A cold injury from 1968 can produce a brand new claim today, and the schedule was written expecting exactly that. DC 7122 rates every affected body part separately, so two frostbitten feet and two hands are four ratings plus the bilateral factor. And the 30 percent level per part turns on a checklist where an X-ray finding counts just as much as tissue loss.
Why cold injuries get a dedicated diagnostic code
Cold injuries (frostbite, immersion or trench foot, chilblains, and severe non-freezing cold injuries) produce long-term residuals that show up years or decades after the exposure. VA recognizes that pattern and gives cold injury its own diagnostic code, 38 CFR 4.104, DC 7122, in the cardiovascular schedule.
Two features of DC 7122 matter most:
- Each affected body part is rated separately. A veteran with cold injury to both feet and both hands has four separate ratings under DC 7122. The ratings then combine under 38 CFR 4.25 (the combined ratings table), and the bilateral factor under 38 CFR 4.26 applies for paired extremities.
- Secondary conditions are claimed on top. If the cold injury caused peripheral neuropathy in the foot, that neuropathy is rated separately under the appropriate DC (often 8520 to 8525 for the affected nerve). Same for amputations, Raynaud's phenomenon, skin cancers in the affected area, or muscle atrophy.
How the three rating levels work
The rating schedule asks two questions: are there ongoing symptoms, and what else is going on in that body part? The combinations are:
30% per affected part
Arthralgia or other pain, numbness, or cold sensitivity, plus two or more of the following:
- Tissue loss
- Nail abnormalities
- Color changes (cyanosis, pallor, erythema)
- Locally impaired sensation
- Hyperhidrosis (excessive sweating)
- X-ray abnormalities (osteoporosis, subarticular punched-out lesions, osteoarthritis)
20% per affected part
Arthralgia or other pain, numbness, or cold sensitivity, plus one of the above (tissue loss, nail abnormalities, color changes, locally impaired sensation, hyperhidrosis, or X-ray abnormalities).
10% per affected part
Arthralgia or other pain, numbness, or cold sensitivity, by itself. Any one of those three symptoms in the affected body part qualifies.
There is no schedular rating below 10 percent for cold injury under DC 7122. If the residuals are truly minimal, the rater can still grant service connection at 0 percent, and the rating can be increased later if the residuals worsen.
What the C&P examiner is looking for
A C&P examiner who follows the Cold Injury Residuals DBQ will document:
- Onset and circumstances of the cold injury (in-service event, date, location, temperature, duration of exposure, level of treatment received).
- Affected body parts (feet, hands, ears, nose, face). Each one is its own examination.
- Current symptoms in plain terms: pain, numbness, cold sensitivity, color changes (does the area turn white, blue, or purple in cold weather?), excess sweating, tingling, burning.
- Objective findings: tissue loss, scarring, nail dystrophy, hair loss in the affected area, decreased peripheral pulses, loss of sensation on monofilament or pinprick testing, atrophic skin.
- X-ray findings, when ordered: osteoporosis, subarticular punched-out lesions, osteoarthritis of the affected joints. The DBQ explicitly asks about these because they meet the 30 percent threshold.
- Functional impact: limitations on standing, walking, fine motor control, working in cold environments, sleeping.
If the examiner does not order X-rays and you have reason to believe X-ray findings are present, you can request them. A normal X-ray does not bar the rating. The X-ray is one of six items that count toward the 30 percent threshold.
Documenting the in-service cold exposure
Few cold injuries were diagnosed at the time. The injury became a problem 10, 30, or 50 years later. To establish the in-service event:
- DD-214 and unit records showing service in a cold weather theater. Common service contexts include:
- Korean War, especially Chosin Reservoir, November to December 1950 - Aleutian Islands campaign, 1942 to 1943 - Battle of the Bulge, December 1944 to January 1945 - Atlantic and Pacific convoy duty - Cold weather training (NWTC Bridgeport, JBER Alaska, Fort Drum) - Korea winter rotations (1953 to present) - Northern European NATO deployments - Mountain Phase Ranger School in winter cycles
- Personal statement on VA Form 21-4138 describing the conditions: temperature, wet versus dry exposure, duration, footwear, whether boots came off, whether the casualty was carried, what treatment was rendered.
- Lay statements on VA Form 21-10210 from buddies who were there, or from family members who observed the recovery.
- Buddy statements are especially useful when the unit was operating in conditions that would not appear on a written record (small unit patrols, snow caves, convoy stops).
- Medical records showing any post-service treatment for the affected extremities, even decades later. Pattern matters.
Korea and the Chosin presumption
VA has long recognized that Korean War veterans who served in cold weather areas during the 1950 winter, especially Chosin Reservoir, experienced widespread cold injuries that were rarely documented. There is no formal presumptive list under 38 CFR 3.309 for cold injury, but VA's adjudication practice gives substantial weight to lay evidence of cold injury for veterans with that service profile. Consult the M21-1 Adjudication Procedures Manual chapters on cold injury for the current evidentiary standards.
Common secondary conditions
After service connection for cold injury, these secondary claims often follow:
- Peripheral neuropathy of the affected limb (DCs 8520 to 8525, depending on the nerve)
- Raynaud's phenomenon (DC 7117) if the vasospasm is chronic
- Skin cancers in the cold-injured area (squamous cell carcinoma, basal cell carcinoma, melanoma)
- Osteoarthritis of the affected joints (DC 5003)
- Amputation residuals (relevant DCs in 38 CFR 4.71a)
- Loss of nails (DC 7820 if disfiguring)
- Psychological residuals (PTSD from the underlying combat event)
For each, the path is secondary service connection under 38 CFR 3.310. Pair the claim with a nexus letter from the treating provider.
How a well-organized claim is structured
A cold injury claim that arrives well-organized usually looks like this:
- VA Form 21-526EZ identifying "cold injury residuals, bilateral feet, bilateral hands" as four separate issues (or three, if only one upper extremity was affected).
- Personal statement on VA Form 21-4138 covering the in-service event.
- Lay statements on VA Form 21-10210 from one or two buddies and a family member.
- Current treatment records showing the residuals (pain, numbness, color changes, nail dystrophy, etc.).
- A cold injury DBQ completed by the treating provider (see the Directive 1134(1) article for how to ask).
- A request for secondary claims to be developed if peripheral neuropathy, Raynaud's, or skin cancer evidence is present.
Regulatory references
- [38 CFR 4.104, DC 7122](https://www.ecfr.gov/current/title-38/chapter-I/part-4/subpart-B/section-4.104), cold injury residuals
- 38 CFR 4.25, combined ratings
- 38 CFR 4.26, bilateral factor
- 38 CFR 3.310, secondary service connection
- VBA Cold Injury Residuals DBQ
- M21-1 Adjudication Procedures Manual, Cold Injury (Cold Weather Injury) chapter
This page is educational and does not promise a specific rating outcome. Work with a VA accredited representative when you can.