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Evidence checklist

Pulmonary Embolism (Residuals)

DC 681738 CFR § 4.97Respiratory

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
Pulmonary function tests (PFTs) with DLCOCritical

Spirometry and DLCO documenting any residual ventilatory or gas exchange impairment. Reduced DLCO is a common residual after pulmonary embolism and directly drives the VA rating level.

Private provider · independent opinion
Nexus opinion linking pulmonary embolism to service ("at least as likely as not")Critical

A medical opinion connecting the PE to a service-related event such as prolonged immobilization, traumatic injury, or surgery performed during or for a service-connected condition.

Private provider · independent opinion
Echocardiogram (if pulmonary hypertension or right heart strain suspected)

Echocardiography documenting any right ventricular dysfunction, pulmonary hypertension, or chronic thromboembolic pulmonary hypertension (CTEPH) as a residual complication.

Private provider · independent opinion
02

Treating physician

0 of 1 collected
Documentation of exercise intolerance and functional limitation

Medical records or personal statement documenting dyspnea on exertion, reduced activity tolerance, and functional limitations persisting after the acute PE episode.

Your treating provider · written request
03

Treatment records

0 of 2 collected
CT pulmonary angiogram (CTPA) confirming PE historyCritical

Imaging study that was used to confirm the pulmonary embolism. If the acute event records are unavailable, subsequent imaging showing chronic thromboembolic changes or residual clot can establish the history.

VA or private records · written request
Anticoagulation treatment records (warfarin, DOAC therapy)Critical

Records documenting ongoing anticoagulation therapy — the need for lifelong anticoagulation due to recurrent PE or chronic thromboembolic disease reflects ongoing residual disability.

VA or private records · written request
04

Lay statements

0 of 1 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 →
05

Benefits questionnaire

0 of 1 collected
Completed DBQ Respiratory ConditionsCritical

Standardized form capturing PFT results, exercise tolerance, treatment requirements, and functional impact of pulmonary embolism residuals.

Provider-completed · VA DBQ formHow to get this →
06

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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