Leishmaniasis, and West Nile virus for the long-term health effects in § 3.317(d). It does not name Lyme disease.

Evidence that speaks to each level

100 — for active disease

What the rater needs to see. Active Lyme disease. That is the formula’s 100 percent line. The line says “For active disease.”

Where that usually lives. The records that document active disease.

After active disease has resolved

What the rater needs to see. The formula’s second cell says to rate at 0 percent for the infection and to rate any residual disability of infection within the appropriate body system. The Lyme note’s examples include arthritis, Bell's palsy, radiculopathy, ocular, or cognitive dysfunction.

Where that usually lives. The examination of the body system the residual affects.

Level	What the rater needs to see	Where that usually lives
100 — for active disease	Active Lyme disease. That is the formula’s 100 percent line. The line says “For active disease.”	The records that document active disease.
After active disease has resolved	The formula’s second cell says to rate at 0 percent for the infection and to rate any residual disability of infection within the appropriate body system. The Lyme note’s examples include arthritis, Bell's palsy, radiculopathy, ocular, or cognitive dysfunction.	The examination of the body system the residual affects.

VA’s public DBQ list, checked October 5, 2026, names “Infectious Diseases (other than HIV-related illness chronic fatigue syndrome and tuberculosis).” The file is Infectious Diseases (other than HIV-related illness chronic fatigue syndrome and tuberculosis).

The exam form

DC 6319 says to evaluate under the General Rating Formula and then prints its residual note. This page does not say the form replaces those lines.

Related codes and how they interact

Melioidosis and unspecified parasitic diseases use the same formula.

DC 6318 and DC 6320 also say “Evaluate under the General Rating Formula.” The residual note is not the same sentence on each code. The Lyme note is the sentence that names arthritis, Bell's palsy, radiculopathy, ocular, or cognitive dysfunction.

Secondary conditions and presumptions

The 2026-10-01 text of § 3.309 does not contain “Lyme,” and the opening list in § 4.88b does not name Lyme disease for § 3.317(d). This page does not add DC 6319 to a presumptive row.

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

How does VA rate Lyme disease under DC 6319?

Under 38 CFR § 4.88b, Diagnostic Code 6319 says to evaluate under the General Rating Formula for Infectious Diseases. Active disease is 100 percent. After active disease has resolved, the formula says to rate at 0 percent for the infection and to rate residuals within the appropriate body system. The note’s examples include arthritis, Bell's palsy, radiculopathy, ocular, or cognitive dysfunction. Education only. VA decides on the evidence.

Does the schedule list Lyme disease as a tropical disease?

The 2026-10-01 text of § 3.309 does not contain “Lyme.” The opening note of § 4.88b does not name Lyme disease among the infectious diseases it lists for § 3.317(d). Education only.

FAQ

What percentage does DC 6319 print on its own row?

None. The row says “Evaluate under the General Rating Formula.” That formula is 100 percent for active disease. After active disease has resolved, it says to rate at 0 percent for the infection and to rate residuals within the appropriate body system. Education only.

Does the Lyme note assign a code to Bell's palsy or radiculopathy?

No. The note says to rate residual disability of infection under the appropriate body system. The examples include arthritis, Bell's palsy, radiculopathy, ocular, or cognitive dysfunction. The note does not print a diagnostic code for those examples.

Is Lyme disease named in the § 4.88b opening list?

No. That note names Brucellosis, Campylobacter jejuni, Coxiella burnetii (Q fever), Malaria, Mycobacterium Tuberculosis, Nontyphoid Salmonella, Shigella, Visceral Leishmaniasis, and West Nile virus. Lyme disease is not in that list. Section 3.309 does not contain “Lyme.”

Next steps

Read the decision for DC 6319, whether it used the active-disease line, and which body system it used for a residual.
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 infectious-disease codes 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 6319 • 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.