Post-Phlebitic Syndrome VA disability rating & claim guide

Make sure the record states whether the edema is intermittent or persistent, and how far elevation relieves it. That distinction is the line between the 10 and 20 percent bands.

Have ulceration documented by its pattern rather than only its presence. Persistent ulceration is part of what the 60 percent band requires, while the 40 percent band is met with or without intermittent ulceration.

Ask that skin findings be named in the schedule's own terms where they are present — stasis pigmentation, eczema, and subcutaneous induration each appear in specific bands.

Keep compression hosiery prescriptions and elevation instructions in the file. Relief by elevation of the extremity or compression hosiery is written into the 10 percent band, and incomplete relief by elevation is written into the 20 percent band.

Where both limbs are involved, ask that each be examined and described on its own, since the Note evaluates a single extremity at a time and combines the results under § 4.25 with the bilateral factor under § 4.26.

Swelling recorded without saying whether it is intermittent or persistent, which leaves the 10 and 20 percent bands indistinguishable in the file.

No record of how the limb responds to elevation, when relief by elevation appears in both the 10 and 20 percent criteria.

An exam that happens to fall while an ulcer is healed, with no history of recurrence in the file, leaving the persistent ulceration the 60 percent band requires unaddressed.

Findings noted without being attributed to venous disease, which is the condition the schedule places on all of them.

Only one limb examined when both are involved, so the second extremity has no separate finding to be evaluated on.

Filing this as an arterial or circulation claim. DC 7121 evaluates venous disease findings; the ankle/brachial index, ankle pressure, toe pressure, and transcutaneous oxygen tension measures belong to peripheral arterial disease under DC 7114, not to this code.

Submitting a history of a past vein problem with no current findings in the limb. Every band is written from present findings — edema, skin changes, induration, ulceration, pain at rest.

Treating varicose veins as a separate rating scheme, when DC 7120 carries no criteria of its own and is evaluated under DC 7121's bands.

Claiming both legs as a single condition, when the Note evaluates each extremity separately and combines them under § 4.25 with the bilateral factor under § 4.26 if applicable.

The schedule titles this code "post-phlebitic syndrome of any etiology", so the cause of the venous damage does not change the criteria. What does matter throughout is the qualifier the criteria sit under: the findings must be attributed to venous disease.

The ladder reads as a progression in the limb rather than a timeline — asymptomatic varicose veins at 0 percent; intermittent edema, or aching and fatigue after prolonged standing or walking, relieved by elevation or compression hosiery at 10 percent; persistent edema only incompletely relieved by elevation at 20 percent; persistent edema with stasis pigmentation or eczema, with or without intermittent ulceration, at 40 percent; persistent edema or subcutaneous induration with stasis pigmentation or eczema and persistent ulceration at 60 percent; and massive board-like edema with constant pain at rest at 100 percent.