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Asthma VA Disability Claims and Ratings

Video Transcription

Kevin Medeiros: Hello and thank you for joining us for this episode of CCK Live in Under Five.  I’m Kevin Medeiros, an attorney here at CCK, and today we’re going to talk about VA disability benefits for asthma.

Asthma, also called bronchial asthma, is a respiratory condition in which a person’s airways become inflamed, making it difficult to breathe.  When the airways become inflamed and narrow, some people may cough, wheeze, or experience shortness of breath.  Severity ranges from person to person, can be relatively minor or it can be relatively severe.

VA provides disability benefits for veterans service-connected for asthma.  The way that they test for the severity is with two different test outcomes.  The first type of test is called the forced expiratory volume or the FEV1.  That’s when an individual exhales into the spirometer as forcefully as possible and it measures the amount that the person is able to exhale in one second.  VA takes that number and compares it to a person without asthma would be able to achieve on that test.

The other test is called the forced vital capacity.  It’s the maximum amount of air that a person can exhale or inhale from the lung.  VA compares the first test to the results of the forced vital capacity and this represents the proportion of a person’s vital capacity they can expel in the first second of a forceful exhale.

VA also, in addition to those tests, looks at other factors that come into play when a person has asthma to achieve a certain rating.  So that would be the number of asthma attacks a person experiences on a weekly or monthly basis, the number of times they have to visit a doctor for asthma-related care, and the frequency of medication used to treat the condition.  The diagnostic code specific to asthma is 6602.  The regulation here is section 4.97.

Some conditions have caps on their ratings less than 100 percent, asthma does not.  It ranges anywhere from 0 percent all the way to 100 percent.  A veteran with a 10 percent rating will score on the range of 71 to 80 percent.  Other than that, the other way when VA will assign a 10 percent rating is if a veteran needs an inhaler or a bronchodilator, which are prescribed to treat asthma, but a 10 percent rating will be assigned if the veteran does not need to use those daily.  For a 30 percent rating, the amount that the individuals able to inhale or exhale on those tests drops down to 56 to 70 percent or they require the daily use of an inhaler or bronchodilator therapy or anti-inflammatory medication.

As we get to the 60 percent rating, we see those percentages drop down again to 40 to 50 percent on the FEV test and that FVC test, or the veteran will need to visit a doctor at least monthly for exacerbations of asthma.  And the other way that a 60 percent rating will be assigned is for intermittent, which VA considers at least three per year courses of corticosteroids or immunosuppressant therapy.  And finally, a 100 percent rating is warranted if results on the FEV or FVC are less than 40 percent, or there are more than one asthma attack per week with episodes of respiratory failure.  In this case, the veteran would be experiencing a pretty severe condition with asthma attacks weekly and resulting episodes of respiratory failure.

The final way a 100 percent rating would be assigned is if the veteran requires daily use of high-dose corticosteroids or immunosuppressive medications.  So, the more severe the condition, the higher the rating VA will assign.

If you’d like more in-depth information on VA ratings for asthma, please check out our blog.  You can also visit our YouTube channel and check out our extensive video library there.  We have some more in-depth discussions.  Thank you for tuning in.