Filing a VA disability claim for asthma can be frustrating, especially if your claim gets denied. Asthma can seriously impact daily life, making it difficult to work or even complete simple tasks. That’s why securing VA disability benefits is essential for many veterans.
However, claim denials are common, often due to missing evidence or VA evaluations that underestimate the severity of your condition.
Understanding how the VA rates asthma and the reasons for denials can help you take the right steps to strengthen your case. Let’s break it down so you know exactly what to do next.
Understanding VA Disability Ratings for Asthma
The VA assigns disability ratings for asthma based on how severe and frequent your symptoms are. These ratings determine the level of compensation you receive.
Asthma is rated under 38 CFR § 4.97, using Diagnostic Code 6602. The rating scale is primarily based on pulmonary function tests, particularly-
- Forced Expiratory Volume in one second (FEV-1) and
- The ratio of FEV-1 to Forced Vital Capacity (FVC).
The VA also considers how often you need medication, emergency treatments, or hospital visits.
- 100% rating: Extremely severe cases with frequent hospitalizations or continuous oxygen therapy.
- 60% rating: Requires multiple doctor visits for breathing treatments per year or daily high-dose medication.
- 30% rating: Moderate cases needing daily inhalers but not frequent medical intervention.
- 10% rating: Mild cases with occasional symptoms controlled by medication.
If your symptoms don’t fit these strict criteria, the VA may assign a lower rating than expected. Understanding these rating factors can help you present the strongest case for your disability claim.
Common Reasons Why VA Denies Asthma Claims
If your asthma claim was denied, you’re not alone. Many veterans face denials due to missing evidence, VA exam errors, or misunderstandings about how asthma is connected to service.
Here are the most common reasons:
Lack of a Service Connection
The VA may deny your claim if there’s no clear link between your asthma and military service. This usually happens if there are no documented complaints or treatments for asthma in your service records.
Insufficient Medical Evidence
Even if asthma developed after service, you need strong medical evidence to support your claim. If your records don’t show consistent treatment, prescription use, or worsening symptoms over time, the VA might reject the claim.
C&P Exam Issues
Compensation & Pension (C&P) exams and Disability Benefits Questionnaire (DBQ) play huge roles in VA decisions. If the examiner downplays your symptoms or the test results don’t reflect your daily struggles, the VA could use that to justify a denial.
Preexisting Condition Ruling
The VA might claim that your asthma existed before service and wasn’t aggravated by military duty. This is especially common if you had mild breathing issues as a child or a family history of asthma.
Application Errors or Missing Information
A simple mistake—like an incomplete form or missing supporting documents—can cause delays or outright denials. The VA requires specific details about your condition and its impact on daily life.
Steps to Take After a Denied Asthma Claim
Getting a denial doesn’t mean the fight is over. Many veterans successfully appeal and win their claims with the right approach. The key is understanding why the VA denied your claim and gathering stronger evidence. Here’s what to do next.
Review the Denial Letter
Start by carefully reading the VA’s decision letter. It will outline why your claim was denied, whether it’s due to a lack of service connection, insufficient medical evidence, or rating disagreements.
Request a Copy of Your C&P Exam
If the denial was based on a C&P exam, get a copy of the examiner’s report. If they downplayed your symptoms or made errors, you can challenge their findings.
Gather More Medical Evidence
If your medical records were incomplete or didn’t reflect the severity of your asthma, gather more supporting documents. This can include recent pulmonary function tests, doctor’s notes, or statements from specialists.
Get a Nexus Letter
A nexus letter from a medical professional can strengthen your claim by clearly linking your asthma to your military service. This is especially helpful if your service records don’t mention asthma directly.
Decide Your Next Step
You can either file a Supplemental Claim with new evidence, request a Higher-Level Review, or formally appeal. Choosing the right path depends on the reason for your denial.
How to Strengthen Your VA Asthma Claim
If you’re refiling or appealing, you need to strengthen your case with more compelling evidence. A stronger claim means a better chance of securing the correct VA rating. Here’s how you can do that.
Provide Detailed Medical Records
Ensure your records show the full history of your asthma, including worsening symptoms, emergency room visits, and medication use. The more documented your condition is, the harder it is for the VA to downplay it.
Get a Private Medical Opinion
If the VA’s C&P exam resulted in an unfair evaluation, seek an independent medical opinion. A specialist can provide a detailed report on how asthma affects your daily life and work capacity.
Track Your Symptoms
Keep a personal log of asthma attacks, medication usage, and hospital visits. The VA relies on specific medical tests, but real-world examples of how asthma impacts your life can add weight to your claim.
Prove a Service Connection
If the VA claims your asthma isn’t service-related, get a nexus letter from a doctor explaining how your military service likely caused or worsened your condition. Environmental exposures, burn pits, or chemical inhalation can serve as strong supporting factors.
Gather Buddy Statements
Statements from fellow service members or family can reinforce your claim by describing how your asthma developed or worsened over time.
Building a strong case takes effort, but doing so can significantly increase your chances of securing the benefits you’re entitled to.
Appealing a VA Asthma Claim Denial
If your claim was denied, you have three main appeal options: Supplemental Claim, Higher-Level Review, or a Board Appeal. Choosing the right one depends on why your claim was denied.
Supplemental Claim
If you have new and relevant evidence, a Supplemental Claim is your best option. This could include updated medical records, a new nexus letter, or a corrected C&P exam report.
Higher-Level Review
If you believe the VA made an error in reviewing your claim but you don’t have new evidence, you can request a Higher-Level Review. A more experienced VA reviewer will re-examine your case.
Board Appeal
If you still disagree with the VA’s decision, you can take your case to the Board of Veterans’ Appeals. This is a longer process, but you have the option to present your case before a judge.
No matter which appeal route you choose, make sure to submit all necessary documents and medical records. A well-prepared appeal can make all the difference in overturning a denial.
Conclusion
A denied VA asthma claim can feel like a setback, but it’s not the end of the road. Many veterans successfully appeal their claims by taking the right steps.
Understanding why your claim was denied is the first step. From there, you can take action to strengthen your case and fight for the benefits you deserve.
Document everything, and don’t hesitate to seek professional assistance if needed. With the right approach, you can turn a denial into an approval and secure the compensation.