Diagnostic Code 7114 · 38 CFR §4.104
Peripheral artery disease (PAD) is a circulatory condition where narrowed arteries reduce blood flow to your limbs, most commonly the legs. The primary symptom is claudication — cramping pain in the legs during walking that goes away with rest. As the disease progresses, pain may occur at rest, wounds may heal slowly, and in severe cases tissue death (gangrene) can occur requiring amputation. Veterans may develop PAD as a result of diabetes, hypertension, smoking during service, or exposure to herbicide agents like Agent Orange. The VA rates PAD based on the severity of symptoms and the results of circulation testing.
| Rating | Criteria |
|---|---|
| 20% | You experience claudication (leg cramping with walking) that occurs after walking more than 100 yards and is relieved by rest. An ankle-brachial index (ABI) of 0.9 or lower confirms reduced circulation. |
| 40% | Claudication occurs after walking between 25 and 100 yards. Walking at a normal pace for even short distances causes leg pain that forces you to stop. Treadmill testing or ABI confirms diminished blood flow. |
| 60% | Claudication occurs after walking less than 25 yards, or you have persistent coolness of the affected extremity, loss of hair on the legs, or one or more healed ulcers from poor circulation. ABI is significantly reduced. |
| 100% | Ischemic rest pain — your legs hurt even when you are not walking. You may have non-healing ulcers, tissue loss, or gangrene. You may have already undergone or been recommended for amputation or bypass surgery. |
An ankle-brachial index (ABI) test — a simple comparison of blood pressure in your arm versus your ankle — is the primary diagnostic evidence. An ABI below 0.9 indicates PAD. Additional testing may include Doppler ultrasound, CT angiography, or MR angiography to visualize the blockages. Treatment records showing medications (blood thinners, statins, antiplatelet drugs), procedures (angioplasty, stenting, bypass grafting), and wound care for circulation-related ulcers document severity. If PAD is secondary to diabetes or hypertension, include a nexus opinion. If claiming under Agent Orange presumptive, provide qualifying service evidence.
About the length of a football field, or roughly one city block. If you have to stop to rest your legs before walking a full block, you are likely in the 40% or higher range. If you can walk several blocks before leg pain starts, you are in the 20% range.
Yes. If both legs are affected by PAD, each leg is rated separately. The bilateral factor (an additional percentage added for conditions affecting both limbs) may also apply, increasing your combined rating.