Understanding VA Disability Ratings for Asthma, Sleep Apnea, and Other Respiratory Conditions: What Veterans Need to Know

 Posted on May 29, 2025 in Uncategorized

Veterans suffering from respiratory conditions such as asthma and sleep apnea often face challenges not only with their health but also with securing the appropriate level of VA disability compensation. Many believe that if they are service-connected for multiple respiratory conditions—say, asthma first, then later diagnosed and connected for sleep apnea—they should receive separate ratings for each condition, thereby increasing their overall combined VA disability rating. However, VA regulations take a different, more restrictive approach.

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Can You Receive Separate VA Ratings for Asthma and Sleep Apnea?

The U.S. Department of Veterans Affairs outlines very specific rules regarding the assignment of disability ratings for respiratory conditions. According to 38 CFR § 4.96(a), veterans cannot receive separate ratings for certain respiratory diseases, including asthma (diagnostic code 6602) and sleep apnea (diagnostic code 6847). Instead, the VA assigns one disability rating based on the predominant respiratory disability.

What Does "Combined Rating" Really Mean?

Many veterans are familiar with the concept of "combined ratings," where the VA uses a formula (not simple addition) to combine multiple ratings. For example, if a veteran has a 30% rating for asthma and is awarded a 50% rating for sleep apnea, these are not simply added to become 80%. The VA uses its own table to combine them: 30% and 50% actually "combine" to 65%, which is then rounded up to 70%.

However, due to 38 CFR § 4.96(a), the VA does not even perform this "combined" calculation when it comes to certain respiratory conditions. Instead, the regulation requires them to select the rating for the more serious (predominant) condition and award that single rating only. This means a veteran with asthma (30%) and sleep apnea (50%) will receive only the higher single rating, 50% in this case, not 70%.

How Is the Predominant Respiratory Disability Determined?

The VA assesses the severity of each respiratory condition based on the relevant diagnostic codes. The predominant disability is the one that warrants the higher evaluation under the VA’s rating schedule. This is generally determined by considering all available medical evidence, including pulmonary function test results, need for treatments such as CPAP machines, and the overall impact on your health and daily function.

• Asthma (Diagnostic Code 6602) can be rated based on pulmonary function test numbers or the need for specific daily therapies.

• Sleep Apnea (Diagnostic Code 6847) is predominantly rated at 50% if a CPAP machine is required and at 30% if not, with the highest ratings (up to 100%) reserved for severe complications.

Why the Single Rating Rule Exists

The regulation is designed to prevent overlapping compensation for symptoms or impairments that stem from the same body system. Since many respiratory symptoms can be shared across these conditions, the VA chooses to award one rating to reflect the overall impairment.

What If You Disagree With the VA's Decision?

Veterans who feel their unique circumstances may warrant separate evaluations, or who are not sure the predominant condition has been correctly rated, should consult with an accredited VA representative or attorney. In very rare cases, there may be an avenue to argue for separate ratings—especially if the conditions have clearly distinct and separately disabling effects that do not overlap—but these scenarios are uncommon.

Tips For Veterans Seeking Higher Ratings for Respiratory Conditions

• Review Your Diagnostic Codes: Ensure that each of your conditions has been evaluated under the correct diagnostic code.

• Gather Strong Medical Evidence: Provide current pulmonary function tests, doctor’s statements, and medication/treatment logs.

• Document Severity: Thoroughly document how each condition impacts your daily life, particularly if it results in hospitalizations, severe limitations, or the need for aggressive treatments.

• Consider Appeals: If you believe the assigned rating does not reflect your true level of disability or the VA has overlooked key evidence, consider appealing the decision within the prescribed timelines.

• Seek Expert Help: Consulting a VA-accredited attorney or representative can ensure your claim is accurately and optimally presented.