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6602
§ 4.97 Schedule of ratings—respiratory system.

Asthma (diagnosed after service)

Chronic inflammatory airway disease causing wheezing, shortness of breath (post-service diagnosis)

What the rating means

VA rates bronchial asthma under diagnostic code 6602. The four possible ratings are 10%, 30%, 60%, and 100%. Each level can be reached through breathing test results, how often you need medical care, or what medications you require — and you only need to meet one of the criteria at a given level to qualify for that rating.

At 10%, your FEV-1 is 71 to 80 percent of predicted, or your FEV-1/FVC ratio is 71 to 80 percent, or you use inhalational or oral bronchodilators on an intermittent basis. At 30%, those breathing test values fall to 56 to 70 percent, or you use daily inhalational or oral bronchodilator therapy, or daily inhalational anti-inflammatory medication. At 60%, FEV-1 or FEV-1/FVC falls to 40 to 55 percent, or you need at least monthly physician visits for exacerbations, or you require at least three courses per year of systemic corticosteroids. At 100%, FEV-1 or FEV-1/FVC drops below 40 percent, or you have more than one attack per week with respiratory failure, or you require daily systemic high-dose corticosteroids or immunosuppressive medications. One important note: if you have no clinical findings of asthma at the time of examination, a verified history of asthmatic attacks must be on record.

Evidence that helps

Pulmonary function test reports are central to this rating. They show your FEV-1 as a percentage of predicted and your FEV-1/FVC ratio — the two measurements that define most rating levels. Make sure test results in your records are dated and include both values.

Treatment records matter at every level. Pharmacy records or prescription histories can show whether your bronchodilator or corticosteroid use is intermittent or daily, and whether those corticosteroids are inhaled or systemic. Records of physician or urgent care visits document how often you need care for exacerbations, which is relevant at the 60% level. Hospital or emergency records showing episodes of respiratory failure support the 100% criteria.

Your own statements, and statements from people who know you, can describe how attacks affect your ability to breathe, work, and carry out daily activities. If you have no clinical findings at the time of a VA examination, records from other providers that document a verified history of asthmatic attacks are needed to establish the rating.

Secondary conditions

Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.