38 CFR Part 4 — 38 CFR § 4.97

Stenosis of the larynx — VA Diagnostic Code 6520

ENT / airway

Diagnostic code

6520

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38 CFR § 4.97 lists Diagnostic Code 6520 as “Larynx, stenosis of, including residuals of laryngeal trauma (unilateral or bilateral).” The lines are 100, 60, 30, and 10. Every percentage line names a Flow-Volume Loop compatible with upper airway obstruction, except that the 100 line also allows a permanent tracheostomy. The note says to evaluate as aphonia (DC 6519). The catalog slug is dc-6520-larynx-stenosis-of.

Reviewed 2026-10-05. Text checked against the eCFR versioner full-text XML for 2026-10-01 on 2026-10-05. Title 38 was last amended on 2026-08-27. On 2026-10-05 the titles list reports up to date as of 2026-10-02, and the 2026-10-02 XML for the sections quoted here matches the 2026-10-01 XML. Section 4.97 source note: [61 FR 46728, Sept. 5, 1996, as amended at 71 FR 28586, May 17, 2006].

The rating criteria at each level

Larynx, stenosis of, including residuals of laryngeal trauma (unilateral or bilateral) — DC 6520

Rating %: 100

Criteria (verbatim). Forced expiratory volume in one second (FEV-1) less than 40 percent of predicted value, with Flow-Volume Loop compatible with upper airway obstruction, or; permanent tracheostomy

Rating %: 60

Criteria (verbatim). FEV-1 of 40- to 55-percent predicted, with Flow-Volume Loop compatible with upper airway obstruction

Rating %: 30

Criteria (verbatim). FEV-1 of 56- to 70-percent predicted, with Flow-Volume Loop compatible with upper airway obstruction

Rating %: 10

Criteria (verbatim). FEV-1 of 71- to 80-percent predicted, with Flow-Volume Loop compatible with upper airway obstruction

Rating %	Criteria (verbatim)
100	Forced expiratory volume in one second (FEV-1) less than 40 percent of predicted value, with Flow-Volume Loop compatible with upper airway obstruction, or; permanent tracheostomy
60	FEV-1 of 40- to 55-percent predicted, with Flow-Volume Loop compatible with upper airway obstruction
30	FEV-1 of 56- to 70-percent predicted, with Flow-Volume Loop compatible with upper airway obstruction
10	FEV-1 of 71- to 80-percent predicted, with Flow-Volume Loop compatible with upper airway obstruction

The 100 line says “less than 40 percent of predicted value,” with the word percent not hyphenated to 40. The 60, 30, and 10 lines say “40- to 55-percent,” “56- to 70-percent,” and “71- to 80-percent.” The hyphen sits on both the number and the word percent.

“Flow-Volume Loop” is capitalized on every line. The 100 line joins “permanent tracheostomy” with “or;”. The 60, 30, and 10 lines do not mention a tracheostomy.

Note: “Or evaluate as aphonia (DC 6519).” The note does not say “or” before a percentage. DC 6520 does not print a 0 percent line.

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.

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 title says “unilateral or bilateral.” It does not print a separate column for one side. 38 CFR § 4.96(d) is the special provision for diagnostic codes 6600, 6603, 6604, 6825-6833, and 6840-6845. DC 6520 is not in that list. The post-bronchodilator rules in paragraph (d) are not printed on DC 6520.

Paragraph (a) of § 4.96 says ratings under diagnostic codes 6600 through 6817 and 6822 through 6847 will not be combined with each other. DC 6520 is not in that span. 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 DC 6518 partial-laryngectomy row names stenosis of larynx (DC 6520) as one of three ways to rate those residuals. DC 6520’s own note points the other way, to aphonia (DC 6519). DC 6519’s 100 line is “Constant inability to communicate by speech,” with superscript 1. DC 6520’s 100 does not carry that superscript.

The 2026-10-01 text of 38 CFR § 3.309 does not contain “6520,” “stenosis,” or “larynx.” This page does not add DC 6520 to a presumptive row.

Source: 38 CFR § 4.97, Diagnostic Code 6520, eCFR full-text XML for 2026-10-01. The source note prints [61 FR 46728, Sept. 5, 1996, as amended at 71 FR 28586, May 17, 2006].

What the words mean in your records

The loop is on every percentage line

Each of 100, 60, 30, and 10 requires a Flow-Volume Loop compatible with upper airway obstruction, paired with an FEV-1 band. The 100 line adds “or; permanent tracheostomy.”

Percent is hyphenated only on the lower three lines

The 100 line says “less than 40 percent of predicted value.” The 60 line says “40- to 55-percent predicted.” The hyphenation is not the same.

The note names DC 6519 only

“Or evaluate as aphonia (DC 6519).” The note does not name DC 6516. DC 6519’s own note sends incomplete aphonia to chronic laryngitis (DC 6516).

Evidence that speaks to each level

FEV-1 and the loop

What the rater needs to see. FEV-1 as a percent of predicted, and a Flow-Volume Loop compatible with upper airway obstruction. The bands are less than 40, 40- to 55-, 56- to 70-, and 71- to 80-percent predicted.

Where that usually lives. The pulmonary-function report that includes the Flow-Volume Loop.

Permanent tracheostomy, or aphonia

What the rater needs to see. A permanent tracheostomy is the alternative on the 100 line. The note says to evaluate as aphonia under DC 6519 instead.

Where that usually lives. The operative record, and the speech findings if the note is the path used.

Level	What the rater needs to see	Where that usually lives
FEV-1 and the loop	FEV-1 as a percent of predicted, and a Flow-Volume Loop compatible with upper airway obstruction. The bands are less than 40, 40- to 55-, 56- to 70-, and 71- to 80-percent predicted.	The pulmonary-function report that includes the Flow-Volume Loop.
Permanent tracheostomy, or aphonia	A permanent tracheostomy is the alternative on the 100 line. The note says to evaluate as aphonia under DC 6519 instead.	The operative record, and the speech findings if the note is the path used.

VA’s public DBQ list, checked October 5, 2026, names “Sinusitis, Rhinitis and Other Conditions of the Nose, Throat, Larynx and Pharynx.” The file is Sinusitis, Rhinitis and Other Conditions of the Nose, Throat, Larynx and Pharynx.

The exam form

DC 6520’s percentages are the FEV-1 and Flow-Volume Loop lines, or a permanent tracheostomy at 100, or evaluation as aphonia under DC 6519. This page does not say the form replaces those sentences.

Related codes and how they interact

Partial laryngectomy can land here

DC 6518 says to rate residuals of a partial laryngectomy as laryngitis (DC 6516), aphonia (DC 6519), or stenosis of larynx (DC 6520). DC 6520 then has its own note back to DC 6519.

Secondary conditions and presumptions

Section 3.309 does not contain “6520” or “larynx.” This page does not add DC 6520 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 stenosis of the larynx under DC 6520?

Under 38 CFR § 4.97, Diagnostic Code 6520 rates stenosis of the larynx, including residuals of laryngeal trauma, unilateral or bilateral, at 100, 60, 30, or 10 by the FEV-1 band, each with a Flow-Volume Loop compatible with upper airway obstruction. Permanent tracheostomy is an alternative on the 100 line. The note says to evaluate as aphonia under DC 6519. Education only. VA decides on the evidence.

Does the 100 percent line require both the loop and a tracheostomy?

The line joins them with “or;”. It is FEV-1 less than 40 percent of predicted, with a Flow-Volume Loop compatible with upper airway obstruction, or a permanent tracheostomy. Education only.

FAQ

What are the DC 6520 percentages?

100, 60, 30, and 10. Each line pairs an FEV-1 band with a Flow-Volume Loop compatible with upper airway obstruction. The 100 line also says “or; permanent tracheostomy.” Education only.

Where is the hyphen in “55-percent”?

On the 60, 30, and 10 lines: “40- to 55-percent,” “56- to 70-percent,” and “71- to 80-percent.” The 100 line says “less than 40 percent of predicted value,” without that hyphen.

Does § 4.96(d) apply to DC 6520?

The paragraph lists diagnostic codes 6600, 6603, 6604, 6825-6833, and 6840-6845. DC 6520 is not in that list. The post-bronchodilator rules are not printed on this code.

Next steps

Read the decision for DC 6520, the FEV-1 percent predicted, whether the Flow-Volume Loop is in the report, and whether a permanent tracheostomy is present.
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 nose, throat, and larynx codes are on the ENT / airway 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 ENT / airway, ordered by diagnostic code number. All ENT / airway codes

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

Source: 38 CFR Part 4, Diagnostic Code 6520 • va.gov

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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.