Case A26038058

Summary

The Veteran, who served in the United States Navy from August 1993 to November 1993, appeals the denial of eligibility for specially adapted housing and a special home adaptation grant. The Veteran is in receipt of a total disability rating based on individual unemployability (TDIU) due to chronic asthma, and is eligible for Dependents' Educational Assistance (DEA). However, the Board found that his permanent and total disability, chronic asthma, does not meet the specific criteria for specially adapted housing under 38 U.S.C. § 2101(a) and 38 C.F.R. § 3.809. Specifically, while the asthma causes shortness of breath and fatigue that limits locomotion, it does not preclude locomotion as defined by regulation, nor does it involve the lower extremities or result in loss of use. For the special home adaptation grant, the Board found that the Veteran's chronic asthma, while permanent and total, was not shown to be the result of an inhalation injury caused by breathing steam or toxic inhalants in a fire environment, as required by 38 U.S.C. § 2101(b) and 38 C.F.R. § 3.809a. The evidence indicated the asthma developed during boot camp due to physical exertion, not an inhalation injury. The Board advised the Veteran to explore the Home Improvements and Structural Alterations (HISA) program as an alternative.

Rationale

Veteran has permanent and total disability (TDIU for asthma).; Asthma limits locomotion but does not preclude it as defined by regulation.; Asthma does not involve lower extremities or result in loss of use.

Full Decision Text

Citation Nr: A26038058
Decision Date: 04/23/26	Archive Date: 04/23/26

DOCKET NO. 250711-564309
DATE: April 23, 2026

ORDER

Eligibility for specially adapted housing is denied. 

Eligibility for special home adaptation grant is denied.  

FINDINGS OF FACT

1. The Veteran's service-connected condition does not manifest with blindness in both eyes, full thickness or subdermal burns, or the loss of use of an upper or lower extremity such as to preclude locomotion without the aid of braces, crutches, canes, or a wheelchair or preclude use of the arms at or above the elbow.

2. The Veteran does not have a permanent and total service-connected disability which includes the anatomical loss or loss of use of both hands, or that is due to burn injuries or residuals of an inhalational injury, nor does he have a service-connected disability due to blindness in both eyes, with corrected central visual acuity of 20/200 or less in the better eye.

CONCLUSIONS OF LAW

1. The criteria for eligibility or assistance in acquiring specially adapted housing have not been met.  38 U.S.C. §§ 2101, 5107; 38 C.F.R. §§ 3.102, 3.809. 

2. The criteria for eligibility for a special home adaptation grant have not been met.  38 U.S.C. §§ 2101, 5107; 38 C.F.R. §§ 3.102, 3.809a.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Navy from August 1993 to November 1993.  

These matters come before the Board of Veterans' Appeals (Board) on appeal from an April 2025 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). 

Within the framework of the Appeals Modernization Act (AMA), in July 2025, the Veteran submitted a VA Form 10182, Decision Review Request Board Appeal (Notice of Disagreement (NOD)) in response to the April 2025 rating decision and elected Direct Review by a Veterans Law Judge.  38 C.F.R. § 19.2(d).  In this regard, the Board notes that under the direct review option, no additional evidence received after the appealed rating decision is to be considered; rather, review is limited to the evidence on record at the time of the April 2025 decision.  It may consider argument, but not evidence, that was received at any time after the April 2025 decision.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence.  38 C.F.R. § 3.2501.  If the evidence is new and relevant, VA will issue another decision on the claims, considering the new evidence in addition to the evidence previously considered.  Id.  Specific instructions for filing a Supplemental Claim are included with this decision. 

Specially Adapted Housing

Eligibility for specially adapted housing is available to a Veteran who is entitled to compensation for permanent and total disability due to: (1) ALS rated as 100 percent disabling under 38 C.F.R. § 4.124a, Diagnostic Code 8017; or (2) blindness in both eyes; or (3) full thickness or subdermal burns that have resulted in contractures with limitation of motion of two or more extremities or of at least one extremity and the trunk; or (4) the loss or loss of use of both upper extremities such as to preclude use of the arms at or above the elbow; or (5) the loss or loss of use of both lower extremities such as to preclude locomotion without the aid of braces, crutches, canes, or wheelchair; (6) the loss or loss of use of one lower extremity together with residuals of organic disease which so affect the functions of balance or propulsion as to preclude locomotion without the aid of braces, crutches, canes, or a wheelchair; or (7) the loss or loss of use of one lower extremity together with the loss or loss of use of one upper extremity which so affect the functions of balance or propulsion as to preclude locomotion without the aid of braces, crutches, canes, or a wheelchair.  38 U.S.C. § 2101(a); 38 C.F.R. § 3.809(a), (b), (d).

A "total" rating is when a Veteran has a single
 loss or loss of use of one lower extremity together with residuals of organic disease which so affect the functions of balance or propulsion as to preclude locomotion without the aid of braces, crutches, canes, or a wheelchair; or (7) the loss or loss of use of one lower extremity together with the loss or loss of use of one upper extremity which so affect the functions of balance or propulsion as to preclude locomotion without the aid of braces, crutches, canes, or a wheelchair.  38 U.S.C. § 2101(a); 38 C.F.R. § 3.809(a), (b), (d).

A "total" rating is when a Veteran has a single disability rated as 100 percent disabling, or a total disability rating based on individual unemployability (TDIU) based on a single disability, or a TDIU based on multiple disabilities with the same etiology that affect mobility.  There is also an exception to this totally disabling service-connected disability requirement for certain disabilities relevant only to Veterans who served after September 11, 2001, and, therefore, not applicable in this case.  See 38 U.S.C. § 2101(a)(2)(C).

The term "preclude locomotion" means the necessity for regular and constant use of a wheelchair, braces, crutches or canes as a normal mode of locomotion although occasional locomotion by other methods may be possible.  38 C.F.R. § 3.809(c).  The term "loss of use" in the context of specially adapted housing claims means "a deprivation of the ability to avail oneself of the anatomical region in question."  Jensen v. Shulkin, 29 Vet. App. 66, 78 (2017).  However, an individual is not automatically eligible to receive specially adapted housing every time he or she is prescribed an assistive device in conjunction with a lower extremity disability.  Id. at 79.  Rather, the "individual must: (1) have a permanent and total disability (2) due to a disorder that (3) involves both lower extremities and (4) causes a loss of use so severe that it precludes locomotion without the regular and constant use of assistive devices."  Id.

Eligibility for specially adapted housing.

Upon review of the record, the Board finds that the criteria for eligibility for specially adapted housing have not been met.

The Veteran is in receipt of a total disability rating based on individual unemployability (TDIU) based on the Veteran's service-connected chronic asthma, effective June 17, 2022, and in a March 2023 rating decision, the agency of original jurisdiction (AOJ) found him eligible for Dependents' Educational Assistance (DEA) under 38 U.S.C. Chapter 35 based on permanent and total disability status.  Thus, the Veteran is entitled to compensation for a permanent and total disability.  However, the record does not show that his permanent and total disability is due to ALS rated as 100 percent disabling, blindness in both eyes, full thickness or subdermal burns that have resulted in contractures with limitation of motion of two or more extremities or of at least one extremity and the trunk, the loss or loss of use of both upper extremities such as to preclude use of the arms at or above the elbow, the loss or loss of use of both lower extremities, the loss or loss of use of one lower extremity with residuals of organic disease or injury which affect the functions of balance and propulsion, or the loss or loss of use of one lower extremity with the loss or loss of use of one upper extremity which affect the functions of balance or propulsion.  38 U.S.C. § 2101(a); 38 C.F.R. § 3.809(a), (b), (d).

The Board acknowledges that the Veteran experiences difficulties walking as physical exertion exacerbates his asthma symptoms, to include shortness of breath and coughing.  See November 2022 Compensation and Pension (C&P) Exam.  Although the Veteran's asthma limits locomotion, it does not preclude locomotion as defined by 38 C.F.R. § 3.809(c).  Additionally, the Veteran's asthma does not involve the lower extremities or results in the loss or loss of use of either lower extremity.  Asthma is a chronic (long-term) lung disease that affects the airways, the tubes that carry air in and out of the lungs.  See https://medlineplus.gov/asthma.html.  The record shows that the Veteran's difficulties with walking are due to shortness of breath and fatigue, and not due to an inability to avail himself of one or both lower extremities.  Accordingly, the Board
 Exam.  Although the Veteran's asthma limits locomotion, it does not preclude locomotion as defined by 38 C.F.R. § 3.809(c).  Additionally, the Veteran's asthma does not involve the lower extremities or results in the loss or loss of use of either lower extremity.  Asthma is a chronic (long-term) lung disease that affects the airways, the tubes that carry air in and out of the lungs.  See https://medlineplus.gov/asthma.html.  The record shows that the Veteran's difficulties with walking are due to shortness of breath and fatigue, and not due to an inability to avail himself of one or both lower extremities.  Accordingly, the Board finds that the Veteran's asthma does not preclude locomotion due to the loss or loss of use of either lower extremity.  A review of the treatment records shows the Veteran's prior requests for knee brace and cane due to his knee pain.  See July 2024 CAPRI (2).  However, apart from chronic asthma, the Veteran is not service connected for any other disability, to include a knee disability.  

Based on the foregoing, the Board finds that the criteria for eligibility for specially adapted housing have not been met.  See 38 U.S.C. § 2101(a); 38 C.F.R. § 3.809(a), (b), (d); see also 38 U.S.C. § 510; 38 C.F.R. § 3.102.

Special Home Adaptation

A Veteran can qualify for a grant for necessary special home adaptations if the Veteran has a service-connected disability that results in blindness in both eyes with 20/200 visual acuity or less in the better eye with the use of a standard correcting lens or a limitation in fields of vision such that the widest diameter of the visual field subtends an angle no greater than 20 degrees; such a disability need not be permanent and total in nature.  

Additionally, a special home adaptation grant is available for a Veteran that has a permanent and total service-connected disability which: (1) includes the anatomical loss or loss of use of both hands; (2) is due to deep partial thickness burns that have resulted in contracture(s) with limitation of motion of two or more extremities or of at least one extremity and the trunk; (3) is due to full thickness or subdermal burns that have resulted in contracture(s) of one or more extremities or the trunk; or, (4) is due to residuals of an inhalation injury (including, but not limited to, pulmonary fibrosis, asthma, and chronic obstructive pulmonary disease (COPD)).  38 U.S.C. § 2101(b); 38 C.F.R. § 3.809a(b) (emphasis added).

Eligibility for special home adaptation grant.

As indicated above, the Veteran does have a permanent and total service-connected disability, specifically his chronic asthma and is not service-connected for any additional disability.  The Veteran has asserted that he is eligible for special home adaptation grant based on his permanent and total service-connected chronic asthma.  See July 2025 VA Form 10182 Notice of Disagreement.  However, a review of the record does not show the Veteran's service-connected chronic asthma is due to residuals of an inhalation injury as required by 38 C.F.R. § 3.809a(b).

The regulation states that to meet this criterion for special home adaptation grants, a Veteran must first have an inhalation injury, and the subsequent disorders listed are examples of possible residuals from that initial inhalation injury.  38 C.F.R. § 3.809a(c)(4).  The VA Adjudication Manual states,

"Qualification for [special home adaptation] based on a respiratory disorder requires more than a showing of permanent and total disability from a respiratory diagnosis such as pulmonary fibrosis, asthma or chronic obstructive pulmonary disease. The diagnosis must have resulted from an inhalational injury caused by breathing steam or toxic fumes, gases and mists present in a fire environment (including, but not limited to, acrolein, chlorine, phosgene, and nitrogen dioxide)."  M21-1, XIII.i.2.B.1.d.

While not binding on Board decisions, the manual provides useful clarification and guidance on the meaning of an "inhalation injury."  DAV v. Sec'y of Veterans Affairs, 859 F.3d 1072, 1077 (Fed. Cir. 2017); see also Overton v. Wilkie, 30 Vet. App. 257 (2018).

Moreover, in adding "inhalation injury" as a basis for entitlement to a grant of special home adaptation, VA specifically stated in the initial Federal Register announcement that
 environment (including, but not limited to, acrolein, chlorine, phosgene, and nitrogen dioxide)."  M21-1, XIII.i.2.B.1.d.

While not binding on Board decisions, the manual provides useful clarification and guidance on the meaning of an "inhalation injury."  DAV v. Sec'y of Veterans Affairs, 859 F.3d 1072, 1077 (Fed. Cir. 2017); see also Overton v. Wilkie, 30 Vet. App. 257 (2018).

Moreover, in adding "inhalation injury" as a basis for entitlement to a grant of special home adaptation, VA specifically stated in the initial Federal Register announcement that:

We are proposing the additional eligibility criterion of residuals of an inhalation injury for special home adaptation grants under § 3.809a because inhalation injuries can result from the same incidents that cause severe burns.  Inhalation injury is due to breathing steam or toxic inhalants such as fumes, gases, and mists present in a fire environment.  Toxic inhalants comprise a variety of noxious gases and particulate matter that are capable of producing local irritation, asphyxiation, and systemic toxicity.  The Washington Manual of Medical Therapeutics 752 (Wash. U. of St. Louis, 32d ed. 2007).

Some examples of toxic inhalants are acrolein, chlorine, phosgene, and nitrogen dioxide.  Inhalation injuries can occur with or without burns to the skin.  However, a significant number of individuals with burns to the skin also have inhalation injury, and the presence of inhalation injury is a determinant of mortality.  Inhalation injury can cause long-term respiratory complications, including, but not limited to, pulmonary fibrosis, asthma, and chronic obstructive pulmonary disease, requiring home adaptation.  The specific residuals of such injury would determine the level of home adaptation.  Residuals of inhalation injury would be rated under the predominant disability and its evaluative criteria.

74 Fed. Reg. 67145, 67148 (Dec. 18, 2009).

It is therefore required that in order to be the basis of a grant for special home adaptation, the respiratory disorder at issue must be permanent and total and have been caused by an inhalation injury due to breathing steam or toxic inhalants such as fumes, gases, and mists present in a fire environment.  

The Veteran does not contend, and the evidence of record does not show, that his service-connected chronic asthma was caused by an inhalation injury due to breathing steam or toxic inhalants such as fumes, gases, and mists present in a fire environment.  Instead, the record shows that he was service connected for his chronic asthma as the condition was incurred and initially diagnosed during service due to physical exertion.  In his service connection claim for asthma, the Veteran reported that he made it through boot camp but was on PT hold and that once he was unable to complete the running portion, he was sent to the hospital for testing.  He indicated the results from the test showed breathing difficulty.  As a result, he was moved to medical separation board and discharged from the military due to his reactive airway disease (asthma).  See May 2009 VA 21-526 Veterans Application for Compensation or Pension.  During a September 2009 VA examination, the Veteran reported that six weeks after he was in boot camp in Florida, he developed inability to breath that was diagnosed as asthma and that he was medically discharged after his diagnosis of asthma while in the service.  See January 2010 Email Correspondence.  

A review of the military personnel records confirms that the Veteran was in boot camp in Florida and subsequently medically discharged due to his symptomatic reactive airway disease, later diagnosed as asthma, and his inability to perform physical training or meet enlistment physical standards.  See May 2009 Military Personnel Record and December 2021 Military Personnel Record.  Service treatment records (STRs) in October 1993 also confirmed that the Veteran was placed on PT hold due to SOB (shortness of breath) with running and that he was unable to pass PRT due to SOB and unable to complete the run in time.  See December 2015 STR - Dental.  In a July 2022 VA respiratory conditions disability benefits questionnaire (DBQ) examination, the examiner diagnosed chronic asthma and noted that the Veteran's condition began with onset of shortness of breath during physical activities in 1993 and that he now had similar symptoms during exertion.  See July 2022 C&P Exam.  

In the absence of evidence of an inhalation injury caused by breathing steam or toxic fumes, gases and mist present in a fire environment, the evidence weighs against finding that the Veteran's chronic asthma would qualify as an
shortness of breath) with running and that he was unable to pass PRT due to SOB and unable to complete the run in time.  See December 2015 STR - Dental.  In a July 2022 VA respiratory conditions disability benefits questionnaire (DBQ) examination, the examiner diagnosed chronic asthma and noted that the Veteran's condition began with onset of shortness of breath during physical activities in 1993 and that he now had similar symptoms during exertion.  See July 2022 C&P Exam.  

In the absence of evidence of an inhalation injury caused by breathing steam or toxic fumes, gases and mist present in a fire environment, the evidence weighs against finding that the Veteran's chronic asthma would qualify as an inhalation injury.  Thus, to the extent the Veteran asserts that he meets the criteria for a special home adaptation grant due to his asthma disability, the Board finds that based on the probative evidence of record, his exercise induced asthma is not the result of an inhalation injury.  

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?

Ultimately, the Veteran does not have a permanent and total disability causing any of the enumerated conditions under 38 C.F.R. §§ 3.809a.  As such, he is ineligible for a special home adaptation.  The appeal is therefore denied.

While the Veteran does not qualify for specially adapted housing under 38 C.F.R. § 3.809 or a special home adaptation grant under 38 C.F.R. § 3.809a, the Board advises that he may apply for a grant from the Home Improvements and Structural Alterations (HISA) program through the Veterans Health Administration, which provides for structural improvements and alterations to a Veteran's residence such as those needed to allow entrance to or exit from the residence, use of essential lavatory and sanitary facilities, accessibility to kitchen or bathroom sinks or counters, and other modifications specified under the regulation.  See 38 U.S.C. §§ 1710(a), 1717(a)(2); 38 C.F.R. § 17.3100.  The requirements for assistance in acquiring specially adapted housing/a special home adaptation grant and the HISA grant differ greatly, and it may be possible that the Veteran could qualify for his requested assistance under this other program.  The Board's identification of this benefit in no way endorses a decision one way or the other, should such an application be submitted.

 

 

T. Raymond

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	J.C., 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.