VA Rating for COVID: Residuals, Long COVID, and Survivor Benefits

The VA rating for COVID isn’t a single number. Because COVID-19 is an acute infectious disease, the VA does not assign it its own diagnostic code. Once the active infection resolves, it’s rated at zero percent, and any lasting condition the infection caused is rated separately under the diagnostic code that fits the affected body system. A veteran with lung scarring is rated under the respiratory schedule; a veteran with heart damage, under the cardiovascular schedule; and so on.

Congress made the service-connection side easier by creating a statutory presumption. The harder work for most claimants is identifying the residual conditions, understanding how each is rated, and gathering the evidence to support them.

Who Qualifies Under the Presumption

Under 38 U.S.C. § 1164, COVID-19 is presumptively service-connected for veterans who served during a qualifying period and whose symptoms appeared within a specified window.¹ The qualifying periods are:

Active duty of more than 48 continuous hours, beginning on or after March 1, 2020, through January 5, 2024.
Active duty for training and National Guard duty under Title 10 orders issued on or after March 13, 2020, through January 5, 2024.
Certain qualifying periods of inactive duty for training between March 13, 2020, and January 5, 2024.²

Symptoms must have manifested during the qualifying duty period (if it exceeded 48 continuous hours) or within 14 days of separation from that duty.¹ When the presumption applies, the VA accepts that both the infection and any resulting disability are connected to service. Veterans who don’t meet these criteria can still file a direct service-connection claim, but they carry the burden of proving the infection was tied to their military service.

How Residuals Are Rated

The rule under 38 CFR § 4.88b is that once the active disease resolves, the infection itself is rated at zero percent and any residual disability is rated within the appropriate body system.³ Each condition is evaluated on its own, and a veteran can hold ratings for multiple residuals at the same time. The one limit is the anti-pyramiding rule: the same symptom cannot be counted twice across different ratings.

A veteran hospitalized for 21 or more consecutive days because of a service-connected COVID infection may qualify for a temporary 100 percent rating covering the hospitalization period.

Respiratory Conditions

Respiratory problems are among the most common long COVID residuals. Conditions like chronic bronchitis, asthma, and restrictive lung disease are rated under 38 CFR § 4.97, primarily on pulmonary function testing (FEV-1 and FEV-1/FVC ratios):³

10 percent: FEV-1 of 71–80 percent predicted, FEV-1/FVC of 71–80 percent, or intermittent inhalational therapy.
30 percent: FEV-1 of 56–70 percent predicted, FEV-1/FVC of 56–70 percent, or daily inhalational therapy.
60 percent: FEV-1 of 40–55 percent predicted, FEV-1/FVC of 40–55 percent, or monthly doctor visits for exacerbations.
100 percent: FEV-1 below 40 percent predicted, FEV-1/FVC below 40 percent, or daily oxygen therapy.

Cardiovascular Conditions

COVID can leave lasting heart damage, including myocarditis, pericarditis, and cardiomyopathy, rated under 38 CFR § 4.104. Cardiomyopathy under Diagnostic Code 7020, for example, is rated on exercise tolerance in METs (metabolic equivalents) and left ventricular ejection fraction:⁴

30 percent: Workload greater than 5 but not greater than 7 METs producing shortness of breath, fatigue, or dizziness, or evidence of cardiac hypertrophy or dilatation on testing.
60 percent: More than one episode of acute congestive heart failure in the past year, workload of 3–5 METs producing symptoms, or ejection fraction of 30–50 percent.
100 percent: Chronic congestive heart failure, workload of 3 METs or less producing symptoms, or ejection fraction below 30 percent.

When a cardiac condition doesn’t have its own diagnostic code, the VA rates it by analogy using a hyphenated code. Heart palpitations are generally rated on objective findings from echocardiograms and EKGs rather than subjective symptoms alone.

POTS

Postural orthostatic tachycardia syndrome has emerged as a significant long COVID condition. It has no dedicated VA diagnostic code, so it’s rated analogously, often under Diagnostic Code 7010 for supraventricular tachycardia or codes tied to syncope and dizziness. Service connection requires a medical opinion linking POTS to the COVID infection or to another service-connected condition.⁵

Mental Health Conditions

Depression, anxiety, and other mental health diagnoses tied to COVID are rated under the General Rating Formula for Mental Disorders at 38 CFR § 4.130, which covers virtually all mental health diagnoses, including generalized anxiety disorder (DC 9400) and major depressive disorder (DC 9434). Ratings turn on occupational and social impairment:⁶

0 percent: Diagnosed but symptoms don’t interfere with functioning or require continuous medication.
10 percent: Mild or transient symptoms that reduce work efficiency only under significant stress, or symptoms controlled by medication.
30 percent: Occasional decrease in work efficiency with depressed mood, anxiety, chronic sleep impairment, or mild memory loss.
50 percent: Reduced reliability and productivity with panic attacks more than once weekly, impaired memory, or difficulty maintaining work and social relationships.
70 percent: Deficiencies in most areas of life with suicidal ideation, near-continuous depression, or inability to maintain effective relationships.
100 percent: Total occupational and social impairment.

The symptom lists at each level are examples, not a closed set. The VA must consider all symptoms affecting functioning, not just those specifically listed.⁷

Neurological Residuals and Loss of Smell

Brain fog, headaches, and cognitive difficulties are among the neurological residuals the VA recognizes as potential long COVID consequences.⁵ These are rated under the neurological section of the schedule based on the specific diagnosis and its severity.

Complete loss of the sense of smell is rated at 10 percent under Diagnostic Code 6275 in 38 CFR § 4.87a, and requires an anatomical or pathological basis confirmed through objective testing.⁸ In one Board of Veterans’ Appeals decision, a veteran received the 10 percent rating with evidence of nerve damage and a smell test score of 10 out of 40.⁹

Chronic Fatigue Syndrome

When persistent fatigue rises to the level of a chronic fatigue syndrome diagnosis, it’s rated under Diagnostic Code 6354 in 38 CFR § 4.88b. Ratings run from 10 to 100 percent based on the severity of fatigue and cognitive impairment. Incapacitating episodes must be documented by a physician prescribing bed rest.³

Fibromyalgia

Fibromyalgia is rated under Diagnostic Code 5025 at three levels:¹⁰

10 percent: Symptoms require continuous medication for control.
20 percent: Symptoms are episodic, often triggered by stress or overexertion, but present more than one-third of the time.
40 percent: Symptoms are constant or nearly constant and resistant to treatment.

Forty percent is the maximum schedular rating for fibromyalgia alone. Pain is considered “widespread” only if it affects both sides of the body, appears above and below the waist, and involves both the spine and the extremities. A secondary condition like depression tied to fibromyalgia can be rated on its own, and the combined evaluation may exceed 40 percent.¹¹

Kidney Conditions

Renal conditions are rated under 38 CFR § 4.115b. Most, including chronic nephritis, glomerulonephritis, and toxic nephropathy, are rated as “renal dysfunction” under common criteria. The higher levels are:¹²

60 percent: Constant albuminuria with some edema, or a definite decrease in kidney function.
80 percent: Persistent edema and albuminuria with elevated BUN (40–80 mg%) or creatinine (4–8 mg%), or generalized poor health marked by lethargy, weakness, and weight loss.
100 percent: Regular dialysis required, or the condition precludes more than sedentary activity.¹³

What Counts as a Long COVID Symptom

VA guidance identifies a broad set of symptoms that may qualify as long COVID residuals when they persist four to twelve weeks or longer after the initial infection. The VA advises reporting any new or worsening symptoms to a health care provider. Recognized categories include:⁵

Fatigue that interferes with daily life and symptoms that worsen after physical or mental activity.
Respiratory symptoms including ongoing cough and difficulty breathing.
Cardiac symptoms including racing or skipped beats, chest pain, palpitations, lightheadedness, and dizziness.
Neurological symptoms including brain fog, trouble concentrating, memory problems, headaches, and blurry vision.
Altered or lost sense of taste and smell.
Anxiety, depression, increased stress, and trouble sleeping.
Abdominal pain and constipation.

The CDC has identified over 200 symptoms associated with long COVID, and other recognized complications include diabetes, blood clots, joint and muscle pain, and post-intensive care syndrome.¹⁴

Filing a Claim

To receive compensation for a COVID residual, a veteran generally needs to establish three things: that they contracted COVID-19; that the infection is service-connected, whether through the presumption or through direct evidence; and that they have a currently diagnosed residual condition with a medical opinion linking it to the COVID infection.

A veteran whose COVID aggravated a pre-existing service-connected disability can file a secondary service-connection claim. This is the right pathway when a new condition developed because of, or was worsened by, a disability the VA already recognizes.¹⁵ The same logic applies when COVID triggers or worsens another secondary condition.

Veterans who contracted COVID while receiving treatment at a VA medical facility may have grounds for a claim under a separate theory of entitlement related to VA-provided care.

COVID-Related Deaths and Survivor Benefits

Under legislation enacted in December 2022 (Pub. L. 117–328), when a veteran’s death certificate lists COVID-19 as a cause of death and the veteran had a service-connected disability that the CDC has linked to severe COVID illness, the VA Secretary must obtain a medical opinion on whether that service-connected condition was a principal or contributory cause of the death.¹⁶ Surviving dependents may use this pathway when seeking Dependency and Indemnity Compensation.

Vaccine-Related Conditions Are Not Currently Presumptive

The presumption in 38 U.S.C. § 1164 covers COVID infection, not vaccine reactions. H.R. 1671, the Justice for Vaccine Injured Veterans Act of 2025, was introduced on February 27, 2025, and would create a presumptive service connection for veterans who received a mandatory COVID-19 vaccination between August 24, 2021, and January 10, 2023, and later developed myocarditis, pericarditis, thrombosis with thrombocytopenia syndrome, Guillain-Barré syndrome, or other conditions the VA determines are positively associated with the vaccine.¹⁷ The bill was referred to the Subcommittee on Disability Assistance and Memorial Affairs on March 27, 2025, and has seen no further action as of mid-2026.¹⁸ Until it becomes law, vaccine-related claims must proceed on a direct service-connection basis.

1
Office of the Law Revision Counsel. 38 U.S.C. § 1164
2
U.S. Department of Veterans Affairs. Presumptive Service Connection Information
3
Cornell Law Institute. 38 CFR § 4.88b – Schedule of Ratings, Infectious Diseases
4
U.S. Department of Veterans Affairs. Board of Veterans’ Appeals Decision, Citation Nr. 1810757
5
U.S. Department of Veterans Affairs. Long COVID Facts and Symptoms
6
Cornell Law Institute. 38 CFR § 4.130 – Schedule of Ratings, Mental Disorders
7
U.S. Department of Veterans Affairs. Board of Veterans’ Appeals Decision, Citation Nr. 23001618
8
Cornell Law Institute. 38 CFR § 4.87a – Schedule of Ratings, Sense Organs
9
U.S. Department of Veterans Affairs. Board of Veterans’ Appeals Decision, Citation Nr. 1539913
10
U.S. Department of Veterans Affairs. Board of Veterans’ Appeals Decision, Citation Nr. A25021800
11
GovInfo. Federal Register – Final Rule for Fibromyalgia Rating Criteria
12
Cornell Law Institute. 38 CFR § 4.115b – Ratings of the Genitourinary System
13
U.S. Department of Veterans Affairs. Board of Veterans’ Appeals Decision, Citation Nr. 19117258
14
Centers for Disease Control and Prevention. Long COVID Signs and Symptoms
15
U.S. Department of Veterans Affairs. When to File a Claim
16
Office of the Law Revision Counsel. 38 U.S.C. § 1164 – Statutory Notes
17
U.S. Congress. H.R. 1671 – Justice for Vaccine Injured Veterans Act of 2025
18
U.S. Congress. H.R. 1671 – All Information