Respiratory System§ 4.97Updated
Rating criteria

VA Diagnostic Code 6604Chronic obstructive pulmonary disease:

Rated from 10% to 100% under § 4.97. Here is what the VA requires at each level.

View official source

Not the right code?

The ladder

What each rating requires

The VA assigns the highest level your evidence actually supports. Read up the stack until your records stop matching.

  1. 100%

    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.

  2. 60%

    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)

  3. 30%

    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

  4. 10%

    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

Chronic Obstructive Pulmonary Disease (COPD) — VA Disability Rating (Diagnostic Code 6604)

Respiratory System · 38 CFR § 4.97

Understanding COPD and How the VA Rates It

Chronic obstructive pulmonary disease (COPD) is a long-term lung condition that affects breathing. Under the VA rating schedule, COPD falls under Diagnostic Code 6604 in the Respiratory System (§ 4.97).

The VA assigns a disability rating for COPD at one of four levels — 10%, 30%, 60%, or 100% — based primarily on the results of pulmonary function tests and certain related findings. In general, the more your lung function is reduced, the higher the rating level.

Rating Levels

100%

Assigned when any of the following is shown:

  • FEV-1 less than 40 percent of predicted value, or
  • FEV-1/FVC (ratio of Forced Expiratory Volume in one second to Forced Vital Capacity) less than 40 percent, or
  • DLCO (SB) (Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method) 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

60%

Assigned when any of the following is shown:

  • 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)

30%

Assigned when any of the following is shown:

  • 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

10%

Assigned when any of the following is shown:

  • 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

What the VA Looks For

When rating COPD under Diagnostic Code 6604, the VA looks at specific measurable findings, including:

  • Pulmonary function test (PFT) results, such as FEV-1, the FEV-1/FVC ratio, and DLCO (SB) measured as a percentage of predicted value
  • Maximum exercise capacity / oxygen consumption (measured in ml/kg/min), where cardiac or respiratory limitation is a factor
  • Related cardiopulmonary findings, such as cor pulmonale (right heart failure), right ventricular hypertrophy, or pulmonary hypertension confirmed by Echo or cardiac catheterization
  • Acute respiratory events, such as episode(s) of acute respiratory failure
  • Treatment needs, such as whether outpatient oxygen therapy is required

Because each rating level lists several alternative criteria (any one of which may apply), the VA evaluates the available test results and clinical findings against these thresholds to determine the appropriate rating.

These criteria are a rendering of § 4.97, diagnostic code 6604. The official version is the one that governs your rating.

View official source
What next

How to claim this

Knowing the criteria is the first half. Getting your file to show them is the second.

  1. Find your level in the stack

    Read each rung against what your medical records already say. The level your records document today is the one the VA can support today.

  2. Name the gap

    Look at the rung above yours and write down exactly what it asks for that your file does not show yet — a diagnosis, a measurement, a prescribed brace, a doctor’s opinion linking it to service.

  3. Claim it by code

    File under diagnostic code 6604 and attach the evidence for the level you are asking for. Other Respiratory System codes may cover your secondary conditions.

Find out which rating your evidence supports.

Six reads your records against these exact criteria and tells you what the VA is still missing.

Start for freeAll 61 Respiratory System codes →