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7121
§ 4.104 Schedule of ratings—cardiovascular system.

Post-phlebitic syndrome

Chronic leg symptoms such as swelling, pain, and skin changes that develop after a blood clot damages leg veins.

What the rating means

Post-phlebitic syndrome of any etiology is rated under diagnostic code 7121, which covers venous disease affecting the limbs. VA rates this condition based on the severity of findings attributed to venous disease in a single extremity, with possible ratings of 0%, 10%, 20%, 40%, 60%, and 100%.

At 0%, varicose veins are visible or palpable but cause no symptoms. At 10%, you have intermittent swelling or aching and fatigue after prolonged standing or walking, with symptoms relieved by elevating the leg or wearing compression hosiery. At 20%, edema persists and is not completely relieved by elevation, with or without early stasis pigmentation or eczema. At 40%, you have persistent edema along with stasis pigmentation or eczema, with or without intermittent ulceration. At 60%, persistent edema or subcutaneous induration is present alongside stasis pigmentation or eczema and persistent ulceration. At 100%, the condition produces massive, board-like edema with constant pain even at rest.

If more than one extremity is affected, VA evaluates each one separately, then combines the ratings, applying the bilateral factor if applicable.

Evidence that helps

Medical records documenting the findings present in your affected extremity are central to establishing the correct rating level. Records that show the presence and persistence of edema — and whether elevation or compression hosiery relieves it — help distinguish lower rating levels from higher ones. Physician notes or imaging that confirm subcutaneous induration, stasis pigmentation, or eczema support the 40% and 60% levels. Documentation of active or persistent ulceration is key to the 60% level. At the highest level, records must show massive board-like edema together with pain that is constant even while you are at rest.

Physical examination findings from VA or private providers are particularly useful, as they can capture the character and extent of swelling, skin changes, and ulcers. Your own statements, and statements from those who observe you daily, can describe how symptoms affect your ability to stand, walk, or carry out daily activities. If more than one leg is affected, records clearly identifying findings in each extremity separately will matter for how VA evaluates and combines the ratings.

Secondary conditions

Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.