Asthma Dbq Question

[Vync]

Hello everyone,

I have a question relating to the DBQ that is used for asthma claims (linked below).

RESPIRATORY CONDITIONS (OTHER THAN TUBERCULOSIS AND SLEEP APNEA)
DISABILITY BENEFITS QUESTIONNAIRE

http://www.vba.va.gov/pubs/forms/VBA-21-0960L-1-ARE.pdf

My DAV rep wants me to send in a DBQ and says it must be filled out completely, including the PFT values.

My asthma was rated at 60% because I received 3+ courses of oral or parenteral corticosteroids within a 12 month period. Because my asthma is rated due to this criteria, not the PFTs, would I still need to have the PFT scores? Should my doc send in the DBQ without PFT's or should they simply enter the values of my most recent PFTs from about a year ago?

Thanks

[Berta]

We discussed the DBQs at last weeks SVR show in archives...........with Dr. Bash------the show might help you.

DBQs are a problem.....the doc has to detail specifics...... I feel you need the PFTs in the DBQ BUT my question is, is there a higher rating available (100%?) for the asthma.....dont have time this minute to check the Rating schedule.....they should have enclosed it with your decision..

AT 90% now, are you still employed? or if not have you applied for TDIU?

[Vync]

Hi Berta,
Thank you very much for responding. I followed your advice and listened to the SVR show with Dr.Bash and it was helpful in clarifying some of my concerns. I am still employed, thankfully.

My DAV rep tells me that he will not help unless the PFT's are included. This is frustrating because I have been SC for asthma for 17 years and my rating would not be based on FEV-1. My last PFT's are over a year old. I read somewhere that they should be no older than six to 12 months old. Should the doc include those values or should I look at getting new PFT's?

The correct rating for my circumstances would be 60%, as detailed below.

Schedule of Ratings - Respiratory System
http://www.benefits.va.gov/warms/docs/regs/38CFR/BOOKC/PART4/S4_97.DOC

6602 Asthma, bronchial:

FEV-1 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; requires daily use of systemic (oral or
parenteral) high dose corticosteroids or immuno-suppressive
medications 100
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 60
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 30
FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80
percent, or; intermittent inhalational or oral bronchodilator therapy 10


Note: In the absence of clinical findings of asthma at time of
examination, a verified history of asthmatic attacks must be of record.

Thanks

[71M10]

I do know there is some guidance in cfr 38 part 4 that lays out some rules on when PFT's are not required.

conditions in this section which under certain circumstances also establish entitlement to special monthly compensation.

(d) Special provisions for the application of evaluation criteria for diagnostic codes 6600, 6603, 6604, 6825-6833, and 6840-6845. (1) Pulmonary function tests (PFT's) are required to evaluate these conditions except:

(i) When the results of a maximum exercise capacity test are of record and are 20 ml/kg/min or less. If a maximum exercise capacity test is not of record, evaluate based on alternative criteria.

(ii) When pulmonary hypertension (documented by an echocardiogram or cardiac catheterization), cor pulmonale, or right ventricular hypertrophy has been diagnosed.

(iii) When there have been one or more episodes of acute respiratory failure.

(iv) When outpatient oxygen therapy is required.

I did notice that 6602 is not in that list so It appears it is not and absolute requirement, only to be waived for one of the reasons below.

I would politely ask your DAV rep why they are adding unnecessary requirements to the ratings process, It sure seems to me your doc should fill out the DBQ, note your steroid treatments sign it and hand it back to you. Your DAV rep when forwarding it should point out that a PFT is not a requirement and that per the enclosed DBQ completed by Physician X, Mr Vync has had x number of sterodial treatments for his asthma over the last year.

Next thing you know they will be telling Amputees that we can't rate them because we can't get an acurate ROM!