Diagnostic Code 6604 · 38 CFR §4.97
Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung condition that makes it increasingly difficult to breathe over time. It usually involves a combination of chronic bronchitis (ongoing inflammation and mucus in the airways) and emphysema (damage to the tiny air sacs in your lungs). Smoking is the most common cause, but many veterans developed COPD from military exposures including burn pits, asbestos, industrial chemicals, and polluted environments during deployment. The VA rates COPD using pulmonary function test results and the level of oxygen therapy required.
| Rating | Criteria |
|---|---|
| 10% | Your FEV-1 is between 71 and 80 percent of predicted, or your FEV-1/FVC ratio is between 71 and 80 percent, or your DLCO (a test measuring gas exchange in your lungs) is between 66 and 80 percent of predicted. At this level you have mild airflow limitation. |
| 30% | Your FEV-1 is between 56 and 70 percent of predicted, or FEV-1/FVC is 56 to 70 percent, or DLCO is 56 to 65 percent of predicted. This represents moderate COPD where daily activities become noticeably harder. |
| 60% | Your FEV-1 falls between 40 and 55 percent of predicted, or FEV-1/FVC is 40 to 55 percent, or DLCO is 40 to 55 percent of predicted. You may also qualify here if your maximum oxygen consumption is between 15 and 20 ml/kg/min on cardiopulmonary exercise testing. |
| 100% | Your FEV-1 is less than 40 percent of predicted, or FEV-1/FVC is below 40 percent, or DLCO is below 40 percent of predicted. A total rating also applies if your maximum oxygen consumption is below 15 ml/kg/min with cardiopulmonary limitation, or if you have cor pulmonale (right heart failure from lung disease), or if you need outpatient oxygen therapy. |
Pulmonary function tests are essential — specifically FEV-1, FEV-1/FVC ratio, and DLCO values. If you use supplemental oxygen, document the prescription including how many liters per minute and how many hours per day. Keep records of hospitalizations for COPD exacerbations, pulmonology visits, and all prescribed medications including inhalers and nebulizers.
Yes. The VA cannot deny service connection solely because you smoked. If military exposures (burn pits, asbestos, chemicals) contributed to your COPD, you may still qualify. The key is showing the in-service exposure was a contributing cause.
Any prescribed outpatient oxygen therapy — whether continuous or nocturnal only — supports a 100 percent rating under DC 6604. Make sure the oxygen prescription is clearly documented in your medical records.
Certain respiratory conditions related to burn pit and toxic exposure are presumptive under the PACT Act. Check the current VA presumptive list for your specific service dates and deployment locations.