VA Disability Rating for Post-Phlebitic Syndrome (DC 7121)
Diagnostic Code 7121 · 38 CFR §4.104
What Is It?
Post-phlebitic syndrome (also called post-thrombotic syndrome) is a long-term complication that develops after a deep vein thrombosis (DVT). After a blood clot damages the valves inside a vein, blood can no longer flow efficiently back to the heart, causing chronic pooling in the affected leg. This results in persistent swelling, pain, skin discoloration, and in severe cases skin breakdown and ulceration. Veterans who had a DVT during or related to military service can develop this chronic condition months or years later. DC 7121 covers post-phlebitic syndrome of any etiology, and every one of its six evaluations opens with the same condition — the findings must be attributed to venous disease. It is also the destination for DC 7120, varicose veins, whose own entry in 38 CFR 4.104 carries an empty rating cell and one line of instruction: evaluate under diagnostic code 7121. A Note to the code makes each evaluation a single extremity: where more than one extremity is involved, each is evaluated separately and the results combined under 38 CFR 4.25, with the bilateral factor at 38 CFR 4.26 where it applies.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Massive board-like edema with constant pain at rest. |
| 60% | Persistent edema or subcutaneous induration, stasis pigmentation or eczema, and persistent ulceration. |
| 40% | Persistent edema and stasis pigmentation or eczema, with or without intermittent ulceration. |
| 20% | Persistent edema, incompletely relieved by elevation of extremity, with or without beginning stasis pigmentation or eczema. |
| 10% | Intermittent edema of extremity or aching and fatigue in leg after prolonged standing or walking, with symptoms relieved by elevation of extremity or compression hosiery. |
| 0% | Asymptomatic palpable or visible varicose veins. |
Evidence Needed
- Records documenting the original DVT event and treatment
- Venous duplex ultrasound showing chronic venous insufficiency and post-thrombotic changes
- Clinical photographs of leg swelling, skin discoloration, and any ulcers
- Leg circumference measurements documenting persistent edema
- Treatment records for compression therapy, wound care, or surgical interventions
- Service medical records or nexus letter connecting the DVT to military service
C&P Exam Tips
- Show the examiner all affected areas — swelling, skin color changes, hardened skin, any ulcers
- Do not elevate your legs for several hours before the exam so edema is visible
- Describe how your symptoms limit you — standing, walking, wearing certain shoes or pants
- Bring photos showing your leg condition on bad days if the exam happens to fall on a good day
- Make sure the examiner examines and rates each affected leg separately
How to File
File on VA Form 21-526EZ. Include records of the original DVT, current venous ultrasound, photos, and evidence of service connection. If the DVT occurred during hospitalization for a service-connected surgery, file as secondary.
Common Mistakes
Not connecting back to the original DVT Post-phlebitic syndrome requires establishing that you had a DVT first. Include all records of the original clot event. Not documenting skin changes Stasis pigmentation (brownish discoloration) and eczema are specific criteria that distinguish between 20 and 40 percent ratings. Have them documented at every appointment. Claiming only one leg if both had DVTs Like varicose veins, each leg is rated separately. If you had DVTs in both legs, claim each leg individually.
Frequently Asked Questions
How long after a DVT does post-phlebitic syndrome develop?
It can develop within months or take years to appear. Some veterans do not develop symptoms until well after service, but the condition can still be connected to the original in-service DVT.
Is this rated the same as varicose veins?
The rating criteria are nearly identical to varicose veins (DC 7120), using the same edema, skin change, and ulceration measures. The difference is the underlying cause — valve damage from a blood clot rather than primary venous insufficiency.
Are both legs rated separately?
Yes. Each affected leg receives its own rating, just like varicose veins.