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Bronchial asthma and chronic obstructive pulmonary disease — rated on pulmonary function tests and treatment, and presumptive under the PACT Act. This guide quotes the actual rating criteria from 38 CFR Part 4 for diagnostic code 6602 / 6604, explains what the C&P examiner measures, covers the presumptive and secondary routes to service connection, and lists the reasons these claims come back denied — and how each gets fixed.
How the VA rates asthma and copd in 2026 — the exact criteria
These are the criteria a VA rater applies, quoted from the rating schedule (§ 4.97). Your rating is the highest level whose wording your evidence meets — and evidence that never uses these words tends to be rated at the bottom.
DC 6602 — Asthma, bronchial
| Rating | Criteria (38 CFR Part 4 wording) |
|---|---|
| 100% | FEV-1 less than 40-percent predicted, or; FEV-1/FVC less than 40 percent, or; more than one attack per week with episodes of respiratory failure, or; requires daily use of systemic (oral or parenteral) high dose corticosteroids or immuno-suppressive medications |
| 60% | FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; at least monthly visits to a physician for required care of exacerbations, or; intermittent (at least three per year) courses of systemic corticosteroids |
| 30% | FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; daily inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication |
| 10% | FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; intermittent inhalational or oral bronchodilator therapy |
In the absence of clinical findings of asthma at the time of examination, a verified history of asthmatic attacks must be of record. A daily inhaled steroid alone earns 30 percent.
DC 6604 — Chronic obstructive pulmonary disease
| Rating | Criteria (38 CFR Part 4 wording) |
|---|---|
| 100% | FEV-1 less than 40 percent of predicted, or; FEV-1/FVC less than 40 percent, or; DLCO (SB) less than 40-percent predicted, or; maximum exercise capacity less than 15 ml/kg/min oxygen consumption, or; cor pulmonale, right ventricular hypertrophy, pulmonary hypertension, episode(s) of acute respiratory failure, or; requires outpatient oxygen therapy |
| 60% | FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; DLCO (SB) of 40- to 55-percent predicted, or; maximum oxygen consumption of 15 to 20 ml/kg/min |
| 30% | FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; DLCO (SB) 56- to 65-percent predicted |
| 10% | FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; DLCO (SB) 66- to 80-percent predicted |
Asthma, COPD, chronic bronchitis, emphysema and constrictive bronchiolitis are PACT Act presumptives for covered toxic-exposure veterans (38 CFR 3.320). Pulmonary function testing (post-bronchodilator) decides the level.
Honest ceiling: 60% with monthly exacerbation care or systemic steroids.
What the C&P examiner measures
Pulmonary function testing (spirometry with post-bronchodilator values; DLCO for COPD) plus a record of inhaled and oral medications, physician visits for exacerbations, and steroid courses. Bring the inhaler prescriptions — a daily inhaled steroid alone supports 30 percent for asthma.
The questions that get at the rating criteria — answer them for yourself before the exam:
- Do you carry an inhaler? How often do you actually use it?
- Were you ever around the burn pits?
Service connection: presumptive, direct, or secondary
Asthma diagnosed after service, COPD, chronic bronchitis, emphysema and constrictive bronchiolitis are PACT Act presumptives (38 CFR 3.320) for covered burn-pit and toxic-exposure service.
Every service-connection claim has three legs: a current diagnosis (the C&P exam can supply it), an in-service event, injury, exposure or an already-connected condition, and a link between the two — which the VA's own examiner addresses at the exam for direct and secondary claims, and which the law supplies for presumptive ones. You do not need a private opinion to file; you need one only if the VA denies for lack of nexus, and a supplemental claim within one year keeps your effective date.
Secondary conditions veterans miss
This condition is more often the secondary in a chain than the anchor — see the secondary-claims guides for the recognized pathways.
What the medical literature says
Institute of Medicine, Long-Term Health Consequences of Exposure to Burn Pits in Iraq and Afghanistan (2011)
The government’s own review of burn pit exposure health effects. Why it matters: Background authority for airborne-hazard claims.
NASEM, Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater (2020) + PACT Act (2022)
Asthma, chronic rhinitis and chronic sinusitis are now PRESUMPTIVE for covered burn-pit/airborne-hazard veterans. Why it matters: Covered theater + diagnosis = presumptive, no nexus needed.
Why asthma and copd claims get denied — and the fix
- PACT Act presumption not applied to an asthma diagnosed after service.
- PFTs done without post-bronchodilator values, or the exam never recorded the daily inhaled steroid that supports 30 percent.
A denial is a grade on the evidence packet, not a verdict on you. Filed as a supplemental claim within one year, the fix keeps your original effective date.
Filing it right the first time
- Intent to File first. It locks your effective date for a year — back pay runs from that day, not from the day the package is ready.
- File everything at once. Every condition with a real symptom and a plausible route — direct, presumptive, secondary, increase — goes in one claim. The VA's duty to assist schedules the exam and pulls your records; a condition held back "for more evidence" only starts its clock later.
- Your statement in the criteria's words. A Statement in Support of Claim (VA Form 21-4138) that describes your worst days and your typical days using the language in the table above is the evidence the rater reads first.
- Your records. VA records through Blue Button, decision letters and code sheet from VA.gov, and private records from each doctor's office or patient portal — or a signed 21-4142 so the VA pulls them.
- Prepare for the exam. Know what the examiner measures (above) and answer honestly, including the bad days.
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See If You Qualify →Frequently asked questions
What is the VA rating for asthma and copd?
Asthma and COPD is rated under diagnostic code 6602 / 6604 (§ 4.97) at 10%, 30%, 60%, 100%. The percentage depends on which criteria in the rating schedule your evidence meets — the full table is on this page.
What is the highest VA rating for asthma and copd?
The highest schedular rating available is 100%. Typical grants land around 30%, but every case is decided on its own evidence.
Is asthma and copd a presumptive condition?
Asthma diagnosed after service, COPD, chronic bronchitis, emphysema and constrictive bronchiolitis are PACT Act presumptives (38 CFR 3.320) for covered burn-pit and toxic-exposure service.
Do I need a nexus letter for asthma and copd?
Not to file. The VA's duty to assist schedules a C&P exam where its own examiner addresses the connection, and presumptive conditions need no opinion at all. A private opinion becomes worth buying only if the VA denies for lack of nexus — a supplemental claim within one year keeps your original effective date.
Rating criteria verified against eCFR (38 CFR Part 4) — last reviewed 2026-09-19. Regulations change; confirm anything decision-critical at ecfr.gov.