Varicose Veins

1. What This Condition Is

Varicose veins are enlarged, twisted veins that develop when the valves inside the veins weaken or fail, allowing blood to pool and pressure to build in the vessel walls. They most commonly appear in the legs and feet, where the effects of gravity and the demands of prolonged standing and walking are greatest. Symptoms range from cosmetic concerns and mild aching to significant pain, swelling, heaviness in the legs, skin changes, and in advanced cases, chronic venous insufficiency, skin ulceration, and thrombophlebitis.

Veterans develop varicose veins from the physical demands of military service: years of standing in formation, marching in boots on hard surfaces, carrying heavy loads, and working in conditions that require sustained time on the feet. The pathophysiology is consistent — repeated venous valve stress from prolonged standing and impact leads to valve incompetence and venous dilation.

Varicose veins are one of the most commonly overlooked compensable VA conditions. Most veterans with symptomatic varicose veins have never filed a claim, either because they do not know the condition is ratable or because they assumed it was cosmetic rather than a service-connected disability. Symptomatic varicose veins — particularly those producing swelling, pain, and skin changes — can reach 20-100% under the VA schedule and carry meaningful disability ratings.

2. VA Rating Criteria

Varicose veins are rated under 38 CFR § 4.104, Diagnostic Code 7120 (Varicose Veins).

The rating is bilateral — each leg with varicose veins may be evaluated separately. If both legs are affected and service-connected, the bilateral factor under 38 CFR 4.26 applies to the combined rating.

The rating formula distinguishes between edema, stasis changes (skin thickening, discoloration, and dermatitis from chronic venous insufficiency), ulceration, and lymphedema as objective markers of severity. Veterans with persistent edema and beginning stasis changes — which may appear as skin darkening around the ankles, skin thickening, or mild venous dermatitis — reach the 20% threshold. Veterans with recurrent ulceration or marked stasis changes, or those with significant lymphedema, can reach 40%.

Under DeLuca v. Brown, 8 Vet. App. 202 (1995), the VA must consider functional loss from pain, weakness, and fatigability — not just the clinical appearance of the veins. If your varicose veins cause pain with prolonged standing that limits your occupational or recreational function, that functional loss is ratable alongside the clinical findings.

3. What to Expect at Your C&P Exam

The examiner will inspect both legs for visibly enlarged, tortuous veins. They will assess for pitting edema (pressing a finger into the skin to see if the indentation persists), skin changes (hyperpigmentation, thickening, atrophy), and any active or healed ulcers.

Be prepared to describe your symptoms with specificity. Tell the examiner whether your legs swell during the day and whether the swelling resolves overnight or persists. Describe pain or heaviness with standing, and at what point during a workday or activity the symptoms appear. Tell the examiner if you have had any venous ulcers, how often they occur, and how long they take to heal.

If you have received treatment — compression stockings, sclerotherapy, ablation procedures, or surgical stripping — describe the history and whether treatment fully resolved your symptoms or only partially controlled them. Residual symptoms after treatment remain ratable.

Describe how your varicose veins limit your ability to stand for prolonged periods, walk distances, or perform job duties. If you have had to change jobs or reduce hours because of leg pain or swelling, document that history.

4. Evidence You Need to Win

Diagnosis: Physician documentation of varicose veins — either clinical diagnosis by a physician or vascular ultrasound (duplex Doppler) confirming venous valve incompetence and reflux. The vascular ultrasound is the most objective diagnostic tool and identifies which specific venous segments are diseased and the severity of reflux.

Nexus Letter: A vascular surgeon, phlebologist, or primary care physician must connect your varicose veins to military service. The letter must describe the in-service physical demands (prolonged standing, marching, load-bearing) that contributed to venous valve failure, describe the current diagnosis, and state "at least as likely as not" that military service caused or significantly contributed to the development of varicose veins. The letter must meet Barr v. Nicholson adequacy standards.

DBQ Form: VA Form 21-0960A-3 (Peripheral Vascular Disease) or the vascular conditions DBQ. Your treating physician or vascular specialist should complete this form with current clinical findings, edema documentation, skin change assessment, and a nexus opinion.

Edema and Skin Change Documentation: Medical records documenting the presence and severity of leg edema and venous stasis changes (skin discoloration, lipodermatosclerosis, stasis dermatitis). Photographs of visible varicosities, skin changes, or ulcers may be submitted with the claim.

Ulcer Documentation: If you have had venous stasis ulcers, records documenting each occurrence, the size, duration, and treatment are required to support the 40% rating level.

Personal Statement: Describe the specific functional limitations from your varicose veins: how long you can stand before pain forces you to stop, whether your legs swell every day, how the condition affected your ability to perform military duties, and how it now affects your civilian employment and daily activities.

Buddy Statements (VA Form 21-10210): Supervisors, co-workers, or family members who have observed your functional limitations from leg pain and swelling provide lay corroboration of symptom impact.

5. Secondary Conditions to Consider

Venous Stasis Ulcers: Recurrent or persistent venous ulcers from advanced varicose veins are captured within the 40% rating criteria, but severe or chronic ulceration may also support ratings for secondary skin conditions or wound care complications.

Chronic Venous Insufficiency (CVI): When varicose vein disease advances to the point of persistent venous insufficiency with irreversible skin changes, CVI may be separately evaluated or may increase the rating under DC 7120 to the 40% level.

Lymphedema: Chronic venous insufficiency can impair lymphatic drainage over time, producing secondary lymphedema. Lymphedema is separately ratable under DC 7120 at the 40% level when combined with other stasis changes.

Cellulitis: Venous stasis ulcers and skin breakdown from varicose vein disease can lead to recurrent cellulitis. Secondary bacterial infections requiring antibiotic treatment are a complication of advanced varicose vein disease.

Depression and Anxiety: Chronic leg pain, functional limitation, and the cosmetic and social burden of varicose vein disease contribute to secondary mood disorders in some veterans.

Lower Back and Hip Conditions: Altered gait mechanics from chronic leg pain can increase stress on the lumbar spine and hips. If service-connected varicose veins contribute to secondary musculoskeletal conditions, those may be separately ratable.

6. Common Mistakes That Kill Claims

Never filing because the condition seems cosmetic. Varicose veins are not cosmetic when they produce edema, pain, stasis changes, or ulcers. Even mild varicose veins with valve incompetence meet the 10% threshold. Veterans who have never filed because they assumed the condition was not compensable may be leaving significant retroactive benefits behind.

Not getting a vascular ultrasound. A visual inspection by a C&P examiner who sees small veins may lead to a 0% rating. A duplex Doppler ultrasound documenting venous valve incompetence and reflux provides objective evidence of disease severity that the clinical exam cannot replicate. Obtain the ultrasound before the C&P exam.

Not documenting edema and stasis changes. The distinction between 10% and 20% hinges on persistent edema and beginning stasis changes. These findings should be documented by a physician in your medical record — not merely described by you at the exam. Bring records from primary care or vascular surgery documenting edema and skin changes.

Missing bilateral claims. If both legs are affected, both should be claimed. A veteran with unilateral varicose veins rated at 20% who also has varicose veins in the other leg is receiving half the compensation they may be entitled to.

Failing to claim the bilateral factor. When both lower extremities are service-connected for varicose veins, the bilateral factor under 38 CFR 4.26 adds to the combined rating. Claim it explicitly.

7. FWD Assist Resources

The following FWD Assist HQ books are directly relevant to a varicose veins claim:

• C&P Exam Prep Guide — covers vascular condition exams and how to describe edema, skin changes, and functional limitations for the rating formula
• Nexus Letters Guide — how to brief a vascular surgeon or primary care physician to produce a nexus letter connecting venous disease to the physical demands of military service
• Secondary Conditions Guide — covers venous stasis complications and what downstream conditions may be ratable from a service-connected vascular condition
• Back, Knee, and Joint Claims Guide — relevant for veterans whose gait compensation from varicose vein pain has produced secondary musculoskeletal conditions

All titles are available at fwdassisthq.com.

8. Get Help Without a Claim Shark

Free, accredited help is available through Veterans Service Organizations including the DAV, VFW, American Legion, and AMVETS. County Veterans Service Officers (CVSOs) file and manage claims at no cost.

Charging upfront fees to assist with a VA claim is illegal under 38 U.S.C. § 5905. VA-accredited attorneys and claims agents may charge fees only after an initial VA decision, capped at 20% of past-due benefits under 38 U.S.C. § 5904. No legitimate representative asks for money before your first decision.

Verify accreditation at va.gov/ogc/accreditation.asp.