Atrial fibrillation and atrial flutter - Chronic bronchitis with pulmonary obstruction Factor
RMA definition
In the SOP for atrial fibrillation the RMA has defined chronic bronchitis with pulmonary obstruction to mean "a respiratory tract disorder with:
- excessive mucus production sufficient to cause cough and sputum production with expectoration for at least three months of each of at least two consecutive years which is not attributable to other respiratory diseases; and
- chronic expiratory obstruction on spirometric evaluation."
Note: In the SOP for atrial flutter the definition refers to "functional evaluation" rather than "spirometric evaluation". However, the only functional evaluation of obstruction in chronic bronchitis is by spirometry so the definitions are essentially identical.
Establishing a history of chronic bronchitis with pulmonary obstruction
Chronic expiratory obstruction is evidenced by:
- a decrease in the person’s Forced Expiratory Volume in one second (FEV1) to 85% or less of the normal predicted value for a person of the same age, height and gender; and
- a ratio of FEV1 to Forced Vital Capacity (FVC) of 75% or less; which is not attributable to other disease; or
- specialist medical assessment indicative of a diagnosis of pulmonary obstruction, including evidence of significant irreversible small airways dysfunction as measured by FEF25-75 (Forced Expiratory Flow between 25% and 75% of the vital capacity), which is not attributable to other disease
A history of chronic bronchitis with pulmonary obstruction should be recorded in doctor’s notes and/or hospital records. However, if these records cannot be obtained, a reliable history of appropriate symptoms or medical treatment at a particular time generally will be accepted, provided this is not negated by other evidence. Seek medical advice if it is unclear whether the claimed symptoms and treatment at that time can be attributed to chronic bronchitis with pulmonary obstruction rather than to some other condition.
Last reviewed for CCPS 16 July 2003.
Preliminary questions [34715]
19163 the veteran has suffered from chronic bronchitis with pulmonary obstruction at some time.
34716 the veteran suffered from chronic bronchitis with pulmonary obstruction at the time of the clinical onset of the condition under consideration.
34717 the veteran has established the causal connection between the chronic bronchitis with pulmonary obstruction and VEA service for the clinical onset of the condition under consideration.
34718 the veteran has established the causal connection between the chronic bronchitis with pulmonary obstruction and operational service for the clinical onset of the condition under consideration.
or
34719 the veteran has established the causal connection between the chronic bronchitis with pulmonary obstruction and eligible service for the clinical onset of the condition under consideration.
Clinical onset and operational service [34718]
34720 the chronic bronchitis with pulmonary obstruction is causally related to operational service.
Clinical onset and eligible service [34719]
34721 the chronic bronchitis with pulmonary obstruction is causally related to eligible service.