- Diagnostic Code
- 6603
- CFR Section
- §4.97 — Respiratory
Rating Tiers
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 ( heart failure), or; ventricular hypertrophy, or; pulmonary hypertension (shown by Echo or cardiac catheterization), or; episode(s) of acute respiratory failure, or; requires outpatient oxygen therapy.
FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; DLCO (SB) of 40- to 55-percent predicted, or; maximum oxygen consumption of 15 to 20 ml/kg/min (with cardiorespiratory limit)
FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; DLCO (SB) 56- to 65-percent predicted
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
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)