**§4.104 Schedule of ratings---cardiovascular system.**

**[Diseases of the Heart]{.smallcaps}**

Rating

**Note 1**: Evaluate cor pulmonale, which is a form of secondary heart
disease, as part of the pulmonary condition that causes it.

**Note 2**: One MET (metabolic equivalent) is the energy cost of
standing quietly at rest and represents an oxygen uptake of 3.5
milliliters per kilogram of body weight per minute. When the level of
METs at which dyspnea, fatigue, angina, dizziness, or syncope develops
is required for evaluation, and a laboratory determination of METs by
exercise testing cannot be done for medical reasons, an estimation by a
medical examiner of the level of activity (expressed in METs and
supported by specific examples, such as slow stair climbing or shoveling
snow) that results in dyspnea, fatigue, angina, dizziness, or syncope
may be used.

**7000** Valvular heart disease (including rheumatic heart disease):

During active infection with valvular heart damage and for three

months following cessation of therapy for the active infection 100

Thereafter, with valvular heart disease (documented by findings on

physical examination and either echocardiogram, Doppler

echocardiogram, or cardiac catheterization) resulting in:

Chronic congestive heart failure, or; workload of 3 METs or less

results in dyspnea, fatigue, angina, dizziness, or syncope,

or; left ventricular dysfunction with an ejection fraction of

less than 30 percent 100

More than one episode of acute congestive heart failure in the past

year, or; workload of greater than 3 METs but not greater than

5 METs results in dyspnea, fatigue, angina, dizziness, or syncope,

or; left ventricular dysfunction with an ejection fraction of

30 to 50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electro-cardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous

medication required 10

**7001** Endocarditis:

For three months following cessation of therapy for active infection

with cardiac involvement 100

Thereafter, with endocarditis (documented by findings on physical

examination and either echocardiogram, Doppler echocardiogram,

or cardiac catheterization) resulting in:

Chronic congestive heart failure, or; workload of 3 METs or less

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of less than

30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of 30 to

50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electrocardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

continuous medication required 10

**7002** Pericarditis:

For three months following cessation of therapy for active infection

with cardiac involvement 100

Thereafter, with documented pericarditis resulting in:

Chronic congestive heart failure, or; workload of 3 METs or less

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of less

than 30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of 30 to

50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electro-cardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous

medication required 10

**7003** Pericardial adhesions:

Chronic congestive heart failure, or; workload of 3 METs or less results

in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular

dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past

year, or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or; left

ventricular dysfunction with an ejection fraction of 30 to 50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electro-cardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous

medication required 10

**7004** Syphilitic heart disease:

Chronic congestive heart failure, or; workload of 3 METs or less

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of less

than 30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of 30 to

50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electrocardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous

medication required 10

**Note**: Evaluate syphilitic aortic aneurysms under DC 7110 (aortic
aneurysm).

**7005** Arteriosclerotic heart disease (Coronary artery disease):

With documented coronary artery disease resulting in:

Chronic congestive heart failure, or; workload of 3 METs or less results

in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular

dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or; left

ventricular dysfunction with an ejection fraction of 30 to 50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electrocardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous

medication required 10

**Note**: If nonservice-connected arteriosclerotic heart disease is
superimposed on service-connected valvular or other non-arteriosclerotic
heart disease, request a medical opinion as to which condition is
causing the current signs and symptoms.

**7006** Myocardial infarction:

During and for three months following myocardial infarction,

documented by laboratory tests 100

Thereafter:

With history of documented myocardial infarction, resulting in:

Chronic congestive heart failure, or; workload of 3 METs or less

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of less

than 30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of 30 to

50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electrocardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

continuous medication required 10

**7007** Hypertensive heart disease:

Chronic congestive heart failure, or; workload of 3 METs or less

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of less

than 30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of 30 to

50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electrocardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous

medication required 10

**7008** Hyperthyroid heart disease:

Include as part of the overall evaluation for hyperthyroidism under

DC 7900. However, when atrial fibrillation is present, hyperthyroidism

may be evaluated either under DC 7900 or under DC 7010

(supraventricular arrhythmia), whichever results in a higher evaluation.

**7010** Supraventricular arrhythmias:

Paroxysmal atrial fibrillation or other supraventricular tachycardia,
with

more than four episodes per year documented by ECG or Holter

monitor 30

Permanent atrial fibrillation (lone atrial fibrillation), or; one to
four

episodes per year of paroxysmal atrial fibrillation or other

supraventricular tachycardia documented by ECG or

Holter monitor 10

**7011** Ventricular arrhythmias (sustained):

For indefinite period from date of hospital admission for initial
evaluation

and medical therapy for a sustained ventricular arrhythmia, or; for

indefinite period from date of hospital admission for ventricular

aneurysmectomy, or; with an automatic implantable Cardioverter-

Defibrillator (AICD) in place 100

Chronic congestive heart failure, or; workload of 3 METs or less results

in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular

dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or; left

ventricular dysfunction with an ejection fraction of 30 to 50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results in

dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electrocardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or;

continuous medication required 10

**Note**: A rating of 100 percent shall be assigned from the date of
hospital admission for initial evaluation and medical therapy for a
sustained ventricular arrhythmia or for ventricular aneurysmectomy. Six
months following discharge, the appropriate disability rating shall be
determined by mandatory VA examination. Any change in evaluation based
upon that or any subsequent examination shall be subject to the
provisions of §3.105(e) of this chapter.

**7015** Atrioventricular block:

Chronic congestive heart failure, or; workload of 3 METs or less results

in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular

dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of 30 to

50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electrocardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous

medication or a pacemaker required 10

**Note**: Unusual cases of arrhythmia such as atrioventricular block
associated with a supraventricular arrhythmia or pathological
bradycardia should be submitted to the Director, Compensation and
Pension Service. Simple delayed P-R conduction time, in the absence of
other evidence of cardiac disease, is not a disability.

**7016** Heart valve replacement (prosthesis):

For indefinite period following date of hospital admission for valve

replacement 100

Thereafter:

Chronic congestive heart failure, or; workload of 3 METs or less results

in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular

dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of 30 to

50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electrocardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous

medication required 10

**Note**: A rating of 100 percent shall be assigned as of the date of
hospital admission for valve replacement. Six months following
discharge, the appropriate disability rating shall be determined by
mandatory VA examination. Any change in evaluation based upon that or
any subsequent examination shall be subject to the provisions of
§3.105(e) of this chapter.

**7017** Coronary bypass surgery:

For three months following hospital admission for surgery 100

Thereafter:

Chronic congestive heart failure, or; workload of 3 METs or less results

in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular

dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or; left

ventricular dysfunction with an ejection fraction of 30 to 50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electrocardiogram,

echocardiogram, or X-ray 30

Workload greater than 7 METs but not greater than 10 METs results in

dyspnea, fatigue, angina, dizziness, or syncope, or; continuous

medication required 10

**7018** Implantable cardiac pacemakers:

For two months following hospital admission for implantation or

reimplantation 100

Thereafter:

Evaluate as supraventricular arrhythmias (DC 7010), ventricular

arrhythmias (DC 7011), or atrioventricular block (DC 7015).

Minimum 10

**Note**: Evaluate implantable Cardioverter-Defibrillators (AICD's)
under DC 7011.

**7019** Cardiac transplantation:

For an indefinite period from date of hospital admission for cardiac

transplantation 100

Thereafter:

Chronic congestive heart failure, or; workload of 3 METs or less results

in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular

dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of 30 to

50 percent 60

Minimum 30

**Note**: A rating of 100 percent shall be assigned as of the date of
hospital admission for cardiac transplantation. One year following
discharge, the appropriate disability rating shall be determined by
mandatory VA examination. Any change in evaluation based upon that or
any subsequent examination shall be subject to the provisions of
§3.105(e) of this chapter.

**7020** Cardiomyopathy:

Chronic congestive heart failure, or; workload of 3 METs or less results

in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular

dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of 30 to

50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electrocardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous

medication required 10

**[Diseases of the Arteries and Veins]{.smallcaps}**

**7101** Hypertensive vascular disease (hypertension and isolated
systolic

hypertension):

Diastolic pressure predominantly 130 or more 60

Diastolic pressure predominantly 120 or more 40

Diastolic pressure predominantly 110 or more, or; systolic pressure

predominantly 200 or more 20

Diastolic pressure predominantly 100 or more, or; systolic pressure

predominantly 160 or more, or; minimum evaluation for an

individual with a history of diastolic pressure predominantly 100

or more who requires continuous medication for control 10

**Note 1**: Hypertension or isolated systolic hypertension must be
confirmed by readings taken two or more times on at least three
different days. For purposes of this section, the term hypertension
means that the diastolic blood pressure is predominantly 90mm. or
greater, and isolated systolic hypertension means that the systolic
blood pressure is predominantly 160mm. or greater with a diastolic blood
pressure of less than 90mm.

**Note 2**: Evaluate hypertension due to aortic insufficiency or
hyperthyroidism, which is usually the isolated systolic type, as part of
the condition causing it rather than by a separate evaluation.

**Note 3**: Evaluate hypertension separately from hypertensive heart
disease and other types of heart disease.

**7110** Aortic aneurysm:

If five centimeters or larger in diameter, or; if symptomatic, or; for

indefinite period from date of hospital admission for surgical

correction (including any type of graft insertion) 100

Precluding exertion 60

Evaluate residuals of surgical correction according to organ systems
affected.

**Note**: A rating of 100 percent shall be assigned as of the date of
admission for surgical correction. Six months following discharge, the
appropriate disability rating shall be determined by mandatory VA
examination. Any change in evaluation based upon that or any subsequent
examination shall be subject to the provisions of §3.105(e) of this
chapter.

**7111** Aneurysm, any large artery:

If symptomatic, or; for indefinite period from date of hospital
admission

for surgical correction 100

Following surgery:

Ischemic limb pain at rest, and; either deep ischemic ulcers or ankle/

brachial index of 0.4 or less 100

Claudication on walking less than 25 yards on a level grade at 2 miles
per

hour, and; persistent coldness of the extremity, one or more deep

ischemic ulcers, or ankle/brachial index of 0.5 or less 60

Claudication on walking between 25 and 100 yards on a level grade at

2 miles per hour, and; trophic changes (thin skin, absence of hair,

dystrophic nails) or ankle/brachial index of 0.7 or less 40

Claudication on walking more than 100 yards, and; diminished peripheral

pulses or ankle/brachial index of 0.9 or less 20

**Note 1**: The ankle/brachial index is the ratio of the systolic blood
pressure at the ankle (determined by Doppler study) divided by the
simultaneous brachial artery systolic blood pressure. The normal index
is 1.0 or greater.

**Note 2**: These evaluations are for involvement of a single extremity.
If more than one extremity is affected, evaluate each extremity
separately and combine (under §4.25), using the bilateral factor, if
applicable.

**Note 3**: A rating of 100 percent shall be assigned as of the date of
hospital admission for surgical correction. Six months following
discharge, the appropriate disability rating shall be determined by
mandatory VA examination. Any change in evaluation based upon that or
any subsequent examination shall be subject to the provisions of
§3.105(e) of this chapter.

**7112** Aneurysm, any small artery:

Asymptomatic 0

**Note**: If symptomatic, evaluate according to body system affected.
Following surgery, evaluate residuals under the body system affected.

**7113** Arteriovenous fistula, traumatic:

With high output heart failure 100

Without heart failure but with enlarged heart, wide pulse pressure,

and tachycardia 60

Without cardiac involvement but with edema, stasis dermatitis, and
either ulceration or cellulitis:

Lower extremity 50

Upper extremity 40

With edema or stasis dermatitis:

Lower extremity 30

Upper extremity 20

**7114** Arteriosclerosis obliterans:

Ischemic limb pain at rest, and; either deep ischemic ulcers or ankle/

brachial index of 0.4 or less 100

Claudication on walking less than 25 yards on a level grade at 2 miles

per hour, and; either persistent coldness of the extremity or ankle/

brachial index of 0.5 or less 60

Claudication on walking between 25 and 100 yards on a level grade at

2 miles per hour, and; trophic changes (thin skin, absence of hair,

dystrophic nails) or ankle/brachial index of 0.7 or less 40

Claudication on walking more than 100 yards, and; diminished peripheral

pulses or ankle/brachial index of 0.9 or less 20

**Note 1**: The ankle/brachial index is the ratio of the systolic blood
pressure at the ankle (determined by Doppler study) divided by the
simultaneous brachial artery systolic blood pressure. The normal index
is 1.0 or greater.

**Note 2**: Evaluate residuals of aortic and large arterial bypass
surgery or arterial graft as arteriosclerosis obliterans.

**Note 3**: These evaluations are for involvement of a single extremity.
If more than one extremity is affected, evaluate each extremity
separately and combine (under §4.25), using the bilateral factor
(§4.26), if applicable.

**7115** Thrombo-angiitis obliterans (Buerger's Disease):

Ischemic limb pain at rest, and; either deep ischemic ulcers or ankle/

brachial index of 0.4 or less 100

Claudication on walking less than 25 yards on a level grade at 2 miles

per hour, and; either persistent coldness of the extremity or ankle/

brachial index of 0.5 or less 60

Claudication on walking between 25 and 100 yards on a level grade at

2 miles per hour, and; trophic changes (thin skin, absence of hair,

dystrophic nails) or ankle/brachial index of 0.7 or less 40

Claudication on walking more than 100 yards, and; diminished peripheral

pulses or ankle/brachial index of 0.9 or less 20

**Note 1**: The ankle/brachial index is the ratio of the systolic blood
pressure at the ankle (determined by Doppler study) divided by the
simultaneous brachial artery systolic blood pressure. The normal index
is 1.0 or greater.

**Note 2**: These evaluations are for involvement of a single extremity.
If more than one extremity is affected, evaluate each extremity
separately and combine (under §4.25), using the bilateral factor
(§4.26), if applicable.

**7117** Raynaud's syndrome:

With two or more digital ulcers plus autoamputation of one or more

digits and history of characteristic attacks 100

With two or more digital ulcers and history of characteristic attacks 60

Characteristic attacks occurring at least daily 40

Characteristic attacks occurring four to six times a week 20

Characteristic attacks occurring one to three times a week 10

**Note**: For purposes of this section, characteristic attacks consist
of sequential color changes of the digits of one or more extremities
lasting minutes to hours, sometimes with pain and paresthesias, and
precipitated by exposure to cold or by emotional upsets. These
evaluations are for the disease as a whole, regardless of the number of
extremities involved or whether the nose and ears are involved.

**7118** Angioneurotic edema:

Attacks without laryngeal involvement lasting one to seven days or

longer and occurring more than eight times a year, or; attacks with

laryngeal involvement of any duration occurring more than twice

a year 40

Attacks without laryngeal involvement lasting one to seven days and

occurring five to eight times a year, or; attacks with laryngeal

involvement of any duration occurring once or twice a year 20

Attacks without laryngeal involvement lasting one to seven days and

occurring two to four times a year 10

**7119** Erythromelalgia:

Characteristic attacks that occur more than once a day, last an average

of more than two hours each, respond poorly to treatment, and that

restrict most routine daily activities 100

Characteristic attacks that occur more than once a day, last an average
of

more than two hours each, and respond poorly to treatment, but that

do not restrict most routine daily activities 60

Characteristic attacks that occur daily or more often but that respond
to

treatment 30

Characteristic attacks that occur less than daily but at least three
times

a week and that respond to treatment 10

**Note**: For purposes of this section, a characteristic attack of
erythromelalgia consists of burning pain in the hands, feet, or both,
usually bilateral and symmetrical, with increased skin temperature and
redness, occurring at warm ambient temperatures. These evaluations are
for the disease as a whole, regardless of the number of extremities
involved.

**7120** Varicose veins:

With the following findings attributed to the effects of varicose veins:

Massive board-like edema with constant pain at rest 100

Persistent edema or subcutaneous induration, stasis pigmentation or

eczema, and persistent ulceration 60

Persistent edema and stasis pigmentation or eczema, with or without

intermittent ulceration 40

Persistent edema, incompletely relieved by elevation of extremity,

with or without beginning stasis pigmentation or eczema 20

Intermittent edema of extremity or aching and fatigue in leg after

prolonged standing or walking, with symptoms relieved by elevation of

extremity or compression hosiery 10

Asymptomatic palpable or visible varicose veins 0

**Note**: These evaluations are for involvement of a single extremity.
If more than one extremity is involved, evaluate each extremity
separately and combine (under §4.25), using the bilateral factor
(§4.26), if applicable.

**7121** Post-phlebitic syndrome of any etiology:

With the following findings attributed to venous disease:

Massive board-like edema with constant pain at rest 100

Persistent edema or subcutaneous induration, stasis pigmentation or

eczema, and persistent ulceration 60

Persistent edema and stasis pigmentation or eczema, with or without

intermittent ulceration 40

Persistent edema, incompletely relieved by elevation of extremity,

with or without beginning stasis pigmentation or eczema 20

Intermittent edema of extremity or aching and fatigue in leg after
prolonged standing or walking, with symptoms relieved by

elevation of extremity or compression hosiery 10

Asymptomatic palpable or visible varicose veins 0

**Note**: These evaluations are for involvement of a single extremity.
If more than one extremity is involved, evaluate each extremity
separately and combine (under §4.25), using the bilateral factor
(§4.26), if applicable.

**7122** Cold injury residuals:

With the following in affected parts:

Arthralgia or other pain, numbness, or cold sensitivity plus two

or more of the following: tissue loss, nail abnormalities, color

changes, locally impaired sensation, hyperhidrosis, X-ray

abnormalities (osteoporosis, subarticular punched out lesions,

or osteoarthritis) 30

Arthralgia or other pain, numbness, or cold sensitivity plus tissue

loss, nail abnormalities, color changes, locally impaired sensation,

hyperhidrosis, or X-ray abnormalities (osteoporosis, subarticular

punched out lesions, or osteoarthritis) 20

Arthralgia or other pain, numbness, or cold sensitivity 10

**Note 1**: Separately evaluate amputations of fingers or toes, and
complications such as squamous cell carcinoma at the site of a cold
injury scar or peripheral neuropathy, under other diagnostic codes.
Separately evaluate other disabilities that have been diagnosed as the
residual effects of cold injury, such as Raynaud's phenomenon, muscle
atrophy, etc., unless they are used to support an evaluation under
diagnostic code 7122.

**Note 2**: Evaluate each affected part (e.g., hand, foot, ear, nose)
separately and combine the ratings in accordance with §§4.25 and 4.26.

**7123** Soft tissue sarcoma (of vascular origin) 100

**Note**: A rating of 100 percent shall continue beyond the cessation of
any surgical, X-ray, antineoplastic chemotherapy or other therapeutic
procedure. Six months after discontinuance of such treatment, the
appropriate disability rating shall be determined by mandatory VA
examination. Any change in evaluation based upon that or any subsequent
examination shall be subject to the provisions of §3.105(e) of this
chapter. If there has been no local recurrence or metastasis, rate on
residuals.

(Authority: 38 U.S.C. 1155)

\[29 FR 6718, May 22, 1964, as amended at 40 FR 42539, Sept. 15, 1975;
41 FR 11300, Mar. 18, 1976; 43 FR 45361, Oct. 2, 1978; 56 FR 51653, Oct.
15, 1991; 62 FR 65219, Dec. 11, 1997; 63 FR 37779, July 14, 1998; 71 FR
52460, Sept. 6, 2006\]

**Supplement *Highlights* references**: 22(1), 24(1), 41(1).

*Next Section is §4.110*

Reserved