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Cold Injury Residuals (Frostbite)

Lasting damage to tissue from exposure to extreme cold during military service, commonly affecting the hands, feet, ears, and nose. The VA rates cold injury residuals based on the presence of symptoms including pain, numbness, cold sensitivity, tissue loss, and nail abnormalities. Each affected extremity is rated separately.

Code: 7122
Criteria: 38 CFR 4.104, DC 7122
Exam length: ~30 minutes
Form: Cold Injury DBQ

Rating steps

The percentages this diagnostic code can be rated at. Which one applies depends on the findings — no tool here can tell you in advance.

What happens at the appointment

The examiner will review the history of your cold injury, including where and when it occurred during service, what body parts were affected, and the severity of the initial injury.
A physical examination of the affected areas will check for skin changes, color differences, nail abnormalities, tissue loss, and sensitivity to cold.
The examiner will assess for residual symptoms including chronic pain, numbness, tingling, cold sensitivity, and hyperhidrosis in the affected areas.
You may be tested for sensory deficits in the affected extremities, including light touch, temperature sensation, and pain response.
The examiner will look for long-term complications such as arthritis in affected joints, skin cancer in previously frostbitten areas, or peripheral neuropathy.

What the examiner is actually filling in

01Each affected body part is rated separately under Diagnostic Code 7122 — hands, feet, ears, and nose can each receive individual ratings.
02The examiner will document specific residuals: arthralgia, numbness, cold sensitivity, tissue loss, nail abnormalities, color changes, and hyperhidrosis.
03Each affected part is rated in three tiers under DC 7122: 10% for pain, numbness, or cold sensitivity alone; 20% for those symptoms plus ONE additional finding (such as tissue loss, nail abnormalities, color changes, hyperhidrosis, X-ray abnormalities, or locally impaired sensation); and 30% for those symptoms plus TWO OR MORE of those findings.
04Whether locally impaired sensation is present in the affected areas.
05The presence of X-ray abnormalities such as osteoporosis, subchondral punched-out lesions, or osteoarthritis in affected joints.

Rated under 38 CFR 4.104, DC 7122. The examiner records findings on the DBQ; a rating specialist makes the decision.

A complete answer sounds like

Emphasize that each affected body part gets its own rating — bilateral frostbite of both feet and both hands could result in four separate ratings.
Describe your cold sensitivity threshold precisely: "My toes go numb and turn white when the temperature drops below 50 degrees" is better than "cold bothers my feet."
If you have developed arthritis in previously frostbitten joints, ask your doctor to specifically note this connection in your medical records.
Bring photos taken during cold weather showing color changes or skin reactions in affected areas.
Mention all symptoms even if they seem minor — nail abnormalities, excessive sweating, and skin color changes each contribute to a higher rating per body part.

What costs veterans points

Not connecting current symptoms to the original cold injury — chronic pain, numbness, and cold sensitivity developing years later are recognized residuals of frostbite.
Failing to report all affected body parts — if both feet and both hands were injured, each affected area should be documented separately as each can receive its own rating.
Not mentioning arthritis in joints of previously frostbitten extremities, which is a well-established late complication of cold injury.
Forgetting to describe how symptoms worsen with cold exposure, including the temperature threshold that triggers problems.
Not reporting nail changes, excessive sweating, or skin color changes in affected areas because they seem minor compared to pain.

The rating criteria, in plain language

Rating levels for Cold Injury Residuals (Frostbite) under 38 CFR 4.104, DC 7122
Rating	Rating criteria	What that means for you
0%	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.	You are service-connected, but the findings do not meet the requirements for a compensable evaluation — no arthralgia or other pain, no numbness and no cold sensitivity in the affected part. This code prints no 0% rung of its own; § 4.31 supplies it: no monthly payment, but the condition is on record and a later increase runs from it. The lowest compensable level under this code is 10 percent.
0%	What supports this level Service records establishing the cold exposure Examination of each affected part recording no pain, numbness or cold sensitivity § 4.104 DC 7122 Note (2): each affected part (hand, foot, ear, nose) is evaluated separately and combined
10%	Arthralgia or other pain, numbness, or cold sensitivity	The affected part has joint pain or other pain, numbness, or cold sensitivity.
10%	What supports this level Examination findings for each affected part — each hand, foot, ear and nose is evaluated separately and then combined (Note (2)) Treatment notes recording pain, numbness or cold sensitivity Your service records showing the cold exposure
20%	Arthralgia or other pain, numbness, or cold sensitivity plus one of the following: Tissue loss, nail abnormalities, color changes, locally impaired sensation, hyperhidrosis, anhydrosis, X-ray abnormalities (osteoporosis, subarticular punched-out lesions, or osteoarthritis), atrophy or fibrosis of the affected musculature, flexion or extension deformity of distal joints, volar fat pad loss in fingers or toes, avascular necrosis of bone, chronic ulceration, carpal or tarsal tunnel syndrome	Pain, numbness or cold sensitivity plus exactly one of the listed findings — tissue loss, nail abnormalities, colour changes, locally impaired sensation, hyperhidrosis, anhydrosis, X-ray abnormalities, muscle atrophy or fibrosis, joint deformity, volar fat pad loss, avascular necrosis, chronic ulceration, or carpal or tarsal tunnel syndrome.
20%	What supports this level X-rays of the affected parts — osteoporosis, punched-out lesions or osteoarthritis each count Examination findings for nail changes, colour changes and sensation Nerve conduction studies if carpal or tarsal tunnel syndrome is suspected A separate evaluation for each affected part
30%	Arthralgia or other pain, numbness, or cold sensitivity plus two or more of the following: Tissue loss, nail abnormalities, color changes, locally impaired sensation, hyperhidrosis, anhydrosis, X-ray abnormalities (osteoporosis, subarticular punched-out lesions, or osteoarthritis), atrophy or fibrosis of the affected musculature, flexion or extension deformity of distal joints, volar fat pad loss in fingers or toes, avascular necrosis of bone, chronic ulceration, carpal or tarsal tunnel syndrome	Pain, numbness or cold sensitivity plus two or more of the listed findings. 30% is the highest evaluation DC 7122 pays for one part — but each affected part (each hand, foot, ear, nose) is evaluated separately and the evaluations are then combined under §§ 4.25 and 4.26.
30%	What supports this level X-rays of every affected part Examination findings covering all of the listed changes A separate evaluation for each hand, foot, ear and nose Note (1): amputations, squamous cell carcinoma at a cold-injury scar, peripheral neuropathy and Raynaud’s syndrome are evaluated separately under their own codes

The middle column is our transcription of the criteria at 38 CFR 4.104, DC 7122, condensed for reading. Read the section itself on eCFR before relying on the exact wording. The items under each level are the kinds of evidence that document it — not a VA checklist, and not a prediction of which level applies to you.

Mistakes we see most often

Not claiming each affected extremity separately — the VA rates each hand and foot individually, so bilateral cold injury residuals can result in four separate ratings.

Not getting X-rays of the affected extremities — osteoporosis, subarticular punched out lesions, and osteoarthritis from cold injury support a higher rating and are often overlooked.

Not documenting cold sensitivity with objective testing — cold stress testing or thermography can provide objective evidence of abnormal vascular response to cold.

Not connecting service records showing cold weather duty assignments — deployment records, unit histories, and buddy statements documenting cold exposure are critical for establishing service connection.

Before & after your exam

These apply to every C&P exam, whatever the condition.

Do not miss the appointment: Missing your C&P exam without a good reason can cost you. Under 38 CFR § 3.655, a missed exam can cause a claim for an increased rating or a reopened claim to be denied, and can cause an original claim to be decided on the evidence already in your file. If you cannot make it, call the VA or the exam company right away to reschedule — a documented good reason (illness, work conflict, no transportation, a family emergency) protects your claim.
Your examiner may be a contractor: Many C&P exams are performed by VA-contracted companies — QTC, Optum Serve (LHI), VES, or MSLA — not at a VA hospital. They will call, text, or mail you to schedule. Do not ignore an unknown number or letter while your claim is pending, and confirm the exam location and time before you go.
The examiner does not decide your claim: The examiner's job is to record findings on the Disability Benefits Questionnaire (DBQ). A rating specialist at the Regional Office makes the actual decision, using the exam together with your full record — service records, medical records, and lay statements. One appointment does not settle everything.
Get a copy of your exam report: After the exam you can request the report (often called the DBQ or C&P exam results) through VA.gov, the Blue Button tool, or your accredited representative. Reading it lets you catch errors while you still have time to respond.
If the exam was inadequate, you have options: If the examiner rushed you, evaluated the wrong condition, or the report is inaccurate, you can submit a statement and new evidence, and — after a decision — request a review (a Supplemental Claim or Higher-Level Review). A single bad exam is not the end of your claim.

View condition guide →View evidence checklist →

Folder readiness

Tick these off as you gather them. Nothing here is required — the exam happens either way — but each one is something the examiner cannot record if it is not in front of them.

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Take it with you

Print the whole guide — what the examiner records, the folder list with your ticks, the criteria table and the mistakes to avoid — and bring it to the appointment.

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C&P Exam Preparation Guides

The VA orders this exam to verify your diagnosis and measure how severe it is right now. It can shape your rating and your monthly compensation — but it does not decide your claim. A rating specialist weighs it against your full record, and if the exam does not reflect your condition, you can say so and ask the VA to correct it.

Source forms
Coverage

Cold Injury Residuals (Frostbite)

Rating steps

What happens at the appointment

What the examiner is actually filling in

A complete answer sounds like

What costs veterans points

The rating criteria, in plain language

What supports this level

What supports this level

What supports this level

What supports this level

Mistakes we see most often

Before & after your exam

Cold Injury Residuals (Frostbite)

Rating steps

What happens at the appointment

What the examiner is actually filling in

A complete answer sounds like

What costs veterans points

The rating criteria, in plain language

What supports this level

What supports this level

What supports this level

What supports this level

Mistakes we see most often

Before & after your exam