Asthma VA Rating and Diagnostic Code 6602 Criteria

Detailed breakdown of each asthma rating tier

Because asthma symptoms fluctuate and often respond to maintenance inhalers between flare-ups, VA rating specialists review both Pulmonary Function Test (PFT) numbers and prescribed medications. When spirometry results fall into one tier and medication requirements fall into a higher tier, 38 CFR 4.7 requires the VA to assign the higher evaluation.

0 percent noncompensable rating

Although Diagnostic Code 6602 does not list an explicit 0% row, the VA assigns 0% under 38 CFR 4.31 when a veteran has service-connected asthma, but spirometry exceeds 80% predicted and no intermittent bronchodilator is required. A 0% rating pays no monthly cash benefit, but establishes service connection, provides no-cost VA care and prescriptions, and allows an increased rating claim if inhalers are needed later or lung function declines.

10 percent disability rating

A 10% evaluation applies when a veteran meets at least one of three criteria:

1. FEV-1 of 71% to 80% predicted: Forced expiratory volume in the first second is mildly reduced compared to predicted reference values for age, height, and sex.
2. FEV-1/FVC ratio of 71% to 80%: The proportion of total vital capacity exhaled in the first second shows mild airflow limitation.
3. Intermittent inhalational or oral bronchodilator therapy: As-needed use of a rescue inhaler—such as a short-acting beta-agonist (albuterol or levalbuterol)—for occasional wheezing, exercise-induced bronchospasm, or shortness of breath, rather than daily.

30 percent disability rating

The 30% tier is the most common evaluation for chronic asthma because it covers standard daily controller therapy. A veteran qualifies for 30% by meeting any one of four criteria:

1. FEV-1 of 56% to 70% predicted.
2. FEV-1/FVC ratio of 56% to 70%.
3. Daily inhalational or oral bronchodilator therapy: Daily scheduled use of a long-acting beta-agonist (LABA), long-acting muscarinic antagonist (LAMA), daily short-acting bronchodilator, or daily oral bronchodilator (such as theophylline).
4. Inhalational anti-inflammatory medication: Use of an inhaled corticosteroid (such as fluticasone, budesonide, mometasone, or beclomethasone) or a combination corticosteroid/bronchodilator inhaler (such as fluticasone/salmeterol or budesonide/formoterol).

A veteran whose asthma is controlled on an inhaled corticosteroid or combination inhaler—with spirometry above 80% on exam day—still qualifies for 30% under the anti-inflammatory inhaler criterion.

60 percent disability rating

A 60% evaluation reflects moderate-to-severe persistent asthma or frequent exacerbations and requires at least one of four criteria:

1. FEV-1 of 40% to 55% predicted.
2. FEV-1/FVC ratio of 40% to 55%.
3. At least monthly visits to a physician for required care of exacerbations: Twelve or more documented clinical, urgent care, or emergency visits per year for physician care of acute flare-ups.
4. Intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids: At least three separate courses within 12 months of systemic steroids—such as oral prednisone tapers, methylprednisolone dose packs, or corticosteroid injections—for exacerbations.

100 percent disability rating

A 100% schedular evaluation applies to severe or steroid-dependent bronchial asthma and requires at least one of four criteria:

1. FEV-1 less than 40% predicted.
2. FEV-1/FVC ratio less than 40%.
3. More than one attack per week with episodes of respiratory failure: Frequent severe attacks accompanied by documented acute respiratory failure.
4. Requires daily use of systemic (oral or parenteral) high-dose corticosteroids or immunosuppressive medications: Continuous daily systemic steroid therapy (such as daily oral prednisone) or immunosuppressive therapy required to control airway inflammation.

Understanding FEV-1, FEV-1/FVC, and the PFT rules in 38 CFR 4.96

VA examiners and adjudicators apply the spirometry rules in 38 CFR 4.96(d):

• Forced Vital Capacity (FVC): Total maximum volume of air forcibly exhaled after a full inhalation.
• Forced Expiratory Volume in One Second (FEV-1): Volume of air exhaled in the first second of that forced breath, expressed as a percentage of predicted normal value.
• FEV-1/FVC Ratio: Percentage of total Forced Vital Capacity expelled in the first second.
• Post-bronchodilator studies (38 CFR 4.96(d)(4)–(5)): Post-bronchodilator testing is required unless pre-bronchodilator results are normal or the examiner states why it should not be done. Adjudicators use post-bronchodilator values unless they are poorer than pre-bronchodilator results, in which case pre-bronchodilator values control.
• Metric disparities and the 100% rule (38 CFR 4.96(d)(6)–(7)): When FEV-1 and FEV-1/FVC correspond to different tiers, the VA uses whichever metric the examiner states most accurately reflects the disability. If both FEV-1 and FVC exceed 100% predicted, no compensable rating is assigned based solely on a reduced FEV-1/FVC ratio.

Status of the 2022 proposed respiratory rating schedule revision

On February 15, 2022, the VA published a Proposed Rule (87 FR 8474, Docket VA-2022-VBA-0009, RIN 2900-AQ72) proposing respiratory schedule updates. For Diagnostic Code 6602, the proposal kept the 10%, 30%, 60%, and 100% tiers and medication criteria, while proposing to shift the FEV-1 cutoff between 60% and 100% from 40% to 45% predicted and rewording the 10% inhaler criterion to “less than daily inhalational or oral bronchodilator therapy.”

As of today, this 2022 proposed rule is not finalized. All asthma claims are decided under current 38 CFR 4.96 and 38 CFR 4.97, and established ratings are protected against reductions from schedule revisions under 38 CFR 3.951(a).

Presumptive service connection under the PACT Act (38 CFR 3.320)

The PACT Act of 2022 expanded presumptive service connection for bronchial asthma by removing the 10-year manifestation limit. Under 38 CFR 3.320(a)(2)(i), asthma is granted presumptive service connection if manifested to any degree at any time after separation from qualifying service.

Under 38 CFR 3.320(a)(4)–(6), fine particulate matter exposure is presumed for active service in:

1. Southwest Asia theater of operations (on or after August 2, 1990): Iraq, Kuwait, Saudi Arabia, the neutral zone between Iraq and Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, Oman, the Gulf of Aden, the Gulf of Oman, the Persian Gulf, the Arabian Sea, the Red Sea, and the airspace above these locations.
2. Additional post-9/11 locations (on or after September 19, 2001): Afghanistan, Syria, Djibouti, or Uzbekistan.

Separately, the covered-veteran definition in 38 U.S.C. 1119(c) also lists Somalia (service on or after August 2, 1990) and Egypt, Jordan, Lebanon, and Yemen (service on or after September 11, 2001, as the statute is worded), and asthma diagnosed after such service is a statutory presumptive condition under 38 U.S.C. 1120(b)(1). The regulation text in 38 CFR 3.320 does not itself name those countries, so check the current VA guidance if you served there.

Direct service connection and aggravation of preservice asthma

Veterans who did not deploy to a PACT Act location—or had asthma noted before enlistment—establish entitlement via direct service connection (38 CFR 3.303) or aggravation (38 CFR 3.306):

• Direct service connection (38 CFR 3.303): Applies when asthma began on active duty due to respiratory infections, exercise-induced bronchospasm, or occupational exposure to jet fuel exhaust, chemical fumes, propellant smoke, or industrial dust documented in service records.
• Presumption of soundness (38 U.S.C. 1111; 38 CFR 3.304(b)): If childhood asthma was in remission and not noted on your Military Entrance Processing Station (MEPS) physical, you are presumed sound at entry unless the VA proves by clear and unmistakable evidence that asthma existed prior to service and was not aggravated by duty.
• Aggravation of preexisting asthma (38 CFR 3.306): If mild or asymptomatic asthma was noted at MEPS and permanently worsened during service, aggravation is presumed under 38 CFR 3.306(b) unless the VA proves by clear and unmistakable evidence that the worsening resulted solely from natural progression.

Coexisting respiratory conditions rule (38 CFR 4.96)

Under 38 CFR 4.96(a), ratings under Diagnostic Codes 6600 through 6817 and 6822 through 6847 cannot be combined. Instead, the VA assigns a single rating under the code reflecting the predominant disability, elevated to the next higher tier if overall severity warrants it:

• Cannot be combined separately with asthma (DC 6602): Obstructive or central sleep apnea (DC 6847), chronic bronchitis (DC 6600), bronchiectasis (DC 6601), emphysema (DC 6603), COPD (DC 6604), interstitial lung diseases (DCs 6825–6833), restrictive lung diseases (DCs 6840–6845), and sarcoidosis (DC 6846).
• Can be rated and combined separately from asthma: Upper-respiratory conditions under Diagnostic Codes 6502 through 6524 fall outside the 38 CFR 4.96(a) bar. Veterans can receive separate ratings for bronchial asthma (DC 6602) alongside chronic sinusitis (DCs 6510–6514) and allergic or vasomotor rhinitis (DC 6522).

How the C&P exam and Respiratory Conditions DBQ measure asthma

During a C&P exam, the clinician completes the Respiratory Conditions (other than tuberculosis and sleep apnea) Disability Benefits Questionnaire (DBQ), verified on the VA Public DBQs page:

1. Verified history of attacks: Under the Note to DC 6602, if your lungs are clear on exam day, a verified history of asthmatic attacks must be of record.
2. Medication regimen: Checkboxes record intermittent or daily bronchodilators, inhalational anti-inflammatory medications, intermittent systemic corticosteroid courses (at least three per year), or daily high-dose systemic corticosteroids or immunosuppressives.
3. Exacerbation visits and respiratory failure: Records monthly physician visits for exacerbations or weekly attacks with respiratory failure.
4. Spirometry (PFTs): Records pre- and post-bronchodilator FVC, FEV-1 (% predicted), and FEV-1/FVC (%). Bring pharmacy logs showing all inhalers and oral prednisone courses from the past year.

Secondary conditions, combined ratings, and accredited help

Under 38 CFR 3.310(a), conditions proximately caused or aggravated by service-connected asthma—or its medications—may qualify for secondary service connection with a medical nexus opinion:

• GERD (DC 7206): Chronic coughing, intrathoracic pressure swings, and lower esophageal sphincter relaxation from bronchodilators may cause or aggravate acid reflux.
• Obstructive sleep apnea (DC 6847): Airway inflammation and steroid-related weight gain may cause or aggravate sleep apnea (evaluated with asthma under the predominant disability rule in 38 CFR 4.96(a)).
• Hypertension (DC 7101), diabetes mellitus (DC 7913), and osteoporosis (DC 5013): Repeated or daily systemic corticosteroid use may cause secondary cardiovascular, metabolic, or bone density conditions.
• Chronic laryngitis (DC 6516) and mood disorders (38 CFR 4.130): Inhaled steroids may irritate the vocal cords, and chronic dyspnea may cause secondary anxiety or depressive disorders.

Asthma ratings combine with non-prohibited ratings using the Combined Ratings Table in 38 CFR 4.25. Model your overall rating with our VA combined rating calculator and estimate retroactive pay with our VA back pay calculator.

If you need help with a claim or appeal, Veterans Service Organizations (VSOs) such as the DAV, VFW, and American Legion provide free representation, and VA-accredited claims agents or attorneys handle appeals. No representative can guarantee an outcome; verify credentials via the VA Office of General Counsel Accreditation Search.