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Respiratory conditions are among the fastest-growing VA disability categories. Exposure to burn pits, dust, and other hazards during military service has contributed to an increase in conditions like asthma, COPD, chronic bronchitis (and others), and may also be linked to sleep apnea.
This guide examines VA respiratory ratings, ratable conditions, proving service connection, and the impact of the PACT Act.
Summary of Key Points
- Respiratory conditions have surged in recent years, with VA claims more than doubling since 2020.
- VA respiratory ratings are based on pulmonary test results, medication or oxygen use, severity of breathlessness, or other symptoms.
- VA-ratable respiratory conditions include upper and lower respiratory, pleural, thoracic, and secondary conditions.
- Many respiratory conditions, such as asthma, COPD, and chronic bronchitis, are now presumptive under the PACT Act, so you don’t need to prove they were caused by service.
Table of Contents
Top Respiratory Conditions Among Veterans
Did You Know? Respiratory conditions have seen the largest increase of any VA disability category.
According to a VBA Report, the top respiratory conditions among veterans are:
- Allergic rhinitis – 30.4% of respiratory claims
- Sleep apnea – 29.5% of respiratory claims
- Maxillary sinusitis – 10.3% of respiratory claims
How VA Respiratory Ratings Are Determined
The VA rates most respiratory conditions on a scale of 0% to 100%, depending on the severity of your symptoms and how much they limit your ability to breathe.
Most ratings are based on results from Pulmonary Function Tests (PFTs), which measure how well your lungs function in moving air in and out.
Common factors that affect VA respiratory ratings include:
- Pulmonary function test (PFT) results, like FEV-1 and FEV-1/FVC ratios
- How often you need inhalers, corticosteroids, or oxygen therapy
- Objective findings or treatment requirements listed under the specific diagnostic code for your condition
The VA also assigns specific diagnostic codes for various respiratory conditions to determine your rating level.
Pulmonary Function Tests: Why They Matter
PFTs play a significant part in determining your disability rating by the VA.
A PFT measures:
- Spirometry: How much air you can exhale and how quickly
- Lung volumes: How much air your lungs can hold
- DLCO: How well oxygen moves from your lungs into your blood
If your test shows reduced airflow or impaired oxygen exchange, it can confirm your current diagnosis and determine your rating. Even if your PFTs look normal, the VA can still rate you based on your need for medications or oxygen therapy.
Pro Tip: If your PFT results are outdated or missing, ask your doctor or a private provider to complete a Disability Benefits Questionnaire (DBQ) to strengthen your claim.
VA-Ratable Respiratory Conditions
The VA categorizes respiratory conditions into upper and lower categories, plus pleural, thoracic, and secondary conditions. VA respiratory ratings are based on the assigned diagnostic code.
Upper Respiratory Conditions
Upper respiratory conditions affect the nose, sinuses, and throat, often causing symptoms like congestion, sinus infections, or allergic rhinitis.
| Condition | Diagnostic Code (DC) |
| Traumatic deviation of nasal septum | 6502 |
| Nose, loss of part of, or scars | 6504 |
| Sinusitis (maxillary, frontal, ethmoid, sphenoid, pansinusitis) | 6510–6514 |
| Laryngitis (chronic) | 6516 |
| Aphonia (loss of voice) | 6519 |
| Laryngectomy (partial or total) | 6520 |
| Stenosis of larynx | 6520 |
| Allergic or vasomotor rhinitis | 6522 |
| Bacterial rhinitis | 6523 |
| Granulomatous rhinitis (e.g., Wegener’s granulomatosis) | 6524 |
| Sleep apnea syndromes (obstructive, central, mixed) | 6847 |
Lower Respiratory and Pulmonary Conditions
Lower respiratory and pulmonary conditions affect the lungs and airways, making it difficult to breathe or obtain sufficient oxygen.
| Condition | Diagnostic Code (DC) |
| Bronchitis, chronic | 6600 |
| Bronchiectasis | 6601 |
| Asthma, bronchial | 6602 |
| Cystic fibrosis | 6601 or 6602 (depending on manifestations) |
| Emphysema | 6603 |
| COPD | 6604 |
| Pulmonary fibrosis | 6825-6833 |
| Pneumoconiosis (asbestosis, silicosis) | 6832-6834 |
| Sarcoidosis | 6846 |
| Pneumonia (residuals, chronic) | 6730 or by analogy |
| Pulmonary tuberculosis (active or inactive) | 6721–6732 |
| Histoplasmosis or other mycotic infections | 6835–6839 |
Pleural and Thoracic Conditions
Pleural and thoracic conditions affect the lining of the lungs or chest wall and may cause chest pain or impaired lung movement.
| Condition | Diagnostic Code (DC) |
| Lung abscess | 6824 |
| Diaphragmatic paralysis or weakness | 6840–6841 |
| Pneumothorax or hemothorax (residuals) | 6843 |
| Post-surgical residuals (lobectomy, pneumonectomy, etc.) | 6844 |
| Pleurisy, chronic | 6845 |
Respiratory-Related Conditions
Some conditions aren’t always listed directly under the Schedule of Ratings for the Respiratory System, but are often rated analogously or secondary to primary respiratory diseases, including:
- Sleep disturbances due to respiratory failure or apnea
- Respiratory cancers (linked to toxic exposures, burn pits, or Agent Orange)
- Sinusitis secondary to allergic rhinitis or deviated septum
- Gulf War–related respiratory symptoms (presumptive conditions)
Proving Service Connection for Respiratory Conditions
There are two main ways to establish service connection for a respiratory condition: direct and secondary.
- Direct service connection means your condition began during or was directly caused by your military service.
- Secondary service connection means your condition developed or got worse because of another service-connected disability.
Direct Service Connection
To prove direct service connection for respiratory conditions, you must provide evidence of the following:
- A current medical diagnosis
- An in-service event, injury, aggravation, or illness
- A medical nexus (link) between your current diagnosis and the in-service event, injury, aggravation, or illness
Secondary Service Connection
To prove secondary service connection, you’ll need:
- A current medical diagnosis of your secondary condition
- A medical nexus showing the condition was caused or aggravated by a primary service-connected disability
Pro Tip: A credible nexus letter from a qualified medical provider can be one of the most powerful forms of evidence when linking your respiratory condition to another service-connected disability.
The PACT Act and the Sharp Rise in VA Respiratory Disabilities
New respiratory VA disabilities jumped from 65,031 in 2020 to over 159,192 in 2024 (a 34% increase from the previous year and more than double the pre-PACT Act baseline)!
This surge is likely linked to the PACT Act, which recognizes burn pit and airborne hazard exposure as causes of certain respiratory conditions.
Many of these are now considered presumptive conditions, meaning you don’t have to prove the connection to your service.
Learn More: Maximizing Your PACT Act Compensation
Filing a VA Claim for Respiratory Conditions
You must file a VA claim to be eligible for a VA disability rating for respiratory issues.
You can file a VA claim using VA Form 21-526EZ:
- Online (Usually the fastest method!)
- By mail
- Via fax
- In person at a VA regional office
Final Thoughts
Understanding how the VA rates respiratory conditions is key to getting the compensation and benefits you’ve earned. Whether you’re managing asthma, COPD, sleep apnea, or another breathing issue, knowing the rating criteria and how the PACT Act applies to your case may strengthen your claim and improve your chances of approval.
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(FAQs) Frequently Asked Questions
How does the VA rate respiratory conditions?
The VA rates respiratory conditions based on pulmonary function tests, medication use, and the use of oxygen therapy.
What is the respiratory disability rating scale?
The respiratory disability rating scale assesses the severity of your breathing condition and determines your benefit level. Ratings range from 0% to 100% based on your current diagnosis, treatment, PFT results, and the VA’s assigned diagnostic code.
What is the upper respiratory infection VA rating?
Can you get TDIU for a respiratory condition?
If your respiratory condition prevents you from securing and maintaining substantially gainful employment, you may qualify for 100% disability compensation through Total Disability Based on Individual Unemployability (TDIU). >> View the TDIU Eligibility Requirements
Can I get a VA rating for shortness of breath?
Shortness of breath (also called dyspnea) isn’t rated as a standalone condition, but it can be a symptom considered under the diagnostic code for your respiratory disorder. The VA determines the severity of your condition mainly through objective test results and treatment requirements. If breathing problems make it difficult for you to walk, work, or sleep, those effects may increase your overall rating. Learn More: How the VA rates Dyspnea
Are respiratory conditions covered under the PACT Act?
Yes. The PACT Act made several respiratory conditions presumptive for veterans exposed to burn pits or airborne hazards during service.
Do I need a nexus letter for a respiratory claim?
While the VA doesn’t require one, a nexus letter from a qualified medical provider can be powerful evidence linking your respiratory condition to military service or another service-connected disability.
Can respiratory conditions be rated secondary to other disabilities?
Yes. Conditions like sleep apnea or chronic bronchitis can be rated secondary if they were caused or worsened by another service-connected condition.
About the Author
Kelly Olone
Kelly Olone is a military spouse who earned her degree in Psychology from Florida International University. After working in the non-profit sector for several years, she turned to her passion for writing. She aims to contribute to a better understanding of the valuable benefits that veterans deserve. As a mom, Kelly navigates the delicate balance between deadlines and bedtime stories with finesse.
