We’ve reviewed files where the leg pain, cold feet, and trouble walking were documented again and again, but the rating still came back low because the vascular test results were missing or incomplete. The symptoms were real. The problem was that the file never showed the ABI, ankle pressure, toe pressure, or oxygen measurement VA uses under the current rating criteria.
A note that says “abnormal circulation” may confirm there is a problem, but it does not tell a rater which percentage the test results support.
A peripheral vascular disease VA rating for peripheral arterial disease is assigned under DC 7114 using objective circulation tests such as ABI, ankle pressure, toe pressure, or transcutaneous oxygen measurements. The VA assigns 20%, 40%, 60%, or 100% to each affected extremity based on the test result showing the greatest level of impairment.
How Does VA Determine A Peripheral Vascular Disease VA Rating?
VA rates peripheral arterial disease under DC 7114 using objective measurements of blood flow in the affected extremity. Although people often use peripheral vascular disease and peripheral arterial disease interchangeably, PVD is a broader term. DC 7114 specifically addresses peripheral arterial disease.
A PAD VA disability rating may be based on any of these measurements:
- Ankle brachial index. ABI compares the systolic blood pressure at the ankle with the pressure in the arm.
- Ankle pressure. This is the systolic blood pressure measured directly at the ankle.
- Toe pressure. This measures systolic pressure at the great toe.
- Transcutaneous oxygen tension. Often written as TcPO2, this test measures oxygen reaching the tissue of the foot.
You don’t have to meet every measurement listed for a rating. One qualifying result can support the evaluation. When several tests are available, VA generally uses the result showing the greatest impairment.
| Rating | At Least One Test Must Show |
|---|---|
| 20% | ABI 0.67 to 0.79, ankle pressure 84 to 99 mm Hg, toe pressure 50 to 59 mm Hg, or TcPO2 50 to 59 mm Hg. |
| 40% | ABI 0.54 to 0.66, ankle pressure 66 to 83 mm Hg, toe pressure 40 to 49 mm Hg, or TcPO2 40 to 49 mm Hg. |
| 60% | ABI 0.40 to 0.53, ankle pressure 50 to 65 mm Hg, toe pressure 30 to 39 mm Hg, or TcPO2 30 to 39 mm Hg. |
| 100% | ABI 0.39 or lower, ankle pressure below 50 mm Hg, toe pressure below 30 mm Hg, or TcPO2 below 30 mm Hg. |
| Normal | ABI 0.80 or higher, ankle pressure at least 100 mm Hg, toe pressure and TcPO2 at least 60 mm Hg. |
Under DC 7114, an ABI of 0.80 or higher is considered normal for rating purposes. Normal ankle pressure is at least 100 mm Hg, while normal toe pressure and TcPO2 are at least 60 mm Hg.
Symptoms still matter. Leg pain, heaviness, coldness, weakness, wounds, and difficulty walking show what poor circulation changes in daily life. They do not replace the objective measurement used to assign the percentage.
Older claudication VA rating guides may still use walking distance, diminished pulses, trophic changes, persistent coldness, or ulcers to distinguish the rating levels. Those are legacy DC 7114 criteria. The current schedule, effective since November 2021, uses objective vascular measurements instead.
What If ABI Does Not Show The Full Severity Of Your PVD?
ABI is often the first number people recognize, but it is not the only test VA can use.
Sometimes ABI does not fully reflect the severity of peripheral arterial disease. When that happens, the examiner may explain that ankle pressure, toe pressure, or TcPO2 testing is needed to show the circulation problem more accurately.
This is why the actual vascular report matters.
A note that says only “abnormal ABI” leaves out the number VA needs. The record should show:
- The exact result
- The date of testing
- Whether the measurement belongs to the right or left side
- Whether ABI accurately reflects the severity of the disease
- Any additional ankle pressure, toe pressure, or TcPO2 results
The current Artery and Vein Conditions DBQ records right and left ABI separately. It also provides space for ankle pressure, toe pressure, and TcPO2 when those measurements are available or clinically necessary.
When each leg has a compensable disability, the bilateral factor may also apply. VA combines the evaluations rather than simply adding the percentages together.
A report that lists only one overall result can create a problem when the disease is bilateral. The evidence should make the right and left findings easy to identify.
Can Peripheral Vascular Disease Be Secondary To Diabetes?
Yes. Peripheral vascular disease secondary to diabetes may qualify when medical evidence shows that service connected diabetes caused or aggravated the vascular disease.
The diagnosis alone does not establish the connection. The nexus opinion should address the history of diabetes, vascular testing, other risk factors, and why causation or aggravation is medically supported in the individual record. VA recognizes secondary service connection when one service connected disability causes or aggravates another condition.
Type 2 diabetes may support a secondary pathway when the medical evidence connects it to the vascular disease. Compensable complications of diabetes can be evaluated separately when they aren't already part of the criteria supporting a 100% diabetes rating.
Long term hypertension may also be relevant, but the relationship isn't automatic. The medical opinion should explain how hypertension caused or aggravated the arterial disease in that particular file.
A service connected cold injury may provide another pathway when the evidence shows lasting vascular damage related to the injury.
The record should explain whether the vascular disease is medically connected to the service connected heart condition rather than relying only on the fact that both involve the circulatory system.
Type 2 diabetes is an Agent Orange presumptive condition for veterans who meet the qualifying service requirements. Peripheral arterial disease itself is not currently on VA’s Agent Orange presumptive list, so it still needs its own service connection pathway.
What Evidence Does A Peripheral Vascular Disease Claim Need?
A strong PVD claim should show the diagnosis, the vascular measurements for each affected extremity, and the correct path to service connection.
Confirmed diagnosis. The record should identify peripheral arterial disease or the specific vascular condition being claimed.
Objective testing for each side. Include the complete vascular study with the actual ABI, ankle pressure, toe pressure, or TcPO2 result. The report should make clear which measurement belongs to the right side and which belongs to the left.
Explanation when ABI is unreliable. If ABI does not accurately reflect the severity of the disease, the examiner should explain why another vascular measurement is needed.
Service connection evidence. Include records showing that the vascular disease began during service or a medical opinion explaining how another service connected condition caused or aggravated it.
Functional impact. Document how pain, weakness, coldness, wounds, reduced walking tolerance, assistive devices, or treatment affect daily activity and work. These effects do not replace the DC 7114 test criteria, but they help show the full disability picture.
Bring the complete vascular study to your C&P exam, not only a note stating that the result was abnormal. The examiner should be able to see the exact measurement, the date, and which extremity was tested.
An Artery and Vein Conditions DBQ can document ABI, ankle pressure, toe pressure, TcPO2 results, procedures, assistive devices, loss of use, and occupational impact.
Can Severe PVD Qualify For Special Monthly Compensation?
Severe service connected vascular disease may support Special Monthly Compensation (SMC) when it causes the anatomical loss or loss of use of a foot.
Loss of use is a much higher standard than pain, limited walking, or needing a cane. VA looks at whether effective function remains for balance and propulsion or whether an amputation with a suitable prosthesis would serve equally well.
The current vascular DBQ asks whether an extremity has become so functionally impaired that no effective function remains beyond what an amputation with a prosthesis would provide. It also asks whether a vascular condition caused an amputation.
How VetClaims Reviews A PVD Claim
We do not review a peripheral vascular disease VA rating by looking only at the diagnosis or the symptom list.
We check the actual vascular measurements for each affected extremity, identify which result supports the highest rating, and look for cases where ABI does not fully reflect the severity of the disease.
We also verify that both affected legs were evaluated. In some files, the report includes right and left findings, but the decision addresses only one side.
The gap is often straightforward: the record says “abnormal circulation,” but the number VA needs is missing.
We also review whether diabetes, cold injury, or another service connected condition may support a secondary path and whether the medical evidence explains causation or aggravation clearly.
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FAQs About Peripheral Vascular Disease VA Ratings
What ankle-brachial index do I need for a compensable rating?
Under the current DC 7114, the minimum 20 percent rating requires an ABI of 0.67 to 0.79 (or an ankle pressure of 84 to 99 mm Hg, a toe pressure of 50 to 59 mm Hg, or a TcPO2 of 50 to 59 mm Hg). A lower result raises the rating: roughly 0.54 to 0.66 for 40 percent, 0.40 to 0.53 for 60 percent, and 0.39 or lower for 100 percent. An ABI of 0.80 or higher is normal for rating purposes.
Is peripheral vascular disease the same as peripheral neuropathy?
No, and the difference matters for your claim. PVD is a circulation problem in the arteries, rated under DC 7114 on objective vascular testing such as ABI, ankle pressure, toe pressure, or TcPO2. Peripheral neuropathy is nerve damage rated under separate nerve codes. Both can cause leg pain, and a veteran can be rated separately for each.
Is peripheral vascular disease an Agent Orange presumptive?
Not on its own. PVD usually reaches Agent Orange through diabetes or ischemic heart disease, both of which are presumptive, so the vascular disease can be claimed secondary to one of those service-connected conditions.
What if the VA folded my PVD into my diabetes rating?
PVD can be rated separately from diabetes when it meets the DC 7114 criteria on its own, meaning a qualifying ABI, ankle pressure, toe pressure, or TcPO2 result for the affected leg. If it was bundled into the diabetes rating, a separate evaluation can be pursued as long as the same symptoms are not counted twice.
Can peripheral vascular disease qualify for TDIU?
It can. Severe PVD that limits how far you can walk or stand weighs on a TDIU claim, especially after an amputation or when combined with other ratings. TDIU pays at the 100 percent rate when service-connected conditions keep you from steady work.