Emphysema, pulmonary

The VA rates Emphysema, pulmonary under Diagnostic Code 6603 at 10%, 30%, 60%, 100%. The minimum 10% rating requires: FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; DLCO (SB) 66- to 80-percent predicted. The maximum 100% rating requires: FEV-1 less than 40 percent of predicted value, or; the ratio of Forced Expiratory Volume in one second to Forced Vital Capacity (FEV-1/FVC) less than 40 percent, or; Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO (SB)) less than 40-percent predicted, or; maximum exercise capacity less than 15 ml/kg/min oxygen consumption (with cardiac or respiratory limitation), or; cor pulmonale (right heart failure), or; right ventricular hypertrophy, or; pulmonary hypertension (shown by Echo or cardiac catheterization), or; episode(s) of acute respiratory failure, or; requires outpatient oxygen therapy..

The VA rates Emphysema, pulmonary under Diagnostic Code (DC) 6603, governed by 38 CFR 38 CFR § 4.97. The diagnostic code establishes the specific rating tiers and severity criteria the VA examiner applies.

A 10% rating requires: FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; DLCO (SB) 66- to 80-percent predicted. A 100% rating requires: FEV-1 less than 40 percent of predicted value, or; the ratio of Forced Expiratory Volume in one second to Forced Vital Capacity (FEV-1/FVC) less than 40 percent, or; Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO (SB)) less than 40-percent predicted, or; maximum exercise capacity less than 15 ml/kg/min oxygen consumption (with cardiac or respiratory limitation), or; cor pulmonale (right heart failure), or; right ventricular hypertrophy, or; pulmonary hypertension (shown by Echo or cardiac catheterization), or; episode(s) of acute respiratory failure, or; requires outpatient oxygen therapy.. The difference typically reflects the frequency, severity, or functional impact of the condition as documented in medical records and C&P examination findings.

Veterans rated for Emphysema, pulmonary may qualify for TDIU if the condition — alone or in combination with other service-connected disabilities — prevents substantially gainful employment. A single disability rated at 60% or higher (or multiple disabilities combining to 70%, with one at 40%) can support a TDIU claim under 38 CFR § 4.16.

Service connection for Emphysema, pulmonary requires three elements: (1) a current diagnosis of the condition, (2) an in-service event, injury, or disease, and (3) a medical nexus linking the current diagnosis to that in-service occurrence. A nexus letter from a treating or independent medical examiner is the most reliable nexus evidence.

A Compensation & Pension (C&P) exam for Emphysema, pulmonary uses a Disability Benefits Questionnaire (DBQ) specific to the body system involved. The examiner documents the frequency, severity, and functional impact of your symptoms. Bring all relevant treatment records and be prepared to describe your worst-day symptoms — the examiner rates your condition based on the full clinical picture, not a single visit.