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Evidence checklist

Deep Vein Thrombosis Residuals (Post-Thrombotic Syndrome)

DC 712138 CFR § 4.104Hematologic/Lymphatic

Evidence strength

Mark what you already have below and your evidence strength appears here.

Target
Saved locally
01

Specialist opinion

Highest value0 of 3 collected
Duplex ultrasound documenting DVT and post-thrombotic changesCritical

An ultrasound showing the original blood clot or lasting damage to your veins (post-thrombotic syndrome). Serial imaging shows progression.

Private provider · independent opinion
Nexus opinion linking DVT to serviceCritical

A medical opinion connecting your blood clot to long immobilization during service, surgery, travel, injury, or a service-connected clotting disorder.

Private provider · independent opinion
Thrombophilia workup (Factor V Leiden, protein C/S, antiphospholipid)

Blood tests checking for inherited or acquired clotting disorders. If you have one, it may have been aggravated by service conditions.

Private provider · independent opinion
02

Treatment records

0 of 2 collected
Anticoagulation therapy recordsCritical

Records showing blood thinner medications (warfarin, rivaroxaban, apixaban) and how long you have been on them. Lifelong anticoagulation shows ongoing disability.

VA or private records · written request
Documentation of post-thrombotic symptoms (swelling, pain, skin changes)Critical

Records describing chronic leg swelling, pain, heaviness, skin discoloration, or ulcers from damaged veins. These residual symptoms determine the rating.

VA or private records · written request
03

Lay statements

0 of 2 collected
Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

You or a witness · VA Form 21-4138 or 21-10210How to get this →
Personal statement describing symptoms and functional impact

Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.

You or a witness · VA Form 21-4138 or 21-10210How to get this →
04

Benefits questionnaire

0 of 1 collected
Completed DBQ Hematologic and Lymphatic ConditionsCritical

A standardized VA form documenting DVT history, post-thrombotic residuals, anticoagulation needs, and functional impact.

Provider-completed · VA DBQ formHow to get this →
05

Service records

0 of 1 collected
Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.

NPRC / milConnect · SF-180

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