VA Disability Rating for Pulmonary Emphysema (DC 6603)
Diagnostic Code 6603 · 38 CFR §4.97
What Is It?
Pulmonary emphysema is a chronic lung condition where the air sacs (alveoli) in the lungs are damaged and destroyed, reducing the surface area available for gas exchange. This causes progressive shortness of breath, as the lungs cannot efficiently transfer oxygen into the blood. Emphysema is one form of chronic obstructive pulmonary disease (COPD). Veterans may develop emphysema from smoking during service, burn pit exposure, asbestos inhalation, industrial chemical exposure, or other environmental hazards encountered during military duty.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | FEV-1 less than 40 percent predicted, or FEV-1/FVC less than 40 percent, or DLCO less than 40 percent, or maximum exercise capacity less than 15 ml/kg/min oxygen consumption, or cor pulmonale, right ventricular hypertrophy, pulmonary hypertension, or need for outpatient oxygen therapy. |
| 60% | FEV-1 of 40 to 55 percent predicted, or FEV-1/FVC of 40 to 55 percent, or DLCO of 40 to 55 percent, or maximum oxygen consumption of 15 to 20 ml/kg/min. |
| 30% | FEV-1 of 56 to 70 percent predicted, or FEV-1/FVC of 56 to 70 percent, or DLCO of 56 to 65 percent. |
| 10% | FEV-1 of 71 to 80 percent predicted, or FEV-1/FVC of 71 to 80 percent, or DLCO of 66 to 80 percent. |
Evidence Needed
- Pulmonary function test results with all values (FEV-1, FVC, FEV-1/FVC, DLCO)
- Chest CT scan showing emphysematous changes
- Oxygen saturation levels and any supplemental oxygen prescription
- Service records documenting environmental exposures
- Deployment records for burn pit or asbestos exposure
- Treatment records showing inhalers, nebulizers, and other respiratory medications
C&P Exam Tips
- Complete the PFT with maximum effort — these numbers directly determine your rating
- If you use supplemental oxygen, bring documentation of the prescription
- Describe your exercise limitations specifically: how far you can walk, what activities are restricted
- Document all military exposures: burn pits, diesel fumes, industrial chemicals, asbestos
- If your DLCO is lower than your FEV-1 values, make sure it is included because it may give a higher rating
How to File
File on VA Form 21-526EZ with PFT results, chest imaging, exposure documentation, and deployment records. Consider PACT Act claims if related to burn pit exposure.
Common Mistakes
Not including DLCO results The DLCO (diffusion capacity) is especially important for emphysema because it measures gas exchange, which is specifically impaired in this condition. It often gives a higher rating than spirometry alone. Not documenting oxygen use If you require supplemental oxygen, this automatically qualifies for 100 percent. Make sure you have a prescription on file. Filing under the wrong code If diagnosed with both emphysema and COPD, the VA will typically use one code. Make sure the code used gives you the best rating.
Frequently Asked Questions
Is emphysema the same as COPD?
Emphysema is one type of COPD. COPD is the broader term that includes both emphysema and chronic bronchitis. The VA may rate under either DC 6603 (emphysema) or DC 6604 (COPD) depending on your specific diagnosis.
Does needing oxygen automatically mean 100 percent?
Yes. The need for outpatient oxygen therapy is one of the criteria for a 100 percent rating.
Can the PACT Act help with my emphysema claim?
If your emphysema is related to burn pit or toxic exposure during service, the PACT Act may provide presumptive service connection, making it easier to establish the link.