If the VA already service-connected your asthma (also called reactive airway disease, chronic bronchitis, COPD, respiratory condition), it can cause or worsen other conditions that are ratable on their own. These "secondary" claims are where many veterans leave money on the table. Below is what a service-connected asthma commonly leads to, why, and what evidence each one takes.
Bronchial asthma is rated under 38 CFR 4.97 by lung function tests or by the treatment you need, whichever fits:
| Bronchial asthma (DC 6602) | Rating |
|---|---|
| FEV-1 under 40% predicted, or FEV-1/FVC under 40%, or more than one attack per week with respiratory failure, or daily high-dose systemic steroids or immunosuppressants | 100% |
| FEV-1 40 to 55% predicted, or FEV-1/FVC 40 to 55%, or at least monthly doctor visits for flare-ups, or at least 3 courses a year of oral/injected steroids | 60% |
| FEV-1 56 to 70% predicted, or FEV-1/FVC 56 to 70%, or daily inhaled or oral bronchodilator, or inhaled anti-inflammatory medication | 30% |
| FEV-1 71 to 80% predicted, or FEV-1/FVC 71 to 80%, or intermittent inhaled or oral bronchodilator | 10% |
A secondary claim only works if the primary condition (asthma) is already service-connected, and you have a nexus — a doctor's opinion that it is "at least as likely as not" the cause. Nexus letter sample and template →
Chronic airway disease and its treatments (including steroids and weight gain) are associated with sleep apnea; the VA will consider apnea secondary to a service-connected respiratory condition.
What you'd need: A sleep study confirming apnea and a nexus opinion linking it to the service-connected respiratory condition.
There is a recognized two-way link between asthma and GERD; reflux can worsen asthma and asthma medications can worsen reflux.
What you'd need: A GERD diagnosis and a nexus opinion connecting it to the respiratory condition or its treatment.
Chronic breathing difficulty and the fear of attacks can cause anxiety and depression.
What you'd need: A mental health diagnosis and a nexus opinion linking it to the respiratory condition.