38 CFR Part 4 — 38 CFR § 4.88b

Coxiella burnetii infection (Q fever) — VA Diagnostic Code 6331

Infectious / immune

Diagnostic code

6331

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38 CFR § 4.88b lists Diagnostic Code 6331 as “Coxiella burnetii infection (Q fever).” The code says to evaluate under the General Rating Formula for Infectious Diseases. The note rates residuals and names chronic hepatitis, endocarditis, osteomyelitis, post Q-fever chronic fatigue syndrome, or vascular infections. Section 3.317(c)(2)(iii) lists “Coxiella burnetii (Q fever).” The schedule title adds the word “infection.”

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 § 3.317 source note prints 75 FR 59970, Sept. 29, 2010, as amended at 75 FR 61356, Oct. 5, 2010; 75 FR 61997, Oct. 7, 2010; 76 FR 41698, July 15, 2011; 76 FR 81836, Dec. 29, 2011; 81 FR 71384, Oct. 17, 2016; 86 FR 51001, Sept. 14, 2021.

The rating criteria at each level

General Rating Formula for Infectious Diseases — DC 6331 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, chronic hepatitis, endocarditis, osteomyelitis, post Q-fever chronic fatigue syndrome, or vascular infections.

DC 6331’s own row does not print a percentage. It says: “Evaluate under the General Rating Formula.” 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. The cell also says to rate any residual disability of infection within the appropriate body system. 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 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. The opening note also names Mycobacterium Tuberculosis. DC 6331 is not that name. DC 6311 is “Tuberculosis, miliary.” The 2026-10-01 schedule titles tuberculosis under more than one code, so § 3.317(c)(2)(v) is not assigned here.

Source: 38 CFR § 4.88b, Diagnostic Code 6331, eCFR full-text XML for 2026-10-01.

What the words mean in your records

Active disease, then the resolved-infection line

The formula’s 100 percent line is “For active disease.” The next line has no number in the rating column. It says to rate at 0 percent for the infection after active disease has resolved, and to rate any residual disability of infection within the appropriate body system.

The schedule title and the § 3.317 name

Section 3.317(c)(2)(iii) says “Coxiella burnetii (Q fever).” The schedule title at DC 6331 is “Coxiella burnetii infection (Q fever).”

The note and the table do not use the same words

The schedule note says “post Q-fever chronic fatigue syndrome” and “vascular infections.” The table says “Post-Q-fever chronic fatigue syndrome,” with a hyphen after Post, and “Vascular infection,” in the singular. The note does not print DC 7001, the schedule title “Endocarditis,” and it does not print DC 6354, “Chronic fatigue syndrome (CFS).” Those codes are separate titles. The note’s phrase is “post Q-fever chronic fatigue syndrome.”

Evidence that speaks to each level

100 — for active disease

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

Where that usually lives. The record that describes active disease, including the confirmation the note requires when it requires one.

After active disease has resolved

What the rater needs to see. The unnumbered formula line: rate at 0 percent for the infection, and rate any residual disability of infection within the appropriate body system. The DC 6331 note states the residual examples printed under that code.

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

Level	What the rater needs to see	Where that usually lives
100 — for active disease	Active disease. That is the formula’s 100 percent line. The line says “For active disease.”	The record that describes active disease, including the confirmation the note requires when it requires one.
After active disease has resolved	The unnumbered formula line: rate at 0 percent for the infection, and rate any residual disability of infection within the appropriate body system. The DC 6331 note states the residual examples printed under that code.	The examination of the body system used for the residual.

VA’s public DBQ list, checked October 5, 2026, names “Infectious Diseases (other than HIV-related illness chronic fatigue syndrome and tuberculosis)” under Infectious Diseases, and, separately, “Persian Gulf/Afghanistan Infectious Diseases.” The files are Infectious Diseases (other than HIV-related illness chronic fatigue syndrome and tuberculosis) and Persian Gulf/Afghanistan Infectious Diseases. The public list prints the infectious-disease title without commas between “HIV-related illness,” “chronic fatigue syndrome,” and “tuberculosis.”

The exam form

DC 6331 says to evaluate under the General Rating Formula and prints the note under that code. This page does not say either form replaces those lines.

Related codes and how they interact

The formula is shared. The note is not.

Several codes in § 4.88b say to evaluate under the same formula. The residual examples under DC 6331 are the ones printed on that code. DC 6304 names liver or splenic damage and central nervous system conditions. That list is not this note. 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.

Secondary conditions and presumptions

38 CFR § 3.317(c)(2)(iii) lists “Coxiella burnetii (Q fever).” Paragraph (c)(1) says a disease listed in paragraph (c)(2) will be service connected if it becomes manifest in a veteran with a qualifying period of service, provided paragraph (c)(3) is also satisfied, except as paragraph (c)(4) provides.

38 CFR § 3.317(c)(3)(i) says, with three exceptions, the disease must have become manifest to a degree of 10 percent or more within 1 year from the date of separation from a qualifying period of service as specified in paragraph (c)(3)(ii). The same paragraph then says malaria must have become manifest to a degree of 10 percent or more within 1 year from that separation, or at a time when standard or accepted treatises indicate that the incubation period commenced during a qualifying period of service. It then says there is no time limit for visceral leishmaniasis or tuberculosis to have become manifest to a degree of 10 percent or more. Paragraph (c)(3)(ii) defines a qualifying period of service as a period meeting paragraph (e), or active military, naval, or air service on or after September 19, 2001, in Afghanistan. Paragraph (c)(4) says a listed disease shall not be presumed service connected if there is affirmative evidence that it was not incurred during a qualifying period of service, that a supervening condition or event caused it between the most recent departure from that service and the onset of the disease, or that it is the result of the veteran’s own willful misconduct or the abuse of alcohol or drugs. Coxiella burnetii (Q fever) is not malaria, visceral leishmaniasis, or tuberculosis. The one-year sentence is the general rule in that paragraph. The 2026-10-01 text does not print a Diagnostic Code 6332 between DC 6331 and DC 6333.

The table to § 3.317, column B under Coxiella burnetii (Q fever), prints: Chronic hepatitis; Endocarditis; Osteomyelitis; Post-Q-fever chronic fatigue syndrome; and Vascular infection. 38 CFR § 3.317(d)(2) says that if a veteran presumed service connected for one of the diseases listed in paragraph (c)(2) is diagnosed with one of the diseases listed in column B of the table to § 3.317, within the time period specified for that disease in the table if a time period is specified, or otherwise at any time, VA will request a medical opinion as to whether it is at least as likely as not that the column B condition was caused by the veteran having had the associated disease in column A. That paragraph is not a rating percentage.

The 2026-10-01 text of 38 CFR § 3.309(a) does not name Coxiella burnetii (Q fever). 38 CFR § 3.309(b) does not name Coxiella burnetii (Q fever). 38 CFR § 3.309(c) does not name Coxiella burnetii (Q fever). 38 CFR § 3.309(e) does not name Coxiella burnetii (Q fever). 38 CFR § 3.309(f) does not name Coxiella burnetii (Q fever). 38 CFR § 3.316 does not name Coxiella burnetii (Q fever). 38 CFR § 3.320 does not name Coxiella burnetii (Q fever). 38 CFR § 3.320a does not name Coxiella burnetii (Q fever). 38 CFR § 3.320b does not name Coxiella burnetii (Q fever). 38 CFR § 3.309(b) lists “Malaria.” It does not list “Coxiella burnetii (Q fever).”

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 6331?

Under 38 CFR § 4.88b, Coxiella burnetii infection (Q fever) is evaluated under the General Rating Formula for Infectious Diseases: 100 percent for active disease, then 0 percent for the infection after active disease has resolved, with residuals rated under the appropriate body system. Education only. VA decides on the evidence.

Is Coxiella burnetii (Q fever) a chronic disease under § 3.309(a)?

Section 3.309(a) does not name Coxiella burnetii (Q fever). Section 3.317(c)(2)(iii) does, for a qualifying period of service under that section.

FAQ

How does VA rate DC 6331?

The code 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 under the appropriate body system. The note under DC 6331 prints the residual examples for this code. Education only.

Which presumption names Coxiella burnetii (Q fever)?

Section 3.317(c)(2)(iii) lists it for a qualifying period of service, with the time rule in paragraph (c)(3)(i). Coxiella burnetii (Q fever) is not malaria, visceral leishmaniasis, or tuberculosis. The one-year sentence is the general rule in that paragraph. The 2026-10-01 text does not print a Diagnostic Code 6332 between DC 6331 and DC 6333. Section 3.309(a), (b), (c), (e), and (f) do not name it.

Does the § 3.317 table assign a percentage?

No. Paragraph (d)(2) says VA will request a medical opinion on whether a column B condition was caused by the infectious disease. The rating instruction for residuals is the note under DC 6331 and the second line of the General Rating Formula.

Next steps

Read the decision for DC 6331, whether the formula’s active-disease line was used, and which body system was used for residuals.
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 6331 • 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.