Getting Veterans Disability Compensation for Respiratory (Breathing) Problems

Veterans who are exposed to airborne toxins—such as pollution, smoke, or chemicals—while on active duty may develop problems such as shortness of breath or upper respiratory infections. If you returned home with a respiratory disorder that was caused or worsened by your time in service, you may be eligible for VA disability compensation.

Service-Connected Disability Benefits for Respiratory Issues

In order to get VA disability benefits for a breathing problem, you'll need to show a "nexus" (link) between your current respiratory illness and your military enlistment. This is called establishing a service connection.

You can establish a service connection in several ways, but the most common methods for veterans to get disability benefits for breathing difficulties is by showing a direct or presumptive service connection.

Establishing a Direct Service Connection for Respiratory Illness

To be eligible for disability compensation for a respiratory problem on the basis of a direct service connection, you need to prove the condition was caused by your active duty.

You can establish a direct service connection with the following evidence:

• a current diagnosis of a respiratory illness
• evidence of an event in service that caused the illness, and
• medical evidence connecting the current respiratory condition to the event in service.

Presumptive Service Connection for Respiratory Illness

Veterans can sometimes establish a service connection for respiratory illnesses without needing to provide evidence of a specific incident that caused the trouble breathing. This is called presumptive service connection because the VA "presumes" that certain exceptionally dangerous military activities or environments are going to cause a medical condition.

Chronic respiratory conditions that can qualify veterans for presumptive service connection include:

• tuberculosis
• bronchiectasis, and
• coccidioidomycosis (Valley fever).

For some respiratory conditions, presumed service connection is only available to veterans stationed in certain locations during a specific time frame.

Gulf War era and post-9/11 veterans. If you served in Southwest Asia or the Middle East and you have symptoms of a respiratory illness, the VA will presume you have a service connection for the following conditions:

• asthma that was diagnosed after separation from service
• bronchitis
• chronic obstructive pulmonary disease (COPD)
• rhinitis
• sinusitis
• constrictive or obliterative bronchiolitis
• emphysema
• interstitial lung disease (ILD)
• pleuritis
• pulmonary fibrosis
• sarcoidosis, and
• breathing-related cancer of any type.

Vietnam veterans. Veterans of the Vietnam war who were exposed to Agent Orange or other herbicides and developed respiratory cancer (cancer of the lung, bronchus, larynx, or trachea) can get disability benefits based on a presumed service connection. For more information, read our article about Agent Orange and disability compensation.

Radiation-exposed veterans. Vets who participated in a "radiation risk activity" (such as nuclear weapons testing or exposure to depleted uranium) and have developed lung cancer, bronchiolo-alveolar carcinoma, or cancer of the pharynx can establish a presumptive service connection for those conditions.

You become eligible to receive VA disability on the basis of a presumptive service connection after 90 days of continuous service. You can find the list of all diseases eligible for a presumptive service connection at 38 CFR §3.309.

VA Disability Ratings for Respiratory Issues

Once you establish a service connection for your respiratory disorder, the VA will assign a disability percentage rating based on how poorly you're able to breathe, demonstrated by medical evidence such as a pulmonary function test.

What Respiratory Problems Does the VA Rate?

The VA evaluates respiratory illnesses using the Schedule of Ratings Disabilities, Section 4.97, diagnostic codes 6502 to 6847. Diseases listed in the schedule for which you can receive compensation include:

• sinusitis
• deviated septum
• laryngitis
• aphonia (difficulty speaking above a whisper or speaking at all)
• rhinitis (stuffy, running nose)
• emphysema
• bronchitis
• chronic obstructive pulmonary disease (COPD) (causes difficulty breathing)
• tuberculosis
• pulmonary vascular disease (causes shortness of breath)
• bacterial infections in the lungs, and
• cancer, and
• sleep apnea.

Understanding the VA's Key Measurements for Rating Respiratory Conditions

The VA rates many respiratory problems by looking at your performance on a pulmonary function test—specifically, how severely your airflow is restricted according to certain measurements. Your medical record should contain evidence of one or more of the following test results:

• Forced expiratory volume (FEV1) measures the amount of air you can exhale from your lungs in one second.
• Forced vital capacity (FVC) measures the total volume of air you can exhale from your lungs at your maximum effort.
• Diffusion capacity of the lungs for carbon monoxide (DLCO) measures the ability of your lungs to transfer oxygen from the air you inhale into your bloodstream.

The VA will also look for evidence of heart dysfunction, including:

• minimal oxygen consumption during exercise
• cor pulmonale (enlargement of the right side of the heart)
• pulmonary hypertension, and
• number of episodes of acute respiratory failure or infection.

The more evidence you have in your medical records of significant trouble breathing, the higher the disability rating for your respiratory condition will be.

VA Rating Scales for Common Types of Respiratory Illnesses

Bronchitis

Chronic bronchitis is rated based mainly on the results of your pulmonary function tests.

• 100% disability is assigned when an FEV1, FVC, or DLCO test result is less than 40 percent of the predicted value.
• 60% disability is assigned when an FEV1, FVC, or DLCO test result is 40 to 55 percent of the predicted value.
• 30% disability is assigned when an FEV1, FVC, or DLCO test result is 56 to 70 percent of the predicted value.
• 10% disability is assigned when an FEV1, FVC, or DLCO test result is 71 to 80 percent of the predicted value.

Additionally, veterans who have oxygen consumption with exercise that's less than a certain amount may be able to establish 60% or 100% disability, and veterans who require outpatient oxygen therapy can have their bronchitis rated at 100%.

Asthma

Asthma is rated based on pulmonary function tests as well as how often you need medication to treat asthma attacks ("exacerbations"). If you're not having asthma symptoms at the time of your Compensation and Pension Exam, you'll need to provide medical evidence of a history of asthma attacks in order to receive disability compensation for your asthma.

Emphysema

Emphysema ratings are similar to those for bronchitis. You'll need to show certain FEV1, FVC, or DLCO test results in order to get a 100%, 60%, 30%, or 10% rating for emphysema.

Sleep Apnea

Sleep apnea is a condition many veterans seek disability compensation for.

• If you have chronic respiratory failure with carbon dioxide retention or cor pulmonale, or you've had a tracheostomy (a surgical tube placed in your windpipe to help you breathe), your sleep apnea will be rated at 100%.
• If you require the use of a CPAP machine, your sleep apnea will be rated at 50%.
• If you sleep excessively during the day (hypersomnolence), your sleep apnea will be rated at 30%.
• If you have a diagnosis of sleep apnea but don't have any symptoms, your sleep apnea will be rated at 0%.

Chronic Obstructive Pulmonary Disease (COPD)

Like chronic bronchitis and emphysema, COPD is rated largely on the basis of the results of pulmonary function tests. Depending on your FEV1, FVC, or DLCO results—or additional indicators of poor respiration such as ventricular hypertrophy—you'll be assigned a rating of 100%, 60%, 30%, or 10%.

Pulmonary Vascular Disease

If you had a pulmonary thromboembolism—a blood clot that gets stuck in your lungs and blocks normal blood flow—but it resolved and you have no more symptoms, you can receive only a 0% rating. But if it resolves and you continue to have symptoms, you can get a 30% rating. If you developed any secondary conditions (such as chronic bronchitis) as a result of pulmonary thromboembolism, those conditions will be rated separately.

If your pulmonary vascular disease is chronic, you may be eligible for a 60% rating if you're on anticoagulant (blood thinning) medication.

The most severe illnesses, such as chronic pulmonary thromboembolism, can be eligible for a 100% rating, but you'll need to also show a secondary condition, like hypertension.

Cancer

Cancer is rated at 100% while you're receiving treatment and for six months after your treatment ends. The VA will then schedule a reexamination to evaluate whether your disability rating should be decreased. If your cancer returns and you resume treatment, you'll be returned to a 100% rating.

How to Apply for Disability Based on Respiratory Illness

You can apply for disability benefits online, in person or over the phone at your VA regional office, or by mailing an Application for Disability Compensation to the following address:

Department of Veterans Affairs
Claims Intake Center
PO Box 4444
Janesville, WI 53547-4444

To learn more about the application process, read our article on applying for VA disability benefits.

_{Updated June 1, 2023}