VA Disability Ratings For Lung Disease And Respiratory Issues

Respiratory illnesses can severely impact a Veteran’s ability to work, maintain relationships, and enjoy daily life. From chronic bronchitis and asthma to more serious conditions like COPD, interstitial lung disease, or lung cancer, these conditions often trace back to exposures or injuries sustained during military service. Unfortunately, many Veterans face significant barriers when seeking VA disability benefits for lung and respiratory conditions.

At Veterans Law Group, we focus exclusively on VA disability appeals. If your claim has been denied or your rating doesn’t reflect the true severity of your condition, our legal team is here to help you secure the compensation and care you’ve earned.

Understanding VA Disability for Respiratory Conditions

The VA offers disability compensation for a wide range of lung and respiratory diseases—but the path to approval is often complex. Claims depend not only on a formal diagnosis but also on a well-documented link to military service.

Common Respiratory Conditions in Veterans

Veterans may be eligible for VA disability benefits for the following service-connected respiratory conditions:

• Chronic Obstructive Pulmonary Disease (COPD)
• Asthma
• Chronic bronchitis
• Pulmonary fibrosis
• Lung cancer
• Emphysema
• Pleurisy
• Tuberculosis (TB)
• Sleep apnea (when linked to respiratory impairment)
• Respiratory conditions caused by burn pit exposure or toxic substances

Each condition is rated based on the severity of symptoms and the degree to which the illness impairs lung function and daily activities.

Establishing Service Connection for Lung Disease

There are three main pathways to prove service connection for a respiratory disability. They are:

A Direct Service Connection

This applies when the respiratory condition began during service or can be directly tied to a specific in-service event or exposure—such as breathing in dust, fumes, or smoke during deployment. Veterans who developed respiratory issues during active duty and have medical documentation from that time may qualify under this category.

A Secondary Service Connection

Sometimes a respiratory issue develops as a result of another service-connected condition. For example, sleep apnea may develop in a Veteran with a service-connected neck injury or obesity caused by limited mobility due to orthopedic conditions.

A Presumptive Service Connection

The VA recognizes certain respiratory diseases as “presumptively” connected to military service under specific conditions. For presumptive claims, the Veteran does not need to prove a direct causal link—only that they served in an eligible location during the qualifying timeframe and have a recognized diagnosis.

How the VA Rates Respiratory Disabilities

VA ratings for lung and respiratory conditions are governed by the Schedule for Rating Disabilities (38 CFR § 4.97). Each respiratory disease is assigned a specific diagnostic code, and the severity of the condition is evaluated based on clinical testing, symptom presentation, and the impact on a Veteran’s daily life.

Pulmonary Function Testing (PFTs)

Most respiratory ratings are determined using Pulmonary Function Tests (PFTs). These tests are critical in measuring how well the lungs move air and exchange gases. The four key PFT components used by the VA include:

• Forced Expiratory Volume in one second (FEV-1): Measures how much air a person can exhale forcefully in one second. Lower scores indicate greater airway obstruction.
• Forced Vital Capacity (FVC): Measures the total amount of air a person can forcefully exhale after taking a deep breath.
• FEV-1/FVC Ratio: Assesses the proportion of air exhaled in the first second compared to the full breath, helping distinguish between obstructive and restrictive lung disease.
• Diffusion Capacity of the Lung for Carbon Monoxide (DLCO): Evaluates how efficiently gases pass from the lungs into the blood—especially important in interstitial lung diseases and pulmonary fibrosis.

The VA assigns ratings based on the lowest measured value across these metrics:

• 10% rating: Assigned for mild limitation (e.g., FEV-1 or FVC at 71–80% predicted, or DLCO at 66–80%).
• 30%–60% ratings: Reflect moderate to moderately severe impairment, typically with PFT values ranging from 40–70% predicted.
• 100% rating: Reserved for very severe impairment, such as FEV-1 less than 40% predicted, DLCO under 40%, or a requirement for continuous oxygen therapy, outpatient oxygen, or evidence of respiratory failure.

Symptom-Based Ratings

When PFTs are unavailable, not feasible, or do not reflect the full extent of disability, the VA may assign a rating based on clinical symptoms and treatment requirements. Relevant considerations may include:

• Persistent dyspnea (shortness of breath) at rest or with minimal exertion
• Use of systemic corticosteroids or bronchodilators
• History of frequent hospitalizations or ER visits for respiratory exacerbations
• Need for inhalation therapy or intermittent oxygen support

In some cases—such as with sarcoidosis, pulmonary hypertension, or lung cancer—ratings may also be determined by the type of treatment required (e.g., chemotherapy, surgical removal of lung tissue), or complications such as weight loss, fatigue, and systemic involvement.

Ultimately, VA respiratory ratings aim to reflect not just clinical measurements, but how the condition functionally impacts a Veteran’s ability to work, breathe, and maintain daily activities. Ensuring that all aspects of the disability are documented—both through testing and through symptom reporting—is essential to receiving an accurate rating.

Why Respiratory Claims Are Denied or Underrated

Despite medical evidence and clear exposure risks, many Veterans find their claims denied or rated too low. Common issues include:

Lack of Nexus

The VA often denies respiratory claims when a clear link between service and the current condition is missing. If the illness was not documented in service or didn’t appear until years later, Veterans must present a strong nexus letter connecting it to military service or a secondary condition. Without this medical opinion, even well-documented conditions may be denied.

Incomplete Testing

If the claim is based on insufficient pulmonary function testing—or if the VA does not order the correct tests—disability ratings may be too low. Accurate and complete testing is essential. Claims that lack data such as DLCO, FEV-1, or oxygen dependency may not reflect the true severity of the condition.

Denial of Presumptive Status

Some Veterans wrongly believe their condition qualifies as presumptive, only to have the VA deny it based on timing or location. Misunderstanding eligibility criteria can lead to unnecessary delays and appeals. The burden then falls on the Veteran to prove exposure and causation through other means.

Outdated Medical Evidence

If the most recent test results or treatment notes are outdated or incomplete, the VA may assume the condition has improved, even when it has worsened. Veterans who haven’t undergone recent pulmonary evaluations may see lower ratings, even if their symptoms and limitations have increased. Ongoing documentation is essential to receiving an accurate rating.

The Burden of Appealing a Denied Lung Disease Claim

Filing an appeal for a denied or underrated respiratory condition involves several steps—all of which can be challenging for Veterans dealing with chronic illness.

Reviewing the Denial

First, the appeal must address the VA’s stated reasons for denial. Was it due to insufficient evidence? An unclear nexus? A misinterpretation of medical records? Understanding the legal basis for the denial is the first step in reversing it.

Obtaining Current Medical Evidence

This may require a new pulmonary function test or updated treatment notes. Veterans must also show how the condition affects their daily life—such as limitations in walking, climbing stairs, or working.

Securing a Medical Nexus Letter

A nexus letter is a written opinion from a medical provider that connects the current lung condition to service. This letter must include a clear rationale and use language consistent with VA standards, such as “at least as likely as not.”

Filing the Correct Appeal Forms

Appeals must be filed within a year of the decision, and Veterans must choose between different lanes: Supplemental Claim, Higher-Level Review, or Board Appeal. Choosing the wrong path or missing a deadline can cause costly delays.

How a VA Disability Lawyer Can Help with Lung Disease Claims

Working with an experienced VA disability lawyer can make all the difference in a respiratory-related claim or appeal. At Veterans Law Group, we provide support in every stage of the appeal process:

Identifying Errors in the VA Decision

We carefully analyze the VA’s denial to determine whether they overlooked evidence, misapplied the law, or failed to consider secondary or presumptive service connection. In many cases, the VA fails to fully assess a Veteran’s exposure history or uses outdated medical records in making its decision. We identify these gaps and prepare a targeted appeal to address them.

Coordinating Medical Exams and Nexus Opinions

We help Veterans obtain VA-compliant pulmonary function tests, gather updated treatment records, and secure medical opinions that support service connection or a worsened condition. If a specialist is needed to confirm a diagnosis or explain causation, we coordinate that support.

Building a Strong Functional Narrative

We assist in collecting lay statements from the Veteran, family members, or coworkers that explain how the condition impacts mobility, self-care, work, and daily functioning. These real-world accounts help paint a fuller picture of disability beyond test scores.

Pursuing Total Disability Based on Individual Unemployability (TDIU)

For Veterans whose lung disease prevents them from working, we help build a TDIU case—seeking compensation at the 100% level, even if the combined rating is lower. We document the work limitations in detail and support them with medical and vocational evidence.

Managing the Appeals Process

From filing Notices of Disagreement to representing clients before the Board of Veterans’ Appeals, we manage every procedural step and legal argument so Veterans can focus on their health. We ensure all deadlines are met, the right evidence is submitted, and the strongest possible case is presented.

Tips for Strengthening a Lung Disease Disability Appeal

Whether you’re appealing a denied claim or seeking a higher rating, these strategies can make a significant difference in the success of your case. Because respiratory claims often hinge on both medical evidence and personal impact, building a strong, well-documented appeal is critical.

Undergo Complete Pulmonary Testing

The VA relies heavily on Pulmonary Function Tests (PFTs) to assign ratings. Make sure your test includes all required components: FEV-1, FVC, FEV-1/FVC ratio, and DLCO. These measurements must be performed using VA-approved procedures, ideally by a qualified pulmonologist or VA-contracted provider. If the test is incomplete or outdated, request a new evaluation to ensure the most accurate rating.

Track Daily Symptoms and Flare-Ups

Keep a journal detailing how your respiratory condition affects you day to day. Record episodes of shortness of breath, chest tightness, and fatigue. Include how far you can walk or climb stairs before becoming winded, and whether you rely on inhalers, oxygen, or nebulizers. Document medication side effects and any ER visits or hospitalizations due to your condition.

Submit Lay Statements

Personal statements from your spouse, family members, or coworkers can illustrate how your lung disease interferes with basic tasks. For example, your spouse might describe your difficulty climbing stairs or how you struggle with basic chores. These statements offer valuable context that lab tests alone cannot provide.

Address Secondary Conditions

If your lung disease has caused or worsened other health problems—such as depression, anxiety, insomnia, or sleep apnea—be sure to include these in your appeal. Secondary conditions can increase your overall rating and entitle you to additional benefits.

Request a Vocational Assessment

If your breathing issues prevent you from holding a steady job, a vocational expert can prepare a report explaining why you’re unable to work. This is especially helpful when applying for Total Disability based on Individual Unemployability (TDIU), which allows for 100% compensation even without a 100% schedular rating.