Diagnostic Code 6818 · 38 CFR §4.97
A pulmonary embolism (PE) occurs when a blood clot travels to the lungs and blocks blood flow through the pulmonary arteries. Veterans who have experienced a PE may have lasting damage to lung tissue or develop chronic pulmonary hypertension as a result. The VA rates residuals of PE based on the ongoing impact on pulmonary function after the acute event has resolved. This is particularly relevant for veterans who developed blood clots during or after service, including those with prolonged immobility during deployments or post-surgical complications.
| Rating | Criteria |
|---|---|
| 0% | PE has fully resolved with no measurable residual impairment on pulmonary function testing and no ongoing symptoms. |
| 30% | Residual impairment shown on pulmonary function tests with mild to moderate reduction in lung capacity. Veteran experiences some exertional dyspnea with moderate activity. |
| 60% | Significant residual pulmonary impairment with markedly reduced exercise tolerance. PFT results show substantial deficits in FEV-1 or DLCO. May require ongoing anticoagulation therapy. |
| 100% | Severe residual damage causing chronic respiratory failure, cor pulmonale (right heart failure), or requiring continuous oxygen therapy. Essentially incapacitating. |
Medical records documenting the initial PE event and its connection to service. Current pulmonary function tests (PFTs) showing residual impairment. CT pulmonary angiography or echocardiogram showing chronic changes. Records of ongoing anticoagulation therapy. Buddy statements describing functional limitations.
Yes, if you can establish a nexus. Many veterans develop PEs secondary to other service-connected conditions, post-surgical complications, or conditions causing prolonged immobility. A medical nexus opinion linking your PE to service or a service-connected condition is key.
Ongoing anticoagulation therapy is considered a residual of the PE and supports a compensable rating. Document all medications and their side effects.
If your PE caused secondary pulmonary hypertension, you may be rated under either code depending on which criteria better captures your disability. The VA should rate under whichever code provides the higher evaluation.