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If you’re a veteran dealing with a pulmonary embolism, understanding your VA disability benefits is crucial to getting the compensation you deserve.
A pulmonary embolism, often linked to blood clots blocking arteries in the lungs, can significantly impact your health and daily life.
In this post, we’ll break down the VA disability rating for pulmonary embolism, how to prove service connection, and the steps to file a strong VA claim.
Summary of Key Points
- A pulmonary embolism VA rating ranges from 0% to 100% based on symptom severity and treatment needs, evaluated under DC 6817 for pulmonary vascular disease.
- Service connection can be primary (directly linked to service) or secondary (caused by another service-connected condition, such as deep vein thrombosis).
- Filing a claim online via VA Form 21-526EZ is a convenient option, with C&P exams sometimes required to assess your condition.
What is a Pulmonary Embolism?
A pulmonary embolism (PE) occurs when a blood clot, usually from a deep vein in the leg (deep vein thrombosis, or DVT), travels to the lungs and blocks an artery. It can restrict blood flow, leading to low oxygen levels and potentially damaging organs such as the heart and brain.
Common symptoms include shortness of breath, chest pain that worsens with breathing, coughing (sometimes producing blood), rapid heartbeat, and lightheadedness, which can lead to fainting.
Common causes of a pulmonary embolism include prolonged immobility, surgery, trauma, or conditions like heart disease or cancer.
How a Pulmonary Embolism Affects Veterans
Veterans are at risk for a pulmonary embolism due to traumatic injuries, surgeries from service-related injuries, or extended periods of inactivity during deployments or evacuations following trauma.
The highest risk factor is being wounded in combat, particularly if the veteran experienced amputation.
How the VA Rates a Pulmonary Embolism
A pulmonary embolism VA rating can be 0%, 30%, 60%, or 100%, under diagnostic code (DC) 6817 Pulmonary Vascular Disease. Ratings depend on the condition’s severity, including evidence of hypertension, heart involvement, and ongoing symptoms or treatments.
Pulmonary Embolism VA Rating Chart
| VA Rating | Criteria |
| 100% | Primary pulmonary hypertension, or; chronic pulmonary thromboembolism with evidence of pulmonary hypertension, right ventricular hypertrophy, or cor pulmonale, or; pulmonary hypertension secondary to other obstructive disease of pulmonary arteries or veins with evidence of right ventricular hypertrophy or cor pulmonale |
| 60% | Chronic pulmonary thromboembolism requiring anticoagulant therapy, or; following inferior vena cava surgery without evidence of pulmonary hypertension or right ventricular dysfunction |
| 30% | Symptomatic, following resolution of acute pulmonary embolism |
| 0% | Asymptomatic, following resolution of pulmonary thromboembolism |
Note: Residuals of a pulmonary embolism should be rated under the most appropriate diagnostic code, such as chronic bronchitis (DC 6600) or chronic pleural effusion or fibrosis (DC 6845), but cannot be combined with the pulmonary embolism evaluation.
Proving Service Connection
To receive a pulmonary embolism VA rating, you must prove that your PE is service-connected.
Primary Service Connection
Primary, or direct, service connection applies if your pulmonary embolism occurred during or is directly linked to your military service.
Proving primary service connection requires:
- A current diagnosis of pulmonary embolism, and
- An in-service event, injury, illness, or aggravation, and
- A medical nexus (such as a nexus letter or statement) linking #1 and #2.
Secondary Service Connection
Secondary service connection applies if your PE was caused or aggravated by another service-connected condition, such as deep vein thrombosis, heart disease, or orthopedic issues related to immobility.
Proving secondary service connection requires a current diagnosis of PE, medical evidence, and a nexus linking your PE to an already service-connected condition.
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Pro Tip: It’s highly recommended to get a credible nexus letter for secondary service connection.
How to File a VA Claim for a Pulmonary Embolism
A convenient way to file a VA claim is online, but you can also download and complete VA Form 21-526EZ and submit it:
- By mail
- Through fax
- In person at a VA regional office
See More: The Best Way to File a VA Claim
C&P Exam for Pulmonary Embolism
After you file your claim, you may be asked to attend a compensation and pension (C&P) exam. A C&P exam assesses your PE’s severity and service connection.
The examiner will review your files, ask about symptoms, and may perform additional tests on your heart, lungs, or pulmonary function. As PE affects multiple body systems, you can expect questions about breathing, pain, and the impact on your daily life.
You can use a Disability Benefits Questionnaire (DBQ) for Respiratory Conditions to prepare or have your doctor complete one.
Related: Is a C&P Exam a Good Sign for Your VA Disability Claim?
VA Secondary Conditions to Pulmonary Embolism
A pulmonary embolism can lead to secondary conditions related to the respiratory and cardiovascular systems. Those conditions include:
- Heart strain or right ventricular hypertrophy, which can also be rated under DC 6817 for pulmonary vascular disease
Conclusion
Navigating the VA disability rating system for a pulmonary embolism can be complex, but with proper service records and medical evidence, you have a better chance of securing the VA compensation and benefits you deserve. By proving service connection, you could be eligible for a pulmonary embolism VA rating of 0%, 30%, 60%, or 100%, which could have a significant impact on your life and well-being.
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FAQs | Frequently Asked Questions
Can you get VA disability for pulmonary embolism?
Yes, veterans can receive VA disability for pulmonary embolism if it’s service-connected, either directly from an in-service event or secondary to another service-connected condition, such as deep vein thrombosis. DVT is typically evaluated under DC 7121 Post-phlebitic syndrome of any etiology.
What is the VA rating for pulmonary embolism?
Pulmonary embolism VA ratings range from 0% (asymptomatic) to 100% (impacts heart function and causes pulmonary hypertension) under DC 6817. There are intermediate ratings of 30% and 60% based on symptom severity.
Is pulmonary embolism included in the PACT Act?
No. While the PACT Act expands VA benefits for veterans with toxic exposure, including from burn pits, pulmonary embolism is not considered a presumptive condition. However, it can be secondary to other PACT Act-related conditions, such as deep vein thrombosis or respiratory conditions.
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The Quality Assurance (QA) team at VA Claims Insider has extensive experience researching, fact-checking, and ensuring accuracy in all produced content. The QA team consists of individuals with specialized knowledge in the VA disability claims adjudication processes, laws and regulations, and they understand the needs of our target audience. Any changes or suggestions the QA team makes are thoroughly reviewed and incorporated into the content by our writers and creators.
About the Author
Katie McCarthy
Katie McCarthy is a writer and editor with experience in daily news and digital and print magazine publishing. She honed her editorial (and firearms) skills at Guns & Ammo before helping launch Black Rifle Coffee Company’s Coffee or Die Magazine as the managing editor. She holds degrees in English (BA) and public administration (MPA). Katie is a military spouse and word nerd who enjoys reading, hiking, camping, gardening, and spending time with her family.
