C&P Exam for Chronic obstructive pulmonary disease (DC 6604)

Diagnostic code: 6604Condition: Chronic obstructive pulmonary diseaseRegulation: 38 CFR § 4.97DBQ: DBQ RESP Respiratory Conditions (other than tuberculosis and sleep apnea)

Which form the examiner uses

For chronic obstructive pulmonary disease (DC 6604), the C&P examiner completes the following Disability Benefits Questionnaire (DBQ):

DBQs are Department of Veterans Affairs Form 21-0960 series documents. Public DBQs are hosted on benefits.va.gov. A handful are examiner-only and are not posted publicly.

What the examiner records

The fields below are reproduced from the DBQ form the examiner completes for this diagnostic code. This is the structural map of the form, showing what the examiner is asked to measure, observe, and record. It is a factual reproduction of the public DBQ, not advice on how to answer.

This DBQ evaluates respiratory conditions (excluding tuberculosis and sleep apnea), including asthma, COPD, bronchitis, bronchiectasis, asbestosis, and diaphragm conditions, organized as Section III subsections per condition.

How DC 6604 maps to this DBQ: for this diagnostic code specifically, the examiner typically completes sections I-VI of this form. Section III is the condition-specific section for this code.

DIAGNOSIS (Section I)
  • 1A. List the claimed condition(s) that pertain to this questionnaire:
  • 1B. Select diagnoses associated with the claimed condition(s) (check all that apply): Asthma — ICD code / Date of diagnosis
  • 1B. Emphysema — ICD code / Date of diagnosis
  • 1B. Chronic obstructive pulmonary disease (COPD) — ICD code / Date of diagnosis
  • 1B. Chronic bronchitis — ICD code / Date of diagnosis
  • 1B. Constrictive bronchiolitis — ICD code / Date of diagnosis
  • 1B. Interstitial lung disease (if checked, specify) — ICD code / Date of diagnosis
  • 1B. Restrictive lung disease (If checked, specify) — ICD code / Date of diagnosis
  • 1B. Mycotic lung disease (If checked, specify) — ICD code / Date of diagnosis
  • 1B. Sarcoidosis — ICD code / Date of diagnosis
  • 1B. Benign or malignant neoplasm or metastases of respiratory system (If checked, specify) — ICD code / Date of diagnosis
  • 1B. Pulmonary vascular disease (Including pulmonary thromboembolism)(If checked, specify) — ICD code / Date of diagnosis
  • 1B. Pleurisy with empyema, with or without pleurocutaneous fistula — Unresolved / Resolved — ICD code / Date of diagnosis
  • 1B. Other diagnosis #1 / #2 / #3 — ICD code / Date of diagnosis
  • 1C. If there are additional diagnoses that pertain to respiratory conditions, list using above format:
MEDICAL HISTORY (Section II)
  • 2A. Describe the history, including onset and course, of the Veteran's respiratory condition(s). Brief summary:
  • 2B. Does the Veteran's respiratory condition require the use of oral or parenteral corticosteroid medications?
  • Requires chronic low dose (maintenance) corticosteroids
  • Requires intermittent courses or bursts of systemic (oral or parenteral) corticosteriods — number of courses or bursts in past 12 months: 0 / 1 / 2 / 3 / 4 or more
  • Requires systemic (oral or parenteral) high dose (therapeutic) corticosteroids for control
  • Requires daily use of systemic (oral or parenteral) high dose corticosteroids
  • Requires daily use of systemic (oral or parenteral) immuno-suppressive medications
  • 2C. Does the Veteran's respiratory condition require the use of inhaled medications?
  • Inhalational bronchodilator therapy — frequency: Intermittent / Daily
  • Inhalational anti-inflammatory medication — frequency: Intermittent / Daily
  • Other inhaled medications, describe:
  • 2D. Does the Veteran's respiratory condition require the use of oral bronchodilators? — frequency: Intermittent / Daily
  • 2E. Does the Veteran's respiratory condition require the use of antibiotics? — list antibiotics, dose, frequency and condition
  • 2F. Does the Veteran require outpatient oxygen therapy for his or her respiratory condition?
  • does the Veteran require continuous oxygen therapy (>17 hours/day)?
PULMONARY CONDITIONS (Section III)
    DIAGNOSTIC TESTING (Section IV)
    • 4A. Have imaging studies or procedures been performed? — Chest x-ray (Date / Results) / MRI (Date / Results) / CT (Date / Results) / HRCT (Date / Results) / Bronchoscopy (Date / Results) / Biopsy (Date / Results) / Other (Date / Results)
    • 4B. Has pulmonary function testing (PFT) been performed?
    • Do PFT results reported below reflect the Veteran's current pulmonary function?
    • Reason PFTs not required: Veteran requires outpatient oxygen therapy / 1 or more episodes of acute respiratory failure / Cor pulmonale/right ventricular hypertrophy/pulmonary hypertension / Exercise capacity testing ≤20 ml/kg/min
    • 4C. Date of test:
    • Pre-bronchodilator FVC: % predicted
    • Pre-bronchodilator FEV1: % predicted
    • Pre-bronchodilator FEV-1/FVC: %
    • Post-bronchodilator FVC: % predicted
    • Post-bronchodilator FEV1: % predicted
    • Post-bronchodilator FEV-1/FVC: %
    • DLCO: % predicted
    • 4D. Which test result most accurately reflects the Veteran's level of disability: FVC % predicted / FEV-1 % predicted / FEV-1/FVC / DLCO
    • 4E. If post-bronchodilator testing has not been completed, indicate reason:
    • 4F. If DLCO testing has not been completed, provide reason:
    • 4G. Does the Veteran have multiple respiratory conditions? — list conditions and predominantly responsible condition:
    • 4H. Has exercise capacity testing been performed? — Maximum exercise capacity <15 ml/kg/min / 15-20 ml/kg/min / >20 ml/kg/min / Unknown results
    • 4I. Are there any other significant diagnostic test findings and/or results? — describe (brief summary):
    FUNCTIONAL IMPACT (Section V)
    • 5A. Regardless of the Veteran's current employment status, do the conditions listed in the diagnosis section impact his/her ability to perform any type of occupational task (such as standing, walking, lifting, sitting, etc.)?
    • If yes, describe the functional impact of each condition, providing one or more examples:
    REMARKS (Section VI)
    • 6A. Remarks (if any - please identify the section to which the remark pertains when appropriate).

    Rating Levels for DC 6604

    The following tiers are reproduced from 38 CFR Part 4, the VA Schedule for Rating Disabilities. Toggle between the official VA criteria and a Plain English explanation.

    Plain-English summaries are AI-generated to explain the official criteria. The official 38 CFR language is the binding legal standard. When in doubt, ask a VSO.

    Evidence cited in published BVA decisions for DC 6604

    The counts below are aggregated from published Board of Veterans Appeals decisions for this diagnostic code. Each row reports how often a given evidence type was discussed in the decision text, broken down by outcome. This is a factual aggregate of the public record, not a prediction or recommendation about any specific claim.

    • VA examination: appeared in 9 granted decisions (6 denied, 14 remanded; 29 total)
    • Private medical opinion: appeared in 5 granted decisions (0 denied, 3 remanded; 8 total)
    • Medical literature: appeared in 1 granted decision (0 denied, 1 remanded; 2 total)
    • Buddy / lay statements: appeared in 0 granted decisions (0 denied, 2 remanded; 2 total)
    • Service treatment records: appeared in 0 granted decisions (2 denied, 2 remanded; 4 total)

    What the Board discussed in granted decisions for DC 6604

    The themes below were extracted by clustering 500 grant-factor sentences from published Board of Veterans Appeals decisions for this diagnostic code. Frequencies indicate how often each theme appeared in the sample. This is a factual aggregate of the public record, not advice or strategy for any specific claim.

    1. 22% Benefit of the doubt doctrine cited as legal standard
      The Board or decision cited the benefit of the doubt rule as the governing legal standard, noting that when evidence is in approximate balance the claimant prevails, without applying it to a specific factual finding.
      112 of 500 sample sentences
    2. 20% Medical nexus opinion linking COPD to in-service toxic exposure
      A VA or private examiner opined that it was at least as likely as not that the Veteran's COPD was caused by or related to in-service toxic exposures such as herbicides, asbestos, burn pits, chemicals, or fumes.
      98 of 500 sample sentences
    3. 16% Evidence found in equipoise supporting service connection grant
      The Board found the lay and medical evidence at least in relative equipoise on whether the Veteran's COPD or other claimed disability was related to service, and resolved that balance in the Veteran's favor to grant the claim.
      79 of 500 sample sentences
    4. 11% Benefit of the doubt inapplicable where preponderance against claim
      The Board found the preponderance of the evidence weighed against the claim, making the benefit of the doubt doctrine inapplicable and resulting in denial.
      57 of 500 sample sentences
    5. 4% COPD rating level warranted based on symptom severity evidence
      The Board found the evidence supported a specific schedular disability rating percentage for COPD or associated pulmonary conditions based on documented symptom severity, pulmonary function test results, or occupational impairment.
      22 of 500 sample sentences
    6. 4% Secondary service connection nexus opinion recorded for COPD
      An examiner or treating physician opined that the Veteran's COPD was at least as likely as not caused or aggravated by a separate service-connected condition such as PTSD, asbestosis, or interstitial lung disease.
      18 of 500 sample sentences
    7. 3% Examiner request or remand for COPD nexus opinion noted
      The Board or record documented a remand instruction or examiner request asking whether the Veteran's COPD was at least as likely as not related to service or a toxic exposure risk activity.
      15 of 500 sample sentences
    8. 3% Private physician nexus opinion for COPD cited in record
      A private treating physician or independent medical expert provided a written opinion in the record finding that the Veteran's COPD was at least as likely as not related to military service or in-service exposures.
      14 of 500 sample sentences
    9. 2% PACT Act or TERA framework applied to COPD nexus determination
      The Board or examiner applied the PACT Act toxic exposure risk activity framework, noting that a nexus opinion was required or obtained regarding whether COPD was caused by the Veteran's documented military toxic exposures.
      8 of 500 sample sentences
    10. 1% Negative VA nexus opinion for COPD noted in record
      A VA examiner concluded that the Veteran's COPD was less likely than not related to service, citing smoking history, lack of in-service respiratory complaints, or insufficient evidence of a causal link.
      7 of 500 sample sentences
    11. 1% TDIU or unemployability finding linked to COPD severity
      The Board found that the Veteran's service-connected COPD, alone or in combination with other disabilities, supported a finding of entitlement to individual unemployability based on documented occupational impairment.
      5 of 500 sample sentences
    12. 1% Benefit of the doubt applied to specific COPD rating or effective date
      The Board expressly applied the benefit of the doubt doctrine to resolve a specific dispute about a COPD disability rating percentage, effective date, or rating criteria in the Veteran's favor.
      5 of 500 sample sentences
    View the full DC 6604 pageSearch BVA decisions for this codeAbout DBQ forms

    Disclaimer: This page reproduces public Department of Veterans Affairs forms (DBQs) and verbatim text from 38 CFR Part 4 (the VA Schedule for Rating Disabilities). It is informational only and is not legal or medical advice. For guidance on a specific claim, contact a VA-accredited representative.