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Cracking the Code: How the VA Combines Respiratory Disability Ratings
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Breathing – a simple, life-sustaining act we often take for granted. For many veterans, however, each breath is more than a biological necessity; it's a vivid reminder of dangerous conditions and harsh environments. From the dusty, remote terrains to the toxic fumes of burn pits, their lungs bear the scars of environmental hazards encountered during their service.
Now, back on home soil, these heroes face a different kind of battle – navigating the complexities of the Department of Veterans Affairs (VA) system to receive the support they deserve for their service-connected respiratory conditions. For those with multiple respiratory issues, the VA uses a unique approach to combine various disability ratings into a single, comprehensive assessment. Understanding this methodology is crucial, as it determines the level of support and compensation veterans receive for the respiratory challenges they now face post-service. Read on to discover more about this process.
An Inside Look at the VA’s Respiratory Rating Process
First, understanding the VA’s general framework for assessing respiratory claims provides helpful context. The VA Schedule for Rating Disabilities categorizes breathing conditions like asthma, COPD, bronchitis and sleep apnea under diagnostic codes 6600-6847. It further details symptoms for each disease that might require VA disability compensation, such as reduced airflow measurements or necessary expensive therapies.
When a veteran files a disability claim for respiratory issues, the VA examines all medical evidence to determine if any diagnosed conditions connect to military service. This requires evaluating a variety of potential service-connected causes, from burn pit toxin exposure to particulate matter inhalation while deployed overseas.
Once a respiratory diagnosis is deemed service-connected, VA raters assign a percentage rating (0-100%) reflecting the severity of the veteran’s respiratory disability. Higher disability ratings typically mean increased monthly disability compensation. Understanding the VA’s rating criteria for different respiratory issues - and different combinations of these issues - helps set expectations for appropriate disability percentages.
Shifting Regulations
Veterans frequently face multiple respiratory conditions as a result of toxic exposures encountered during service. For instance, conditions like reactive airway dysfunction syndrome (coded as 6601) and chronic bronchitis (6600) often have their roots in exposure to burn pit smoke. In the past, the VA would assess and compensate each of these conditions independently, according to specific rating criteria for each one.
However, recent changes in VA regulations require a shift in this approach. Now, if multiple respiratory conditions share a common cause or “etiology,” such as exposure to burn pit fumes or desert dust, they are combined into a single evaluation. In practical terms, this approach means that even if a veteran's symptoms technically qualify for separate ratings for each respiratory condition, the VA will instead issue a single unified rating. This rating is designed to reflect the overall impact of the veteran's respiratory disabilities.
Importantly, this doesn't mean that the severity of individual conditions is overlooked. The VA raters are required to adjust or elevate this combined rating to accurately represent the full extent of the impairment caused by all of a veteran's respiratory conditions.
Common Causes of Respiratory Conditions in Veterans
The VA has a structured approach to evaluating these service-connected respiratory conditions. Under the schedule for rating disabilities, each condition is assessed based on its severity and impact on the veteran's health. Respiratory conditions, due to their often interlinked symptoms and effects on the respiratory system, require a nuanced approach.
To fully understand the VA's recent approach to consolidating respiratory disability ratings, it's important to know the common origins of these conditions among veterans. The environments and circumstances they endured during service play a key role in the challenges they face today.
Burn Pits - the use of large pit incinerators on overseas bases was a common practice, where all waste from military operations was burned. The toxic smoke from these pits, laden with carcinogens, had a direct and damaging impact on the respiratory health of personnel stationed nearby. Veterans who served in areas with extensive burn pit use often experience a range of respiratory conditions as a result.
Particulate Matter - in desert environments, microscopic dust particles containing heavy metals and other harmful substances posed a significant risk. Prolonged exposure to this particulate matter often led to chronic lung inflammation and ongoing breathing difficulties.
Oil Well Fires - during the first Gulf War, more than 600 oil wells were set ablaze, producing smoke clouds filled with soot and harmful particulate matter. These clouds, which lingered for months, had a significant impact on the respiratory health of veterans exposed to them. Many of these service members have since experienced long-term respiratory health issues as a consequence of inhaling these toxic substances.
Herbicide Agents - during the Vietnam War era, the widespread spraying of Agent Orange and other herbicides introduced toxic contaminants into the environment. These substances have been linked to multiple respiratory cancers, with affected veterans continuing to struggle with lung and airway issues years later.
When One Breath Impacts Another: How the VA Combines Respiratory Disability Ratings
The process of combining respiratory disability ratings by the VA is meticulous, intended to ensure veterans receive fair and accurate evaluations for their service-connected conditions. It involves a two-step approach:
1. Assessing the Predominant Disability
Initially, VA raters focus on identifying the 'predominant' respiratory condition - the one that most significantly impacts the veteran's health. This is typically the condition with either more severe symptoms or a higher individual disability rating. Raters weigh measurements like reduced Forced Vital Capacity (FVC) or Necessary Outpatient Oxygen Therapy documented in earlier medical evidence.
For instance, if a veteran has asthma rated at 30% and sleep apnea rated at 50%, sleep apnea would be considered the predominant condition. In such cases, a single rating is assigned that reflects the predominant condition. Therefore in this example, the veteran would receive a consolidated 50% rating for both asthma and sleep apnea. This streamlined approach ensures the focus remains on the condition that most affects the veteran's daily life.
2. Evaluating Secondary Disabilities
The next step in the evaluation process involves examining any secondary disabilities and their symptoms. Raters look at whether these additional conditions exacerbate the severity of the predominant condition. For example, a veteran might have COPD rated at 50% and clinically diagnosed sleep apnea that aggravates nighttime breathing issues. While COPD might have the higher initial rating, the added complications from sleep apnea, such as increased daytime breathing difficulties, could warrant a higher combined rating.
In such cases, the overall impact might justify an elevation beyond the 50% rating, offering a more comprehensive reflection of the veteran's respiratory health.
It's important to note that there are no fixed mathematical formulas applied in these elevation decisions. Instead, the VA relies on a case-by-case evaluation, determining whether the combined effects of all respiratory conditions necessitate an increase in the rating of the predominant condition. This method ensures that the rating accurately encapsulates the full scope of the disability as experienced by the veteran. However, it's also important to remember that the combined ratings cannot exceed 100%.
If Your VA Respiratory Disability Benefits Have Been Denied, Contact Wettermark Keith
If your VA respiratory disability benefits have been unjustly reduced or denied by the VA system, know that you're not alone. Wettermark Keith’s accredited VA disability attorneys are dedicated to supporting veterans in positions like yours, and we understand the intricacies and frustrations of drawn-out VA claims.
Our team offers free consultations 24/7 at 877-715-9300. We believe in your right to fair representation and are committed to helping you secure the benefits you deserve. Our expertise and experience in handling VA disability claims mean we're well-equipped to guide you through the appeals process, addressing complexities and advocating for your needs. Remember, you have a right to compensation for the hardships you've endured. Let us help you breathe a little easier as we work together towards obtaining the respiratory disability benefits you need.
Wettermark Keith, with offices located throughout Alabama, Tennessee, and Florida, has an excellent reputation as one of the most accomplished personal injury firms in the country. Our reach is not only regional but includes a diverse range of practice areas, including premises liability law, personal injury cases, auto wrecks, trucking wrecks, nursing home abuse, medical malpractice, on-the-job injuries, social security disability, and veterans’ disability claims, to name just a few. At Wettermark Keith, we believe in taking cases personally. Our purpose is to practice with care and compassion- to tell our clients’ stories and make their voices heard. We do this by building strong relationships based on constant communication and an unwavering dedication to truth and trust. You should never wonder what’s going on with your case. We will keep you in the loop and represent you as if you are family- because to us, you are.
Frequently Asked Questions
The VA rates respiratory conditions like asthma, COPD, sleep apnea and bronchitis under diagnostic codes 6600-6847 in the Schedule for Rating Disabilities. Each code classifies common signs like reduced pulmonary function test metrics, required treatments, or side effects. Higher percentages reflect increasing condition severity and impacts on veteran health and functioning.
In cases of multiple connected breathing issues, VA consolidates all respiratory disabilities with shared origin causes into one streamlined rating reflecting whichever disease is currently most severe or “predominant.” This merged evaluation aims to capture overall impairment effects veterans experience from entwined conditions.
When combining respiratory ratings, VA guidelines direct raters to first assess which individual condition currently meets the highest severity percentage based on documented measurements like reduced airflow or necessary oxygen therapy. That diagnosis forms the baseline rating, but raters still must judge if other issues like sleep apnea then exacerbate predominant condition effects, which could warrant rating elevation.
Yes, since nightly CPAP therapy demonstrates clinically significant sleep apnea, those symptoms must factor into assessments of any co-existing conditions like asthma in terms of judging true overall severity. If disrupted sleep provokes more frequent daytime asthma attacks, those effects may justify boosting the combined rating above predominant condition levels alone to fully account for total veteran health impacts.
No - unfortunately, new VA protocols require consolidating any respiratory diagnoses that stem from shared environmental exposure causes - like burn pits or desert particulate matter - into one singular rating. However, the combined effects of sinus blockages or inflammation worsening asthma attacks could still contribute to a rating elevation during review.
Yes, veterans can reopen claims down the road if respiratory testing or physician observations confirm measurable declines in functioning like further reduced FEV levels. Submitting this updated medical evidence allows VA raters to reassess if previous ratings still accurately reflect veterans' current experienced disability levels.
Yes, severe breathing issues can potentially qualify you for a 100% disability rating. Even if a single respiratory condition doesn't meet the criteria for a 100% rating on its own, the combined effects of multiple breathing problems can lead to what's known as individual unemployability (IU). If these conditions significantly impact your ability to work, you may be eligible for 100% disability compensation based on IU, even if your medical conditions individually do not add up to 100%.
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