VA Disability Rating for Respiratory Conditions

Respiratory conditions like asthma, Chronic Obstructive Pulmonary Disease (COPD), and asbestosis affect many veterans due to their military service. These conditions can significantly impact daily life and job performance.

If you’re a veteran struggling with respiratory issues, understanding VA disability ratings can be crucial in securing the benefits and support you need.

This guide will walk you through common respiratory conditions recognized by the VA, how to establish service connection, disability rating criteria, and tips for maximizing your benefits.

Respiratory Conditions Recognized by the VA

The VA recognizes various respiratory conditions that can qualify for disability benefits.

Here’s a brief overview of common conditions affecting veterans:

• Asthma: Chronic condition causing airway inflammation and narrowing, leading to breathing difficulties.
• Chronic Obstructive Pulmonary Disease (COPD): Includes emphysema and chronic bronchitis, causing airflow blockage and breathing problems.
• Asbestosis: Lung scarring caused by asbestos fiber inhalation, often with a long latency period.
• Sleep Apnea: Sleep disorder characterized by pauses in breathing during sleep.
• Rhinitis: Inflammation of the nasal passages, often causing congestion, runny nose, and sneezing.
• Sinusitis: Inflammation or swelling of the tissue lining the sinuses, causing pain, pressure, and difficulty breathing through the nose. (Diagnostic Code 6510-6514)
• Bronchitis: Inflammation of the bronchial tubes, which can be acute or chronic.
• Lung Cancer: Malignant tumor growth in the lung tissue, often associated with exposure to carcinogens such as asbestos or Agent Orange.

When it comes to VA disability ratings for respiratory conditions, veterans need to be aware of the concept of pyramiding. This principle prevents multiple ratings for the same symptoms or impairments. For example, the VA typically won’t grant separate ratings for sleep apnea and asthma, as both affect breathing. However, the VA may allow separate ratings for conditions affecting different areas of the respiratory system, such as rhinitis and sinusitis.

Additionally, the VA has generally determined that disabilities caused by smoking are not service-connected. This rule applies even if the military supplied cigarettes in your MREs or if you picked up the habit during your service years.

But there are exceptions to this rule, and the waters can get murky when it comes to respiratory conditions. Every case is unique, and the specifics of your situation matter. If you’re unsure about your eligibility or need help navigating these rules, don’t go it alone. Our team of accredited attorneys at ProVet Legal is standing by, ready to dive into the details of your case. We’ve helped countless veterans cut through the red tape and secure the benefits they’ve earned.

Common Causes of Respiratory Conditions in Veterans

Veterans may develop respiratory conditions due to various service-related exposures and experiences. Understanding these potential causes is crucial for establishing service connection.

Here are some of the most common causes:

Burn Pits

Military burn pits were large areas used to incinerate all types of waste generated by military bases, particularly in Iraq and Afghanistan during the post-9/11 era. While effective for waste disposal, these pits emitted toxic smoke with severe health consequences.

Sulfur Mine Fire in Iraq

In June 2003, a fire at the Mishraq State Sulfur Mine Plant near Mosul, Iraq, became the largest man-made sulfur fire in history. Air samples showed toxic gas levels immediately dangerous to health and life. Firefighters from the 101st Airborne Division were most exposed, experiencing both short-term and long-term health effects, including lung damage.

Particulate Matter (PM)

Veterans stationed in Iraq or Afghanistan were likely exposed to dust, sandstorms, and other environmental hazards containing particulate matter. PM is a complex mixture of extremely small particles and droplets. Inhalation can cause respiratory conditions and lung damage.

Oil Well Fires

During the Persian Gulf War, Iraqi forces set fire to over 600 oil wells in Kuwait, creating a massive environmental hazard. The fires burned for eight months, releasing soot and dirt into the air, and causing serious respiratory issues.

Agent Orange Exposure

Agent Orange, one of several “rainbow herbicides,” was used during the Vietnam War era to defoliate large areas. It was a mixture of two highly toxic chemicals: 2,4-D and 2,4,5-T, which may cause respiratory cancers (lung, bronchus, larynx, or trachea).

Other causes may include:

• Chemical Exposure: Industrial solvents, fuel vapors, paint fumes, cleaning agents
• Occupational Hazards: Welding fumes, engine exhaust, aircraft emissions
• Confined Space Work: Poor ventilation in ships, submarines, or tanks
• Training Exercises: Tear gas exposure, smoke inhalation during simulations
• Radiation Exposure: Nuclear weapons testing, working with radar systems or nuclear propulsion

Veterans who have experienced any of these factors should document their exposure when filing for VA disability benefits for respiratory conditions.

Understanding these causes can significantly strengthen a veteran’s claim for service connection and appropriate compensation.

Establishing Service-Connection for Respiratory Conditions

To receive VA disability benefits for these respiratory conditions, you must establish a service connection:

Direct Service Connection

If your condition began during or was worsened by your military service. This requires medical evidence and service records showing the onset or aggravation of the condition during service.

Presumptive Service Connection

For certain conditions and circumstances, the VA presumes a service connection. For example, asbestosis may be presumptively service-connected for veterans with known asbestos exposure during service.

Secondary Service Connection

If your respiratory condition is caused or aggravated by another service-connected condition.

VA Disability Rating Criteria for Respiratory Conditions

The VA assigns disability ratings based on the severity of the condition. All conditions are rated under 38 CFR § 4.97 but with different diagnostic codes.

When determining ratings for respiratory conditions, VA primarily considers two measurements from pulmonary function tests (PFTs):

• FEV-1 (Forced Expiratory Volume in one second): The amount of air you can forcefully exhale in one second.
• FVC (Forced Vital Capacity): The total amount of air you can forcefully exhale after taking a deep breath.

These measurements help the VA assess the severity of your respiratory condition.

Bronchitis (Diagnostic Code 6600)

• 100%: FEV-1 less than 40% predicted, or FEV-1/FVC less than 40%, or DLCO (SB) less than 40% predicted, or maximum exercise capacity less than 15 ml/kg/min oxygen consumption, or cor pulmonale, or right ventricular hypertrophy, or pulmonary hypertension, or episodes of acute respiratory failure, or requires outpatient oxygen therapy
• 60%: FEV-1 of 40-55% predicted, or FEV-1/FVC of 40-55%, or DLCO (SB) of 40-55% predicted
• 30%: FEV-1 of 56-70% predicted, or FEV-1/FVC of 56-70%, or DLCO (SB) of 56-65% predicted
• 10%: FEV-1 of 71-80% predicted, or FEV-1/FVC of 71-80%, or DLCO (SB) of 66-80% predicted

Sleep Apnea (Diagnostic Code 6847)

• 100%: Chronic respiratory failure with carbon dioxide retention, need for tracheostomy, or cor pulmonale
• 50%: Requires use of breathing assistance device such as CPAP machine
• 30%: Persistent daytime hypersomnolence
• 0%: Asymptomatic, but documented sleep disorder

Proposed Changes:

VA has proposed updates to the rating criteria for sleep apnea. If implemented, these changes would apply to new claims, while existing ratings would be grandfathered under the current, more favorable schedule.

The proposed criteria aim to align disability ratings more closely with treatment effectiveness:

• 0%: Symptoms fully controlled by treatment
• 10%: Persistent symptoms despite treatment (e.g., some daytime sleepiness, but overall improvement)
• Higher ratings: Reserved for severe cases where treatment is ineffective or causes significant impairment

Veterans with pending sleep apnea claims or considering filing should be aware of these potential changes and their implications for disability ratings.

Rhinitis (Diagnostic Code 6522)

• 30%: Polyps present
• 10%: No polyps, but greater than 50% obstruction of nasal passages on both sides or complete obstruction on one side

Asthma (Diagnostic Code 6602)

• 100%: FEV-1 less than 40% predicted, or FEV-1/FVC less than 40%, or more than one attack per week with episodes of respiratory failure, or requires daily use of systemic corticosteroids
• 60%: FEV-1 of 40-55% predicted, or FEV-1/FVC of 40-55%, or at least monthly visits to a physician for required care of exacerbations, or intermittent courses of systemic corticosteroids
• 30%: FEV-1 of 56-70% predicted, or FEV-1/FVC of 56-70%, or daily inhalational or oral bronchodilator therapy, or inhalational anti-inflammatory medication
• 10%: FEV-1 of 71-80% predicted, or FEV-1/FVC of 71-80%, or intermittent inhalational or oral bronchodilator therapy

Chronic Obstructive Pulmonary Disease (COPD) (Diagnostic Code 6604)

• 100%: FEV-1 less than 40% predicted, or FEV-1/FVC less than 40%, or DLCO (SB) less than 40% predicted, or maximum exercise capacity less than 15 ml/kg/min oxygen consumption, or cor pulmonale, or right ventricular hypertrophy, or pulmonary hypertension, or episodes of acute respiratory failure, or requires outpatient oxygen therapy
• 60%: FEV-1 of 40-55% predicted, or FEV-1/FVC of 40-55%, or DLCO (SB) of 40-55% predicted, or maximum oxygen consumption of 15-20 ml/kg/min
• 30%: FEV-1 of 56-70% predicted, or FEV-1/FVC of 56-70%, or DLCO (SB) of 56-65% predicted
• 10%: FEV-1 of 71-80% predicted, or FEV-1/FVC of 71-80%, or DLCO (SB) of 66-80% predicted

Asbestosis (Diagnostic Code 6833)

• 100%: FVC less than 50% predicted, or DLCO (SB) less than 40% predicted, or maximum exercise capacity less than 15 ml/kg/min oxygen consumption with cardiorespiratory limitation, or cor pulmonale or pulmonary hypertension, or requires outpatient oxygen therapy
• 60%: FVC of 50-64% predicted, or DLCO (SB) of 40-55% predicted, or maximum exercise capacity of 15-20 ml/kg/min oxygen consumption with cardiorespiratory limitation
• 30%: FVC of 65-74% predicted, or DLCO (SB) of 56-65% predicted
• 10%: FVC of 75-80% predicted, or DLCO (SB) of 66-80% predicted

Sinusitis (Diagnostic Codes 6510-6514)

• 50%: Following radical surgery with chronic osteomyelitis, or; near constant sinusitis characterized by headaches, pain and tenderness of affected sinus, and purulent discharge or crusting after repeated surgeries
• 30%: Three or more incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; more than six non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting
• 10%: One or two incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; three to six non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting
• 0%: Detected by X-ray only

Lung Cancer (Diagnostic Code 6819)

• 100%: For six months following the cessation of any surgical, X-ray, antineoplastic chemotherapy or other therapeutic procedure
• After six months, the rating is based on residuals, if there is no local recurrence or metastasis

*Note: For lung cancer, VA will schedule a mandatory VA examination six months following the completion of treatment to determine the appropriate disability rating based on residual effects.

If you’ve received a VA decision about your claim that you disagree with, don’t hesitate to reach out. Our experienced team can review your case and help you fight for the benefits you deserve. Contact us today for a free consultation.

Gathering Evidence for Your Respiratory Condition Claim

The success of your VA disability claim for a respiratory condition often hinges on the quality and comprehensiveness of the evidence you provide. Building a strong case requires a strategic approach to collecting and presenting relevant information. This evidence not only helps establish service connection but also supports the severity rating of your condition.

To support your VA disability claim, focus on collecting the following types of evidence:

• Medical diagnosis and treatment records
• Results of pulmonary function tests (PFTs)
• Records of hospitalizations or ER visits due to respiratory issues
• For asbestosis claims, evidence of asbestos exposure during service
• Lay statements from you, family, or fellow service members about your condition and its impact

Remember, the goal is to paint a clear picture of how your respiratory condition is connected to your military service and how it impacts your daily life. Be thorough in your documentation and don’t hesitate to seek help from medical professionals or veterans’ advocates in gathering and interpreting this evidence.

Appealing a VA Disability Rating Decision

Receiving a denial or an unsatisfactory rating for your respiratory condition claim can be frustrating and disheartening. But, it’s important to remember that this is not the end of the road. You have the right to appeal the VA’s decision, and with the right approach, you can potentially secure the benefits you deserve.

The appeals process for VA disability claims can be complex and time-consuming. It requires a thorough understanding of VA regulations, the ability to interpret medical evidence, and the skill to present your case effectively. This is where professional assistance can make a significant difference.

Common reasons for appealing a VA decision include:

• Denial of service connection
• Assignment of a lower disability rating than expected
• Incorrect effective date
• Failure to consider all evidence or symptoms

At ProVet Legal, our VA disability attorneys stand up for veterans, fighting to secure the benefits you’ve earned through your service and sacrifice.

Don’t let a disappointing VA decision prevent you from receiving the benefits you’ve earned. Contact us today for a free consultation. Let our experienced team review your case and explain your options.