38 CFR Part 4 — 38 CFR § 4.104

Buerger's disease — VA Diagnostic Code 7115

Cardiovascular

Diagnostic code

7115

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38 CFR § 4.104 lists Diagnostic Code 7115 as “Thrombo-angiitis obliterans (Buerger's Disease).” The lower-extremity line says to rate under DC 7114. The upper-extremity lines are 100, 60, 40, and 20. Section 3.309(a) lists “Thromboangiitis obliterans (Buerger's disease),” without the hyphen and with a lowercase “d” in disease.

Reviewed 2026-10-05. Text checked against the eCFR versioner full-text XML for 2026-10-01 on 2026-10-05. Title 38 was up to date as of 2026-10-01 and last amended on 2026-08-27. The § 4.104 source note prints 62 FR 65219, Dec. 11, 1997, as amended at 63 FR 37779, July 14, 1998; 71 FR 52460, Sept. 6, 2006; 79 FR 2100, Jan. 13, 2014; 82 FR 50804, Nov. 2, 2017; 86 FR 54093, Sept. 30, 2021; 86 FR 62095, Nov. 9, 2021.

The rating criteria at each level

Thrombo-angiitis obliterans (Buerger's Disease) — DC 7115

Rating %: —

Criteria (verbatim). Lower extremity: Rate under DC 7114.

Rating %: 100

Criteria (verbatim). Deep ischemic ulcers and necrosis of the fingers with persistent coldness of the extremity, trophic changes with pains in the hand during physical activity, and diminished upper extremity pulses

Rating %: 60

Criteria (verbatim). Persistent coldness of the extremity, trophic changes with pains in the hands during physical activity, and diminished upper extremity pulses

Rating %: 40

Criteria (verbatim). Trophic changes with numbness and paresthesia at the tips of the fingers, and diminished upper extremity pulses

Rating %: 20

Criteria (verbatim). Diminished upper extremity pulses

Rating %	Criteria (verbatim)
—	Lower extremity: Rate under DC 7114.
100	Deep ischemic ulcers and necrosis of the fingers with persistent coldness of the extremity, trophic changes with pains in the hand during physical activity, and diminished upper extremity pulses
60	Persistent coldness of the extremity, trophic changes with pains in the hands during physical activity, and diminished upper extremity pulses
40	Trophic changes with numbness and paresthesia at the tips of the fingers, and diminished upper extremity pulses
20	Diminished upper extremity pulses

Peripheral arterial disease — DC 7114, used when DC 7115 says to rate the lower extremity under it

Rating %: 100

Criteria (verbatim). 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

Rating %: 60

Criteria (verbatim). 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

Rating %: 40

Criteria (verbatim). 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

Rating %: 20

Criteria (verbatim). 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

Rating %	Criteria (verbatim)
100	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
60	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
40	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
20	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

DC 7115 Note (1): 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.

DC 7115 Note (2): Trophic changes include, but are not limited to, skin changes (thinning, atrophy, fissuring, ulceration, scarring, absence of hair) as well as nail changes (clubbing, deformities).

DC 7114 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.

DC 7114 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

DC 7114 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.

The upper-extremity lines under DC 7115 are 100, 60, 40, and 20. The code does not print a 10 or 0 percent line for the upper extremity. DC 7114’s printed lines are also 100, 60, 40, and 20. 38 CFR § 4.31 says: “In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met.” 38 CFR § 4.7 assigns the higher rating when the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 CFR § 4.6 requires each element affecting the evidence to be studied so that decisions will be equitable and just.

The 100 percent upper-extremity line says “pains in the hand.” The 60 percent line says “pains in the hands.” Those are the words in the two cells.

The Diseases of the Heart caption in 38 CFR § 4.104 is in brackets: “Unless otherwise directed, use this general rating formula to evaluate diseases of the heart.” DC 7115 and DC 7114 print their own lines. Those lines do not use METs.

DC 7114 Note (3) says: “Evaluate residuals of aortic and large arterial bypass surgery or arterial graft as peripheral arterial disease.” That note is on DC 7114.

Source: 38 CFR § 4.104, Diagnostic Codes 7115 and 7114, eCFR full-text XML for 2026-10-01.

What the words mean in your records

Lower extremity uses DC 7114

The DC 7115 line is “Lower extremity: Rate under DC 7114.” DC 7114 is “Peripheral arterial disease.” Its 100, 60, 40, and 20 percent lines each say “At least one of the following” and then list ankle/brachial index, ankle pressure, toe pressure, or transcutaneous oxygen tension. Note (2) of DC 7114 ends with the words “highest impairment value” and does not print a period after them.

One extremity, then combine

Note (1) of DC 7115 and Note (4) of DC 7114 say the 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 in § 4.26, if applicable.

The chronic-disease spelling

Section 3.309(a) prints “Thromboangiitis obliterans (Buerger's disease).” DC 7115 prints “Thrombo-angiitis obliterans (Buerger's Disease).” The hyphen and the capital D are in the schedule title. They are not in the § 3.309(a) name.

Evidence that speaks to each level

Upper extremity — 100, 60, 40, or 20

What the rater needs to see. The findings named in that line: ulcers and necrosis at 100, coldness and trophic changes at 60, trophic changes with numbness and paresthesia at the fingertips at 40, or diminished upper extremity pulses at 20. The 100 percent cell says “pains in the hand.” The 60 percent cell says “pains in the hands.”

Where that usually lives. The vascular examination of that arm or hand.

Lower extremity — DC 7114

What the rater needs to see. An objective ABI, ankle pressure, toe pressure, or Tc PO2 in one of the four ranges. Note (1) states the normal values and says all measurements must be determined by objective testing.

Where that usually lives. The test report. Note (2) says which test is used when AP, TP, and Tc PO2 are not of record.

Level	What the rater needs to see	Where that usually lives
Upper extremity — 100, 60, 40, or 20	The findings named in that line: ulcers and necrosis at 100, coldness and trophic changes at 60, trophic changes with numbness and paresthesia at the fingertips at 40, or diminished upper extremity pulses at 20. The 100 percent cell says “pains in the hand.” The 60 percent cell says “pains in the hands.”	The vascular examination of that arm or hand.
Lower extremity — DC 7114	An objective ABI, ankle pressure, toe pressure, or Tc PO2 in one of the four ranges. Note (1) states the normal values and says all measurements must be determined by objective testing.	The test report. Note (2) says which test is used when AP, TP, and Tc PO2 are not of record.

VA’s public DBQ list, checked October 5, 2026, names “Artery and Vein Conditions” under Cardiovascular. The file is Artery and Vein Conditions.

The exam form

DC 7115 has its own upper-extremity lines and a direction to rate the lower extremity under DC 7114. This page does not say the form replaces those lines.

Related codes and how they interact

Peripheral arterial disease is the lower-extremity code

DC 7114 is the code DC 7115 names for the lower extremity. DC 7124 is Raynaud's disease, with 10 and 0 percent lines and a different definition of characteristic attacks. Section 3.309(a) lists both “Raynaud's disease” and “Thromboangiitis obliterans (Buerger's disease)” as separate names.

Secondary conditions and presumptions

38 CFR § 3.309(a) lists “Thromboangiitis obliterans (Buerger's disease).” 38 CFR § 3.307(a)(3) says the disease must have become manifest to a degree of 10 percent or more within 1 year (for Hansen's disease (leprosy) and tuberculosis, within 3 years; multiple sclerosis, within 7 years) from the date of separation from service as specified in paragraph (a)(2). Paragraph (a)(1) requires 90 days or more during a war period or after December 31, 1946. 38 CFR § 3.309(a) says the listed diseases shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within those time limits, provided the rebuttable presumption provisions of § 3.307 are also satisfied. Paragraph (a) of § 3.307 also says no condition other than one listed in § 3.309(a) will be considered chronic. The longer periods in paragraph (a)(3) do not name Buerger's disease.

38 CFR § 3.308(a) says there is no provision for presumptive service connection for chronic disease, as distinguished from tropical diseases, based on peacetime service before January 1, 1947.

The 2026-10-01 text of 38 CFR § 3.309(e) does not name it. 38 CFR § 3.309(f) does not name it. 38 CFR § 3.309(d) does not name it. 38 CFR § 3.320 does not name it. 38 CFR § 3.320a does not name it. 38 CFR § 3.320b does not name it. 38 CFR § 3.316 does not name it. 38 CFR § 3.317 does not name it. Section 3.309(b) does not name it. Section 3.309(c) does not name it.

A separate question, when a presumption does not decide it, is a medical question on the facts under 38 CFR § 3.310. Paragraph (a) covers disability proximately due to or the result of a service-connected disease or injury. Paragraph (b) covers increase in severity and requires a medical baseline.

Short answers

What is the VA rating for DC 7115?

Under 38 CFR § 4.104, thrombo-angiitis obliterans (Buerger's Disease) is rated 100, 60, 40, or 20 percent for the upper extremity. The lower extremity is rated under DC 7114, peripheral arterial disease. The code does not print a 0 percent line. Education only. VA decides on the evidence.

How does the chronic-disease list spell this condition?

Section 3.309(a) says “Thromboangiitis obliterans (Buerger's disease).” The schedule title at DC 7115 hyphenates thrombo-angiitis and capitalizes Disease.

FAQ

How does VA rate Buerger's disease under DC 7115?

For the upper extremity, the lines are 100, 60, 40, and 20 percent. The 100 percent line requires deep ischemic ulcers and necrosis of the fingers, with the coldness, trophic changes, hand pain during activity, and diminished pulses that the cell names. The lower-extremity line says to rate under DC 7114. Education only.

Why do the 100 and 60 percent lines use different words for the hand?

The 100 percent cell says “pains in the hand.” The 60 percent cell says “pains in the hands.” The schedule prints both.

Is Buerger's disease on the one-year chronic list?

Section 3.309(a) lists “Thromboangiitis obliterans (Buerger's disease).” Section 3.307(a)(3) uses one year, except the longer periods it names for Hansen's disease (leprosy), tuberculosis, and multiple sclerosis.

Is Buerger's disease on the herbicide or Camp Lejeune list?

The 2026-10-01 text of §§ 3.309(e) and 3.309(f) does not name thromboangiitis obliterans or Buerger's disease. Sections 3.320, 3.320a, 3.320b, 3.316, and 3.317 do not name it.

Next steps

Read the decision for DC 7115 or DC 7114, which extremity was rated, and which measurement or finding was used.
The free worksheet is a place to write the code, the findings, and the records you already have. It does not file a claim or protect a filing date. An accredited representative is at find a VSO.
Other cardiovascular codes are on the cardiovascular diagnostic-code index.

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Other codes in this body system

Nearby catalog entries in Cardiovascular, ordered by diagnostic code number. All Cardiovascular codes

Also: DC code lookup (tools) lists the same index in a compact layout.

Source: 38 CFR Part 4, Diagnostic Code 7115 • va.gov

⚠️ Important Disclaimer

This page provides general educational information based on public VA regulations and VA.gov resources. It is not legal or medical advice, and My Claim Packet is not a VA-accredited representative. Any worksheets or draft documents produced by the tools must be reviewed for accuracy and are not filed with VA for you. Ratings and service connection are decided case-by-case from the individual record. Consult a VA-accredited VSO, claims agent, attorney, or qualified clinician for help with your situation, and verify current rules using the linked official source.