COPD Questions

Thompson13Bravo

Registered Member
I was recently diagnosed with COPD, and the other day my PA told me that he planned on dropping a MEB packet for me in December if there are no improvements. The respritory specialists I have been seeing say they don't expect any improvement. I have about 69% lung capacity and have went from maxing my run to no longer able to even try it. I have had several PFTs, the breathing challenge where you try many different inhalants with no improvement to my lung capacity. I did the exercise test and I don't have exercise induced asthma so that is where the COPD diagnosis came from. It has also caused my blood pressure to be elevated but controlled with meds. The doc explaned the BPM to me as since I cannot get enough O2 into my lungs, my heart beats faster and harder than it should to compensate. I am currently on Spireva, Advair, Albuterol as a rescue inhaler, and lisiniprol for the BP. How should I expect this to play out? I have no knowledge on the MEB process but I am starting to do my research as I expect it to be coming soon. Any insight, advice, or help would be greatly appreciated. Thank you.
 

usafaviator

PEB Forum Veteran
From the sounds of your symptoms and non-reaction to the meds, you will most likey be found unfit. I'm in the same boat with a slew of lung issues, and I was found unfit. Prepare for it.
 

Thompson13Bravo

Registered Member
Is this something that gets any form of disability compensation? What about a chance of reclassification, I
am field artillery so I know that is out, but can I try and stay in at a desk job? Thanks aviator hope it all works out for you.
 

usafaviator

PEB Forum Veteran
If your conditions affect your ability to PT, deploy or conduct soldiering skills (rucking, formations, shooting, etc.), odds are pretty high that you would be found unfit. If you want to fight to be retained, you most certainly can, but if your lung disease is unresponsive to meds and irreversable (and thus uncontrollable), you have an uphill battle to fight. I'm in no way trying to discourage you, but I believe in facing things head on and keeping reality in perspective. COPD is in the VASRD and is compensable, as long as you are deemed unfit by the PEB, the VA rates you 30% or greater and the PEB accepts the VA ratings and applies them to a med retirement for you. Anything less than 30%, and being found unfit will net you severance pay....you want 30% or greater if you are found unfit...retirement is much more beneficial (arguably) than severance.

6604 Chronic obstructive pulmonary disease:
FEV-1 less than 40 percent of predicted value, or; the ratio of Forced Expiratory Volume in one second to Forced Vital Capacity (FEV-1/FVC) less than 40 percent, or; Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO (SB)) less than 40-percent predicted, or; maximum 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 (shown by Echo or cardiac catheterization), or; episode(s) of acute respiratory failure, or; requires outpatient oxygen therapy. 100%

FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; DLCO (SB) of 40- to 55-percent predicted, or; maximum oxygen consumption of 15 to 20 ml/kg/min (with cardiorespiratory limit) 60%

FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; DLCO (SB) 56- to 65-percent predicted 30%

FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; DLCO (SB) 66- to 80-percent predicted 10%

Source:http://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=38:1.0.1.1.5&idno=38#38:1.0.1.1.5.2.102.46

The numbers above are determined by PFT's, so compare your breathing test numbers to the above to get a good idea of what you would rate. I would guess, from experience, that 69% lung capacity would put you up in the 30% category, but to be sure your need to know what your FEV's are. Additionally, you should get asthma added to your diagnosis...because they are treating you for it...Advair is an inhaled corticosteroid used typically by asthmatics, Albuterol is an inhaled oral bronchodialator, also used with asthma...both of which net a 30% rating in the VARD under asthma. Spiriva contains Tiotropium, which is also a bronchodialator (albeit longer acting that Albuterol) used by people with COPD.
 

Army aviator

Registered Member
Hello usafaviator, I am in a somewhat similar boat, as far as COPD. Mine started years ago as "breathing difficulties" after loosing part of a lung to lung cancer and a lobectomy (never a smoker, go figure). It was eventually diagnosed by the VA as COPD, and I was rated by the VA at 100 percent for the COPD with an FEV-1/FEV ratio of 34 percent. Over the years, it became harder and harder to fly and deploy, etc, and big Army finally started the MEB process.
I went to a new VA PFT exam back in late September of 2016 and amazingly enough, the tech said my FEV is like 73 percent, even though I can't walk with flight gear more than about 20 ft, or climb any stairs without sucking wind! How can I have gotten better on paper, when physically I am much worse on my breathing?
I am waiting to hear the results of the PEB, but I hope they use the earlier VA C&P lung exam, because it reflected much more accurately my real lung capacity.
Anyway Brother, I think there are more folks with COPD or other assorted breathing problems than DoD ever realized.
Be well, and try to stay healthy.
 

Army aviator

Registered Member
Just to update a previous post on COPD. I was entered into the MEB process in AUG 2016, and they recommended that I go thru PEB, due to COPD (that had been previously diagnosed by the VA, service connected, 100 percent). I had multiple VA exams under the IDES system for a number of issues, related to being an Aviator for 39 years, wearing NVGs for years, combat, etc. The PEB board I felt treated me very fairly, and in Jan 2017 sent my 199 back with a 100 percent DoD rating for the same COPD, found Unfitting for my MOS. I am now waiting to finish off whatever needs to be done after signing my Form 199. Hate to have my body so deteriorated, but grateful to the Docs and the PEBLO and MSC for their good work on my case.
 

mrando69

PEB Forum Veteran
Registered Member
It was eventually diagnosed by the VA as COPD, and I was rated by the VA at 100 percent for the COPD with an FEV-1/FEV ratio of 34 percent.
Did they use the values before bronchodilator or after? I read somewhere that the VA uses the post-bronchodilator values for ratings. That doesn't really make sense to me. If it's true, that's gonna mean a huge difference in rating for me. My pre FEV-1 is 33% and my post is 64%.
 

Army aviator

Registered Member
Did they use the values before bronchodilator or after? I read somewhere that the VA uses the post-bronchodilator values for ratings. That doesn't really make sense to me. If it's true, that's gonna mean a huge difference in rating for me. My pre FEV-1 is 33% and my post is 64%.
In my case they used on the C &P exam the values after the bronchodilator, which made it appear initially that my breathing was much better. I was very concerned about that. But I should not have been so concerned, because the VA Rating Examiner that analyzed the PFT Exam decided that between two tests that were so different (one showed me meeting the criteria for 100 percent and the other for 10 percent), he chose the earlier tests that showed me at 100 percent. The Army PEB board also went with 100. It really would not have made much difference, since all of the issues added together by the VA would have come to about 280 percent, which still defaults to 100 percent. But my point is that both the VA treated me fairly in their rating, as well as the Army PEB board. No complaints in my end. But if all you have to be evaluated at all is COPD, then, yes, it could make a huge difference. Be safe and stay patient.
 
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