Asthma plus sleep apnea is not asthma percent plus sleep apnea percent
38 C.F.R. §4.96(a) is one of the specific rules that overrides the general combination arithmetic, and it surprises people who have been told that more diagnoses mean more compensation.
What it says
Ratings under diagnostic codes 6600 through 6817, and 6822 through 6847, are not combined with each other. Where there is lung or pleural involvement, ratings under 6819 and 6820 are not combined with each other or with either of those ranges.
Instead: "A single rating will be assigned under the diagnostic code which reflects the predominant disability, with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation."
One narrow exception sits in the same paragraph: in cases protected by Pub. L. 90-493, the graduated 50 and 30 percent ratings for inactive tuberculosis are not elevated.
Which conditions are inside the rule
The ranges are what matter, not whether two conditions feel related. Find each condition's code in §4.97 and check it against the ranges.
| Example | Inside the rule? | What follows |
|---|---|---|
| Asthma (6602) and sleep apnea (6847) | Yes — both codes are inside the ranges | One rating under the predominant disability. Do not expect an asthma percentage added to an apnea percentage. |
| Sinusitis (6510–6514) and sleep apnea (6847) | Sinusitis is outside the ranges | §4.96(a) does not itself bar a separate evaluation. §4.14, the actual manifestations, and service connection all still apply. |
| Rhinitis (6522) and asthma (6602) | Rhinitis is outside the ranges | Separate ratings are possible if each one's requirements are actually met. The code ranges alone do not award anything. |
Being outside the range is not a grant. It only means this particular rule is not what stops you.
What "predominant" does not mean
It does not mean whichever diagnosis sounds worse. And a diagnosis does not vanish from your record because one rating was assigned.
The analysis has three parts: identify the criteria actually met under each potentially applicable code, decide which disability predominates, and then decide whether the overall disability warrants elevation to the next higher evaluation. That last step is a real part of the rule and is the one most often left undone.
The regulation does not say to add percentages, and it does not say every coexisting condition earns an automatic bump.
Reading your decision
Write down the exact diagnostic codes, the criteria the medical evidence meets under each, which code VA picked as predominant, and what it said about elevation.
If VA addressed only one of two established respiratory diagnoses, that omission is worth naming — but name it accurately. The missing diagnosis does not create a second payable rating. What it may do is change which disability predominates, or whether the overall severity warrants elevation.
For the conditions themselves, see asthma and sleep apnea.
Rules and forms change, and exceptions apply. Follow the instructions on your own decision letter and the linked governing sources. This site does not track your deadlines or file anything for you.
Reviewed October 6, 2026