Post-Thrombotic Syndrome (Post-Phlebitic Syndrome)
Post-thrombotic syndrome is chronic leg swelling, pain, skin changes, and sometimes ulcers that develop after a deep vein thrombosis (blood clot) damages the vein. VA rates it per affected leg on edema, skin changes, and ulceration.
How the VA rates it
Rated under DC 7121, which the regulation titles 'Post-phlebitic syndrome of any etiology' (post-thrombotic syndrome is the modern clinical name). The findings must be attributed to venous disease. Tiers run from 0 percent for asymptomatic visible veins to 100 percent for massive board-like edema with constant pain at rest. Each affected extremity is rated separately and combined, with the bilateral factor when both legs are involved.
Rating criteria by percentage
Rated up to 100%Massive board-like edema with constant pain at rest, attributed to venous disease.
Persistent edema or subcutaneous induration, stasis pigmentation or eczema, and persistent ulceration.
Persistent edema and stasis pigmentation or eczema, with or without intermittent ulceration.
Persistent edema that is not completely relieved by elevating the leg, with or without beginning stasis pigmentation or eczema.
Intermittent edema, or aching and fatigue in the leg after prolonged standing or walking, relieved by elevation or compression hosiery.
Asymptomatic palpable or visible varicose veins.
Secondary condition strategy
Commonly claimed secondary to this
Conditions veterans often develop from this one — each can be its own rating under 38 CFR 3.310.
- Pulmonary embolism residuals — A DVT that throws a clot to the lungs can leave respiratory residuals, rated separately under the respiratory schedule.
This is often secondary to
If you already have one of these service-connected, it may support connecting this condition.
- Knee Replacement — DVT is a known complication of joint replacement and other lower-extremity surgery; post-thrombotic syndrome is commonly claimed secondary to service-connected knee or hip surgery.
- Immobilization after orthopedic injury — Casting, bed rest, or immobility from service-connected injuries can cause DVT and later post-thrombotic syndrome.
Evidence that strengthens this claim
- Link the syndrome to a documented DVT - submit the ultrasound or hospital records from the original clot, especially if it followed a service-connected surgery or injury.
- Document whether leg swelling persists despite elevation - that distinguishes 20 percent from 10 percent.
- Have your provider chart stasis pigmentation, hardened skin, and any ulcers, and photograph them - these findings drive the 40 and 60 percent tiers.
- If both legs are affected, insist each is rated separately with the bilateral factor applied.
Rating rules to know
Ratings are per extremity; combine multiple extremities under 38 CFR 4.25 with the bilateral factor (38 CFR 4.26) if applicable. Painful surgical scars from vein procedures can be rated separately under DC 7804.
Related diagnostic codes
More heart & circulatory conditions
Hypertension (High Blood Pressure)
Hypertension is chronically elevated blood pressure. VA rates it on your actual documented blood pressure readings, with a minimum 10 percent rating for veterans who need continuous medication and have a history of diastolic pressure of 100 or more.
Rated up to 60%
Coronary Artery Disease (Ischemic Heart Disease)
Coronary artery disease is narrowing of the heart's arteries that limits blood flow. VA rates it under the General Rating Formula for Diseases of the Heart, based on the exercise workload (in METs) at which heart failure symptoms appear.
Rated up to 100%
Varicose Veins
Varicose veins are enlarged, twisted veins, usually in the legs, that can cause aching, swelling, skin changes, and ulcers. VA rates them per affected leg based on edema, skin changes, and ulceration.
Rated up to 100%
Atrial Fibrillation (AFib)
Atrial fibrillation is an irregular, often rapid heart rhythm. VA rates it under DC 7010 (supraventricular tachycardia) based on how many treatment interventions you need per year, with a maximum schedular rating of 30 percent.
Rated up to 30%
Disclaimer: Valor Rating is not affiliated with the U.S. Department of Veterans Affairs. This content is for educational purposes only and does not constitute legal or medical advice. Always review your documents carefully before submitting to the VA. For official guidance, consult an accredited VSO, claims agent, or attorney.