Get ready for your exam
Asthma and breathing
Asthma (including burn pit / PACT Act)
What it is
Asthma means your airways swell and tighten, making it hard to breathe.
VA's code numbers for this: 6602
What the examiner will do
Who does it: A VA doctor or a VA contract examiner. VA's exam page (updated Aug 15, 2025) names four contract companies: Loyal Source Government Services, OptumServe Health Services, Leidos QTC Health Services, and Veterans Evaluation Services (VES). (LHI is an older name; it is now part of OptumServe.) You can't pick which one. Answer every call or letter about scheduling.
- A VA or contract doctor, NP, or PA, plus a PFT at a lab. Exam about 20-30 minutes; PFT about 30-60 minutes.
- Questions: When did asthma start? Triggers? How often do you use each inhaler? Steroid pills this year? ER visits? Where and when did you deploy?
- Bring your inhalers or a list. Ask if you should hold any medicine before the PFT.
Tests, in plain words
- PFT (pulmonary function test)
- You take a deep breath and blow out as hard and fast as you can into a tube.
- FEV-1
- How much air you can blow out in the first 1 second. VA compares it to what's normal for someone your age, height, and sex ('percent predicted'). 100% = normal. Lower = worse.
- FVC
- The total amount of air you can blow out in one full breath.
- FEV-1/FVC
- The share of your total breath that comes out in the first second. Lower means the airways are narrowed.
- Before and after inhaler
- They often test, give you a puff of rescue medicine, then test again. VA's rule for other lung conditions uses the 'after' number unless it's worse (38 CFR 4.96(d)); see open questions for asthma.
- Medicine-based levels
- You can qualify by medicine use alone (for example, a daily inhaler = 30%), even with a normal breathing test.
- PACT Act
- Asthma diagnosed after service is presumed caused by burn pits and airborne hazards if you served in the Southwest Asia theater (Aug 2, 1990 on) or Afghanistan, Syria, Djibouti, or Uzbekistan (Sept 19, 2001 on).
The examiner fills out a form called a DBQ. You can read it ahead of time: Respiratory Conditions (other than Tuberculosis and Sleep Apnea) DBQ (opens VA's site).
The rating levels, in plain words
VA picks the level that best matches how often and how badly the condition affects you.
10%
Breathing test at 71-80% of normal, OR you use a rescue inhaler or breathing pills now and then (not daily).
VA's exact words
FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; intermittent inhalational or oral bronchodilator therapy
Rule: 38 CFR 4.97, DC 6602
30%
Breathing test at 56-70%, OR you use an inhaler or breathing pill every day, OR you use a steroid (anti-inflammatory) inhaler.
VA's exact words
FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; daily inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication
Rule: 38 CFR 4.97, DC 6602
60%
Breathing test at 40-55%, OR you see a doctor at least monthly for flare-ups, OR you need steroid pills or shots (like prednisone) at least 3 times a year.
VA's exact words
FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, 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
Rule: 38 CFR 4.97, DC 6602
100%
Breathing test under 40%, OR more than one attack a week with breathing failure, OR daily high-dose steroid pills/shots or immune-suppressing drugs.
VA's exact words
FEV-1 less than 40-percent predicted, or; FEV-1/FVC less than 40 percent, 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 immuno-suppressive medications
Rule: 38 CFR 4.97, DC 6602
What to track before your exam
What to write down: Every inhaler and how often you use it, steroid bursts, urgent care/ER visits, and flare-ups.
How: Print your pharmacy record for 12 months (shows refills of inhalers and prednisone). For 30 days, log rescue inhaler puffs and flare-ups. Keep a list of every steroid course with dates.
Your log: what to write each time
- Date
- Daily controller inhaler used?
- Rescue inhaler puffs (#)
- Flare-up? trigger
- Doctor/ER visit for breathing?
- Steroid pills started (date, days)
- Missed work or activity?
Tap Print this page to get a blank log sheet and your exam-day checklist on paper.
Exam-day checklist
Tick each one off. Nothing you tick is saved or sent anywhere.
What to bring: Bring a photo ID, your list of medicines and doses, your home log, and any new private records you have not sent to VA yet. VA says you don't have to bring anything, but your notes help you remember. A spouse or caregiver may come along. VA says you can ask the examiner if they can stay in the room. The examiner may ask them to wait outside.
Tell the examiner
Honest exam rules
- Tell the whole truth. Don't add to it. Don't shrink it.
- Describe a normal day AND your worst days. Say how often the worst days happen.
- Answer the question you were asked. Skip the habit of saying 'I'm fine' or 'it's not that bad' when it is.
- It's OK to read from your log or notes. Hand the examiner a copy if they will take it.
- Don't act out symptoms or guess at numbers. If you don't know or can't remember, say so.
- If something hurts or makes you worse during the exam, say so right then.
- Fraud warning: knowingly giving VA false information is a federal crime (18 U.S.C. 1001) and can cost you all your benefits (38 U.S.C. 6103). Honest, complete answers protect you.
Common mistakes
Normal breathing test, so you think you'll get 0%. Daily inhaler use alone = 30%.
Where this comes from: 38 CFR 4.97, DC 6602
Steroid bursts and monthly visits not in the records. Bring pharmacy printouts.
Where this comes from: 38 CFR 4.97, DC 6602
No asthma signs on exam day. VA then needs a verified history of attacks in your records.
Where this comes from: 38 CFR 4.97, DC 6602 Note
Not claiming under PACT. Asthma diagnosed after qualifying service is presumptive.
Where this comes from: 38 CFR 3.320(a)(2)(i)
Questions to ask together
A spouse, grown child or friend can read these out loud. Talk about each one before the exam, so nothing gets left out.
- Which inhalers do you use, and how often - every day or only sometimes?
- How many times this year did you take steroid pills like prednisone?
- Did you go to the doctor, urgent care, or ER for breathing this year? How often?
- Where and when did you deploy?
- What triggers your attacks, and what can't you do during one?
Rule changes you may hear about
Today's rules (above) are what VA uses unless a change is final.
Proposed, not law yet
VA proposed small asthma changes: 100% would start below 45% FEV-1 (now below 40%); 60% would be 45-55%; 10% would say 'less than daily' bronchodilator use. It would also add a new code for constrictive bronchiolitis.
Where it stands: Proposed Feb 15, 2022 and Sept 12, 2024 (supplement). Not final as of Oct 30, 2026.
87 FR 8474 and 89 FR 74162, RIN 2900-AQ72
Cancelled, not in force
On Feb 17, 2026, VA put out a quick rule that would have rated you with the help your medicine gives you (38 CFR 4.10). VA cancelled it 10 days later. The old wording is back. Court case Jones v. Shinseki, 26 Vet. App. 56 (2012) still says: if the rating rule doesn't mention medicine, VA can't lower your rating because medicine helps.
Where it stands: Rescinded effective Feb 27, 2026. Not in force.
91 FR 7118 (Feb 17, 2026), interim final rule; 91 FR 9712 (Feb 27, 2026), rescission. RIN 2900-AS49
Sources
Helping The Brave doesn't file or prepare claims. This guide is free education, not medical or legal advice. The VA examiner measures and VA decides your rating.