Chronic Orthostatic Hypotension

DC 7199-7101Cardiovascular38 CFR 4.104, DC 7199-7101

A condition where your blood pressure drops significantly when you stand up, causing dizziness, lightheadedness, or fainting. The VA rates it by analogy to hypertension, based on tilt table test results, how often you faint, and what medications you need.

How the VA rates this condition

The VA rates this condition based on how often symptoms occur and how severe each episode is. The examiner will ask about the frequency, duration, and intensity of your episodes, as well as how they affect your ability to work.

Diagnostic code

DC 7199-7101

Rating range

0% – 60%

Rating levels

Rating criteria are defined in 38 CFR 4.104, DC 7199-7101. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

Rating Levels

Your orthostatic hypotension causes severe and frequent syncope that substantially limits your ability to work and perform daily activities. You have recurrent falls with injuries, and maximum medical therapy has not controlled your episodes.

What the VA looks for

Frequent syncope refractory to maximum medical therapy
Recurrent falls with injuries requiring medical treatment
Inability to maintain employment due to syncope risk
Tilt table test showing severe autonomic dysfunction
Documentation of preclusion from activities requiring standing or driving

Common Pitfalls

⚠Not getting a tilt table test — this is the objective diagnostic standard for orthostatic hypotension. Orthostatic vital signs at a clinic visit may not capture the full severity of your condition.
⚠Not documenting every syncope and near-syncope episode — the frequency of fainting directly determines your rating. Keep a diary of all episodes including date, time, activity, and any resulting injuries.
⚠Not connecting orthostatic hypotension to service-connected conditions — it is commonly secondary to diabetic neuropathy, PTSD medications, traumatic brain injury, and spinal cord injuries.
⚠Not documenting functional limitations — the VA needs to see how orthostatic hypotension affects your ability to work, drive, and perform daily tasks. Employer statements and lay evidence are valuable.
⚠Not reporting fall-related injuries — falls from syncope can cause fractures, head injuries, and other conditions that may warrant separate ratings.

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Condition Rating Guides

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Chronic Orthostatic Hypotension

How the VA rates this condition

Diagnostic code

DC 7199-7101

Rating range

0% – 60%

Rating levels

Rating Levels

What the VA looks for

Frequent syncope refractory to maximum medical therapy
Recurrent falls with injuries requiring medical treatment
Inability to maintain employment due to syncope risk
Tilt table test showing severe autonomic dysfunction
Documentation of preclusion from activities requiring standing or driving

Common Pitfalls

⚠Not getting a tilt table test — this is the objective diagnostic standard for orthostatic hypotension. Orthostatic vital signs at a clinic visit may not capture the full severity of your condition.

⚠Not documenting every syncope and near-syncope episode — the frequency of fainting directly determines your rating. Keep a diary of all episodes including date, time, activity, and any resulting injuries.

⚠Not connecting orthostatic hypotension to service-connected conditions — it is commonly secondary to diabetic neuropathy, PTSD medications, traumatic brain injury, and spinal cord injuries.

⚠Not documenting functional limitations — the VA needs to see how orthostatic hypotension affects your ability to work, drive, and perform daily tasks. Employer statements and lay evidence are valuable.

⚠Not reporting fall-related injuries — falls from syncope can cause fractures, head injuries, and other conditions that may warrant separate ratings.