Varicose Veins VA Rating: Diagnostic Code 7120 and 7121 Criteria

Detailed breakdown of each varicose veins rating tier

When a VA rating specialist reviews treatment records and a Compensation and Pension (C&P) examination, the assigned percentage turns on specific clinical findings in the affected extremity.

0 percent non-compensable rating

A 0% rating applies when a veteran has service-connected varicose veins that are palpable or visible on examination, but the condition is asymptomatic—without swelling, leg aching, or fatigue after prolonged standing or walking. While a 0% rating does not pay monthly compensation, it establishes service connection, qualifies the veteran for no-cost VA health care and compression stockings for the condition, and preserves the right to file for an increased evaluation if symptoms progress.

10 percent rating

A 10% rating is warranted when venous disease produces either:

• Intermittent edema of the extremity (swelling in the lower leg, ankle, or foot that comes and goes); or
• Aching and fatigue in the leg after prolonged standing or walking, with symptoms relieved by elevation of the extremity or compression hosiery.

Because the regulation uses “or”, visible swelling is not required for a 10% evaluation if prolonged standing or walking causes leg aching and fatigue relieved by elevating the leg or wearing compression stockings. A single 10% rating pays $180.42 per month for a veteran with no dependents, effective 2025-12-01.

20 percent rating

A 20% rating applies when the limb shows persistent edema, incompletely relieved by elevation of the extremity, with or without beginning stasis pigmentation or eczema.

The key boundary between 10% and 20% is whether swelling resolves with elevation or compression (10%) or remains persistent and incompletely relieved by elevation (20%). Early brownish skin staining or mild scaling dermatitis may be present at 20%, but is not required if persistent edema is documented. A 20% evaluation pays $356.66 per month for a veteran alone.

40 percent rating

A 40% rating requires persistent edema and stasis pigmentation or eczema, with or without intermittent ulceration.

Unlike the 20% tier, the 40% tier requires both persistent edema and established stasis pigmentation (rusty brown hemosiderin discoloration in the lower leg or ankle) or stasis eczema (red, scaling, weeping, or crusted venous dermatitis). This tier also covers veterans who experience intermittent ulceration—venous skin ulcers that open periodically, heal with wound care, and later recur. A 40% rating pays $795.84 per month for a veteran without dependents.

60 percent rating

A 60% rating requires three concurrent findings:

1. Persistent edema or subcutaneous induration (woody hardening and thickening of the skin and subcutaneous tissue, clinically known as lipodermatosclerosis); and
2. Stasis pigmentation or eczema; and
3. Persistent ulceration (chronic venous ulcers that remain continuously present or fail to heal).

Because all three criteria are joined by “and”, advancing from 40% to 60% requires persistent ulceration alongside stasis skin changes and either persistent edema or subcutaneous induration. A 60% rating pays $1,435.02 per month for a veteran alone.

100 percent rating

A 100% rating requires massive board-like edema with constant pain at rest. In this stage of severe chronic venous insufficiency, diffuse fibrosis and fluid congestion leave the limb rigidly swollen (“board-like”) with unremitting pain even while resting or elevating the leg. A 100% evaluation pays $3,938.58 per month for a veteran with no dependents.

Separate extremity ratings and the bilateral factor (38 CFR 4.26)

Under the binding Note to Diagnostic Code 7121 in 38 CFR 4.104, varicose vein evaluations apply to a single extremity. When both the right and left legs are service connected, each leg receives its own percentage rating.

If both lower extremities have compensable service-connected evaluations (10% or higher on each side), 38 CFR 4.26 requires the bilateral factor:

1. Combine the left and right extremity ratings using the Combined Ratings Table in 38 CFR 4.25.
2. Add 10% of that combined value directly to the combined number.
3. Round to the nearest 10% after all service-connected disabilities are combined (values ending in 5 round up).

Examples of bilateral varicose vein math

• 10% right leg + 10% left leg: 10% and 10% combine to 19%. Adding the 10% bilateral factor (1.9) equals 20.9%, which rounds to 20% ($356.66 per month for a veteran alone).
• 20% right leg + 20% left leg: 20% and 20% combine to 36%. Adding the 10% bilateral factor (3.6) equals 39.6%, which rounds up to 40% ($795.84 per month for a veteran alone, instead of rounding down to 30% without the bilateral factor).
• 40% right leg + 40% left leg: 40% and 40% combine to 64%. Adding the 10% bilateral factor (6.4) equals 70.4%, rounding to 70% ($1,808.45 per month for a veteran alone, compared to 60% without the bilateral factor).

Under 38 CFR 4.26(a) and (c), the bilateral factor also applies when a compensable varicose vein rating in one leg pairs with any compensable disability in the opposite leg (such as knee pain or flat feet), but does not apply if one extremity is rated 0% with no other compensable disability on that side.

Establishing service connection for varicose veins

Direct service connection and aggravation

Under 38 CFR 3.303, direct service connection requires a current diagnosis of varicose veins or chronic venous insufficiency, evidence of in-service onset or complaints, and a medical nexus linking the condition to military service. Prolonged standing during watch duty on steel ship decks, guard duty, flight-line or motor-pool maintenance, and heavy ruck marches frequently strain lower-extremity venous valves. Service treatment records noting leg swelling, aching veins, phlebitis, or compression stocking prescriptions support direct service connection. If varicose veins existed before enlistment, a veteran may establish service connection by aggravation under 38 CFR 3.306 if military duty permanently worsened the condition beyond natural progression.

Secondary service connection under 38 CFR 3.310

Under 38 CFR 3.310(a), a veteran may claim varicose veins or post-phlebitic syndrome secondary to an existing service-connected disability when supported by a qualified medical nexus opinion:

• Lower-extremity orthopedic conditions (Knee pain, ankle injuries, or Flat feet): Impaired ankle or knee motion, altered gait, or muscle atrophy may weaken the calf muscle pump that propels venous blood back toward the heart.
• Post-surgical Deep Vein Thrombosis (DVT): A blood clot following surgery or immobilization for a service-connected joint or spine injury can damage deep venous valves and cause post-phlebitic syndrome under Diagnostic Code 7121.
• Weight gain as an intermediate step: Under VAOPGCPREC 1-2017, obesity caused by service-connected mobility limitations or psychiatric medications may serve as an intermediate step if a physician links the resulting venous pressure to varicose veins.

Conversely, service-connected varicose veins may support secondary claims under 38 CFR 3.310 for complications outside the DC 7121 criteria—such as saphenous nerve neuropathy following surgical vein stripping or ablation (rated under 38 CFR 4.124a), deep vein thrombosis, or secondary depression and anxiety (38 CFR 4.130) related to chronic rest pain and ulcer care. Adjudicators apply 38 CFR 4.14 to ensure skin findings already compensated under DC 7121 (stasis eczema and ulceration) are not rated twice.

How the C&P exam and Artery and Vein Conditions DBQ measure varicose veins

During a VA C&P examination, the clinician completes the Artery and Vein Conditions Disability Benefits Questionnaire (DBQ), available on the VA Public Disability Benefits Questionnaires page. For each affected extremity, the examiner records:

1. History and symptom relief: Whether prolonged standing or walking causes aching, fatigue, or intermittent swelling, and whether symptoms are relieved by leg elevation or compression hosiery (10% criteria).
2. Edema and tissue induration: Whether edema is persistent and incompletely relieved by elevation (20%+ criteria), whether subcutaneous induration is present (60% criteria), or whether massive board-like edema with constant pain at rest exists (100% criteria).
3. Stasis skin changes and ulcers: Presence of beginning or established stasis pigmentation, stasis eczema, intermittent ulceration (40% criteria), or persistent ulceration (60% criteria).
4. Prior treatments: History of compression therapy, sclerotherapy, laser or radiofrequency ablation, or vein stripping, along with residual impairment in each limb.

Because venous swelling is often milder in the morning and intermittent ulcers may be healed on exam day, veterans should bring wound-care records, dermatology notes, and compression stocking prescriptions to document chronic findings.

Combining ratings and getting accredited help

After evaluating each extremity and applying the bilateral factor if eligible, the VA combines your varicose vein rating with your other disabilities under 38 CFR 4.25. You can calculate how single-leg or bilateral ratings affect your monthly compensation using our VA combined rating calculator.

If you need help filing a claim or appealing an evaluation, consider working with a VA-accredited representative. Accredited Veterans Service Organizations (VSOs)—such as the DAV, VFW, and American Legion—provide assistance free of charge, and accredited claims agents or attorneys can assist with appeals. No representative can guarantee a specific rating or outcome. Verify credentials through the official VA Office of General Counsel Accreditation Search.