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Burn Pit Constrictive Bronchiolitis

Damage to the small airways in the lungs from breathing in smoke and toxins from military burn pits. This condition is especially important for veterans covered by the PACT Act. The scarring in the small airways makes it hard to breathe and gets worse over time. The VA rates this condition based on lung function test results.

Code: 6600
Criteria: 38 CFR 4.97, DC 6600
Exam length: ~30-45 minutes
Form: Respiratory Conditions DBQ

Rating steps

0%
10%
30%
60%
100%

The percentages this diagnostic code can be rated at. Which one applies depends on the findings — no tool here can tell you in advance.

What happens at the appointment

Pulmonary function testing including spirometry, lung volumes, and DLCO will be performed — constrictive bronchiolitis may show obstructive, restrictive, or mixed patterns on PFTs.
The examiner will ask detailed questions about your deployment history, burn pit exposure locations and duration, and the timeline of symptom onset relative to deployment.
You will be asked about exercise intolerance, which is often the most prominent symptom — previously fit service members who can no longer run or perform at prior physical levels.
The examiner may review a chest CT, ideally a high-resolution CT (HRCT) with expiratory images, which can show air trapping and mosaic attenuation patterns characteristic of constrictive bronchiolitis.
You will be questioned about whether you have undergone or been offered a surgical lung biopsy, which is the definitive diagnostic test but is invasive and not always performed.

What the examiner is actually filling in

01PFT results including FEV1, FVC, FEV1/FVC ratio, and DLCO — even mildly abnormal values in a previously healthy veteran are significant.
02HRCT findings including air trapping, mosaic perfusion, and bronchial wall thickening.
03Exercise capacity and the degree of exertional limitation compared to expected fitness for age and prior activity level.
04Whether the condition is at least as likely as not related to documented burn pit or airborne hazard exposure during military service.
05Whether supplemental oxygen is required and the current treatment regimen including inhalers, pulmonary rehabilitation, and activity restrictions.

Rated under 38 CFR 4.97, DC 6600. The examiner records findings on the DBQ; a rating specialist makes the decision.

A complete answer sounds like

Emphasize the before-and-after contrast: "Before my deployment to Balad in 2007, I was running 30 miles a week and scored 290 on my Army PFT. Now I get winded walking up one flight of stairs."
If your PFTs are near-normal but you are clearly symptomatic, ask the examiner to note the discrepancy — constrictive bronchiolitis is known for causing significant exercise limitation with relatively preserved resting PFTs.
Request cardiopulmonary exercise testing (CPET) if it has not been done — this test can reveal exercise-induced ventilatory limitation that resting PFTs miss.
Mention the PACT Act by name if applicable — the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act of 2022 expanded VA coverage for burn pit exposure conditions.
If you have been diagnosed by a civilian pulmonologist, bring that opinion, especially if it links constrictive bronchiolitis to burn pit exposure — outside medical opinions can strongly support your claim.

What costs veterans points

Assuming normal PFTs mean no disease — constrictive bronchiolitis can cause significant symptoms with only mildly abnormal or even normal spirometry, so exercise testing or DLCO may be more revealing.
Not registering with the VA Airborne Hazards and Open Burn Pit Registry, which serves as documentation of exposure and can support your claim.
Failing to connect symptoms to the specific deployment with burn pit exposure — the timeline between exposure and symptom onset is crucial for establishing service connection.
Not requesting a high-resolution CT with expiratory images — a standard CT or chest X-ray may miss the air trapping pattern that is characteristic of this condition.
Not mentioning that you were a fit, active service member before the exposure and are now unable to perform at even a fraction of your previous physical capacity.

The rating criteria, in plain language

Rating levels for Burn Pit Constrictive Bronchiolitis under 38 CFR 4.97, DC 6600
Rating	Rating criteria	What that means for you
0%	In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met.	You have constrictive bronchiolitis confirmed on biopsy or imaging but you do not meet the requirements for a compensable evaluation. DC 6600 prints no 0% rung of its own; § 4.31 supplies it, and a 0% rating still establishes service connection. The lowest compensable level under this code is 10 percent.
0%	What supports this level High-resolution CT or lung biopsy establishing the diagnosis FEV-1, FEV-1/FVC and DLCO (SB) all above 80 percent predicted Airborne Hazards and Open Burn Pit Registry enrollment
10%	FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; DLCO (SB) 66- to 80-percent predicted.	You have constrictive bronchiolitis with FEV-1 of 71 to 80 percent predicted, or FEV-1/FVC of 71 to 80 percent, or DLCO (SB) of 66 to 80 percent predicted.
10%	What supports this level FEV-1 of 71-80% predicted DLCO of 66-80% predicted Deployment records showing burn pit exposure Airborne Hazards and Open Burn Pit Registry enrollment CT showing air trapping or mosaic attenuation
30%	FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; DLCO (SB) 56- to 65-percent predicted.	You have constrictive bronchiolitis with FEV-1 of 56 to 70 percent predicted, or FEV-1/FVC of 56 to 70 percent, or DLCO (SB) of 56 to 65 percent predicted.
30%	What supports this level FEV-1 of 56-70% predicted DLCO of 56-65% predicted High-resolution CT showing constrictive bronchiolitis pattern Lung biopsy if performed PACT Act toxic exposure documentation
60%	FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; DLCO (SB) of 40- to 55-percent predicted, or; maximum oxygen consumption of 15 to 20 ml/kg/min (with cardiorespiratory limit).	You have constrictive bronchiolitis with FEV-1 of 40 to 55 percent predicted, or DLCO (SB) of 40 to 55 percent predicted, or maximum oxygen consumption of 15 to 20 ml/kg/min.
60%	What supports this level FEV-1 of 40-55% predicted DLCO of 40-55% predicted Significant exercise limitation Multiple inhaler medications prescribed Progressive worsening documented on serial PFTs
100%	FEV-1 less than 40 percent of predicted value, or; the ratio of Forced Expiratory Volume in one second to Forced Vital Capacity (FEV-1/FVC) less than 40 percent, or; Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO (SB)) less than 40-percent predicted, or; maximum exercise capacity less than 15 ml/kg/min oxygen consumption (with cardiac or respiratory limitation), or; cor pulmonale (right heart failure), or; right ventricular hypertrophy, or; pulmonary hypertension (shown by Echo or cardiac catheterization), or; episode(s) of acute respiratory failure, or; requires outpatient oxygen therapy.	You have constrictive bronchiolitis with FEV-1 less than 40 percent predicted, or DLCO (SB) less than 40 percent predicted, or you require supplemental oxygen, or you have cor pulmonale or pulmonary hypertension.
100%	What supports this level FEV-1 less than 40% predicted DLCO (SB) less than 40% predicted Maximum exercise capacity less than 15 ml/kg/min Outpatient oxygen therapy prescribed Cor pulmonale, right ventricular hypertrophy, or pulmonary hypertension on echocardiogram or cardiac catheterization Episodes of acute respiratory failure

The middle column is our transcription of the criteria at 38 CFR 4.97, DC 6600, condensed for reading. Read the section itself on eCFR before relying on the exact wording. The items under each level are the kinds of evidence that document it — not a VA checklist, and not a prediction of which level applies to you.

Mistakes we see most often

Not registering with the Airborne Hazards and Open Burn Pit Registry — this free VA registry documents your exposure and strengthens your claim. Register even if you have not yet filed.

Standard PFTs may appear near-normal despite significant small airway disease — request high-resolution CT with expiratory views to show air trapping, and ask for full PFTs including lung volumes and DLCO.

Not taking advantage of PACT Act presumptive coverage — the PACT Act creates a presumption of service connection for certain respiratory conditions related to burn pit and toxic exposure. Check if your deployment and condition qualify.

Not documenting all deployment locations and dates with burn pit exposure — your DD-214, deployment orders, and buddy statements describing the burn pits at your specific location are critical evidence.

Before & after your exam

These apply to every C&P exam, whatever the condition.

Do not miss the appointment: Missing your C&P exam without a good reason can cost you. Under 38 CFR § 3.655, a missed exam can cause a claim for an increased rating or a reopened claim to be denied, and can cause an original claim to be decided on the evidence already in your file. If you cannot make it, call the VA or the exam company right away to reschedule — a documented good reason (illness, work conflict, no transportation, a family emergency) protects your claim.
Your examiner may be a contractor: Many C&P exams are performed by VA-contracted companies — QTC, Optum Serve (LHI), VES, or MSLA — not at a VA hospital. They will call, text, or mail you to schedule. Do not ignore an unknown number or letter while your claim is pending, and confirm the exam location and time before you go.
The examiner does not decide your claim: The examiner's job is to record findings on the Disability Benefits Questionnaire (DBQ). A rating specialist at the Regional Office makes the actual decision, using the exam together with your full record — service records, medical records, and lay statements. One appointment does not settle everything.
Get a copy of your exam report: After the exam you can request the report (often called the DBQ or C&P exam results) through VA.gov, the Blue Button tool, or your accredited representative. Reading it lets you catch errors while you still have time to respond.
If the exam was inadequate, you have options: If the examiner rushed you, evaluated the wrong condition, or the report is inaccurate, you can submit a statement and new evidence, and — after a decision — request a review (a Supplemental Claim or Higher-Level Review). A single bad exam is not the end of your claim.

View condition guide →View evidence checklist →

Folder readiness

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Print the whole guide — what the examiner records, the folder list with your ticks, the criteria table and the mistakes to avoid — and bring it to the appointment.

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C&P Exam Preparation Guides

The VA orders this exam to verify your diagnosis and measure how severe it is right now. It can shape your rating and your monthly compensation — but it does not decide your claim. A rating specialist weighs it against your full record, and if the exam does not reflect your condition, you can say so and ask the VA to correct it.

Source forms
Coverage

Burn Pit Constrictive Bronchiolitis

Rating steps

What happens at the appointment

What the examiner is actually filling in

A complete answer sounds like

What costs veterans points

The rating criteria, in plain language

What supports this level

What supports this level

What supports this level

What supports this level

What supports this level

Mistakes we see most often

Before & after your exam

Burn Pit Constrictive Bronchiolitis

Rating steps

What happens at the appointment

What the examiner is actually filling in

A complete answer sounds like

What costs veterans points

The rating criteria, in plain language

What supports this level

What supports this level

What supports this level

What supports this level

What supports this level

Mistakes we see most often

Before & after your exam