| Description | Rating |
|---|---|
| 7114 Peripheral arterial disease: | |
| At least one of the following: Ankle/brachial index less than or equal to 0.39; ankle pressure less than 50 mm Hg; toe pressure less than 30 mm Hg; or transcutaneous oxygen tension less than 30 mm Hg | 100 |
| At least one of the following: Ankle/brachial index of 0.40-0.53; ankle pressure of 50-65 mm Hg; toe pressure of 30-39 mm Hg; or transcutaneous oxygen tension of 30-39 mm Hg | 60 |
| At least one of the following: Ankle/brachial index of 0.54-0.66; ankle pressure of 66-83 mm Hg; toe pressure of 40-49 mm Hg; or transcutaneous oxygen tension of 40-49 mm Hg | 40 |
| At least one of the following: Ankle/brachial index of 0.67-0.79; ankle pressure of 84-99 mm Hg; toe pressure of 50-59 mm Hg; or transcutaneous oxygen tension of 50-59 mm Hg | 20 |
| GENERAL RATING FORMULA FOR DISEASES OF THE HEART: | |
| During and for three months following myocardial infarction, confirmed by laboratory tests | 100 |
| Thereafter, use the General Rating Formula | |
| Workload of 3.0 METs or less results in heart failure symptoms | 100 |
| Workload of 3.1-5.0 METs results in heart failure symptoms | 60 |
| Workload of 5.1-7.0 METs results in heart failure symptoms; or evidence of cardiac hypertrophy or dilatation confirmed by echocardiogram or equivalent (e.g., multigated acquisition scan or MRI) | 30 |
| Workload of 7.1-10.0 METs results in heart failure symptoms; or continuous medication required for control | 10 |
Note (1): The ankle/brachial index (ABI) is the ratio of the systolic blood pressure at the ankle divided by the simultaneous brachial artery systolic blood pressure. For the purposes of this diagnostic code, normal ABI will be greater than or equal to 0.80. The ankle pressure (AP) is the systolic blood pressure measured at the ankle. Normal AP is greater than or equal to 100 mm Hg. The toe pressure (TP) is the systolic blood pressure measured at the great toe. Normal TP is greater than or equal to 60 mm Hg. Transcutaneous oxygen tension (Tc PO2) is measured at the first intercostal space on the foot. Normal Tc PO2 is greater than or equal to 60 mm Hg. All measurements must be determined by objective testing.
Note (2): If AP, TP, and Tc PO2 testing are not of record, evaluate based on ABI unless the examiner states that an AP, TP, or Tc PO2 test is needed in a particular case because ABI does not sufficiently reflect the severity of the veteran’s peripheral arterial disease. In all other cases, evaluate based on the test that provides the highest impairment value
Note (3): Evaluate residuals of aortic and large arterial bypass surgery or arterial graft as peripheral arterial disease.
Note (4): These evaluations involve a single extremity. If more than one extremity is affected, evaluate each extremity separately and combine (under § 4.25), using the bilateral factor (§ 4.26), if applicable.