- Diagnostic Code
- 6520
- CFR Section
- §4.97 — Respiratory
Rating Tiers
100%
Forced expiratory volume in one second (FEV-1) less than 40 percent of predicted value, with Flow-Volume Loop compatible with upper airway obstruction, or; permanent tracheostomy
60%
FEV-1 of 40- to 55-percent predicted, with Flow-Volume Loop compatible with upper airway obstruction
30%
FEV-1 of 56- to 70-percent predicted, with Flow-Volume Loop compatible with upper airway obstruction
10%
FEV-1 of 71- to 80-percent predicted, with Flow-Volume Loop compatible with upper airway obstruction
Rated Under Formula
This condition is rated using the §4.97 general rating formula.
What Raters Look For
Based on M21-1 adjudication criteria for Respiratory conditions. These are the factors a VA rater evaluates when assigning a rating percentage.
M21-1 III.iv.4.B- •Pulmonary function test results: FEV1 (% of predicted), FVC, FEV1/FVC ratio, and DLCO
- •Exercise tolerance in METs (metabolic equivalents) if cardiac limitation is also relevant
- •Frequency of exacerbations requiring medical visits, oral steroids, or hospitalization
- •Oxygen therapy use — whether prescribed and under what conditions
- •Sleep study results and AHI score if sleep apnea is claimed
- •Medication regimen: inhalers, systemic steroids, biologics
- •Smoking history (noted but not used to reduce rating)
NoteFor sleep apnea, raters look specifically at whether a CPAP/BiPAP is required — that alone meets the 50% rating criteria under DC 6847.