Veterans Medical Advisor



                         Case from Bureau of Veterans Appeals

Dr. Bash is a veteran of


Roanoke Regional Office Represented by: VIRGINIA DEPARTMENT OF VETERANS SERVICES Rating Decision September 14, 2012 INTRODUCTION

The records reflect that you are a veteran of the Vietnam Era. You served in the Army from August 1, 1972 to September 13, 1973. We received a Notice of Disagreement from you on March 21, 2012, about our earlier decision to deny service connection for chronic obstructive pulmonary disease (COPD). Based on a review of the evidence listed below, we have mad,e the following decision on your claim.


Service co1mection for COPD ( claimed also as asthma) is granted with an evaluation of 60 percent effective March 24, 2011.


VA Form 21-526, Veteran's Application for Compensation and/or Pension, dated March 18, 2011, re:ceived March 24, 2011.

We have assigned a 60 percent disability evaluation because PFTs show forced expiratory volume in one second (FEV-1) of 40 to 55 percent of the predicted value; and ratio FEV-1 to forced vital capacity (FEVl/FVC) of 40 to 55 percent. To assign a greater evaluation of 100 percent, there must be FEV-1 less than 40 percent predicted; or FEV -1 /FV C less than 40 percent; or diffusion capaciy of the lung for carbon monoxide by the single breath method [DLCO (SB)] less than 40 percent predicted; or maximm exercise capacity less than 15 ml/kg/min oxygen consumption (with cardiac or respiratory limitation); or cor pulmonale (right heart failure); or right ventricular hypertrophy; or pulmonary hypertension (shon by echo.or cardiac catheterization); or episode(s) of acute respiratory failure; or the requirement for outpatient oxygen therapy. We cannot grant a higher evaluation at this time because your symptomatology does not approximate the criteria for a rating in excess of 60 percent.

Records from Martinsburg VA Medical Center show on March 11, 2010, post-prescription PFTs revealed FVC of 111 percent predicted, FEV-1 of 70 percent predicted, and FEV-1/FVC ratio of 48 percent. On VA exam, your post-bronchodilator PFTs revealed FVC of 79 percent predicted, FEV-1 of 52 percent predicted, and FEV-1/FVC ratio of 52 percent. Interpretation was moderately severe obstruction before medication and no significant improvement after medication. A DLCO was not done as the PFT results were sufficient to evaluate your pulmonory status. There were no complications such as cor pulmonale, right ventricular hypertrophy, pulmonory hypertensionm or chronic respiratory failure with carbon dioxide retention. You reported treatment with Symbicort 80/45 two times daily as well as Albuterol ProAir as needed with good response. You did not require the usage of outpatient oxygen therapy.

We have assigned an effective date of March 24, 2011, the date we received your claim.


Title 38 of the Code of Federal Regulations, Pensions, Bonuses and Veterans' Relief contains the regulations of the Department of Veterans Affairs which govern entitlement to all veteran benefits. For additional information regarding applicable laws and regulations, please consult your local library, or visit us at our web site,


Craig N. Bash M.D., M.B.A.

Neuro-Radiologist and Associate Professor

Uniformed Services School of Medicine


4938 Hampden Lane
Bethesda, Md 20814

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