- Diagnostic Code
- 7121
- CFR Section
- §4.104 — Cardiovascular
Rating Tiers
Massive board-like edema with constant pain at rest
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, incompletely relieved by elevation of extremity, with or without beginning stasis pigmentation or eczema
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
Asymptomatic palpable or visible varicose veins
Rated Under Formula
This condition is rated using the §4.104 general rating formula.
Workload of 3.0 METs or less results in heart failure symptoms
Workload of 3.1-5.0 METs results in heart failure symptoms
Workload of 5.1-7.0 METs results in heart failure symptoms; or evidence of cardiac hypertrophy or dilatation confirmed by echocardiogram or equivalent (e.g., multigated acquisition scan or magnetic resonance imaging)
Workload of 7.1-10.0 METs results in heart failure symptoms; or continuous medication required for control
What Raters Look For
Based on M21-1 adjudication criteria for Cardiovascular conditions. These are the factors a VA rater evaluates when assigning a rating percentage.
M21-1 III.iv.4.C- •Ejection fraction percentage from echocardiogram or MUGA scan
- •Exercise tolerance in METs from stress test results
- •NYHA functional class (I–IV) documented in treatment records
- •Arrhythmia type, documented frequency, and whether it requires intervention
- •Workup findings: EKG, Holter monitor, echocardiogram, cardiac catheterization
- •Episodes of heart failure, hospitalizations, or emergency care
- •Current medications and whether the condition is controlled or progressive