Diagnostic Code 7635 · 38 CFR §4.116
An ectopic pregnancy is one that implants outside the uterus — most commonly in a fallopian tube, occasionally in the ovary, cervix, or abdominal cavity. The pregnancy cannot develop normally outside the uterus, and as it grows it can rupture the surrounding tissue, producing internal bleeding that becomes life-threatening within hours. Risk factors that overlap with women veterans include prior pelvic infection (the most common is chlamydia, which often causes silent tubal scarring), prior tubal surgery, prior ectopic pregnancy, in vitro fertilization, and certain forms of contraception. Acute ectopic pregnancy is a surgical emergency typically managed with methotrexate (for early unruptured cases) or with laparoscopic salpingostomy or salpingectomy (for ruptured or larger cases). DC 7635 rates the residuals: the recovery from the acute episode, any chronic pelvic complications, the impact on future fertility, and the psychological sequelae. The VA evaluates the residuals using whichever framework best captures the dominant impairment — chronic pelvic pain may track under residuals of pelvic inflammatory disease (DC 7614), surgical loss of one or both fallopian tubes may be evaluated under DC 7614 or the removal-of-creative-organ pathway, and infertility may support SMC-K under 38 USC 1114(k) for loss of use of a creative organ.
| Rating | Criteria |
|---|---|
| 0% | Resolved ectopic pregnancy with no current residuals, no chronic pelvic pain, no fertility impact, and no ongoing functional limitation. |
| 10% | Mild residuals — occasional pelvic pain, intermittent dyspareunia, or mild scarring on imaging without significant functional impact, OR loss of one fallopian tube without other complications. |
| 30% | Moderate residuals — chronic pelvic pain requiring ongoing treatment, recurring pelvic infections, loss of both fallopian tubes resulting in infertility, OR significant adhesion disease producing functional limitation. |
| 50% | Severe residuals — refractory chronic pelvic pain not controlled by standard treatment, complete loss of reproductive function with severe psychological impact, OR catastrophic surgical complications (massive transfusion residuals, organ loss beyond the reproductive system). |
The original emergency or surgical records documenting the ectopic pregnancy — beta-hCG levels, ultrasound findings, operative report — are foundational. Pathology reports from any surgical removal of the affected tube or ovary confirm what was removed. Pelvic imaging (ultrasound, MRI, or hysterosalpingogram) characterizes current pelvic anatomy and any residual adhesions or scarring. Records of any subsequent fertility workup document the impact on reproduction. Mental health records covering grief, depression, or anxiety following pregnancy loss support secondary psychological claims. Service medical records establishing the in-service event close the nexus when the original ectopic pregnancy occurred during active duty.
Yes when residuals persist. A resolved ectopic pregnancy with no residuals rates at 0%, which still preserves service connection in case later complications develop. Residuals that justify higher ratings include chronic pelvic pain, infertility from loss of one or both tubes, surgical adhesion disease producing ongoing dysfunction, and significant psychological impact. A single in-service episode with residuals can support a permanent rating; the rating reflects the lasting impact, not the brief nature of the original event.
Special Monthly Compensation under 38 USC 1114(k) is paid for "loss of use of a creative organ." Loss of both fallopian tubes — surgically removed during ectopic pregnancy management or non-functional from scarring — produces loss of natural conception capacity and is recognized as loss of use of the reproductive function. SMC-K is paid in addition to the underlying schedular rating, so it should always be requested in addition to the DC 7635 evaluation when this loss has occurred.
Yes when the underlying ectopic pregnancy is service-connected and the depression is medically linked to the loss. The nexus opinion typically frames the depression and complicated grief as secondary to the service-connected reproductive loss. The mental health claim is filed under the appropriate code (DC 9434 major depression, DC 9400 generalized anxiety, etc.) and rated independently from the gynecological condition itself.