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Reactive Airway Disease

A condition where your airways overreact to irritants, causing wheezing, coughing, and shortness of breath. Often linked to in-service chemical or environmental exposures. The VA rates reactive airway disease based on lung function tests and medication requirements, using the same criteria as bronchial asthma.

Code: 6602
Criteria: 38 CFR 4.97, DC 6602
Exam length: ~30 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

The examiner will take a detailed history of your reactive airway disease including triggers, frequency of attacks, and how it differs from or overlaps with asthma, focusing on onset during or after military service.
Pulmonary Function Tests (PFTs) will be performed measuring FEV-1, FEV-1/FVC ratio, and bronchodilator response to objectively quantify your airflow limitation.
You will be asked about your current medication regimen including daily inhaled corticosteroids, bronchodilators, oral corticosteroids, and how frequently you need rescue inhaler use.
The examiner will ask about exacerbation history including emergency room visits, hospitalizations, and courses of systemic corticosteroids over the past twelve months.
Your in-service exposure history will be explored, particularly burn pit exposure, chemical exposure, dust and sand inhalation, or smoke exposure that triggered the reactive airway disease.

What the examiner is actually filling in

01PFT results are the primary rating criteria — the examiner records FEV-1 and FEV-1/FVC ratio percentages, with ratings ranging from 10% to 100% based on severity under DC 6602.
02Medication requirements are assessed, particularly whether you require daily inhalational or oral bronchodilator therapy, inhaled corticosteroids, or systemic corticosteroids.
03The frequency and severity of exacerbations are documented, including the number of physician visits, ER visits, and hospitalizations for respiratory crises per year.
04The examiner evaluates whether the condition requires at least monthly visits to a physician for required care of exacerbations, which supports a 60% or 100% rating.
05A functional impact statement is provided describing how reactive airway disease affects your ability to perform physical labor, work in certain environments, and sustain employment.

Rated under 38 CFR 4.97, DC 6602. The examiner records findings on the DBQ; a rating specialist makes the decision.

A complete answer sounds like

Take your medications as prescribed before the exam — the VA rates your condition in its treated state, and your regular PFT results on medication are what determine your rating.
Be specific about corticosteroid courses: "I took prednisone 40mg for 10 days three times this year" is far more useful than "I sometimes take steroids for flare-ups."
If you have exercise-induced symptoms, ask the examiner to note this and consider requesting a methacholine challenge test if standard PFTs appear near-normal at rest.
Describe your worst exacerbations in detail — what triggered them, how long they lasted, what treatment was required, and how many days of work or activity you lost.
Bring a list of environmental triggers you must avoid (dust, chemicals, cold air, smoke) and explain how these avoidance requirements limit your employment options and daily activities.

What costs veterans points

Withholding your controller medications before the exam thinking it will show worse results — the VA rates based on your treated condition, and stopping medications can be dangerous.
Understating the frequency of systemic corticosteroid use, which is a key rating criterion — three or more courses per year of oral steroids supports a higher rating.
Not tracking exacerbation frequency with specific dates and details, leading to vague responses like "a few times" instead of "seven emergency visits in the past year."
Failing to establish the link between military exposures and symptom onset — the examiner needs a clear timeline showing symptoms began during or shortly after exposure.
Not reporting how reactive airway disease limits physical activity and employment, focusing only on acute attacks rather than the daily baseline limitations.

The rating criteria, in plain language

Rating levels for Reactive Airway Disease under 38 CFR 4.97, DC 6602
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 are service-connected, but the findings do not meet the requirements for a compensable evaluation — FEV-1 and the FEV-1/FVC ratio both above 80 percent predicted, and no bronchodilator therapy. This code prints no 0% rung of its own; § 4.31 supplies it: no monthly payment, but the condition is on record and a later increase runs from it. The lowest compensable level under this code is 10 percent.
0%	What supports this level A verified history of asthmatic attacks of record — DC 6602’s Note requires this where there are no clinical findings at examination FEV-1 and FEV-1/FVC both above 80 percent predicted on post-bronchodilator PFT No intermittent or daily inhalational or oral bronchodilator therapy
10%	FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; intermittent inhalational or oral bronchodilator therapy.	Your lung function tests show FEV-1 of 71 to 80 percent predicted, or FEV-1/FVC of 71 to 80 percent, or you need intermittent inhalational or oral bronchodilator therapy.
10%	What supports this level FEV-1 of 71-80% predicted FEV-1/FVC ratio of 71-80% Intermittent bronchodilator use (rescue inhaler) Pulmonary function test (PFT) results
30%	FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; daily inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication.	Your lung function tests show FEV-1 of 56 to 70 percent predicted, or FEV-1/FVC of 56 to 70 percent, or you need daily inhalational or oral bronchodilator therapy, or inhalational anti-inflammatory medication.
30%	What supports this level FEV-1 of 56-70% predicted FEV-1/FVC ratio of 56-70% Daily bronchodilator use Daily inhaled corticosteroid use PFT results documenting obstruction
60%	FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; at least monthly visits to a physician for required care of exacerbations, or; intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids.	Your lung function tests show FEV-1 of 40 to 55 percent predicted, or FEV-1/FVC of 40 to 55 percent, or you have at least monthly visits to a physician for required care of exacerbations, or intermittent (at least three per year) courses of systemic corticosteroids.
60%	What supports this level FEV-1 of 40-55% predicted FEV-1/FVC ratio of 40-55% Monthly physician visits for exacerbations Three or more courses of oral/IV corticosteroids per year Emergency room visits for reactive airway episodes
100%	FEV-1 less than 40-percent predicted, or; FEV-1/FVC less than 40 percent, or; more than one attack per week with episodes of respiratory failure, or; requires daily use of systemic (oral or parenteral) high dose corticosteroids or immuno-suppressive medications.	Your lung function tests show FEV-1 less than 40 percent predicted, or FEV-1/FVC less than 40 percent, or you have more than one attack per week with episodes of respiratory failure, or you require daily use of systemic high dose corticosteroids or immunosuppressive medications.
100%	What supports this level FEV-1 less than 40% predicted FEV-1/FVC ratio less than 40% More than one attack per week with respiratory failure Daily systemic high-dose corticosteroids Daily immunosuppressive medications Hospitalizations for respiratory failure

The middle column is our transcription of the criteria at 38 CFR 4.97, DC 6602, 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 linking reactive airway disease to specific in-service exposures — document burn pit, chemical, or toxic substance exposure with dates, locations, and duration.

Failing to get methacholine challenge testing — standard PFTs may appear normal at rest. A methacholine or bronchoprovocation test can objectively demonstrate airway hyperreactivity.

Not distinguishing reactive airway disease from pre-existing asthma — if you had no respiratory issues before service, emphasize the onset of symptoms during or after service exposure.

Not documenting medication use and frequency — the difference between intermittent and daily bronchodilator use is the difference between 10% and 30%.

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.

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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

Reactive Airway Disease

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

Reactive Airway Disease

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