Pulmonary Embolism Residuals — VA Disability Rating Criteria (DC 6817)
Diagnostic Code 6817 · 38 CFR §4.97
What Is It?
DC 6818 no longer exists — it was removed on October 7, 1996 when VA rewrote the respiratory schedule, and residuals of pulmonary embolism moved into DC 6817, "Pulmonary Vascular Disease." That is not a loose analogy: DC 6817’s own rows name the condition, setting 30 percent for a veteran who is "symptomatic, following resolution of acute pulmonary embolism" and 0 percent for one who is asymptomatic after resolution. 38 CFR § 3.951(a) is the provision to know: a readjustment to the rating schedule "shall not be grounds for reduction of a disability rating in effect on the date of the readjustment unless medical evidence establishes that the disability to be evaluated has actually improved." Under § 3.951(b), an evaluation continuously held at or above its level for 20 years or more cannot be reduced at all except on a showing of fraud, and under § 3.957 service connection in effect 10 years or more cannot be severed except for fraud or a defect in the record of service. The old code still appears in this page’s web address because the address has not changed; the code the page teaches has. A pulmonary embolism occurs when a clot travels to the lungs and blocks flow through the pulmonary arteries. What VA rates afterwards is what is left: continuing symptoms, the need for long-term anticoagulation, and in the worst cases chronic thromboembolic pulmonary hypertension with right ventricular strain.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Primary pulmonary hypertension; or chronic pulmonary thromboembolism with evidence of pulmonary hypertension, right ventricular hypertrophy, or cor pulmonale; or pulmonary hypertension secondary to other obstructive disease of the pulmonary arteries or veins with evidence of right ventricular hypertrophy or cor pulmonale. |
| 60% | Chronic pulmonary thromboembolism requiring anticoagulant therapy, or following inferior vena cava surgery without evidence of pulmonary hypertension or right ventricular dysfunction. |
| 30% | Symptomatic, following resolution of acute pulmonary embolism. |
| 0% | Asymptomatic, following resolution of pulmonary thromboembolism. Note: other residuals following pulmonary embolism are evaluated under the most appropriate diagnostic code — chronic bronchitis (DC 6600) or chronic pleural effusion or fibrosis (DC 6844) are the examples § 4.97 gives — but that evaluation is not combined with any of the evaluations above. |
Evidence Needed
Medical records documenting the initial PE event and its connection to service. Current pulmonary function tests (PFTs) showing residual impairment. CT pulmonary angiography or echocardiogram showing chronic changes. Records of ongoing anticoagulation therapy. Buddy statements describing functional limitations.
C&P Exam Tips
Ensure your examiner documents any chronic changes visible on imaging. Request PFTs including DLCO, which is particularly sensitive to PE-related damage. Describe your worst days and how your breathing limits daily activities. If you use anticoagulants, bring your medication list.
How to File
File VA Form 21-526EZ naming residuals of pulmonary embolism; the rater assigns DC 6817. The rows are not scored on pulmonary function testing — read them closely. Ongoing anticoagulant therapy for chronic pulmonary thromboembolism is itself the 60 percent criterion, so the anticoagulation record matters more than a spirometry number. For 100 percent you need documented pulmonary hypertension with right ventricular hypertrophy or cor pulmonale — echocardiogram or right heart catheterisation. If you developed the embolism because of another service-connected condition or its treatment, such as post-surgical immobility, file it as secondary.
Common Mistakes
Submitting pulmonary function tests as the main evidence. DC 6817’s criteria turn on pulmonary hypertension, right ventricular findings, anticoagulation and symptomatic status — not on FEV-1 or DLCO. Filing under DC 6818, which has not existed since 1996. Letting the "other residuals" note pass unnoticed: chronic bronchitis or pleural effusion after an embolism is evaluated under DC 6600 or DC 6844, but § 4.97 forbids combining that with the DC 6817 evaluation, so the question is which path pays more, not how to stack them.
Frequently Asked Questions
My decision cites DC 6818. Is my rating at risk?
Not from the code change. DC 6818 was removed on October 7, 1996 and pulmonary embolism residuals moved to DC 6817. 38 CFR § 3.951(a) provides that a readjustment to the rating schedule is not grounds for reducing an evaluation in effect unless medical evidence shows the disability has actually improved — and a rating held continuously for 20 years is protected outright under § 3.951(b).
I am on lifelong blood thinners after a PE. What does that get me?
Read the 60 percent row: "chronic pulmonary thromboembolism requiring anticoagulant therapy." If the anticoagulation is for chronic pulmonary thromboembolism, the therapy requirement is the criterion. Make sure the prescribing note states the indication clearly, because a record that just shows a prescription does not establish why.
Can I get a separate rating for the lung scarring the embolism left?
It is rated, but not combined. § 4.97 directs that other residuals after a pulmonary embolism be evaluated under the most appropriate code — chronic bronchitis at DC 6600 or chronic pleural effusion or fibrosis at DC 6844 — and then says not to combine that evaluation with the DC 6817 evaluation. VA assigns the one that produces the higher result.