Evidence Checklist: Bronchial Asthma

Pulmonary function tests (PFTs) with pre/post bronchodilator spirometryCritical

Spirometry documenting FEV-1, FVC, and FEV-1/FVC ratio before and after bronchodilator use. The VA rates asthma primarily on FEV-1 percent predicted, with additional consideration for the number of required treatments.

Nexus opinion linking asthma to service ("at least as likely as not")Critical

A medical opinion stating it is "at least as likely as not" (50%+ probability) that your asthma is connected to in-service exposures (burn pits, chemical agents, occupational irritants) or in-service onset.

Pulmonologist or allergist diagnosis and evaluationCritical

Specialist evaluation confirming the asthma diagnosis, documenting frequency of attacks, severity classification (intermittent, mild persistent, moderate persistent, severe persistent), and triggers.

Treatment records (inhalers, systemic corticosteroids, emergency visits)Critical

Records documenting the medication regimen including short-acting bronchodilators, inhaled corticosteroids, long-acting bronchodilators, and any systemic (oral or parenteral) corticosteroid use. Higher steroid requirements drive higher VA ratings.

Symptom log documenting attack frequency and severity

Personal diary tracking the frequency of asthma attacks, rescue inhaler use, nighttime awakenings, and any work or activity limitations. Frequency and severity are key rating drivers.

Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

Completed DBQ Respiratory ConditionsCritical

Standardized form capturing PFT results, treatment requirements, attack frequency, and functional limitations from asthma.

Documentation of in-service toxic or occupational exposure

Service records, deployment orders, or PACT Act toxic exposure registry enrollment documenting burn pit exposure, chemical agent contact, or other respiratory hazards.

Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.