VA Disability Rating for Thrombo-Angiitis Obliterans / Buerger Disease (DC 7115)
Diagnostic Code 7115 · 38 CFR §4.104
What Is It?
Thrombo-angiitis obliterans, also known as Buerger disease, is an inflammatory condition that causes blood clots and swelling in small and medium arteries and veins, primarily in the hands and feet. It is strongly associated with tobacco use. The condition restricts blood flow, causing pain, tissue damage, and in severe cases gangrene and amputation. Veterans who developed this condition during service or as a result of service-related tobacco dependence may be eligible for compensation. DC 7115 splits by limb, and the two halves work differently. For a lower extremity the code prints one line — rate under DC 7114, peripheral arterial disease — so a leg or foot is evaluated on ankle/brachial index, ankle pressure, toe pressure or transcutaneous oxygen tension, on the bands set out on that code. For an upper extremity the code gives its own four evaluations, and they are read off physical findings rather than pressure measurements: ischemic ulcers and necrosis of the fingers, persistent coldness of the extremity, trophic changes, pain in the hand during physical activity, numbness and paresthesia at the fingertips, and diminished upper extremity pulses. Note (1) makes each evaluation a single extremity — where more than one is affected, each is evaluated separately and combined under 38 CFR 4.25, with the bilateral factor at 38 CFR 4.26 where it applies. Note (2) defines trophic changes: skin changes such as thinning, atrophy, fissuring, ulceration, scarring and absence of hair, as well as nail changes such as clubbing and deformities. The code prints no 0 percent row, so where the criteria are not met 38 CFR 4.31 assigns 0.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Upper extremity: deep ischemic ulcers and necrosis of the fingers with persistent coldness of the extremity, trophic changes with pains in the hand during physical activity, and diminished upper extremity pulses. (A lower extremity is rated under DC 7114.) |
| 60% | Upper extremity: persistent coldness of the extremity, trophic changes with pains in the hands during physical activity, and diminished upper extremity pulses. (A lower extremity is rated under DC 7114.) |
| 40% | Upper extremity: trophic changes with numbness and paresthesia at the tips of the fingers, and diminished upper extremity pulses. (A lower extremity is rated under DC 7114.) |
| 20% | Upper extremity: diminished upper extremity pulses. (A lower extremity is rated under DC 7114.) |
Evidence Needed
- For a lower extremity: ankle/brachial index, ankle pressure, toe pressure or transcutaneous oxygen tension results — the DC 7114 bands are what a leg or foot is rated on
- For an upper extremity: examination findings recording persistent coldness, trophic changes, pain in the hand during activity, numbness or paresthesia at the fingertips, and the state of the upper extremity pulses
- Angiography or CT angiography showing the characteristic segmental blockages
- Photos or records of trophic skin changes, ulcers, or gangrene
- Records of any amputations related to the condition
- Smoking history documentation and service medical records
- Nexus opinion linking the condition to military service
C&P Exam Tips
- For a leg or foot, make sure ankle/brachial index testing is performed and the number recorded — a lower extremity is rated on the DC 7114 bands
- For a hand or arm, make sure the examiner records whether your upper extremity pulses are diminished — that finding alone carries the 20 percent evaluation, and it appears in all four
- Show and have the examiner document any trophic changes — skin thinning, atrophy, fissuring, ulceration, scarring, absence of hair, and nail clubbing or deformity
- Report any ulcers, past or present, and any amputations or tissue loss
- Be prepared to discuss your smoking history, as this is a significant factor in the diagnosis
How to File
File on VA Form 21-526EZ with vascular studies, imaging, and a nexus letter. Say which limbs are affected: a lower extremity is rated under DC 7114 on ankle/brachial index, ankle pressure, toe pressure or transcutaneous oxygen tension, while an upper extremity is rated on DC 7115's own findings. Include any tissue damage and all circulation test results. If amputations were required, file those separately under the amputation codes.
Common Mistakes
Not getting ankle/brachial index testing for an affected leg A lower extremity is rated under DC 7114, which is scored on the measured index, ankle pressure, toe pressure or transcutaneous oxygen tension. Request the testing before filing. Arguing an upper extremity on walking distance The upper extremity evaluations turn on ischemic ulcers, persistent coldness, trophic changes, fingertip numbness and diminished pulses — walking distance appears nowhere in the code. Not photographing trophic changes Skin thinning, hair loss, nail changes, and ulcers support a higher rating. Take dated photos and have them entered into your medical record.
Frequently Asked Questions
Is Buerger disease related to smoking during military service?
The condition is strongly linked to tobacco use. If you began smoking during service or your tobacco dependence was related to service, this connection may support your claim.
What if I need an amputation?
Amputations from Buerger disease are rated separately under the amputation codes, which typically provide significant ratings. You can be rated for both the vascular disease and any resulting amputations. Note (1) to DC 7115 also makes each extremity a separate evaluation: where more than one limb is affected, each is evaluated on its own and the results are combined under 38 CFR 4.25, with the bilateral factor at 38 CFR 4.26 where it applies.
Can the condition improve if I stop smoking?
Stopping tobacco use is the most important step and can halt progression, but existing damage is usually permanent. Your rating is based on current residual disability.