Chronic Obstructive Pulmonary Disease (COPD) is an inflammatory lung disease that causes obstructive airflow to and from the lungs. Symptoms of COPD include coughing, difficulty breathing, wheezing, tightness of the chest, and frequent respiratory infections. COPD is often referred to as chronic bronchitis or emphysema. However, a person can have symptoms of both, or, for example, have symptoms of COPD and not bronchitis.
What Causes COPD?
COPD can be caused by exposure to harmful gases or particulate matter, such as sand and dust. Veterans who served in Iraq and Afghanistan after September 11, 2001 may have been exposed to burn pits, open-air pits used on U.S. military bases to burn waste. Servicemembers exposed to the hazardous chemicals released from the burn pits may experience severe respiratory conditions after service, including COPD.
Service Connection for COPD
Veterans seeking service connection for COPD will likely be service connected on a direct basis. Direct service connection requires veterans to meet three criteria. Veterans must have:
- A current diagnosis
- An in-service event, injury, or symptom
- A medical “nexus” linking the in-service occurrence to their current diagnosis
How Does VA Rate COPD?
VA rates COPD based on the results of respiratory functioning tests, such as Forced Expiratory Volume in 1 Second (FEV-1), the ratio of FEV-1 to Forced Vital Capacity (FCV), the Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO (SB)), and exercise testing.
FEV-1 is the maximum amount of air that a person can breath out in 1 second. FEV-1 is measured against the FEV-1 for a normal person of your size and age.
FCV is the total amount of air that a person can exhale after taking a full breath in. Similar to FEV-1, it is expressed in a percentage of the average person similar to you.
DLCO (SB) measures the ability of a person’s lungs to transfer gas from air that is inhaled to their red blood cells. The test measure this by testing how much carbon monoxide is left when a person exhales compared with how much they inhaled. This measurement is compared to that of a normal, average person.
Exercise testing determines show much oxygen a person’s blood uses when they are functioning at maximum capacity, meaning the maximum amount of physical activity that the person can repeat and sustain. This measure is expressed in the amount of oxygen used by your body weight per minute.
VA Rating Schedule for COPD
VA rates COPD under 38 C.F.R. 4.97, diagnostic code 6604. Ratings range from 10 to 100 percent disabling, and are meant to compensate veterans for the lack of earning capacity caused by their condition.
The 10 percent rating requires that a veteran have one of the following:
- FEV-1 of 71 to 80% predicted
- FEV01/FVC of 71 to 80%
- DLCO (SB) of 66 to 80% predicted
The 30 percent rating for COPD requires:
- FEV-1 of 56 to 70% predicted, or;
- FEV-1/FVC of 56 to 70%, or;
- DLCO (SB) of 56 to 65% predicted
The 60 percent rating requires:
- A FEV-1 of 40 to 55% predicted, or;
- FEV-1/FVC of 40 to 55%, or; DLCO (SB) of 4 to 55% predicted, or;
- Maximum oxygen consumption of 15 to 20 ml/kg/min (with cardiorespiratory limit)
Finally, the 100 percent rating for COPD requires that a veteran have one of the following:
- FEV-1 less than 40% predicted
- FEV-1/FVC less than 40%
- DLCO (SB) less than 40% predicted
- Maximum exercise capacity less than 15 ml/kg/min oxygen consumption
- Right heart failure
- Right ventricular hypertrophy
- Pulmonary hypertension shown by Echo or cardiac catheterization
- Episodes of acute respiratory failure
- Require outpatient oxygen therapy
NOTE: Veterans can only be rated for one respiratory condition. For instance, if a veteran has COPD and asthma that they believe were caused by service, they can only receive VA disability benefits for one of them.