Rating Criteria by Level
Under 38 CFR § 4.97, DC 6602, each rating level lists several alternative criteria separated by "or." You only have to meet one of them. A veteran whose FEV-1 is normal but who takes a daily controller inhaler still meets the 30% standard, and the VA is required to apply whichever criterion yields the higher evaluation.
Criteria: FEV-1 of 71 to 80% of predicted value, or FEV-1/FVC ratio of 71 to 80%, or intermittent inhalational or oral bronchodilator therapy.
This is the entry level for a compensable asthma rating. A rescue inhaler used occasionally (not daily) meets the treatment criterion on its own, even when your pulmonary function test numbers look normal. Document every prescription refill: refill frequency is what the examiner uses to judge "intermittent" versus "daily."
Criteria: FEV-1 of 56 to 70% of predicted value, or FEV-1/FVC ratio of 56 to 70%, or daily inhalational or oral bronchodilator therapy, or use of inhalational anti-inflammatory medication.
This is the most common asthma rating. A daily maintenance inhaler (a steroid controller such as fluticasone or budesonide, or a daily bronchodilator) satisfies this level regardless of your FEV-1 score. Veterans are frequently under-rated here because the examiner records only PFT numbers and never asks about daily controller medication. Bring your medication list to the exam.
Most common rating: a daily controller inhaler qualifies on its own
Criteria: FEV-1 of 40 to 55% of predicted value, or FEV-1/FVC ratio of 40 to 55%, or at least monthly visits to a physician for required care of exacerbations, or intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids.
Three or more prednisone tapers in a year is enough on its own, even if your breathing tests are stable between flares. This level also meets the single-condition schedular threshold for TDIU. Keep a record of every urgent care visit, ER visit, and steroid burst: the count is what the rater needs and it is rarely reconstructed accurately from VA records alone.
Criteria: FEV-1 less than 40% of predicted value, or FEV-1/FVC ratio less than 40%, or more than one attack per week with episodes of respiratory failure, or requires daily use of systemic (oral or parenteral) high-dose corticosteroids or immunosuppressive medications.
The 100% level requires either severely reduced pulmonary function or continuous high-dose systemic treatment. Daily inhaled steroids do not count here: the criterion is systemic (oral or injected) high-dose corticosteroids or an immunosuppressive biologic. Documented episodes of respiratory failure requiring intervention more than once a week also qualify.
How to Service-Connect Asthma
Direct service connection requires a current diagnosis, an in-service event or exposure, and a medical nexus linking the two. Asthma has an unusually strong presumptive path, so many veterans never need a nexus opinion at all.
PACT Act Presumptive (Burn Pits)
Asthma diagnosed after service is a PACT Act presumptive condition for veterans who served in qualifying burn pit and toxic exposure locations. With qualifying service and a diagnosis, the VA presumes the connection. No nexus letter needed.
Direct Service Connection
Asthma was diagnosed on active duty, or you were treated in service for wheezing, shortness of breath, or recurrent bronchitis. An inhaler prescribed before separation, or a profile limiting physical training, is strong evidence in your service treatment records.
Secondary to GERD or Sinus Disease
Acid reflux triggers bronchospasm, and chronic sinusitis drives airway inflammation through post-nasal drainage. A nexus opinion stating that a service-connected condition caused or aggravated your asthma establishes secondary service connection.
What Happens at Your C&P Exam
The VA will schedule a compensation and pension exam with a VA or contracted examiner, who completes the respiratory conditions DBQ. For asthma, the examiner will typically:
- Order or review pulmonary function tests, recording post-bronchodilator FEV-1 percent predicted and the FEV-1/FVC ratio
- Ask which inhalers you use and whether you use them daily or only as needed
- Count courses of systemic (oral) corticosteroids such as prednisone in the past 12 months
- Ask how often you see a physician for exacerbations, and whether any required an ER visit or hospitalization
- Document related conditions you have raised (sinusitis, rhinitis, GERD, sleep apnea)
- Provide a nexus opinion if secondary service connection is claimed
Bring a printed medication list with prescription dates, your refill history from the pharmacy, and a written count of steroid tapers and urgent care visits from the past year. If your PFT is done on a symptom-free day, say so on the record: the treatment criteria are what will carry your rating.
Secondary Conditions to Asthma
Once asthma is service-connected, you can file secondary claims for conditions it caused or worsened, including side effects of long-term treatment. Each adds its own rating to your combined total.
Chronic SinusitisUpper and lower airway inflammation travel together. Rated 0 to 50% on incapacitating episodes requiring antibiotics.
Allergic RhinitisFrequently coexists with asthma and shares the same exposure history. Rated 0 to 30% under DC 6522.
GERDReflux both triggers asthma and is worsened by bronchodilators and oral steroids. Rated 10 to 60%.
Sleep ApneaNocturnal asthma and airway inflammation are recognized contributors. A CPAP prescription rates 50%.
Anxiety and DepressionChronic breathlessness and activity limits commonly drive mood disorders. Rated 0 to 100% on the mental disorders scale.
Steroid Side EffectsLong-term corticosteroid use is linked to osteoporosis, cataracts, and glucose intolerance, each separately ratable.
Atopic skin disease belongs on this list too. Veterans with asthma often carry chronic eczema or dermatitis from the same allergic and exposure history, and it is rated separately under DC 7806 on body surface coverage and systemic therapy.
SourcesLast reviewed: July 2026
Asthma VA Rating FAQ
What is the VA rating for asthma with a daily inhaler?
Daily inhalational or oral bronchodilator therapy, or use of an inhalational anti-inflammatory (steroid) medication, meets the 30% criteria under DC 6602. That pays $552.47/month for a veteran alone at 2026 rates. Intermittent (not daily) inhaler use rates 10%.
Is asthma a PACT Act presumptive condition?
Yes. Asthma diagnosed after service is presumptive under the 2022 PACT Act for veterans who served in qualifying burn pit and toxic exposure locations, including Iraq, Afghanistan, and the Gulf War theater. Presumptive status means you need only the diagnosis and qualifying service, not a nexus opinion.
How does the VA measure asthma severity?
The VA uses post-bronchodilator pulmonary function tests (FEV-1 percent predicted and the FEV-1/FVC ratio) alongside treatment requirements: bronchodilator frequency, daily controller medication, and courses of systemic corticosteroids per year. Whichever criterion produces the higher rating is the one applied.
Can asthma be rated at 100%?
Yes. The 100% level requires FEV-1 below 40% predicted, an FEV-1/FVC ratio below 40%, more than one attack per week with episodes of respiratory failure, or daily high-dose systemic corticosteroids or immunosuppressive medication.
Can I get separate ratings for asthma and sinusitis or rhinitis?
Yes. Asthma (DC 6602), chronic sinusitis (DC 6510 to 6514), and allergic rhinitis (DC 6522) fall under separate diagnostic codes with different symptom sets, so each can carry its own rating and they combine under VA math.
Does asthma qualify for TDIU?
Asthma at 60% meets the single-condition schedular threshold for TDIU. At 30% it does not on its own, but it can combine with other service-connected conditions to reach the 70% combined threshold with one condition rated 40% or higher.
What if my breathing test looks normal on exam day?
Asthma is episodic, so a good PFT on a good day is common and does not defeat a claim. DC 6602 is written so that medication requirements are an independent path to each rating level. Ask the examiner to record your daily controller medication, rescue inhaler frequency, and any steroid tapers in the past year.
Can asthma be service-connected secondary to another condition?
Yes. Asthma is commonly aggravated by service-connected GERD (acid reflux triggers bronchospasm) and by chronic sinusitis or rhinitis through post-nasal drainage. A nexus opinion stating that the service-connected condition caused or aggravated the asthma establishes secondary service connection.