How the Board ruled on asthma, COPD and lung claims, 2021–2025

Asthma / COPD / lung condition (direct service connection)

Direct (began in or was caused by service), or theory not stated in the Board order

40.2% granted of 3,031 decided cases (margin of error 38.5–41.9%). 1,218 granted, 1,813 denied, 4,209 sent back to VA (remanded, not decided), 672 dismissed.

What convinced the Board in granted cases

• The Board favored opinions explaining how in-service exposures harm the lungs, and discounted VA opinions that rejected the exposure, gave generic facts not applied to the veteran, or relied only on time gaps. (7 of 13 decisions read; e.g. A22015540, A22020041, 23036472)
• The Board accepted the veteran's credible account of in-service exposures or breathing symptoms that began in service and continued, often backed by in-service treatment records. (6 of 13 decisions read; e.g. A24041834, A24049127, A23026993)
• Several grants rested on presumptions for Gulf War or burn pit (PACT Act) service, where a qualifying condition and service were enough without proving a direct link. (4 of 13 decisions read; e.g. 23036472, 22004548, 21049082)

Common reasons in denied cases

• Most denials were because the record showed no current diagnosed lung condition, such as normal breathing tests or no treatment for asthma or bronchitis during the appeal. (7 of 12 decisions read; e.g. A25017230, A25015325, A25033007)
• The veteran's own belief that symptoms were a specific lung disease, or were caused by service, was not treated as competent medical evidence. (3 of 12 decisions read; e.g. A25033007, A25025711, 22017901)
• Some claims failed because service records showed no in-service lung problem or qualifying exposure, and symptoms were not continuous after service. (3 of 12 decisions read; e.g. A24012734, 21062795, 22017901)

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Asthma / COPD / lung condition (exposure claims)

Exposure (e.g. Agent Orange, Camp Lejeune, burn pits)

24.5% granted of 440 decided cases (margin of error 20.8–28.8%). 108 granted, 332 denied, 808 sent back to VA (remanded, not decided), 42 dismissed.

What convinced the Board in granted cases

• Opinions linking an exposure such as asbestos or herbicides to the lung condition, especially citing literature, won; VA opinions lost weight when unexplained, speculative, or contradicted by literature. (5 of 11 decisions read; e.g. 21036401, A25024947, 22001046)
• Presumptions for burn pit or particulate matter exposure, or Gulf War illness, decided several grants once qualifying service and a respiratory condition were shown. (4 of 11 decisions read; e.g. A24055330, 21061001, A21014706)
• Credible lay testimony that breathing problems began in service or deployment and continued afterward supported grants. (3 of 11 decisions read; e.g. 22053068, 23002951, 23055648)

Common reasons in denied cases

• Only the veteran's own belief linked the lung condition to an exposure; that is not competent medical evidence, and no medical opinion supported it. (6 of 12 decisions read; e.g. A21007513, 24031002, 21062971)
• There was no current diagnosed lung disability, or no confirmed diagnosis such as asbestosis; symptoms were attributed to other conditions. (6 of 12 decisions read; e.g. 24009049, A24007085, A25020029)
• Detailed VA opinions or records attributed COPD to smoking, sometimes noting a long gap after service, and were given great weight. (3 of 12 decisions read; e.g. 21057384, 21062971, 22010331)

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Asthma / COPD / lung condition secondary to any service-connected condition

Secondary (caused or worsened by a service-connected condition)

31.4% granted of 229 decided cases (margin of error 25.8–37.7%). 72 granted, 157 denied, 436 sent back to VA (remanded, not decided), 19 dismissed.

What convinced the Board in granted cases

• The Board gave strong weight to treating or private physicians who explained that the lung problem was a direct result of a service-connected condition or its treatment, such as leukemia, cancer or radiation. (5 of 12 decisions read; e.g. 21049301, 21015223, A24020764)
• Claims won on aggravation when an opinion explained how a service-connected condition, such as sinusitis or Parkinson's medication, made asthma or COPD worse, sometimes backed by medical literature. (4 of 12 decisions read; e.g. 21013967, 23017427, 21020387)
• Negative VA opinions lost weight when they ignored the favorable opinions and submitted medical article, or applied a stricter standard of proof than the law requires. (2 of 12 decisions read, few decisions; e.g. 21028754, 21020387)

Common reasons in denied cases

• The most common reason for denial was a reasoned VA opinion that tied the lung disease to another cause, most often long-term smoking, after reviewing the record and medical literature. (6 of 13 decisions read; e.g. 21071838, 22023659, 21016754)
• Private opinions gave no adequate rationale, or no doctor linked the lung problem to service at all, and the veteran's own belief about the cause was not competent medical evidence. (4 of 13 decisions read; e.g. 21043868, 21013587, 21041573)
• Other claims failed because the underlying condition was not service-connected, no lung disability was shown, or service records showed no breathing problems. (4 of 13 decisions read; e.g. 23050209, 21013587, 23056100)

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Asthma / COPD / lung condition secondary to PTSD

Secondary (caused or worsened by a service-connected condition)

Small sample: 19 decided cases, too few for a reliable percentage. 6 granted, 13 denied, 53 sent back to VA (remanded, not decided), 0 dismissed.

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Asthma / COPD / lung condition secondary to sinusitis / rhinitis

Secondary (caused or worsened by a service-connected condition)

Small sample: 19 decided cases, too few for a reliable percentage. 8 granted, 11 denied, 23 sent back to VA (remanded, not decided), 1 dismissed.

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Asthma / COPD / lung condition secondary to sarcoidosis / pulmonary fibrosis

Secondary (caused or worsened by a service-connected condition)

Small sample: 14 decided cases, too few for a reliable percentage. 4 granted, 10 denied, 11 sent back to VA (remanded, not decided), 1 dismissed.

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Asthma / COPD / lung condition secondary to heart disease

Secondary (caused or worsened by a service-connected condition)

Small sample: 13 decided cases, too few for a reliable percentage. 4 granted, 9 denied, 21 sent back to VA (remanded, not decided), 1 dismissed.

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Asthma / COPD / lung condition secondary to cancer (other)

Secondary (caused or worsened by a service-connected condition)

Small sample: 11 decided cases, too few for a reliable percentage. 8 granted, 3 denied, 20 sent back to VA (remanded, not decided), 1 dismissed.

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Asthma / COPD / lung condition secondary to depression / psychiatric disorder

Secondary (caused or worsened by a service-connected condition)

Small sample: 10 decided cases, too few for a reliable percentage. 3 granted, 7 denied, 27 sent back to VA (remanded, not decided), 1 dismissed.

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