Citation Nr: A25086355 Decision Date: 10/07/25 Archive Date: 10/07/25 DOCKET NO. 231227-406429 DATE: October 7, 2025 ORDER Entitlement to an initial rating in excess of 60 percent for asthma is denied. FINDING OF FACT The weight of the competent and probative evidence is against a finding that the Veteran's asthma has manifested as FEV-1 less than 40 percent predicted, FEV-1/FVC less than 40 percent, or more than one attack per week with episodes of respiratory failure, or requirement for daily use of systemic high dose corticosteroids or immuno-suppressive medication at any time during the period on appeal. CONCLUSION OF LAW The criteria for an initial rating in excess of 60 percent for asthma are not met. 38 U.S.C. §§ 1155; 5107(b); 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.97, Diagnostic Code 6602. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1973 to June 1986. This matter is before the Board of Veterans' Appeals (Board) on appeal from a November 2023 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran selected the Evidence docket without a Board hearing in the Appeals Modernization Act (AMA) review system by submitting a VA Form 10182 (Evidence Submission Request: Board (Notice of Disagreement)) in December 2023. Based upon the selection of the Evidence Submission docket, the Board may only consider the evidence of record as of November 10, 2023 - the date of the rating decision on appeal and evidence submitted with or within 90 days of the VA's receipt of the VA Form 10182 on December 27, 2023. See 38 C.F.R. § 20.303. If the Veteran submitted evidence that was added to the record after November 10, 2023, and before VA received the Form 10182 on December 27, 2023, or 90 days after VA's receipt of the VA Form 10182, the Board did not consider it. If the Veteran wishes to have VA consider any evidence that was not considered, a supplemental claim should be submitted identifying such evidence. See 38 C.F.R. § 3.2501. Increased Rating Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities, found in 38 C.F.R., Part 4. The percentages are based on the average impairment of earning capacity as a result of service-connected disability, and separate diagnostic codes identify the various disabilities and the criteria for specific ratings. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. If two disability evaluations are potentially applicable, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for that rating; otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. All reasonable doubt as to the degree of disability will be resolved in favor of the claimant. 38 C.F.R. § 4.3. Where entitlement to compensation has already been established and an increase in the disability rating is at issue, the primary concern is the present level of disability. Francisco v. Brown, 7 Vet. App. 55, 58 (1994). However, the Board must also consider staged ratings, which are appropriate in this case. Hart v. Mansfield, 21 Vet. App. 505, 50910 (2007). Hyphenated diagnostic codes are used when a rating under one diagnostic code requires the use of an additional diagnostic code to identify the basis for the evaluation assigned; the additional code is shown after the hyphen. The evaluation of the same disability under several diagnostic codes, known as pyramiding, must be avoided; 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. Esteban v. Brown, 6 Vet. App. 259, 262 (1994); 38 C.F.R. § 4.14. In view of the number of atypical instances it is not expected, especially with the more fully described grades of disabilities, that all cases will show all the findings specified. Findings sufficiently characteristic to identify the disease and the disability therefrom, and above all, coordination of rating with impairment of function will, however, be expected in all instances. 38 C.F.R. § 4.21. In evaluating the evidence, the Board has been charged with the duty to assess the credibility and weight given to evidence. Davidson v. Shinseki, 581 F. 3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007). Indeed, the Court has declared that in adjudicating a claim, the Board has the responsibility to do so. Bryan v. West, 13 Vet. App. 482, 488-89 (2000). In doing so, the Board is free to favor one medical opinion over another, provided it offers an adequate basis for doing so. Owens v. Brown, 7 Vet. App. 429, 433 (1995). Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under the laws administered by VA. VA shall consider all information and medical and lay evidence of record. Where there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. The Veteran is competent to report symptoms observable by sense and contemporaneous medical diagnoses, but not competent to diagnose or assess the etiology of complex medical disorders. See Jandreau, 492 F.3d 1377; 38 C.F.R. § 3.159(a). An initial rating in excess of 60 percent for asthma. The Veteran contends entitlement to an initial rating in excess of 60 percent for his service-connected asthma. Specifically, the Veteran contends entitlement to a 100 percent disability rating. See 12/27/2023 10182. For background, the November 2023 rating decision granted service connection for asthma and assigned a disability rating of 60 percent, effective May 8, 2023, under 38 C.F.R. § 4.96, Diagnostic Code 6602. Diagnostic Code 6602 provides a 10 percent rating for FEV-1 of 71 to 80 percent predicted, or FEV-1/FVC of 71 to 80 percent, or intermittent inhalational or oral bronchodilator therapy. A 30 percent rating for 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. A 60 percent for 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. A maximum 100 percent rating for bronchial asthma with an FEV-1 of 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 the disability requires daily use of systemic (oral or parenteral) high dose corticosteroids or immunosuppressive medications. 38 C.F.R. § 4.97, DC 6602. When the pulmonary function tests (PFTs) are not consistent with clinical findings, evaluation should be based on the PFTs unless the examiner states why they are not a valid indication of respiratory functional impairment in a particular case. 38 C.F.R. § 4.96(d)(3). Post-bronchodilator studies are required when PFTs are done for disability evaluation purposes, except when the results of pre-bronchodilator pulmonary function tests are normal or when the examiner determines that post-bronchodilator studies should not be done and states why. 38 C.F.R. § 4.96(d)(4). When evaluating based on PFTs, raters are to use post-bronchodilator results in applying the evaluation criteria in the rating schedule unless the post-bronchodilator results were poorer than the pre-bronchodilator results. In those cases, use the pre-bronchodilator values for rating purposes. 38 C.F.R. § 4.96(d)(5). After review of the competent and relevant medical and lay evidence, the Board finds that an initial rating in excess of 60 percent for the service-connected asthma is not warranted. Turning to the competent and probative medical evidence, the Veteran was afforded a VA examination in September 2023. The Veteran reported shortness of breath with exertion. The examiner reported that the Veteran required chronic low dose corticosteroids, the use of intermittent inhalational bronchodilator therapy, and intermittent oral bronchodilator. Additionally, the examiner reported that the Veteran did not require the use of antibiotics or oxygen therapy. Further, the examiner reported that the Veteran did not have episodes of respiratory failure in the past 12 months or any physician visits for required care of exacerbations. The objective examination included a pulmonary function analysis, which showed pre-bronchodilator testing of FVC of 45 percent, an FEV-1 of 43 percent, and an FEV-1/FVC of 74 percent. Also, post-bronchodilator testing showed an FVC of 45 percent, an FEV-1 of 43 percent, and an FEV-1/FVC of 73 percent. Finally, as functional impairment, the examiner stated the Veteran would experience shortness of breath with exertion. See 9/7/2023 C&P Examination. The Board finds the September 2023 VA examination to be adequate and probative for rating purposes, as it reflects an in-person examination, a recorded history from the Veteran, objective testing, and medical expertise. See Nieves-Rodrigues v. Peake, 22 Vet. App. 295 (2008). The Board places much weight on this competent medical evidence. The Veteran's VA and private medical treatment records do not show that the Veteran has had a FEV-1 less than 40 percent predicted, FEV-1/FVC less than 40 percent, or more than one attack per week with episodes of respiratory failure, or requirement for daily use of systemic high dose corticosteroids or immuno-suppressive medication at any time during the period on appeal. Based on the totality of the evidence discussed above, the Board finds that the competent and probative evidence shows that an initial rating in excess of 60 percent for the Veteran's asthma is not warranted. In this regard, the Veteran has not contended, and the medical evidence does not reflect, that there is any evidence of FEV-1 less than 40 percent predicted, FEV-1/FVC less than 40 percent, or more than one attack per week with episodes of respiratory failure, or requirement for daily use of systemic high dose corticosteroids or immuno-suppressive medication at any time during the relevant appeal period. Therefore, the criteria for a rating of 100 percent under DC 6602 have not been met. The Board has also considered the Veteran's lay contentions that he is entitled to a rating of 100 percent for his service-connected asthma due to reported shortness of breath with exertion. See 9/7/2023 C&P Examination. He is competent to describe observable symptoms. However, the Veteran is not competent to identify a specific level of disability of this disorder according to the appropriate diagnostic codes. Such competent evidence concerning the nature and extent of the Veteran's disability has been provided by the medical personnel who have examined him during the current appeal and who have rendered pertinent opinions in conjunction with the evaluations. The medical findings (as provided in the September 2023 VA examination report and the clinical records) directly address the criteria under which his disability is evaluated. As such, the Board finds these records to be more probative than the Veteran's subjective complaints of increased symptomatology. In light of the above, after review of all the relevant competent medical and lay evidence of record, the Board finds that the Veteran's asthma has not manifested in FEV-1 less than 40 percent predicted, FEV-1/FVC less than 40 percent, or more than one attack per week with episodes of respiratory failure, or requirement for daily use of systemic high dose corticosteroids or immuno-suppressive medication, as required for a 100 percent rating. The Board therefore finds that the criteria for an initial rating in excess of 60 percent for asthma have not been met at any time during the relevant appeal period. As the evidence persuasively weighs against the claim (that is to say, is neither in approximate balance nor nearly equal), the benefit-of-the-doubt rule is inapplicable, and the claim is denied. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7, 4.97. L.M. YASUI Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J.F. 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.