Veterans Health CentreVeterans Health CentreExpert DVA Doctor
0429 146 039Book appointment

SoP Library › Chronic venous insufficiency of the lower limb and varicose veins of the lower limb

Statement of Principles

Chronic venous insufficiency of the lower limb and varicose veins of the lower limb — DVA SoP factors

Every factor in the Repatriation Medical Authority Statements of Principles for Chronic venous insufficiency of the lower limb and varicose veins of the lower limb. DVA can only accept a claim for Chronic venous insufficiency of the lower limb and varicose veins of the lower limb if at least one of these factors is met and connected to your service. Reasonable Hypothesis (RH) applies to operational service; Balance of Probabilities (BoP) applies to peacetime service.

How a VHC DVA claim worksAll 357 SoPsBook appointment

Source: Repatriation Medical Authority Statements of Principles as held by the Veterans Health Centre. SoPs are amended and replaced regularly; always confirm the current instrument at rma.gov.au before relying on it.

Chronic venous insufficiency of the lower limb and varicose veins of the lower limb

RH No. 7 of 2021 · BoP No. 8 of 202144 factors

Meaning of chronic venous insufficiency of the lower limb and varicose veins of the lower limb: For the purposes of this Statement of Principles, chronic venous insufficiency of the lower limb: (a) means chronic impairment of venous blood flow or venous return affecting one or both of the lower limbs; and Chronic Venous Insufficiency Of The Lower Limb And Varicose Veins Of The Lower Limb (b) includes: (i) corona phlebectatica (dilated veins on the foot and ankle); (ii) lipodermatosclerosis; (iii) pigmentation or venous eczema; and (iv) venous ulcers; and (c) excludes varicose veins of the lower limb.

Reasonable Hypothesis (RH) — Statement of Principles No. 7 of 2021

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting chronic venous insufficiency of the lower limb or varicose veins of the lower limb or death from chronic venous insufficiency of the lower limb or varicose veins of the lower limb with the circumstances of a person's relevant service:

  1. (1)
    having deep vein thrombosis within a deep vein that drains the affected lower limb before the clinical onset of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;

    Note: deep vein that drains the affected lower limb is defined in the Schedule 1 - Dictionary.

  2. (2)
    having chronic complete or partial obstruction of a vein that drains the affected lower limb before the clinical onset of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;
  3. (3)
    being pregnant at the time of the clinical onset of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;
  4. (4)
    standing for at least four hours per day, on more days than not, for a continuous period of at least the five years before the clinical onset of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;

    Note: Standing does not require complete immobility for four continuous hours, and may include intermittent periods of walking short distances.

  5. (5)
    having chronic dysfunction of the calf muscle pump in the affected lower limb at the time of the clinical onset of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;

    Note: Causes of chronic dysfunction of the calf muscle pump include trauma and motor disorders (such as paraplegia, arthritis, chronic immobility, frozen ankle and severe sedentary state).

  6. (6)
    being obese at the time of the clinical onset of chronic venous insufficiency of the lower limb or varicose veins of the lower limb; Chronic Venous Insufficiency Of The Lower Limb And Varicose Veins Of The Lower Limb;

    Note: being obese is defined in the Schedule 1 - Dictionary.

  7. (7)
    having an acquired arteriovenous fistula involving the blood vessels that supply the affected lower limb at the time of the clinical onset of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;
  8. (8)
    having trauma to a valve in a vein of the affected lower limb causing dysfunction or incompetence of that valve before the clinical onset of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;
  9. (9)
    having tricuspid valve regurgitation, in the presence of a pulsatile greater saphenous vein, at the time of the clinical onset of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;
  10. (10)
    for chronic venous insufficiency of the lower limb only: (a) having varicose veins of the affected lower limb at the time of the clinical onset of chronic venous insufficiency of the lower limb; (b) having heart failure at the time of the clinical onset of chronic venous insufficiency of the lower limb;
  11. (11)
    for varicose veins of the thigh only, having a varicosity of an abdominal or pelvic vein, leading to reflux into the affected thigh vein via interconnecting or collateral veins, at the time of the clinical onset of varicose veins of the thigh;
  12. (12)
    having deep vein thrombosis within a deep vein that drains the affected lower limb before the clinical worsening of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;

    Note: deep vein that drains the affected lower limb is defined in the Schedule 1 - Dictionary.

  13. (13)
    having chronic complete or partial obstruction of a vein that drains the affected lower limb before the clinical worsening of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;
  14. (14)
    being pregnant at the time of the clinical worsening of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;
  15. (15)
    standing for at least four hours per day, on more days than not, for a continuous period of at least the five years before the clinical worsening of chronic venous insufficiency of the lower limb or varicose veins of the lower limb; Chronic Venous Insufficiency Of The Lower Limb And Varicose Veins Of The Lower Limb;

    Note: Standing does not require complete immobility for four continuous hours, and may include intermittent periods of walking short distances.

  16. (16)
    having chronic dysfunction of the calf muscle pump in the affected lower limb at the time of the clinical worsening of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;

    Note: Causes of chronic dysfunction of the calf muscle pump include trauma and motor disorders (such as paraplegia, arthritis, chronic immobility, frozen ankle and severe sedentary state).

  17. (17)
    being obese at the time of the clinical worsening of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;

    Note: being obese is defined in the Schedule 1 - Dictionary.

  18. (18)
    having an acquired arteriovenous fistula involving the blood vessels that supply the affected lower limb at the time of the clinical worsening of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;
  19. (19)
    having trauma to a valve in a vein of the affected lower limb causing dysfunction or incompetence of that valve before the clinical worsening of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;
  20. (20)
    having tricuspid valve regurgitation, in the presence of a pulsatile greater saphenous vein, at the time of the clinical worsening of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;
  21. (21)
    for chronic venous insufficiency of the lower limb only: (a) having varicose veins of the affected lower limb at the time of the clinical worsening of chronic venous insufficiency of the lower limb; (b) having heart failure at the time of the clinical worsening of chronic venous insufficiency of the lower limb;
  22. (22)
    for varicose veins of the thigh only, having a varicosity of an abdominal or pelvic vein, leading to reflux into the affected thigh vein via interconnecting or collateral veins, at the time of the clinical worsening of varicose veins of the thigh;
  23. (23)
    inability to obtain appropriate clinical management for chronic venous insufficiency of the lower limb or varicose veins of the lower limb;

Aggravation-only factors: the factors in subsections 9(12) to 9(23) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.

Balance of Probabilities (BoP) — Statement of Principles No. 8 of 2021

21 factors

At least one of the following factors must exist before it can be said that, on the balance of probabilities, chronic venous insufficiency of the lower limb or varicose veins of the lower limb or death from chronic venous insufficiency of the lower limb or varicose veins of the lower limb is connected with the circumstances of a person's relevant service:

  1. (1)
    having deep vein thrombosis within a deep vein that drains the affected lower limb before the clinical onset of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;

    Note: deep vein that drains the affected lower limb is defined in the Schedule 1 - Dictionary.

  2. (2)
    having chronic complete or partial obstruction of a vein that drains the affected lower limb before the clinical onset of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;
  3. (3)
    being pregnant at the time of the clinical onset of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;
  4. (4)
    standing for at least four hours per day, on more days than not, for a continuous period of at least the five years before the clinical onset of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;

    Note: Standing does not require complete immobility for four continuous hours, and may include intermittent periods of walking short distances.

  5. (5)
    having chronic dysfunction of the calf muscle pump in the affected lower limb at the time of the clinical onset of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;

    Note: Causes of chronic dysfunction of the calf muscle pump include trauma and motor disorders (such as paraplegia, arthritis, chronic immobility, frozen ankle and severe sedentary state).

  6. (6)
    having an acquired arteriovenous fistula involving the blood vessels that supply the affected lower limb at the time of the clinical onset of chronic venous insufficiency of the lower limb or varicose veins of the lower limb; Chronic Venous Insufficiency Of The Lower Limb And Varicose Veins Of The Lower Limb;
  7. (7)
    having trauma to a valve in a vein of the affected lower limb causing dysfunction or incompetence of that valve before the clinical onset of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;
  8. (8)
    having tricuspid valve regurgitation, in the presence of a pulsatile greater saphenous vein, at the time of the clinical onset of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;
  9. (9)
    for chronic venous insufficiency of the lower limb only: (a) having varicose veins of the affected lower limb at the time of the clinical onset of chronic venous insufficiency of the lower limb; (b) having heart failure at the time of the clinical onset of chronic venous insufficiency of the lower limb; (c) being obese at the time of the clinical onset of chronic venous insufficiency of the lower limb;

    Note: being obese is defined in the Schedule 1 - Dictionary.

  10. (10)
    for varicose veins of the thigh only, having a varicosity of an abdominal or pelvic vein, leading to reflux into the affected thigh vein via interconnecting or collateral veins, at the time of the clinical onset of varicose veins of the thigh;
  11. (11)
    having deep vein thrombosis within a deep vein that drains the affected lower limb before the clinical worsening of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;

    Note: deep vein that drains the affected lower limb is defined in the Schedule 1 - Dictionary.

  12. (12)
    having chronic complete or partial obstruction of a vein that drains the affected lower limb before the clinical worsening of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;
  13. (13)
    being pregnant at the time of the clinical worsening of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;
  14. (14)
    standing for at least four hours per day, on more days than not, for a continuous period of at least the five years before the clinical worsening of chronic venous insufficiency of the lower limb or varicose veins of the lower limb; Chronic Venous Insufficiency Of The Lower Limb And Varicose Veins Of The Lower Limb;

    Note: Standing does not require complete immobility for four continuous hours, and may include intermittent periods of walking short distances.

  15. (15)
    having chronic dysfunction of the calf muscle pump in the affected lower limb at the time of the clinical worsening of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;

    Note: Causes of chronic dysfunction of the calf muscle pump include trauma and motor disorders (such as paraplegia, arthritis, chronic immobility, frozen ankle and severe sedentary state).

  16. (16)
    having an acquired arteriovenous fistula involving the blood vessels that supply the affected lower limb at the time of the clinical worsening of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;
  17. (17)
    having trauma to a valve in a vein of the affected lower limb causing dysfunction or incompetence of that valve before the clinical worsening of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;
  18. (18)
    having tricuspid valve regurgitation, in the presence of a pulsatile greater saphenous vein, at the time of the clinical worsening of chronic venous insufficiency of the lower limb or varicose veins of the lower limb;
  19. (19)
    for chronic venous insufficiency of the lower limb only: (a) having varicose veins of the affected lower limb at the time of the clinical worsening of chronic venous insufficiency of the lower limb; (b) having heart failure at the time of the clinical worsening of chronic venous insufficiency of the lower limb; (c) being obese at the time of the clinical worsening of chronic venous insufficiency of the lower limb;

    Note: being obese is defined in the Schedule 1 - Dictionary.

  20. (20)
    for varicose veins of the thigh only, having a varicosity of an abdominal or pelvic vein, leading to reflux into the affected thigh vein via interconnecting or collateral veins, at the time of the clinical worsening of varicose veins of the thigh;
  21. (21)
    inability to obtain appropriate clinical management for chronic venous insufficiency of the lower limb or varicose veins of the lower limb;

Aggravation-only factors: the factors in subsections 9(11) to 9(21) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.

A VHC Diagnostic Assessment addresses each of these factors one by one against your service record and clinical history. See how a VHC DVA claim works, see all fees ($600 + GST per stage) or book an appointment.

About Dr Thomas Perkins

One doctor. Every report.

Founding doctor of the Veterans Health Centre in Ipswich, Queensland, and one of Australia's most experienced practitioners in veterans' medicolegal medicine.

Dr Perkins has spent more than thirteen years working exclusively with current and former ADF members — treating their conditions, writing their reports and navigating the DVA system alongside them. With over 100,000 claims submitted and 2,000 Permanent Impairment Assessments completed, he has seen precisely what separates an accepted claim from a rejected one at every level, from initial liability to the Veterans' Review Board.

Every chart review, diagnostic assessment, impairment rating and appeal that leaves this clinic is personally overseen by Dr Perkins. No template, no locum, no hand-off.

0429 146 039 reception@vhc.org.au

Book appointment