VA Disability Rating for Cold Injury Residuals (DC 7122)
Diagnostic Code 7122 · 38 CFR §4.104
What Is It?
Cold injury residuals are the lasting effects of cold weather injuries such as frostbite, trench foot, or immersion foot that occurred during military service. These injuries damage blood vessels, nerves, and tissues in exposed areas, most commonly the hands and feet. Long-term residuals can include chronic pain, numbness, cold sensitivity, color changes, nail damage, joint stiffness, and skin problems. Each affected extremity is rated separately, so veterans with multiple affected hands and feet can receive multiple ratings. The step from 10 to 20 to 30 percent turns on a list of thirteen findings, and it is worth reading in full because several of them are easy to leave undocumented: tissue loss, nail abnormalities, colour changes, locally impaired sensation, hyperhidrosis, anhydrosis, X-ray abnormalities (osteoporosis, subarticular punched-out lesions, or osteoarthritis), atrophy or fibrosis of the affected musculature, flexion or extension deformity of distal joints, volar fat pad loss in fingers or toes, avascular necrosis of bone, chronic ulceration, and carpal or tarsal tunnel syndrome. One of them alongside pain, numbness or cold sensitivity is 20 percent; two or more is 30 percent. Two Notes matter as much as the list. Note (1) directs that amputations of fingers or toes, and complications such as squamous cell carcinoma at the site of a cold injury scar or peripheral neuropathy, be evaluated separately under other diagnostic codes — and that other disabilities diagnosed as residual effects of cold injury, such as Raynaud’s syndrome (secondary Raynaud’s phenomenon, DC 7117) or muscle atrophy, also be evaluated separately, unless they are being used to support the evaluation under DC 7122 itself. Note (2) directs that each affected part — hand, foot, ear, nose — be evaluated separately and the ratings combined in accordance with 38 CFR 4.25 and 4.26.
Rating Criteria
| Rating | Criteria |
|---|---|
| 30% | 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, anhydrosis, X-ray abnormalities (osteoporosis, subarticular punched-out lesions, or osteoarthritis), atrophy or fibrosis of the affected musculature, flexion or extension deformity of distal joints, volar fat pad loss in fingers or toes, avascular necrosis of bone, chronic ulceration, carpal or tarsal tunnel syndrome. |
| 20% | With the following in affected parts: arthralgia or other pain, numbness, or cold sensitivity plus one of the following — tissue loss, nail abnormalities, color changes, locally impaired sensation, hyperhidrosis, anhydrosis, X-ray abnormalities (osteoporosis, subarticular punched-out lesions, or osteoarthritis), atrophy or fibrosis of the affected musculature, flexion or extension deformity of distal joints, volar fat pad loss in fingers or toes, avascular necrosis of bone, chronic ulceration, carpal or tarsal tunnel syndrome. |
| 10% | With the following in affected parts: arthralgia or other pain, numbness, or cold sensitivity. |
Evidence Needed
- Service medical records documenting the cold injury event — frostbite treatment, trench foot diagnosis, or cold weather exposure
- Current examination findings: sensation testing, skin assessment, nail condition, color changes
- X-rays of affected hands or feet showing any bony changes (osteoporosis, arthritis, punched-out lesions)
- Documentation of cold sensitivity and functional limitations
- Nerve conduction studies if neuropathy is present
- Buddy statements from fellow service members who witnessed the cold exposure event
C&P Exam Tips
- Each hand and foot is rated separately — make sure the examiner evaluates every affected extremity individually
- Point out all residual findings: nail changes, skin discoloration, areas of numbness, tissue loss
- Describe your cold sensitivity — what temperature triggers symptoms, what precautions you must take
- If you have joint pain in affected areas, report it and request X-rays to check for bony changes
- Bring any photos showing your hands or feet during cold exposure reactions
- Buddy statements from people who served with you can help establish the cold exposure event
How to File
File on VA Form 21-526EZ, claiming each affected extremity as a separate condition. Include service records of the cold exposure, current examination findings, X-rays, and buddy statements. The VA has recognized cold injury claims from veterans who served in Korea, Alaska, northern Europe, and other cold environments.
Common Mistakes
Leaving findings off the list The step from 10 to 20 to 30 percent is a count of findings from a list of thirteen, and several of the thirteen — anhydrosis, atrophy or fibrosis of the muscle, flexion or extension deformity of the distal joints, volar fat pad loss, avascular necrosis of bone, chronic ulceration, carpal or tarsal tunnel syndrome — are ones a general examination will not record unless you raise them. Only claiming one extremity when multiple were affected Each hand and foot is rated separately. If frostbite affected both feet and both hands, claim all four extremities individually. Not getting X-rays X-ray abnormalities like osteoporosis or arthritis in the affected areas count as additional findings that increase the rating from 20 to 30 percent. Missing secondary conditions Cold injuries cause multiple separate conditions — Raynaud syndrome, peripheral neuropathy, and arthritis can all be claimed in addition to the cold injury residuals themselves. No documentation of the cold exposure event If service records do not document the specific event, buddy statements and unit records showing deployment to cold environments can establish the exposure.
Frequently Asked Questions
Are all four extremities rated separately?
Yes. Each affected hand and foot receives its own rating. A veteran with frostbite residuals in both feet could receive two separate 20 percent ratings, for example.
What if my service records do not mention frostbite?
You can support your claim with buddy statements from fellow service members, unit deployment records showing service in cold environments, and current medical evidence consistent with past cold injury.
Can I claim both cold injury residuals and Raynaud syndrome?
Yes. Cold injury residuals (DC 7122) and Raynaud syndrome (DC 7117) are separate conditions with different rating criteria. If you have both, file for both.
Is Korean War cold injury service connection presumptive?
Cold injuries from the Korean War era are well-recognized by the VA. While not formally presumptive in the same way as some other conditions, the VA acknowledges the extreme cold conditions of the Korean conflict and these claims are generally well-received.