EDUCATIONAL TOOL ONLY. Not legal or medical advice. Not affiliated with the VA.
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Post-Phlebitic Syndrome VA Disability Rating
DC 7121 | 38 C.F.R. § 4.104 | M21-1, Part IV.ii.2.D
OVERVIEW
Post-phlebitic syndrome (PPS), also called post-thrombotic syndrome, is rated under DC 7121 at 38 C.F.R. § 4.104. Covers residuals of DVT and other causes of venous insufficiency. Note: These evaluations are for a single extremity; bilateral involvement requires separate ratings for each extremity. The bilateral factor under § 4.26 does NOT apply.
RATING CRITERIA (6 LEVELS)
100% — Massive board-like edema with constant rest pain
Massive board-like edema with constant pain at rest.
60% — Persistent edema, stasis changes, and persistent ulceration
Persistent edema or subcutaneous induration, stasis pigmentation or eczema, and persistent ulceration.
40% — Persistent edema and stasis pigmentation or eczema
Persistent edema and stasis pigmentation or eczema, with or without intermittent ulceration.
20% — Persistent edema incompletely relieved by elevation
Persistent edema, incompletely relieved by elevation, with or without beginning stasis pigmentation or eczema.
10% — Intermittent edema or post-standing fatigue
Intermittent edema or aching and fatigue in leg after prolonged standing or walking, with symptoms relieved by elevation or compression hosiery.
0% — Asymptomatic varicose veins
Asymptomatic palpable or visible varicose veins.
KEY EVIDENCE TO GATHER
-Doppler ultrasound or venous duplex scan confirming DVT or venous insufficiency
-Records of acute DVT treatment (anticoagulation therapy)
-Documentation of chronic venous insufficiency: edema, stasis changes, ulcers
-Records of compression garment prescriptions
-Service records documenting deployment conditions or immobilization
SECONDARY CONDITIONS (2 MAPPED)
DC 7801/7804
Venous stasis ulcers cause scarring — rate under scar codes.
DC 6817
PE from DVT causes pulmonary vascular disease — rate pulmonary residuals separately.
C&P EXAM TIPS (5)
1.Key distinction: persistent vs. intermittent edema — persistent is present daily regardless of activity.
2.Stasis pigmentation, eczema, and ulcers are objective findings supporting higher ratings — document specifically.
3.Bilateral DVT/PPS rates each extremity separately — bilateral factor does NOT apply.
4.Venous ulcers healed with scarring are separately ratable under scar codes.
5.Post-phlebitic syndrome from service-connected DVT is automatically secondary — file the secondary claim.
RELEVANT CASE LAW
38 C.F.R. § 4.104, DC 7121 Note
Evaluations are for involvement of a single extremity. If more than one extremity is involved, rate separately. The bilateral factor under § 4.26 does NOT apply to post-phlebitic syndrome.
DOLLAR IMPACT
10%: $175.03/mo. 40% (persistent edema with stasis): $673.28/mo. 60% (persistent ulceration): $1,131.68/mo. Bilateral PPS frequently reaches 50-70% combined.
EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026