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Chronic Obstructive Pulmonary Disease (COPD)

A group of lung diseases that block airflow and make it hard to breathe, including emphysema and chronic bronchitis. The VA rates COPD based on lung function tests (FEV-1, FEV-1/FVC, or DLCO) measuring how well your lungs work.

Code: 6604
Criteria: 38 CFR 4.97, DC 6604
Exam length: ~30-45 minutes
Form: Respiratory 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

The examiner will order or review pulmonary function tests (PFTs). The key values are FEV-1 (forced expiratory volume in 1 second), FEV-1/FVC ratio, and DLCO (diffusing capacity) — these numbers determine your VA rating.
You will be asked to perform spirometry: breathing into a mouthpiece with maximum effort, blowing as hard and long as you can. Multiple attempts are typical to get reliable readings.
The examiner will ask about your breathing symptoms: chronic cough, sputum production, wheezing, and how far you can walk or what activities cause shortness of breath.
Your oxygen use will be reviewed — whether you require supplemental oxygen continuously, only at night, or only during exertion.
The examiner will ask about exacerbations: how many COPD flare-ups you have had in the past year, whether they required ER visits, hospitalizations, or oral steroid courses.

What the examiner is actually filling in

01FEV-1 percent predicted — the primary PFT value for the VA rating. 71-80% = 10%, 56-70% = 30%, 40-55% = 60%, below 40% = 100%.
02FEV-1/FVC ratio — another rating criterion. 71-80% = 10%, 56-70% = 30%, 40-55% = 60%, below 40% = 100%.
03DLCO (diffusing capacity) percent predicted — particularly important if your spirometry underestimates your impairment. 66-80% = 10%, 56-65% = 30%, 40-55% = 60%, below 40% = 100%.
04Whether the veteran requires supplemental oxygen therapy.
05Maximum exercise capacity in METs and overall functional impairment from COPD.

Rated under 38 CFR 4.97, DC 6604. The examiner records findings on the DBQ; a rating specialist makes the decision.

A complete answer sounds like

The VA rates COPD under Diagnostic Code 6604 using PFT results. Know the thresholds: FEV-1 of 71-80% predicted = 10%, 56-70% = 30%, 40-55% = 60%, below 40% = 100%.
Give absolute maximum effort on spirometry — blow as hard and as long as you can. Submaximal effort produces artificially low results that the examiner may mark as unreliable.
If you use oxygen at any time (even only at night or during exertion), make sure it is documented. Continuous oxygen therapy is the basis for a 100% rating.
The VA uses the PFT value that produces the highest rating — FEV-1, FEV-1/FVC, or DLCO. Bring all three measurements so the best one can be applied.
If your COPD has worsened over time, bring PFT results from multiple years to show the decline. A clear downward trend supports your claim for an increased rating.

What costs veterans points

Using your bronchodilator inhaler just before the PFT, which temporarily improves your airflow numbers and does not represent your baseline lung function.
Not giving maximum effort on spirometry. If the technician says your effort was suboptimal, the results may be discarded and you will need to repeat the test.
Forgetting to mention supplemental oxygen use — continuous oxygen therapy automatically qualifies for a 100% rating under the respiratory rating schedule.
Not reporting the frequency of exacerbations. The number of acute flare-ups, ER visits, and hospitalizations per year is significant for rating purposes.
Saying "I manage okay" instead of describing how COPD limits your daily life. If you cannot walk to the mailbox, climb stairs, or do yard work without stopping to catch your breath, say so.

The rating criteria, in plain language

Rating levels for Chronic Obstructive Pulmonary Disease (COPD) under 38 CFR 4.97, DC 6604
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 COPD diagnosed by a physician, but you do not meet the requirements for a compensable evaluation. DC 6604 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 COPD diagnosis in the treatment records FEV-1, FEV-1/FVC and DLCO (SB) all above 80 percent predicted on post-bronchodilator PFT No cor pulmonale, respiratory failure, or oxygen requirement
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.	Your lung function tests show 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 FEV-1/FVC ratio of 71-80% DLCO (SB) of 66-80% predicted Pulmonary function test (PFT) results
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.	Your lung function tests show 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 FEV-1/FVC ratio of 56-70% DLCO (SB) of 56-65% predicted Moderate airflow obstruction on PFT
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).	Your lung function tests show 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).
60%	What supports this level FEV-1 of 40-55% predicted FEV-1/FVC ratio of 40-55% DLCO (SB) of 40-55% predicted Maximum oxygen consumption 15-20 ml/kg/min Severe airflow obstruction on PFT
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.	Your lung function tests show FEV-1 less than 40 percent predicted, or FEV-1/FVC less than 40 percent, or DLCO (SB) less than 40 percent predicted, or maximum oxygen consumption less than 15 ml/kg/min (with cardiorespiratory limit), or cor pulmonale (right heart failure), or right ventricular hypertrophy, or pulmonary hypertension, or you need outpatient oxygen therapy.
100%	What supports this level FEV-1 less than 40% predicted FEV-1/FVC ratio less than 40% DLCO (SB) less than 40% predicted Maximum oxygen consumption less than 15 ml/kg/min Cor pulmonale or right ventricular hypertrophy Pulmonary hypertension on echocardiogram Episodes of acute respiratory failure Outpatient oxygen therapy prescription

The middle column is our transcription of the criteria at 38 CFR 4.97, DC 6604, 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 getting a complete pulmonary function test including DLCO — if FEV-1 does not qualify you for a higher rating, DLCO may. The VA must use whichever test result gives you the higher rating.

Not connecting COPD to in-service exposures such as burn pits (PACT Act), asbestos, or chemical exposure — document your specific exposures.

Failing to report supplemental oxygen use — outpatient oxygen therapy automatically qualifies for 100%. Bring your oxygen prescription.

Not filing for secondary conditions caused by COPD such as pulmonary hypertension, depression from activity limitation, or sleep disturbance.

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

Tick these off as you gather them. Nothing here is required — the exam happens either way — but each one is something the examiner cannot record if it is not in front of them.

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Take it with you

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.

Frequently paired

Documented secondary or co-occurring conditions. Each is examined separately and has its own guide.

Free tool · 282 guides · DBQ-aligned

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

Chronic Obstructive Pulmonary Disease (COPD)

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

Chronic Obstructive Pulmonary Disease (COPD)

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