Veterans with varicose veins routinely describe all day swelling and still land at 10 percent. The line between 10 and 20 percent under DC 7121 is a single word pair: intermittent versus persistent, plus whether elevation actually relieves the swelling. A record that captures only occasional symptoms rates the record, not the legs, and each leg is rated separately with the bilateral factor on top.
Veterans with varicose veins routinely describe all-day swelling and still land at 10 percent. The line between 10 and 20 percent under DC 7121 is a single word pair: intermittent versus persistent, plus whether elevation actually relieves the swelling. A record that captures only occasional symptoms rates the record, not the legs. Each leg is rated separately, with the bilateral factor on top.
How VA rates varicose veins
VA rates varicose veins under diagnostic code 7121 in the cardiovascular schedule (38 CFR 4.104). The schedule points the older varicose-vein code (7120) to 7121, the post-phlebitic syndrome scale, so this one set of criteria governs. The rating turns on swelling, skin changes, ulceration, and pain, and whether they persist or come and go.
The percentage levels (per leg)
- 0 percent: asymptomatic palpable or visible varicose veins.
- 10 percent: intermittent swelling of the extremity, or aching and fatigue in the leg after prolonged standing or walking, with symptoms relieved by measures such as elevating the leg or wearing compression hosiery.
- 20 percent: persistent swelling that is incompletely relieved by elevation, with or without early stasis pigmentation or eczema.
- 40 percent: persistent swelling and stasis pigmentation or eczema, with or without intermittent ulceration.
- 60 percent: persistent swelling or subcutaneous induration, stasis pigmentation or eczema, and persistent ulceration.
- 100 percent: massive board-like swelling with constant pain at rest.
Why "persistent" is the key word
The jump from 10 to 20 percent is the difference between intermittent swelling that elevation or compression relieves and persistent swelling that elevation does not fully relieve. Veterans often describe daily, all-day swelling but get rated at 10 percent because the record only mentions occasional symptoms. Whether the swelling is persistent, and whether elevation actually relieves it, is the fact the rating depends on.
Each leg is rated separately
These evaluations apply to a single extremity. When both legs have varicose veins, each leg is rated on its own and then combined under 38 CFR 4.25, with the bilateral factor under 38 CFR 4.26 added. Two legs at 10 percent each are worth more combined than a single 10 percent rating, so claim both legs when both are involved.
Skin changes and ulcers raise the rating
Stasis pigmentation (brown discoloration), eczema, and especially ulceration move the rating into the 40 to 60 percent range. Photographs of the skin changes and any ulcers, plus the treatment record, help document a level that a brief exam can miss.
Common rating details veterans overlook
- Persistent versus intermittent swelling is the line between 20 and 10 percent.
- Whether elevation relieves the swelling is part of the criteria, so the exam should address it.
- Each leg is rated separately and combined, with the bilateral factor when both legs are involved.
- Stasis skin changes and ulceration drive the 40 to 60 percent levels, so document them with photos.
- The old code 7120 is rated under 7121, so the post-phlebitic scale is what applies.