The Asthma (Bronchial) DBQ is driven by objective pulmonary function test (PFT) numbers and medication history. The examiner must record FEV-1, FEV-1/FVC ratio, frequency of exacerbations requiring physician care, and whether systemic (oral or parenteral) corticosteroids are used. Ratings under 38 CFR § 4.97, Diagnostic Code 6602 are almost entirely determined by these three elements.
PFTs are mandatory
VA requires current PFT results for asthma ratings unless medically contraindicated. The key values are FEV-1 percent predicted and the FEV-1/FVC ratio. Post-bronchodilator results are used when available. Without PFTs the claim is usually deferred or rated at the lowest level supported by medication history alone.
What the examiner is filling out
The Respiratory Conditions DBQ for asthma asks the examiner to record:
- Diagnosis — bronchial asthma confirmed by history and PFTs.
- PFT results — FEV-1 % predicted and FEV-1/FVC ratio (pre- and post-bronchodilator if performed).
- Medications — daily inhalers, oral steroids, biologics, or immuno-suppressants.
- Exacerbations — number of attacks per week or month that required a physician visit or ER care.
- Respiratory failure — any episodes requiring intubation or ICU-level care.
The DC 6602 schedule
Mild impairment. Daily rescue inhaler use alone usually lands here.
Moderate impairment. Daily controller inhalers (steroid or combination) support this level.
Severe impairment. Either PFT numbers or documented monthly exacerbations plus steroid bursts qualify.
Maximum schedular rating. Daily oral steroids or frequent respiratory failure episodes are the clearest paths.
The phrases that map to each tier
Magic words for this tier
To establish daily medication use (30%+):
- “I use a daily inhaled corticosteroid (or combination inhaler) every morning and night.”
- “My rescue inhaler is used multiple times per week even with daily controllers.”
Magic words for this tier
To establish monthly exacerbations or intermittent steroids (60%):
- “I have required prednisone bursts or ER visits roughly once a month over the last year.”
- “My pulmonologist has prescribed short courses of oral steroids at least monthly.”
Magic words for this tier
To establish daily systemic steroids or respiratory failure (100%):
- “I take oral prednisone every day at [dose] mg.”
- “I have been hospitalized or intubated more than once a week during flare-ups.”
Evidence that wins
Bring the actual PFT report (not just a summary), pharmacy records showing inhaler refills and steroid prescriptions, and any ER or urgent-care notes for exacerbations. A simple log of attacks (date, treatment, whether steroids were given) is highly persuasive when corroborated by treatment records.
What NOT to say
What NOT to say
- “I only use my inhaler when I feel short of breath.” (Suggests intermittent use only.)
- “I haven’t been to the ER in years.” (Without context, this undercuts frequency.)
- “The steroids are just for bad days.” (Vague — specify daily vs. intermittent.)
- “My breathing is usually fine between attacks.” (Does not address PFT results or daily meds.)
Use this with the rest of the site
- ▸ Asthma (Bronchial) condition guide — the full rating schedule, evidence checklist, and tactical plays.
- ▸ C&P Exam Prep generator — builds a personalized checklist for your specific conditions.
- ▸ Claim Coach — walks you through the 10 steps including C&P prep at Step 7.
- ▸ Full C&P exam guide — the universal say/don’t-say rules that apply to every exam.
Educational content only. DBQ structures are public knowledge from M21-1 and archived sources; VA discontinued public DBQ distribution in 2020 but the rating criteria these forms map to remain in 38 CFR Part 4. Not legal or medical advice. Always consult a VA-accredited VSO or attorney for claim-specific guidance. CFR citations: 38 CFR § 4.97 Diagnostic Code 6602 (bronchial asthma), § 4.96 (special provisions for respiratory conditions), M21-1 IV.ii.2.B (respiratory DBQ development)..