Respiratory system · 38 CFR 4.97
Respiratory Conditions and VA Disability
The respiratory system covers your lungs, sinuses, and airways. The VA rates these conditions under 38 CFR 4.97. Sleep apnea, asthma, sinusitis, and rhinitis are some of the most claimed, and many are tied to burn pits and other airborne hazards from service.
Patriot Path writes the medical piece of these claims. Our physicians write nexus letters and independent medical opinions that connect your breathing condition to your service. One flat fee of $1,500, and the first consultation is free.
Medically reviewed by the Patriot Path Medical Team
Licensed MD and PhD reviewers • Last updated: June 2026
Conditions in this system
These are the respiratory conditions veterans claim most. Sleep apnea has a full guide now. The rest are on the way.
- Sleep apnea
The most claimed respiratory condition. Often linked to PTSD or sinus disease.
DC 6847
- Asthma
Rated on breathing-test results, or how often you need an inhaler or oral steroids. Now a PACT Act burn-pit presumptive.
DC 6602
- Chronic sinusitisGuide in progress
Rated on how many flare-ups or sinus surgeries you have each year.
DC 6510-6514
- Allergic rhinitisGuide in progress
Rated on nasal blockage and whether you have polyps.
DC 6522
- COPD
Chronic obstructive pulmonary disease. Rated on pulmonary function tests.
DC 6604
- Chronic bronchitisGuide in progress
Rated on pulmonary function tests, like most lung conditions.
DC 6600
How the VA rates respiratory conditions
Most lung conditions are rated on a pulmonary function test, or PFT. It measures how much air you can breathe out and how fast. Lower numbers mean a higher rating.
Some conditions use a different yardstick. Asthma can be rated on how often you need an inhaler or oral steroids. Sinusitis is rated on how many flare-ups or surgeries you have in a year.
One rule trips up a lot of veterans. The VA usually will not pay twice for the same lost function. This is the anti-pyramiding rule (38 CFR 4.14). If two breathing conditions overlap, the VA tends to rate the one that pays more. It is worth knowing before you file.
Connecting a respiratory condition to service
There are a few ways to tie a breathing condition to your service:
- Direct. An exposure or event in service caused it. Burn pits, sand and dust, asbestos, and chemicals are common causes.
- Presumptive (PACT Act). For asthma, chronic rhinitis, and chronic sinusitis diagnosed within ten years of qualifying service, the VA already accepts the link to airborne hazards.
- Secondary. Another service-connected condition caused or worsened it (38 CFR 3.310). Sleep apnea secondary to PTSD, sinus disease, or weight gain is a common example.
For a direct or secondary claim, the VA needs a current diagnosis, an in-service cause, and a medical opinion linking them (38 CFR 3.303). That opinion has to clear the “at least as likely as not” standard, a 50% or better chance. That standard is the benefit-of-the-doubt rule under 38 U.S.C. 5107(b), carried out in 38 CFR 3.102. A nexus letter is that linking opinion.
Frequently asked questions
Is sleep apnea a respiratory condition for the VA?
Yes. The VA rates sleep apnea in the respiratory system under 38 CFR 4.97, Diagnostic Code 6847, even though many veterans first link it to PTSD or sinus problems.
Can I get a separate rating for asthma and sleep apnea?
Usually not. Both affect your breathing, and the VA's anti-pyramiding rule (38 CFR 4.14) stops it from paying twice for the same loss of function. The VA generally rates the one that pays more. Conditions that affect different functions, like rhinitis and sinusitis, can sometimes be rated on their own.
How does the VA decide a respiratory rating?
Most lung conditions are rated on a pulmonary function test (PFT), which measures how much and how fast you can breathe out. Some, like asthma and sinusitis, are also rated on how often you have attacks or need medication.
Did the PACT Act change respiratory claims?
Yes. The PACT Act added presumptive service connection for several airborne-hazard conditions, including asthma, chronic rhinitis, and chronic sinusitis diagnosed within ten years of qualifying service. Sleep apnea is not on that presumptive list and is usually established by direct or secondary connection.
Do I need a nexus letter for a respiratory claim?
If your condition is presumptive under the PACT Act, you may not. For everything else, especially conditions diagnosed after you left service or claimed as secondary to another condition, a nexus letter is often what decides the claim.
Have a breathing condition from service?
Tell us what you are dealing with. The first consultation is free, and we will tell you straight whether a nexus letter can strengthen your claim.
Sources & regulatory references
- VA disability compensation (VA.gov) https://www.va.gov/disability/
- 38 CFR 4.97, Schedule of ratings, respiratory system (eCFR) https://www.ecfr.gov/current/title-38/section-4.97
- 38 CFR 4.14, Avoidance of pyramiding (eCFR) https://www.ecfr.gov/current/title-38/section-4.14
- 38 CFR 3.303, Principles relating to service connection (eCFR) https://www.ecfr.gov/current/title-38/section-3.303
- 38 CFR 3.310, Secondary service connection (eCFR) https://www.ecfr.gov/current/title-38/section-3.310
- 38 U.S.C. 5107, Benefit of the doubt (Cornell LII) https://www.law.cornell.edu/uscode/text/38/5107
- The PACT Act and your VA benefits (VA.gov) https://www.va.gov/resources/the-pact-act-and-your-va-benefits/