A pulmonary embolism is a serious medical condition that can have lasting health effects and may qualify veterans for VA disability benefits.
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In this article we explain what a pulmonary embolism is, how the VA assigns a pulmonary embolism VA rating, and commonly related conditions that could qualify you for additional monthly compensation.
Key Takeaways
- The VA rates pulmonary embolisms using diagnostic code 6817 for pulmonary vascular disease.
- Pulmonary embolism VA ratings can be 0%, 30%, 60%, or 100%, depending on whether the condition is chronic or acute and whether it causes symptoms.
- PE is often connected to diabetes, DVT, or even cancer.
In this article about the pulmonary embolism VA rating:
What is a pulmonary embolism?
A pulmonary embolism is a blood clot that blocks the flow of blood to an artery in the lung. Typically, the blood clot starts in a deep vein in the leg and travels to the lung, but it can form elsewhere in the body.
Symptoms of pulmonary embolism can include:
- Shortness of breath even when resting
- Sharp chest pain, especially when taking a deep breath
- Fainting
- Coughing up blood mucus
- Tachycardia or heart palpitations
- Lightheadedness
- Dizziness
- Excessive sweating
- Leg pain or swelling
- Clammy or discolored skin
Pulmonary embolism VA rating
To evaluate and assign a VA disability rating for pulmonary embolism, the VA uses criteria found under diagnostic code 6817 for pulmonary vascular disease.
Potential disability ratings for the condition are 0%, 30%, 60%, or 100%. Ratings are assigned based on whether your condition is chronic or acute and whether or not you experience symptoms.
Pulmonary embolism and related conditions
A pulmonary embolism can develop as a result of another underlying medical condition. Veterans should be aware of these related conditions, as they may qualify for additional VA disability compensation by filing a claim for a secondary service connection.
Pulmonary embolism secondary to deep vein thrombosis
Deep vein thrombosis (DVT) occurs when a blood clot forms in a deep vein, most commonly in the lower legs. Risk factors include long periods of travel with limited movement, smoking, and injuries to a vein.
If a DVT clot breaks loose and travels to the lungs, it can cause a pulmonary embolism, becoming a serious and potentially life-threatening condition.
Veterans with service-connected DVT who later develop a pulmonary embolism as a result may be eligible to receive VA disability compensation for both conditions.
Pulmonary embolism and diabetes
Research suggests patients with diabetes may be more likely to experience pulmonary embolism than those without the condition.
One study found diabetes may also raise the risk of deep vein thrombosis, especially in women. As previously mentioned, when part of a DVT clot breaks loose and moves to the lungs, it can result in a pulmonary embolism.
If you’re a veteran with service-connected diabetes, this is especially important to understand. If you develop a pulmonary embolism linked to your service-connected diabetes, you may be eligible for a VA rating for pulmonary embolism secondary to diabetes.
Pulmonary embolism and cancer
Cancer is another health condition that may increase your risk of pulmonary embolism, especially those with gastrointestinal, pancreatic, and lung cancers.
There are several factors that strongly tie cancer to pulmonary embolism. These include:
- Cancer cells increasing blood clotting
- Effects of certain cancer-treating drugs and surgeries
- Reduced mobility from weakness and fatigue
Veterans exposed to ionizing radiation, burn pits, Agent Orange, and other toxins are also at a higher risk of developing certain types of cancer. According to the VA, over 50,000 cases of cancer are reported annually.
Veterans who are diagnosed with service-connected cancer and develop pulmonary embolisms as a result may be eligible for a pulmonary embolism VA rating secondary to cancer.
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VA TDIU for pulmonary embolism
In some cases, a veteran may be awarded total disability based on individual unemployability (TDIU) for chronic issues with their vascular system and pulmonary embolisms. TDIU is also known as individual unemployability or simply IU. Veterans are eligible for these benefits if they can’t hold down “substantially gainful” employment due to their service-connected conditions.
Veterans who receive TDIU benefits are compensated at the same level as those with a 100% disability rating, even though their combined rating is below 100%.
Veterans will typically be eligible for TDIU if they have:
- At least one service-connected disability rated at 60% or more disabling OR
- Two or more service-connected disabilities with at least one rated at 40% or more disabling and a combined rating of 70% or more
How Woods & Woods can help
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Frequently asked questions
To evaluate a VA disability rating for pulmonary embolism, the VA uses criteria under diagnostic code 6817 pulmonary vascular disease. Ratings for the condition can be 0%, 30%, 60%, or 100%, depending on whether your condition is acute or chronic, and whether you experience symptoms.
Veterans may be at a greater risk of developing a pulmonary embolism if they have deep vein thrombosis (DVT), diabetes, or cancer. Veterans who smoke, are obese, live sedentary lifestyles, or had COVID-19 may also be more likely to develop blood clots.
Neil Woods
Neil Woods is a VA disability attorney and the owner and president of Woods & Woods. He received his law degree from Western Michigan University.
