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April 27, 2023

VA Disability Ratings for Reactive Airway Disease (Veteran’s Guide)

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Despite service members’ bold work for our country, they are inevitably exposed to irritants that can affect their quality of life. Disability benefits may be available to veterans exposed to specific irritants like gasses, fumes, or smoke while serving, leading to reactive airway disease. 

This article details how you, as a veteran, may be entitled to VA benefits if you have been diagnosed with reactive airway disease directly linked to your service. 

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What is Reactive Airway Disease?

Reactive Airway Disease (RAD) refers to several respiratory illnesses causing the bronchial tubes in your lungs to react to an outside irritant, like gasses, fumes, mildew, or mold. 

While RAD is considered a generic non-medical term and you’ll find doctors using it to describe many breathing issues, including:

  • COPD
  • Asthma
  • Inflammation
  • Difficulty breathing
  • Uncontrolled mucus production
  • Congestive heart failure 

Reactive airway disease shouldn’t be confused with Reactive Airway Dysfunction Syndrome (RADS), typically a one-time condition from inhaling vapors or corrosive gas. In addition, while RAD is closely related to asthma, the two are different. 

Read our VA Disability Rating for Asthma Explained for more. 

Reactive Airway Disease Risk Factors

Several contributing factors increase your risk for reactive airway disease, including:

  • Cigarette smoke exposure
  • Exposure to toxins, smoke, and other chemicals
  • Allergies
  • Family history of asthma or reactive airway disease
  • Specific careers, including police, fire department, cleaners, emergency service workers, welders, and farmers 

What Causes Reactive Airway Disease in Veterans?

Veterans who were exposed to airborne hazards, toxic fumes from sulfur fires and/or open-air burn pits could be at risk of having Reactive Airway Disease.

Here’s a closer look at the top three causes of reactive airway disease in veterans.

Sulfur Mines 

Veterans in contact with hydrogen sulfide and sulfur dioxide gasses while in-service have been known to develop breathing problems. Those affected may experience irritation in the eyes, throat, nose, and coughing. 

In addition, service members exposed to high levels of sulfur dioxide might experience airway obstruction affecting their quality of life. For example, in 2003, a fire ignited at the Mishraq State Sulfur Mine Plant near Mosul, Iraq, and burned for nearly a month. 

Service members exposed to the fires experienced minor burns, blood-tinged nasal mucus, and irritation. Veterans might be eligible for VA benefits if exposed to the mine fire. 

Burn Pits 

Veterans who served in Iraq, Djibouti, and other areas of the Southwest Asian theater of military operations used burn pits to dispose of hazardous methods like diesel fuel, ammunition, and medical waste. While the system worked well to minimize the amount of trash, it also emitted poisonous smoke plumes. 

The plumes released into the air contained carcinogens and hazardous pollutants, which can cause reactive airway disease. One of the largest burn pits was more than 10 acres and was found at Joint Base Balad.

Read our Burn Pit Symptoms: The Top 5 Things to Know to learn more. 

Particulate Matter 

Burn pits are also responsible for emitting particulate matter, a combination of liquid droplets and tiny particles that can be harmful if ingested or inhaled. Particulate matter was also found in Iraq and Afghanistan sand storms. 

The U.S. Department of Veteran Affairs (VA) announced a presumptive service connection in 2021 for veterans who had the following:

  • Diagnosis of asthma, sinusitis, or rhinitis 
  • Served in Southwest Asia and certain additional areas 
  • Conditions presented themselves within 10 years of qualifying service 

The presumptive service connection allows veterans to connect their conditions to their service more efficiently. 

VETERAN WITH COPD

Symptoms of Reactive Airway Disease

RAD is frequently compared to asthma due to similar symptoms veterans often find. There are various symptoms of reactive airway disease, including the following:

  • Shortness of breath 
  • Wheezing
  • Consistent cough that doesn’t go away 
  • Tightness in the chest
  • Difficulty breathing 

It’s important to understand that the symptoms you experience may vary from another veteran. For example, symptoms can be mild in some, while others experience life-threatening side effects that require immediate attention. 

Common Conditions Linked to Reactive Airway Disease 

While asthma is the most common condition linked to reactive airway disease, there are several more you may experience. 

COPD

While COPD has symptoms similar to reactive airway disease, the two differ. COPD is a chronic lung condition affecting your breathing and worsening over time.

Croup 

Croup is commonly associated with infants but can occur at any age and cause coughing, difficulty breathing, swelling, and throat narrowing. 

Bronchitis

Veterans may also experience bronchitis, leading to lung irritation, inflammation, shortness of breath, congestion, and coughing. 

Emphysema

Also associated with smoking, emphysema is a severe lung disease that makes breathing difficult and damages your lung’s air sacs. It can also cause wheezing, chest tightness, and coughing. 

Bronchiectasis 

Bronchiectasis is a severe lung infection that can damage your airways and cause inflammation. Common symptoms include chest congestion, shortness of breath, and a persistent cough. 

Treatment of Reactive Airway Disease 

There are several medications veterans can take to treat reactive airway disease that is also used for asthma. Depending on the medication, you can expect quick relief from RAD or experience long-term control of symptoms. 

You may be offered one of the following medications to help treat reactive airway disease. 

  • Corticosteroids-used to ease inflammation
  • Bronchodilators-used to open airways 
  • Mast cell stabilizers and leukotriene inhibitors-used to prevent inflammation

According to the University of Pittsburgh Medical Center, you should limit exposure to specific irritants or conditions that trigger RAD, including:

  • Smoke
  • Allergies to pollen, dust, pets, and mold
  • Exercise 
  • Strong odors
  • Weather changes 

Since not every trigger is avoidable, it’s best to understand the risks you face when exposing yourself to specific environments. 

VA DOCTOR VIEWING CHEST XRAY

Establishing the Connection of Reactive Airway Disease in Veterans 

As a veteran, you must provide the following information connecting your condition to receive VA benefits. 

  • Proof of an in-service illness, injury, or disease 
  • Diagnosis from your medical professional related to your reactive airway disease 
  • A medical connection between your current diagnosis and your in-service illness or injury (Independent Medical Opinion or Nexus Letter)
  • Documentation of the severity of your illness 

Since you can have reactive airway disease from other causes, like smoking or allergies, you must directly link your illness to your time serving. Therefore, keeping records of all doctor visits, medications, and other treatments you received for RAD is crucial. 

Once veterans establish the connection of their service to the RAD diagnosis, they will receive the appropriate reactive airway disease VA rating. 

VETERAN WITH REACTIVE AIRWAY DISEASE 2

VA Disability Ratings for Reactive Airway Disease 

The reactive airway disease is rated analogously with bronchial asthma since they share the same symptoms and are categorized under the 38 C.F.R. § 4.97, Diagnostic Code (DC) 6602

The reactive airway disease VA rating varies from 10%-100% and is based on the FEV1/FVC ratio, representing how well a person can exhale. 

The Diagnostic Code 6602 ratings are the following: 

100% Rating

  • 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 immunosuppressive medications

60% Rating

  • 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 (oral or parenteral) corticosteroids

30% Rating

  • 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% Rating

  • FEV–1 of 71- to 80-percent predicted, or 
  • FEV–1/FVC of 71 to 80 percent, or
  • Intermittent inhalational or oral bronchodilator therapy

The service member must provide records of the attacks if there are no clinical findings of asthma or reactive airway disease during the examination. 

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