Chronic obstructive pulmonary disease — VA Rating Criteria (38 CFR DC 6604)

The VA rates Chronic obstructive pulmonary disease under Diagnostic Code 6604 at the following tiers: 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..

Diagnostic Code 6604 is the VA rating identifier for Chronic obstructive pulmonary disease within 38 CFR 38 CFR § 4.97. It defines the specific symptom criteria and percentage thresholds a VA adjudicator uses to assign a disability rating. The diagnostic code is listed on a veteran's rating decision letter.

The highest schedular rating for Chronic obstructive pulmonary disease under DC 6604 is 100%. This tier 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.. Veterans who cannot secure substantially gainful employment due to Chronic obstructive pulmonary disease alone or in combination with other service-connected conditions may also qualify for TDIU at the 100% compensation rate under 38 CFR § 4.16.

Chronic obstructive pulmonary disease is rated under 38 CFR 38 CFR § 4.97, Diagnostic Code 6604. This section is part of the Schedule for Rating Disabilities (38 CFR Part 4) and can be read in full at the eCFR website.

Conditions commonly secondary to Chronic obstructive pulmonary disease include: Cor Pulmonale (Right Heart Failure), Major Depression (COPD-Related), Pulmonary Hypertension. Secondary conditions caused or aggravated by a service-connected disability are ratable under 38 CFR § 3.310. Medical nexus evidence linking the primary and secondary condition is required.

Service connection for Chronic obstructive pulmonary disease requires three elements: (1) a current diagnosis of the condition, (2) an in-service event, injury, or disease that may have caused or aggravated it, and (3) a medical nexus connecting the current diagnosis to that in-service event. A nexus letter from a treating physician or independent medical examiner is the most reliable nexus evidence. C&P exam findings can also establish nexus if adequately documented.