VARICOSE VEINS

Summary

The veteran, who served in the U.S. Army from January 2008 to August 2010, appeals the denial of an increased disability rating for his service-connected s/p left varicocele with surgical resection, claimed as a groin condition. The veteran sought a higher rating due to constant pain, intermittent swelling, limited movement, and the need to wear compression hosiery 24 hours a day. The Board reviewed evidence of record up to the June 2021 rating decision, including a May 2021 VA examination and the June 2025 hearing transcript. The VA examiner diagnosed s/p varicocele with surgical resection, noting no other related issues like voiding dysfunction or renal dysfunction. The veteran testified at the hearing about constant aching pain, pain with prolonged activity, intermittent swelling, and the need for compression hosiery. The Board found the veteran's reported activity-limiting pain analogous to the criteria for a 10 percent rating under Diagnostic Code 7120, resolving reasonable doubt in his favor. However, the Board determined the evidence did not support a higher rating due to the absence of persistent edema or stasis pigmentation. The Board also found no basis for a higher rating under Diagnostic Code 7525 for urinary tract infections. Service connection for s/p left varicocele with surgical resection is granted at 10 percent.

Rationale

Veteran's symptoms analogous to DC 7120 criteria; Benefit of doubt resolved in veteran's favor; Activity-limiting pain reported

Full Decision Text

Citation Nr: A26040808
Decision Date: 04/30/26	Archive Date: 04/30/26

DOCKET NO. 210824-181883
DATE: April 30, 2026

ORDER

Entitlement to a rating of 10 percent, but no higher, for service-connected s/p left varicocele with surgical resection (claimed as groin condition) is granted.

FINDING OF FACT

1. During the relevant period, the Veteran's service-connected left varicocele has manifested as tenderness, pain, and intermittent edema with symptoms relieved by compression hosiery; there was no evidence of persistent edema, incompletely relieved by elevation of extremity, with or without beginning stasis pigmentation or eczema testicular atrophy nor loss of use of a creative organ.  

CONCLUSION OF LAW

1. The criteria for entitlement to a rating of 10 percent, but no higher, for service-connected s/p left varicocele with surgical resection have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.321, 3.400, 4.1, 4.7, 4.20, 4.88, 4.89, 4.104 Diagnostic Code 7120-7520, 4.115 Diagnostic Code 7120-7525.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty in the U.S. Army from January 2008 to August 2010.

This matter is before the Board of Veterans' Appeals (Board) on appeal of an August 2021 higher-level rating decision of a Department of Veterans Affairs (VA) Regional Office (RO), the agency of original jurisdiction (AOJ). 

In the August 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on June 24, 2025. A copy of the hearing transcript has been associated with the Veteran's electronic claims file.

Therefore, the Board may only consider the evidence of record at the time of the June 2021 rating decision, which was subsequently subject to higher-level review, as well as any evidence submitted by the Veteran [or representative] at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision, which was subsequently subject to higher-level review and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801. 

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim[s], considering the new evidence in addition to the evidence previously considered. Id. Specific 

Increased Ratings

Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities, found in 38 C.F.R., Part 4. The rating schedule is primarily a guide in the rating of disability resulting from all types of diseases and injuries encountered as a result of, or incident to, military service. The ratings are intended to compensate, as far as can practicably be determined, the average impairment of earning capacity resulting from such diseases and injuries and their residual conditions in civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. § 4.1.

The veteran's entire history is to be considered when making disability ratings. 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995). In a claim for a greater original rating after an initial award of service connection, all of the evidence submitted in support of the veteran's claim is to be considered. See Fenderson v. West, 12 Vet. App. 119 (1999). Where entitlement to compensation has already been established and increase in disability rating is at issue, present level of disability is of primary concern. See Francisco v. Brown, 7 Vet. App. 55, 58 (1994). VA must determine whether the level of disability warrants the assignment of different disability ratings at different times over the life of the claim, a practice known as a "st
 v. Derwinski, 1 Vet. App. 589 (1995). In a claim for a greater original rating after an initial award of service connection, all of the evidence submitted in support of the veteran's claim is to be considered. See Fenderson v. West, 12 Vet. App. 119 (1999). Where entitlement to compensation has already been established and increase in disability rating is at issue, present level of disability is of primary concern. See Francisco v. Brown, 7 Vet. App. 55, 58 (1994). VA must determine whether the level of disability warrants the assignment of different disability ratings at different times over the life of the claim, a practice known as a "staged rating." See Fenderson, 12 Vet. App at 119.

Where there is a question as to which of two ratings shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7.

When all the evidence is assembled, VA is responsible for determining whether the weight of the evidence is in approximate balance. If the positive and negative evidence is evenly or approximately balanced, the claimant receives the benefit of the doubt. See Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc) (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application).

Entitlement to a rating of 10 percent, but no higher, for service-connected s/p left varicocele with surgical resection (claimed as groin condition) is granted.

On appeal, the Veteran seeks entitlement to an increased rating of s/p left varicocele with surgical resection (claimed as groin condition). Specifically, the Veteran contends that he is entitled to an increased rating due to constant pain, swelling, limited movement and needing to wear compression hosiery 24 hours per day. See June 2025 Hearing Transcript, at 3.

The Veteran was granted service-connection for s/p left varicocele with surgical resection with a noncompensable rating effective October 27, 2015. See October 2018 Rating Decision - Narrative, at 3-4. The Veteran filed a supplemental claim in April 2021, which was denied in June 2021 rating decision. The Veteran filed a higher level review request and the issue was again denied in August 2021. 

The Veteran's s/p left varicocele with surgical resection is rated under 38 C.F.R. § 4.104, Diagnostic Code (DC) 7120-7525. A noncompensable rating was assigned based on a diagnosed disability with no compensable symptoms.

Hyphenated diagnostic codes are used when a rating under one diagnostic code requires use of an additional diagnostic code to identify the basis for the rating assigned; the additional code is shown after the hyphen. 38 C.F.R. § 4.27. Where a veteran has been diagnosed as having a specific condition and the diagnosed condition is not listed in the Ratings Schedule, the diagnosed condition will be evaluated by analogy to closely-related diseases or injuries in which not only the functions affected, but the anatomical localizations and symptomatology, are closely analogous.38 C.F.R. § 4.20. In this case, the Veteran's diagnosis is not specified in the Rating Schedule. Thus, the Veteran has been rated by analogy under DC 7120-7525 for varicose veins and urinary tract infection.

DC 7120 for varicose veins is evaluated under DC 7021, the criteria for post-phlebitic syndrome of any etiology. A 10 percent rating is assigned for intermittent edema of extremity or aching and fatigue in the leg after prolonged standing or walking, with symptoms relieved by elevation of extremity or compression hosiery. A 20 percent rating is assigned for persistent edema, incompletely relieved by elevation of extremity, with or without beginning stasis pigmentation or eczema. A 40 percent rating is assigned for persistent edema and stasis pigmentation or eczema, with or without intermittent ulceration. A 60 percent rating is assigned for persistent edema or subcutaneous induration, stasis pigmentation or eczema, and persistent ulceration. A 100 percent (total) rating is assigned with massive board-like edema with constant pain at rest. 38 C.F.R. § 4.104.

Diagnostic Code 7525 address only chronic epididymo-orchitis, and directed that it be treated as a urinary tract infection. 38 C.F.R. § 4.115b. A 10 percent rating is assigned for
 pigmentation or eczema. A 40 percent rating is assigned for persistent edema and stasis pigmentation or eczema, with or without intermittent ulceration. A 60 percent rating is assigned for persistent edema or subcutaneous induration, stasis pigmentation or eczema, and persistent ulceration. A 100 percent (total) rating is assigned with massive board-like edema with constant pain at rest. 38 C.F.R. § 4.104.

Diagnostic Code 7525 address only chronic epididymo-orchitis, and directed that it be treated as a urinary tract infection. 38 C.F.R. § 4.115b. A 10 percent rating is assigned for long-term drug therapy, 1-2 hospitalizations per year, and/or requiring intermittent intensive management. A 30 percent rating is assigned for recurrent symptomatic infection requiring drainage/frequent hospitalization (greater than two times/year), and/or requiring continuous intensive management. Finally, poor renal function is to be rated under the relevant rating criteria for renal dysfunction. 38 C.F.R. § 4.115a. 

The Board notes that the Veteran filed an increased rating claim for his service-connected s/p left varicocele with surgical resection in April 2021; therefore, the following analysis will only consider evidence from the date of the claim. 38 C.F.R. § 3.400(o)(2).

February 2021 private outpatient treatment records indicated that the Veteran had left varicocele surgery in 2010 but his symptoms have not been resolved. His issue is considered chronic. The Veteran wears compression hosiery 23 hours per day. See June 2025 MTR, at 1. 

In May 2021, the Veteran underwent a VA artery and vein conditions examination. The VA examiner indicated that a complete review of the Veteran's claims file and in-person examination had been conducted. Here, the VA examiner indicated that the Veteran's condition would be best addressed under a male reproductive organ conditions examination based on an updated diagnosis of varicocele related to male genitalia. See May 2021 Vein C&P, at 7.

In May 2021, the Veteran underwent a VA male reproductive organ conditions examination. Here, the VA examiner stated in 2009 the Veteran underwent a surgical procedure to remove the varicocele from the left testicle; he does not have any varicose vein or vascular issues in the extremities. The Veteran was diagnosed with s/p varicocele with surgical resection. See May 2021 C&P, at 2. The Veteran does not take medication, does not have voiding dysfunction, erectile dysfunction, retrograde ejaculation, a history of chronic epididymitis, epididymo-orchitis or prostatitis. Also, the VA examiner found no renal dysfunction. 

At the June 2025 Board hearing, the Veteran stated that he has been in constant pain, and wears compression hosiery 24 hours a day, seven days a week, which limits his movement since at least 2021. The Veteran also reported intermittent swelling and pain with physical activity such as prolonged walking or standing. See August 2025 Hearing Transcript, at 3. The Veteran stated that the symptoms referenced as not having been resolved (despite surgery) in the February 2021 private outpatient treatment records referred to his constant pain, pain with prolonged walking and standing, intermittent swelling, and wearing compression hosiery. Id., at 6.

With resolution of reasonable doubt in the Veteran's favor, the Board finds that the Veteran experiences activity-limiting pain that is analogous to aching and fatigue after prolonged standing or walking as described in the criteria for a 10 percent disability rating under DC 7120. Notably, at his June 2025 Board hearing, the Veteran endorsed constant aching pain, pain with prolonged walking or standing, and limited movement due to wearing compression hosiery. In light of these reports of activity-restricting pain, the assignment of a higher rating of 10 percent is warranted under DC 7120.

However, although a higher rating of 10 percent is warranted, the evidence of record does not reflect symptomatology that would meet the criteria for a rating in excess of 10 percent. While the Veteran does experience activity-limiting pain, there is no indication that he experiences persistent edema or beginning stasis pigmentation or eczema. Without evidence of more severe symptomatology, to include edema, a rating in excess of 10 percent is not appropriate under DC 7120.

Additionally, the medical evidence of record does not establish that the Veteran's service-connected s/p left varicocele with surgical resection warrants a disability rating in excess of 10 percent under DC 7525. The Veteran's disability has not required long-term drug therapy, hospitalization
 higher rating of 10 percent is warranted, the evidence of record does not reflect symptomatology that would meet the criteria for a rating in excess of 10 percent. While the Veteran does experience activity-limiting pain, there is no indication that he experiences persistent edema or beginning stasis pigmentation or eczema. Without evidence of more severe symptomatology, to include edema, a rating in excess of 10 percent is not appropriate under DC 7120.

Additionally, the medical evidence of record does not establish that the Veteran's service-connected s/p left varicocele with surgical resection warrants a disability rating in excess of 10 percent under DC 7525. The Veteran's disability has not required long-term drug therapy, hospitalization, intensive management, or been manifested by renal dysfunction to warrant an initial rating in excess of 10 percent under the criteria for urinary tract infections. As such, an initial rating in excess of 10 percent cannot be granted under DC 7525.

The Board has reviewed the remaining diagnostic codes relating to the genito-urinary system. However, the record contains no medical evidence indicating that the Veteran's s/p left varicocele with surgical resection is manifested by symptoms other than those discussed above. As such, an increased rating cannot be assigned under 38 C.F.R. § 4.115b, DC 7500-7524, 7527-7542 (2010).

Based on the foregoing, the Board concludes that the evidence is in approximate balance that a 10 percent rating, but no higher, is warranted for the Veteran's s/p left varicocele with surgical resection, with reasonable doubt being resolved in the Veteran's favor. Therefore, as the benefit-of-the-doubt rule is for application, the Board finds that the grant of increased rating for the Veteran's service-connected s/p left varicocele with surgical resection is warranted. 38 U.S.C. § 5107(b): 38 C.F.R. § 3.102. To this extent the Veteran's appeal is granted.

 

R. Bisignani

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Loy, T.

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.