VA Disability Rating Guide

VA Respiratory Ratings Guide

How the VA rates asthma, COPD, chronic bronchitis, and emphysema under 38 CFR § 4.97 — the exact pulmonary function test thresholds that decide your percentage, the anti-combination rule that traps most veterans, and how to prepare for your breathing exam.

The Foundation

Your Pulmonary Function Test Decides Everything

Nearly every respiratory rating comes down to one test: the pulmonary function test (PFT). The VA looks at three numbers, and your rating is set by whichever one is worst. Understanding them is the difference between a 10% and a 60%.
1

FEV-1

Forced Expiratory Volume in one second — the amount of air you can force out in the first second of a hard exhale, shown as a percent of what a healthy person your age and size would produce. This is the primary number the VA uses.

2

FEV-1 / FVC

The ratio of your one-second volume to your total forced exhale (Forced Vital Capacity). A low ratio signals obstruction — air getting trapped because your airways cannot empty efficiently.

3

DLCO

Diffusing capacity for carbon monoxide — how well oxygen passes from your lungs into your blood. Veterans with emphysema-predominant disease often qualify for a higher rating on DLCO than on spirometry alone.

Critical detail: For most respiratory codes the VA rates on your post-bronchodilator results (after the inhaler), unless the medication made your numbers worse. If your C&P exam skips DLCO testing, request it — the VA is required to obtain a complete evaluation, and DLCO is where many emphysema and toxic-exposure claims earn their higher rating.

The Rating Formula

General PFT Rating Schedule

This schedule governs chronic bronchitis (DC 6600), emphysema (DC 6603), and COPD (DC 6604), and forms the spirometry side of asthma (DC 6602). The VA applies whichever measurement yields the highest rating.
Rating FEV-1 (% predicted) FEV-1/FVC DLCO (% predicted)
10%71–80%71–80%66–80%
30%56–70%56–70%56–65%
60%40–55%40–55%40–55%
100%FEV-1 <40%, or FEV-1/FVC <40%, or DLCO <40%, or max exercise capacity <15 ml/kg/min, or cor pulmonale, or right ventricular hypertrophy, or pulmonary hypertension, or acute respiratory failure, or requires outpatient oxygen therapy.

A 60% rating may also be assigned for maximum oxygen consumption of 15–20 ml/kg/min with a cardiorespiratory limit. Source: 38 CFR § 4.97.

By Diagnostic Code

How the VA Rates Each Respiratory Condition

Each condition has its own diagnostic code under 38 CFR § 4.97. Asthma stands apart because it can be rated on medication use, not just PFT numbers.
DC 6602

Asthma

Asthma is unique: you can reach a rating on medication use alone, even with decent PFT numbers. This is one of the most under-claimed paths to a higher rating.

10%Intermittent inhaler (bronchodilator) therapy
30%Daily inhaler or inhaled anti-inflammatory medication
60%Monthly physician visits for exacerbations, or 3+ courses of oral steroids per year
100%Weekly attacks with respiratory failure, or daily high-dose systemic steroids
DC 6604

COPD

Chronic obstructive pulmonary disease is rated purely on the general PFT schedule above (10/30/60/100). COPD is a PACT Act presumptive for many burn-pit and airborne-hazard veterans — if you deployed to a covered location, service connection may be presumed.

DC 6600

Chronic Bronchitis

Rated on the general PFT schedule. Persistent productive cough with confirmed airflow limitation on spirometry is the typical presentation. Often appears alongside COPD and toxic-exposure claims.

DC 6603

Emphysema

Also rated on the general PFT schedule, but emphysema is the condition where DLCO matters most. Gas exchange is impaired even when spirometry looks fair, so a complete PFT with DLCO frequently unlocks a higher rating.

DC 6601

Bronchiectasis

Rated differently — on incapacitating episodes of infection rather than PFTs. Ratings run 10% (antibiotics twice a year) up to 100% (incapacitating infection of at least six weeks total per year), or by pulmonary impairment as for chronic bronchitis, whichever is higher.

DC 6847

Sleep Apnea

Rated separately: 0% (documented but asymptomatic), 30% (persistent daytime sleepiness), 50% (requires a CPAP), 100% (chronic respiratory failure, cor pulmonale, or tracheostomy). See our full Sleep Apnea Rating Guide.

The Trap Most Veterans Miss

The Anti-Combination Rule (38 CFR § 4.96)

This single rule blindsides more respiratory claimants than anything else. Understand it before you file, or you will leave a rating on the table.

You cannot stack respiratory codes

Conditions rated under diagnostic codes 6600–6817 and 6822–6847 cannot be combined with each other. If you have both asthma and COPD, the VA rates you under the single code that gives the higher percentage — not both added together.

But you can combine outside the range

A respiratory condition can be combined with conditions outside that range — such as sinusitis (DC 6510–6514) or rhinitis (DC 6522). These are separate ratings that build your combined total instead of competing with it.

The strategy: Claim every respiratory condition so the VA must rate you under the highest one — then add the conditions that legally stack on top, like rhinitis and sinusitis, plus any secondary conditions below. That is how a single 30% breathing rating becomes a much larger combined number.
Build Your Combined Rating

Conditions Commonly Secondary to Respiratory Disease

Breathing conditions rarely travel alone. Each of these can be separately service-connected with the right medical evidence.

Sleep Apnea

Chronic respiratory disease and the weight gain from steroid treatment are well-documented contributors to obstructive sleep apnea — frequently a 50% add-on with a CPAP.

Rhinitis & Sinusitis

Upper-airway conditions sit outside the anti-combination range, so they stack on top of your lung rating. Common after burn-pit and airborne-hazard exposure.

GERD

Acid reflux both aggravates asthma and develops as a side effect of long-term respiratory medication. It is rated separately under the digestive system.

Depression & Anxiety

Chronic breathlessness and activity limits frequently lead to a service-connectable mental health condition — often one of the largest secondary ratings.

Pulmonary Hypertension & Cor Pulmonale

Advanced lung disease strains the right side of the heart. These findings can independently support a 100% respiratory evaluation.

Chronic Fatigue

Low oxygenation and disrupted sleep drive persistent fatigue that affects work capacity and can support a TDIU argument.

Exam Strategy

C&P Exam Tips for Respiratory Claims

Your PFT numbers decide your rating, and how the exam is run directly affects those numbers. Walk in prepared.
1

Insist on a Complete PFT

Ask that FEV-1, FEV-1/FVC, and DLCO are all measured. If DLCO is skipped, your rating is built on incomplete data — and that usually means a lower number than you deserve.

2

Clarify Pre vs Post-Bronchodilator

Most codes rate on post-bronchodilator results. Make sure the examiner records both, and that the correct set is used for your rating.

3

Document Your Medications

For asthma, your medication regimen alone can drive the rating. Bring a current list: daily inhalers, anti-inflammatories, and any oral steroid courses with dates.

4

Log Your Exacerbations

Monthly physician visits for flare-ups or three steroid courses a year support 60%. Keep a record of every urgent visit, ER trip, and prescription.

5

Describe Functional Impact

Explain how breathing limits your daily life and work — stairs, walking distance, sleep, missed workdays. This supports secondary claims and TDIU.

6

Tie It to Service or PACT Act

If you had airborne-hazard or burn-pit exposure, say so. Many respiratory conditions are PACT Act presumptive, which can establish service connection without a separate nexus fight.

FAQ

Common Questions About Respiratory Ratings

Was Your Lung Condition Caused by Burn Pits?

Many respiratory conditions are presumptive under the PACT Act for veterans exposed to burn pits and airborne hazards. See exactly which conditions qualify and how to file.

Toxic Exposure & PACT Act Guide →

Need Help With Your Respiratory Claim?

Book a free 15-minute strategy call. We will review your PFT results, identify every condition that stacks, and build the evidence plan for your maximum rating.

Book Free Strategy Call →
305-897-2805