VA Disability Rating for Erythromelalgia (DC 7119)
Diagnostic Code 7119 · 38 CFR §4.104
What Is It?
Erythromelalgia is a rare vascular condition characterized by episodes of burning pain, redness, and warmth in the extremities, most commonly the feet and hands. Episodes are often triggered by warmth, exercise, or standing, and are relieved by cooling. The condition can be primary (occurring on its own) or secondary to other conditions such as blood disorders or neuropathy. Veterans may develop erythromelalgia from service-related exposures, medications, or as a secondary effect of other service-connected conditions.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Characteristic attacks that occur more than once a day, last an average of more than two hours each, respond poorly to treatment, and that restrict most routine daily activities. |
| 60% | Characteristic attacks that occur more than once a day, last an average of more than two hours each, and respond poorly to treatment, but that do not restrict most routine daily activities. |
| 30% | Characteristic attacks that occur daily or more often but that respond to treatment. |
| 10% | Characteristic attacks that occur less than daily but at least three times a week and that respond to treatment. |
Evidence Needed
- Medical records with a confirmed diagnosis of erythromelalgia
- Documentation of attack frequency, triggers, and duration
- Photos taken during active episodes showing redness and swelling
- Treatment records showing medications tried and their effectiveness
- Thermal testing or infrared imaging if performed
- Service medical records or nexus letter explaining the service connection
C&P Exam Tips
- Keep an episode log with frequency, duration, triggers, and severity for each attack
- Take photos during flare-ups showing the redness and swelling
- Document which treatments you have tried and how effective they were — this matters for the 60 and 100 percent ratings
- Describe how the condition limits your daily activities: can you wear shoes, walk, stand, work?
- If attacks are triggered by warmth, the exam room itself may provoke symptoms — this can actually help demonstrate the condition
How to File
File on VA Form 21-526EZ with medical records, episode documentation, photos, and a nexus letter. If claiming secondary to another condition, include that service-connected condition's evidence.
Common Mistakes
Not tracking attack frequency The rating hinges on how often attacks occur: less than weekly, one to three times weekly, or four or more times weekly. Keep a meticulous log. Not documenting treatment failure For 60 and 100 percent ratings, the VA looks at whether attacks respond to treatment. Document every medication tried and its effectiveness. Relying on verbal descriptions alone Photos taken during active episodes are critical evidence. The redness and swelling are visible and photographs well.
Frequently Asked Questions
What is a characteristic attack of erythromelalgia?
A characteristic attack involves burning pain, visible redness, and increased warmth in the affected extremities, typically the feet or hands. Episodes may last minutes to hours and are usually triggered by warmth, exercise, or standing.
Is erythromelalgia hard to get diagnosed?
It can be, because episodes come and go. A specialist in vascular medicine or pain management can usually make the diagnosis based on history, photos, and sometimes thermal testing during a provoked episode.
Can I claim this secondary to a blood disorder?
Yes. Erythromelalgia can be secondary to polycythemia vera, thrombocytosis, and other blood conditions. If you have a service-connected blood disorder, file erythromelalgia as secondary.