BRONCHITIS

J. ABRAMS · 2026 · Case ID: A26028758

MIXED

Summary

The Veteran, an Air Force Veteran who served from November 2013 to September 2014, appeals rating decisions concerning her service-connected bronchitis with asthma. The Veteran sought an initial disability rating of 60 percent through December 26, 2023, a 10 percent rating between December 27, 2023, and November 11, 2025, and a rating exceeding 60 percent thereafter, including an earlier effective date for the 60 percent rating. The Board reviewed VA examination reports from May 2023, December 2023, and December 2025, along with the Veteran's private and VA medical records. The May 2023 examination showed a pre-bronchodilator FEV-1 of 48% predicted, while the December 2023 examination showed a pre-bronchodilator FEV-1/FVC ratio of 78% predicted. The December 2025 examination showed a pre-bronchodilator FEV-1 of 18% predicted and an FEV-1/FVC ratio of 48% predicted. The Board found the evidence supported an initial 60 percent rating through December 26, 2023, based on the December 2023 PFT results. However, the Board denied higher ratings for subsequent periods, finding the evidence did not meet the criteria for higher evaluations, particularly noting the lack of daily bronchodilator use, frequent corticosteroid use, or consistent severe exacerbations required for higher ratings. The Board also addressed the Veteran's contentions regarding effective dates, granting the 60 percent rating effective December 26, 2023, but denying higher ratings or earlier effective dates for those higher ratings.

Rationale

Evidence supports 60 percent rating through December 26, 2023.; December 2023 PFT results met criteria for 60 percent rating.; Subsequent periods did not meet criteria for higher ratings.

Service Branch

AIR FORCE

Special Benefit

NO SPECIAL BENEFIT

Docket No.

260213-624968

Full Decision Text

Citation Nr: A26028758
Decision Date: 03/31/26 Archive Date: 03/31/26

DOCKET NO. 260213-624968
DATE: March 31, 2026

ORDER

Entitlement to an initial disability rating of 60 percent through December 26, 2023, for bronchitis with asthma, is granted.

Entitlement to a disability rating of 10 percent, between December 27, 2023 and November 11, 2025, for bronchitis with asthma, is denied.

Entitlement to a disability rating in excess of 60 percent, since November 12, 2025 - to include consideration of an effective date for the 60 percent disability rating prior to November 12, 2025 - for bronchitis with asthma is denied.

FINDINGS OF FACT

1. An in-person VA respiratory examination was conducted on December 4, 2023, but the spirometry was not performed until December 27, 2023.

2. The claims file contains no pulmonary function test performed prior to December 27, 2023, that shows a Forced Expiratory Volume in 1 second (FEV-1) of less than 40-percent predicted, a FEV-1/Forced Vital Capacity (FEV-1/FVC) ratio of less than 40-percent, or a Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO) of less than 40-percent predicted; there is also no evidence that the Veteran had a maximum exercise capacity of less than 15 ml/kg/min oxygen consumption with cardiac or respiratory limitation or that she had been diagnosed with cor pulmonale or pulmonary hypertension, experienced episodes of acute respiratory failure, experienced more than one asthma attack a week (with episodes of respiratory failure), was prescribed outpatient oxygen therapy, or used a systemic high-dose corticosteroid or immuno-suppressive medication on a daily basis during this period.

3. The claims file contains no pulmonary function test performed between December 27, 2023, and November 11, 2025, that shows an FEV-1 of 70-percent or less than predicted, an FEV-1/FVC ratio of 70-percent or less, or an DLCO of 70-percent or less predicted; there is also no evidence that the Veteran's maximum exercise capacity was 20 ml/kg/min oxygen consumption or less (with cardiorespiratory limitation) or that she required medical care on at least a monthly basis for asthma exacerbations, experienced respiratory failure, used an inhaled or oral bronchodilator therapy on a daily basis, or was prescribed an systemic corticosteroid or immuno-suppressive, an anti-inflammatory medication, or outpatient oxygen therapy during this period.

4. The claims file contains no pulmonary function test performed since November 12, 2025, showing an FEV-1 of less than 40-percent predicted, an FEV-1/FVC) ratio of less than 40-percent, or an DLCO of less than 40-percent predicted; there is also no evidence that the Veteran has had a maximum exercise capacity of less than 15 ml/kg/min oxygen consumption with cardiac or respiratory limitation, that the she has been diagnosed with cor pulmonale or pulmonary hypertension, has experienced episodes of acute respiratory failure, has experienced more than one asthma attack a week (with episodes of respiratory failure), has been prescribed outpatient oxygen therapy, or has used a systemic high-dose corticosteroid or immuno-suppressive medication on a daily basis.

CONCLUSIONS OF LAW

1. The criteria for an initial disability rating of 60 percent through December 26, 2023, for bronchitis with asthma, have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.400, 4.1-4.14, 4.96, 4.97, Diagnostic Codes (DCs) 6600, 6602.

2. The criteria for a disability rating of 10 percent, between December 27, 2023 and November 11, 2025, for bronchitis with asthma, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1-4.14, 4.96, 4.97, DCs 6600, 6602.

3. The criteria for a disability rating in excess of 60 percent since November 12, 2025 - to include consideration of an effective date for the 60 percent disability rating prior to November 12, 2025 - for bronchitis with asthma,
The criteria for a disability rating of 10 percent, between December 27, 2023 and November 11, 2025, for bronchitis with asthma, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1-4.14, 4.96, 4.97, DCs 6600, 6602.

3. The criteria for a disability rating in excess of 60 percent since November 12, 2025 - to include consideration of an effective date for the 60 percent disability rating prior to November 12, 2025 - for bronchitis with asthma, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.400, 4.1-4.14, 4.96, 4.97, Diagnostic Codes (DCs) 6600, 6602.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Air Force from November 2013 to March 2014 and April 2014 to September 2014.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from November 2025 and December 2025 rating decisions by a Department of Veterans Affairs (VA) regional office, which is the Agency of Original Jurisdiction (AOJ).

The Veteran elected the Board's Direct Review docket. See February 2026 VA Form 10182. This restricts the Board's review to the evidence of record at the time of the rating decisions on appeal. 38 C.F.R. § 20.301.

The Board notes that evidence was associated with the claims file after the rating decisions on appeal, which was during a period of time that is outside the applicable evidentiary window. Therefore, the Board has not considered this evidence in its present decision. 38 C.F.R. § 20.300(a).

If the Veteran would like VA to consider the additional evidence that the Board could not consider, the Veteran may file a supplemental claim (VA Form 20-0995) and identify the evidence that the AOJ should consider. 38 C.F.R. § 3.2501. Specific instructions for filing a supplemental claim are included following this decision.

The Board has interpreted the Veteran's statements as reflecting an intent to have this matter reviewed in an expeditious manner, which the Board finds to be an implicit waiver of the Veteran's right to change the original review option she requested the Board process the appeal under pursuant to Williams v. McDonough, 37 Vet. App.?305 (2024). The matter is ready for adjudication.

As a final preliminary matter, the Board recognizes that the Veteran has been awarded a total disability rating (100 percent rating) based on the combination of her service-connected disabilities. In an enclosure included with the November 2025 supplemental claim, she reported that her service-connected respiratory disability "continue[s] to impact my employment." However, there are inconsistent references as to whether she has worked during the review period and, if so, when. The claims file shows that, October 2024, VA received a VA Form 21-526EZ with a claim for a total disability rating based on individual unemployability (TDIU) and that she identified her service-connected mental health disabilities as the cause of her unemployability. She subsequently withdrew this claim in January 2025. See January 2025 VA Form 27-0820. The claims file also shows that the AOJ requested the Veteran complete a VA Form 21-8940 but that no form has been returned to date. See, e.g., November 2024 Subsequent Development Letter. She has provided only statements that she was placed on paid leave while her employer completed an investigation and earning statements for September 2025 and October 2025. See October 2024 & October 2025 Correspondences.

The Board has found no assertion that she is unemployable solely due to the bronchitis with asthma on appeal here. If the Veteran wishes to file a claim for a TDIU rating as to a "single" service-connected disability, she should submit an application (such as but not limited to a VA Form 21-8940) that clearly identifies the "single" disability she believes impairs her ability to secure and follow a substantially gainful occupation. 38 C.F.R. § 4.16.

Increased Rating

Disability evaluations are determined by evaluating the extent to which a veteran's service-connected disability adversely affects the veteran's ability to function under the ordinary conditions of daily life, including employment, by comparing the veteran's symptomatology with the criteria set forth in the Schedule for Rating Disabilities. 38 C.F.R., Part 4. The percentage ratings represent as far as can practicably be determined the average impairment in earning capacity resulting from such diseases and injuries and the residual conditions in civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Generally, the degree of disabilities specified are considered adequate to compensate for considerable loss of working time from exacerbation or illness proportionate to the severity of the several grades of disability. Id. The basis of disability ratings is the ability of the body as a whole, or of the psyche, or of a system or organ of the body, to function under the ordinary conditions of daily life, including employment. 38 C.F.R. § 4.10.

Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating; otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran. 38 C.F.R. § 4.3. A "staged ratings" is appropriate when the factual findings show distinct time periods where a service-connected disability exhibits symptoms that would warrant different ratings. 38 C.F.R. § 4.13; Hart v. Mansfield, 21 Vet. App. 505 (2007).

The evaluation of the same disability under a separate DC, known as "pyramiding," must be avoided. 38 C.F.R. § 4.14. However, separate ratings may be assigned for distinct disabilities resulting from the same injury so long as the symptomatology for one disability is not duplicative of or overlapping with the symptomatology of the other disability. Id.

The veteran will be afforded the benefit of the doubt when the evidence is in approximate balance regarding the merits of an issue material to the determination, but such rule is not applicable if the evidence persuasively favors one side. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776, 781-82 (Fed. Cir. 2021) (en banc).

1. Entitlement to an initial disability rating of 60 percent through December 26, 2023, for bronchitis with asthma, is granted.

2. Entitlement to a disability rating of 10 percent, between December 27, 2023 and November 11, 2025, for bronchitis with asthma, is denied.

3. Entitlement to a disability rating in excess of 60 percent, since November 12, 2025 - to include consideration of an effective date for the 60 percent disability rating prior to November 12, 2025 - for bronchitis with asthma, is denied.

The review period in this matter starts on April 27, 2023, the date VA received the Veteran's application for disability compensation. 38 C.F.R. §§ 3.155, 3.400(b)(2). The evidentiary record is limited to the evidence in the claims file at the time of the rating decisions on appeal. 38 U.S.C. § 7113; 38 C.F.R. § 20.301.

Veteran's contentions

The Board recognizes that, in the February 2026 VA Form 10182, the Veteran disagreed with the "effective date." However, in a separate statement included with her November 2025 supplemental application, she argued that the 10 percent disability rating should be "restored" to the original 60 percent rating. See November 2025 Correspondences. She has made no argument that the AOJ erred when it assigned the effective date for the award of service connection, April 27, 2023.

The Veteran has continuously pursued a claim as to
the rating decisions on appeal. 38 U.S.C. § 7113; 38 C.F.R. § 20.301.

Veteran's contentions

The Veteran has continuously pursued a claim as to the disability rating for the service connection bronchitis with asthma that is on appeal. 38 C.F.R. § 3.2500(c). VA received the Veteran's supplemental claim one month after the November 2025 rating decision. The Board received this appeal within a year of both the November 2025 and December 2025 rating decisions.

Moreover, the Board recognizes that an appeal of a claim for an increased rating requires it consider not only whether the service-connected disability met the criteria for a higher evaluation in general but to identify if and when the service-connected disability met the criteria for a higher evaluation at any point during the review period. As the United States Court of Appeals for Veterans Claims (Court) held in Hart, a veteran is entitled to "staged" ratings if the evidence supports more than one evaluation during the relevant period. Thus, a request for a higher evaluation encompasses a request for an earlier "effective date" as to a particular evaluation during the period being reviewed.

Accordingly, because the adjudication of a claim for an increased disability rating encompasses a claim as to the effective date of any change in the disability rating during the review period, the Board has re-characterized the Veteran's disagreement with the effective date as a claim for an increased evaluation of the staged ratings for the service-connected bronchitis with asthma. The adjudication of the increased rating claims will encompass all effective date concerns.

Additionally, though the November 2025 rating decision lowered the disability evaluation, there is no issue related to the propriety of a rating reduction pursuant to 38 C.F.R. §§ 3.105, 3.343, 3.344, because there is no prior final decision that awarded an initial disability rating for the service-connected bronchitis with asthma. The November 2025 decision awarded service connection, which is one of the two rating decisions on appeal, never became final.

Legal Criteria

The VA regulations require a disability rating for some respiratory conditions, including bronchitis and asthma, to be based on the predominate disability. 38 C.F.R. § 4.96(a). As to bronchitis, it is to be based on post-bronchodilator values unless the pre-bronchodilator values are normal, or the examiner explains why post-bronchodilator testing should not be performed (e.g., contraindicated). 38 C.F.R. § 4.96(d)(4). If the post-bronchodilator values are poorer than the pre-bronchodilator values, the disability rating will be based on the pre-bronchodilator values. 38 C.F.R. § 4.96(d)(5). When there is a disparity between the post-bronchodilator Forced Vital Capacity (FVC) and the FEV-1 values that would result in different ratings, the disability rating is based on the value the examiner states most accurately reflects the veteran's disability. 38 C.F.R. § 4.96(d)(6).

VA rates bronchitis under DC 6600. 38 C.F.R. § 4.97.

A 10 percent disability rating is assigned when the evidence shows an FEV-1, FVC/FEV-1 ratio, or DLCO of 71- to 80-percent predicted. A 30 percent disability rating is assigned when the evidence shows an FEV-1, FVC/FEV-1 ratio, or DLCO of 56- to 70-percent predicted. A 60 percent disability rating is assigned when the evidence shows an FEV-1, FVC/FEV-1 ratio, or DLCO of 40- to 55-percent predicted; or a maximum oxygen consumption of 15 to 20 ml/kg/min with cardiac or respiratory limitation. A 100 percent rating is assigned when the evidence shows: a FEV-1, FVC/FEV-1 ratio, or DLCO of less than 40-percent predicted; a maximum exercise capacity less than 15 to 20 ml/kg/min oxygen consumption with cardiac or
assigned when the evidence shows an FEV-1, FVC/FEV-1 ratio, or DLCO of 56- to 70-percent predicted. A 60 percent disability rating is assigned when the evidence shows an FEV-1, FVC/FEV-1 ratio, or DLCO of 40- to 55-percent predicted; or a maximum oxygen consumption of 15 to 20 ml/kg/min with cardiac or respiratory limitation. A 100 percent rating is assigned when the evidence shows: a FEV-1, FVC/FEV-1 ratio, or DLCO of less than 40-percent predicted; a maximum exercise capacity less than 15 to 20 ml/kg/min oxygen consumption with cardiac or respiratory limitation; cor pulmonale (right heart failure); right ventricular hypertrophy; pulmonary hypertension shown by an echocardiogram or cardiac catheterization; episodes of acute respiratory failure; or, that the veteran requires outpatient oxygen therapy.

VA rates asthma under DC 6602. Id. A 10 percent disability rating is assigned when the evidence shows: an FEV-1 or FVC/FEV-1 ratio of 71- to 80-percent predicted; or an inhaled or oral bronchodilator therapy is being used on an intermittent basis. A 30 percent disability rating is assigned when the evidence shows: an FEV-1 or FVC/FEV-1 ratio of 56- to 70-percent predicted; an inhaled or oral bronchodilator therapy is being used on a daily basis; or an inhaled anti-inflammatory medication is being used. A 60 percent disability rating is assigned when the evidence shows: an FEV-1 or FVC/FEV-1 ratio of 40- to 55-percent predicted; there is evidence of at least monthly visits to a physician for asthma exacerbations requiring care; or, the veteran has completed at least three courses of oral or parenteral systemic corticosteroids within a 12-month period. A 100 percent rating is assigned when the evidence shows: a FEV-1 or FVC/FEV-1 ratio of less than 40-percent predicted; the veteran experiences more than one asthma attack a week with episodes of respiratory failure; or, the veteran uses an oral or parenteral systemic high-dose corticosteroid or immuno-supportive medication on a daily basis.

The Note to DC 6602 states that, in the absence of clinical findings of asthma at time of examination, a verified history of asthmatic attacks must be of record. Id.

Factual Background

The Veteran's private and VA medical records do not show she has been diagnosed with cor pulmonale or pulmonary hypertension. See generally CAPRI & Medical Treatment Record; see also C&P Exams. She has never completed formal testing to evaluate her oxygen consumption during exercise. She has not been prescribed outpatient (supplemental) oxygen. She has not been treated for respiratory failure.

The private and VA medical records show that the Veteran's past medical history includes asthma and/or bronchitis but there is no evidence that a treating provider ordered a spirometry (also referred to as a pulmonary function test (PFT)) or similar respiratory study prior to or during the review period. See id.

In response to the Veteran's application for service connection, she was afforded a VA respiratory conditions examination in May 2023. See June 2023 C&P Exam. The pertinent diagnoses were asthma and chronic bronchitis. The Veteran's symptoms were described to include intermittent shortness of breath, cough, and dyspnea on exertion. The examiner stated that the Veteran required inhaled bronchodilator therapy on an intermittent basis. She was using an oral bronchodilator on a daily basis. She had used an antibiotic but no more than twice a year. There was no evidence of an asthma attack or episode of respiratory failure in the past 12 months. There was no evidence she received medical care for an exacerbation of the asthma. A PFT was completed, which showed the following:

PRE-BRONCHODILATOR POST-BRONCHODILATOR, if indicated

FEV-1 48% predicted 47% predicted

FEV-1/FVC 97% 98%

DLCO Not tested Not tested

The examiner found the FEV-1 value most accurately reflected the Veteran's level of disability and that DLCO testing was not indicated.

FEV-1 48% predicted 47% predicted

FEV-1/FVC 97% 98%

DLCO Not tested Not tested

The examiner found the FEV-1 value most accurately reflected the Veteran's level of disability and that DLCO testing was not indicated.

At the request of the Veteran, she was afforded a second VA respiratory conditions examination on December 4, 2023; the PFT was completed on December 27, 2023. See January 2024 C&P Exam. There was no change to the diagnoses. Her medications included Albuterol, Singulair (Montelukast), Flonase, and Zyrtec. The examiner stated that the Veteran had required only one course of systemic corticosteroids in the last 12 months. She was using an inhaled bronchodilator therapy on an intermittent basis. She was not using an oral bronchodilator therapy or taking an antibiotic. There was no evidence of an asthma attack or episode of respiratory failure in the past 12 months. She required care for asthma exacerbations less than monthly. The PFT revealed the following pertinent results:

PRE-BRONCHODILATOR POST-BRONCHODILATOR, if indicated

FEV-1 88% predicted Not tested

FEV-1/FVC 78% Not tested

DLCO Not tested Not tested

The examiner found the pre-bronchodilator FEV-1/FVC ratio most accurately reflected the Veteran's level of disability. Post-bronchodilator testing (and DLCO testing) was not performed because the pre-testing results were normal.

Following the November 2025 supplemental claim, the Veteran was afforded a third VA respiratory examination in December 2025. There was no change to the diagnoses. She reported feeling awful at the time of the examination and "coughing uncontrollably, cough, and short of breath, feel clogged, chest pain, wheezing, tightness in my chest, phlegm orange/green colored, get winded, flare up." Her current medications included an albuterol inhaler, nebulizer, and codeine cough medicine as needed. The examiner stated that the Veteran had not required any corticosteroids in the last 12 months. She was using an inhaled bronchodilator therapy on an intermittent basis. She was not using an oral bronchodilator therapy or taking an antibiotic. She did not require supplemental oxygen. Imaging showed no acute cardiopulmonary disease. The PFT results were as follows:

PRE-BRONCHODILATOR POST-BRONCHODILATOR, if indicated

FEV-1 18% predicted 44% predicted

FEV-1/FVC 48% 54.4%

DLCO Not tested Not tested

The examiner noted that the FEV-1/FVC ratio most accurately reflected the Veteran's level of disability and that DLCO testing was not indicated.

Analysis

In general, the Board finds the effective date for the 10 percent disability rating should be December 26, 2023, to reflect the date of the PFT was completed and not the date of the in-person VA examination. Higher disability ratings than what the AOJ already assigned is not warranted.

The Board finds the May 2023, December 2023, and December 2025 examination reports and PFT results highly probative and gives the reports limited weight. Each examiner appears to have reviewed the pertinent evidence in the claims file at the time of the examination, to include the PFT results. The examiners' statements do not appear to be inconsistent with the evidence of record during the staged periods. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007).

Of note, the VA examiners did not provide an explanation as to why each examiner believed the FEV-1/FVC ratio most accurately reflected the Veteran's level of disability at that time. The Board recognizes that the FEV-1 results (under either DC 6600 or 6602) are consistent with noncompensable and 60 percent ratings respectively. It appears that each examiner selected the result most favorable to the Veteran. Because a request for the examiners to provide a rationale for the selections would not avail the Veteran of a higher rating, the Board finds the evidence of record sufficient for adjudication.

Additionally, the Board recognizes that the December 2025 VA examination report and PFT indicate that the clinical examination and diagnostic testing were performed during a flare and, thus, might not necessarily reflect the Veteran
each examiner believed the FEV-1/FVC ratio most accurately reflected the Veteran's level of disability at that time. The Board recognizes that the FEV-1 results (under either DC 6600 or 6602) are consistent with noncompensable and 60 percent ratings respectively. It appears that each examiner selected the result most favorable to the Veteran. Because a request for the examiners to provide a rationale for the selections would not avail the Veteran of a higher rating, the Board finds the evidence of record sufficient for adjudication.

Additionally, the Board recognizes that the December 2025 VA examination report and PFT indicate that the clinical examination and diagnostic testing were performed during a flare and, thus, might not necessarily reflect the Veteran's true disability picture at the time. The consideration of post-bronchodilator testing in DCs 6600 and 6602 shows VA considers the ameliorative effects of medication has on these respiratory disabilities. Ingram v. Collins, 30 Vet. App. 130 (2025); see also Jones v. Shinseki, 26 Vet. App. 56, 61 (2012). Because it is likely that a new examination could show improvement in the disability, the Board will not remand this matter to obtain potentially negative evidence.

Prior to December 26, 2023 - in excess of 60 percent

The evidence does not support the rating criteria for a total (100 percent) disability rating for the service-connected bronchitis with asthma prior to December 26, 2023. 38 C.F.R. § 4.97, DCs 6600, 6602. The December 2023 post-bronchodilatory (and pre-bronchodilator) FEV-1 value and the FVC/FEV-1 ratio were above 40. The Board finds no evidence contradicting the examiner's statement that a DLCO was not performed because such test was not indicated for the Veteran's condition. The Veteran had not undergone exercise capacity testing. See also, generally CAPRI, Medical Treatment Record, & C&P Exams. Additionally, the medical evidence fails to show that the Veteran had been diagnosed with cor pulmonale or pulmonary hypertension. The medical evidence shows no episodes of acute respiratory failure or that she had been prescribed supplemental oxygen. 38 C.F.R. § 4.97, DC 6600.

Additionally, the medical record and lay statements do not show that the Veteran was experiencing at least two asthma attacks a week with episodes of respiratory failure prior to December 27, 2023. There is no evidence that she was prescribed and used a systemic high-dose corticosteroid or an immuno-suppressive medication on a daily basis during this period. 38 C.F.R. § 4.97, DC 6602.

The Board finds the Veteran is competent (qualified) to describe her respiratory symptoms, to include but not limited to problems with coughing, shortness of breath, and phlegm. However, there is nothing in the record to show she has the training or credentials to evaluate the current nature, extent, and severity of the asthma and bronchitis, as reflected by the applicable diagnostic criteria for each condition. Jones v. Brown, 7 Vet. App. 134, 137-138 (1994). Moreover, her assertions as to the frequency and severity are not fully supported when considering the documented complaints and the clinical findings contained in the VA treatment records. See generally CAPRI. Likewise, some of the rating criteria involve a mechanical application of diagnostic findings (FEV-1 and FVC/FEV-1 ratio), testing of which the Veteran does not appear to have medical training or experience to perform or interpret. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011).

Because of this, from December 26, 2023, an initial disability rating of 60 percent, but no higher, for bronchitis with asthma, is warranted.

From December 27, 2023, to November 11, 2025 - in excess of 10 percent

Though the evidence supports pushing the effective date of the 60 percent rating to December 26, 2023, with the 10 percent rating effective December 27, 2023, the date the PFT was performed rather than the initial in-person examination, the same evidence does not support a disability rating higher than 10 percent for the service-connected bronchitis with asthma between December 27, 2023, and November 11, 2025. 38 C.F.R. § 4.97, DCs 6600, 6602. The December 2023 pre-bronchodilator FEV-1 values and the FVC/FEV-1 ratio were above 70. A DLCO was not performed because "other" (normal pre-bronchodilator results with no post-bronchodilator testing). The Veteran had not undergone exercise capacity testing. See generally CAPRI, Medical Treatment Record, & C&P Exams. The medical evidence fails to show that the Veteran had been diagnosed with cor pulmonale or pulmonary hypertension. The medical evidence shows no episodes of acute respiratory failure or that she had been prescribed supplemental oxygen. 38 C.F.R. § 4.97, DCs 6600.

Though the Veteran had used a bronchodilator, she was not using it on a daily basis. She was no longer using an inhaled anti-inflammatory. There was no evidence that she had been prescribed a corticosteroid or immuno-suppressive for a minimum of three times within 12 months of the beginning of this staged period. There was no history of respiratory failure accompanying exacerbations of the asthma or that the asthma had been so significant that it required monthly care visits. Id., DC 6602.

For the reasons previously addressed, the Board is not persuaded by the lay evidence that a disability rating in excess of 10 percent was warranted for the period between December 27, 2023, and November 11, 2025. Jandreau, 492 F.3d at 1377; Kahana, 24 Vet. App. at 435.

Since November 12, 2025 - in excess of 60 percent

For similar reasons discussed above, the evidence does not support the rating criteria for a total (100 percent) disability rating for the service-connected bronchitis with asthma since November 12, 2025. 38 C.F.R. § 4.97, DCs 6600, 6602. The December 2025 post-bronchodilatory FEV-1 value and the FVC/FEV-1 ratio were above 40. The Board finds no evidence contradicting the examiner's statements that a DLCO was not performed because such test was not indicated for this Veteran based on her specific case. The Veteran has never undergone exercise capacity testing. See also, generally CAPRI, Medical Treatment Record, & C&P Exams. Additionally, the medical evidence fails to show that the Veteran has ever been diagnosed with cor pulmonale or pulmonary hypertension. There is no evidence that she has been treated for acute respiratory failure or prescribed supplemental oxygen. 38 C.F.R. § 4.97, DC 6600.

Additionally, the medical record and lay statements do not show that the Veteran has experienced more than one asthma attack a week with episodes of respiratory failure since November 12, 2023. There is no evidence that she has been prescribed and has used a systemic high-dose corticosteroid or an immuno-suppressive medication on a daily basis during this period. 38 C.F.R. § 4.97, DC 6602.

As to the disability rating itself, the Board recognizes that the Veteran has not contested the assignment of a 60 percent disability rating in general. Jandreau, 492 F.3d at 1377; Kahana, 24 Vet. App. at 435.

The Veteran's contentions focus on whether she is entitled to a 60 percent disability rating prior to November 12, 2025, including going back to December 27, 2023 (as granted herein), effectively leaving the original 60 percent disability rating unchanged. See November 2025 Correspondence. DCs 6600 and 6602 involve a mechanical application of PFT results, specific diagnoses, specifical clinical findings, and specific prescriptions. There is no evidence in the private or VA medical records that the Veteran completed an PFT outside of testing obtained in conjunction with the May 2023, December 2023, and December 2025 VA examinations. See June
24 Vet. App. at 435.

The VA medical records do show that the Veteran was diagnosed with COVID in April 2024 and reported ongoing symptoms, including coughing and wheezing during a May 2024 encounter. See June 2024 CAPRI. The provider identified the pertinent diagnosis as asthmatic bronchitis and prescribed an albuterol inhaler and cough syrup. In April 2025, May 2025, and June 2025, the Veteran reported a worsening cough related to seasonal allergies. See October 2025 CAPRI; November 2025 Medical Treatment Record. She denied any issues related to wheezing or dyspnea. The clinical examinations showed her lungs were clear to auscultation with no audible rales, crackles, and/or wheezes. There is no medical evidence that demonstrates a criterion for a 60 percent (or higher) disability rating under DC 6600 or 6602 was present between December 27, 2023, and November 11, 2025, to support increasing the disability rating to 60 percent (or higher) prior to the date the AOJ assigned the rating, which the AOJ awarded in the Veteran's favor (based on the date VA received the supplemental claim and not the date of the PFT study).

The Board acknowledges the Veteran's contention that she believes the effective date for the 60 percent disability rating should be earlier because the disability rating should never have been lowered. See November 2025 Correspondences. The Vetrean contends that her respiratory disability never improved and that she has continued to experience significant symptoms. However, as previously stated, DCs 6600 and 6602 take a fairly mechanical approach when evaluating the respective respiratory disabilities. Although there has been continuous pursuit, the medical evidence fails to show at least one criterion for a 60 percent (or even 30 percent) disability rating was present between December 27, 2023, and the November 2025 application.

In light of the above, the evidence shows the Veteran's bronchitis with asthma met the criteria for an initial disability rating of 60 percent until December 26, 2023. Though the Board finds the correct effective date for the 10 percent rating to be December 27, 2023, the criteria for a disability rating in excess of 10 percent between December 27, 2023, and November 11, 2025, are not met. The evidence also does not show the criteria for a disability rating in excess of 60 percent since November 12, 2025, to include an earlier effective date for the 60 percent rating, met. Thus, the claims for higher ratings are denied in general and only a later effective date for the 60 percent disability rating is granted.

J. Abrams

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board T. Burden, Associate Counsel

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.

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