Body system: Cardiovascular SystemRegulation: 38 CFR § 4.104
A traumatic arteriovenous fistula is an abnormal connection between an artery and vein caused by injury, creating a shortcut that forces your heart to work harder. The VA rates this condition from 20% to 100% based on location and severity - higher ratings go to those with heart complications or lower extremity involvement. The rating reflects how much the condition affects your heart function and daily activities, with 100% reserved for cases causing serious heart failure.
Rating levels
- 100% — You qualify for this rating if your traumatic arteriovenous fistula (abnormal connection between an artery and vein caused by injury) has caused high-output heart failure, meaning your heart is working too hard trying to pump the extra blood flowing through the abnormal connection. This condition puts severe strain on your heart because it has to pump much more blood than normal, leading to symptoms like severe shortness of breath, extreme fatigue, swelling in your legs and feet, and inability to do normal daily activities.
- 60% — Your heart is working harder than normal and has grown larger in size, but it hasn't failed yet. You have a wide difference between your upper and lower blood pressure readings (wide pulse pressure), and your heart beats faster than normal most of the time (tachycardia). The enlarged heart occurs because the abnormal connection between your artery and vein forces your heart to pump extra blood to compensate.
- 50% — You qualify for this rating if you have a traumatic arteriovenous fistula (an abnormal connection between an artery and vein caused by injury) located in your lower extremity (leg, thigh, or foot area). This condition occurs when trauma creates an unusual pathway that allows blood to flow directly from an artery into a vein, bypassing normal circulation and potentially causing symptoms like swelling, pain, or circulation problems in the affected leg.
- 40% — You qualify for this rating if you have a traumatic arteriovenous fistula (an abnormal connection between an artery and vein caused by injury) located in your arm, shoulder, or hand area. This condition typically causes symptoms like swelling, pain, unusual blood flow patterns, or a pulsing sensation in the affected upper extremity. The fistula must have resulted from a service-connected injury or trauma to qualify for this rating.
- 30% — You qualify for this rating if you have a traumatic arteriovenous fistula (an abnormal connection between an artery and vein caused by injury) located in your lower extremity (leg, thigh, or foot). This condition involves blood flowing directly from an artery to a vein through an injury-created passage, bypassing normal circulation through smaller blood vessels.
- 20% — You qualify for this rating if you have a traumatic arteriovenous fistula (an abnormal connection between an artery and vein caused by injury) located in your upper extremity (arm, shoulder, or hand area). This condition occurs when trauma creates an unwanted pathway that allows blood to flow directly from an artery into a vein, bypassing normal circulation.