Raynaud's Disease — VA Disability Rating Criteria (DC 7124)

Diagnostic Code 7124 · 38 CFR §4.104

What Is It?

Raynaud's disease — primary Raynaud's — is a vascular condition where blood vessels in the fingers and toes constrict excessively in response to cold temperatures or emotional stress, causing episodes of colour change, numbness, tingling and pain. 'Primary' is the whole point of the code: DC 7124 is for Raynaud's that arises on its own, with no underlying disease driving it. Where the Raynaud's is secondary — to an autoimmune condition, to vibration injury, to a medication, or as a residual effect of a cold injury — the schedule sends it to DC 7117, Raynaud's syndrome, and Note (3) to DC 7124 says so expressly. That distinction decides how much the code is worth. DC 7124 prints two evaluations and no more: 10 percent for characteristic attacks associated with trophic change or changes, such as tight, shiny skin, and 0 percent for characteristic attacks without trophic changes. DC 7117, the secondary code, runs 100, 60, 40, 20 and 10 percent. Note (1) to DC 7124 defines a characteristic attack as intermittent and episodic colour changes of the digits of one or more extremities, lasting minutes or longer, with occasional pain and paresthesias, precipitated by exposure to cold or by emotional upsets — and the evaluation is for the disease as a whole, regardless of how many extremities are involved or whether the nose and ears are involved. Note (2) defines trophic changes: skin changes such as thinning, atrophy, fissuring, ulceration, scarring and absence of hair, as well as nail changes such as clubbing and deformities. DC 7124 is a new code, added when 38 CFR 4.104 was revised in 2021; before that the schedule had no separate entry for primary Raynaud's.

Rating Criteria

Evidence Needed

Medical records documenting the diagnosis and, above all, whether it is primary or secondary — that single word decides whether you are rated under DC 7124 or DC 7117. Records showing the characteristic colour changes (pallor, cyanosis, rubor). Documentation of trophic changes, which is what separates the 10 percent evaluation from 0: skin thinning, atrophy, fissuring, ulceration, scarring or absence of hair, and nail clubbing or deformity — tight, shiny skin is the example the code itself gives. A symptom diary logging attack frequency, duration, triggers, and affected digits over several months. Photographs of hands or feet during attacks showing the color changes — these are extremely helpful evidence. Cold stimulation testing or vascular studies confirming the diagnosis. Documentation of any digital ulcers or tissue loss. Service records of cold weather exposure, vibration exposure, or the service-connected condition that caused the Raynaud's. Buddy statements from people who have witnessed the attacks.

C&P Exam Tips

The biggest challenge with Raynaud's C&P exams is that attacks may not occur in the warm exam room. Bring photographs taken during attacks showing the color changes in your fingers or toes. Present your symptom diary documenting attack frequency — the rating depends entirely on how often attacks occur. Describe specific triggers: what temperatures, what activities, how long exposure before an attack begins. If you have digital ulcers or scars from past ulcers, make sure the examiner documents them. Explain the functional impact: inability to work in cold environments, dropping objects due to numbness, pain that disrupts activities. If your Raynaud's is secondary to cold injury residuals or vibration exposure, ensure the examiner notes that connection.

How to File

File on VA Form 21-526EZ. Which code you file under is the first decision. DC 7124 is for primary Raynaud's disease — Raynaud's with no underlying cause. If your Raynaud's followed a cold injury, a vibration injury, an autoimmune condition or a medication, it is secondary Raynaud's and it belongs under DC 7117, which prints evaluations up to 100 percent; Note (1) to DC 7122 expressly directs that Raynaud's syndrome diagnosed as a residual effect of cold injury be evaluated separately from the cold injury residuals themselves. Under DC 7124 the whole question is trophic changes, so submit photographs and examination findings showing skin thinning, tight or shiny skin, fissuring, scarring, absence of hair, or nail clubbing or deformity, alongside your symptom diary and any vascular studies.

Common Mistakes

Filing primary Raynaud's when yours is secondary DC 7124 prints only 10 and 0 percent. Raynaud's that follows a cold injury, vibration exposure, an autoimmune disease or a medication is secondary Raynaud's, rated under DC 7117, which runs to 100 percent. Ask your provider to state in the record which form you have. Not documenting trophic changes Under DC 7124 that is the entire difference between 10 percent and 0. Not photographing attacks Raynaud's attacks are episodic and may not occur during the C&P exam. Photographs showing the distinctive colour changes (white then blue then red), and any trophic change to the skin or nails, are some of the best evidence you can provide. Filing only Raynaud's when cold injury residuals also apply If your Raynaud's developed from frostbite or cold exposure, file for both cold injury residuals (DC 7122) and the Raynaud's — but that Raynaud's is the secondary form, so it is claimed under DC 7117, not this code. Note (1) to DC 7122 says the two are evaluated separately.

Frequently Asked Questions

Can Raynaud's be secondary to cold injury residuals?

Yes, and Note (1) to DC 7122 says so directly: disabilities diagnosed as residual effects of cold injury, naming Raynaud's syndrome, are evaluated separately from the cold injury residuals themselves, unless the same findings are being used to support the DC 7122 evaluation. But Raynaud's arising that way is the secondary form, so it is rated under DC 7117 — not under DC 7124, which is for primary Raynaud's disease.

What counts as a characteristic attack?

Note (1) to DC 7124 defines it as intermittent and episodic colour changes of the digits of one or more extremities, lasting minutes or longer, with occasional pain and paresthesias, precipitated by exposure to cold or by emotional upsets. In practice that is the familiar sequence — pallor, then cyanosis, then rubor as blood flow returns. The evaluation is for the disease as a whole, however many extremities are involved, and whether or not the nose and ears are affected.

How do I prove attack frequency if they do not happen at the doctor's office?

Keep a detailed daily symptom diary recording each attack: date, time, trigger, duration, affected digits, and severity. Take photographs during attacks showing the colour changes. Buddy statements from family members or coworkers who witness your attacks are also valuable evidence. Under DC 7124, though, frequency is not what moves the evaluation — trophic changes are. Photograph the skin and nails between attacks as well.

Is Raynaud's from vibration exposure service-connectable?

Yes. Hand-arm vibration syndrome from operating heavy equipment, power tools, weapons systems, or machinery during service can cause Raynaud's phenomenon — but Raynaud's with a cause behind it is secondary Raynaud's, which is rated under DC 7117 rather than under this code. Document your MOS duties involving vibration exposure and provide a nexus opinion connecting the vibration to your current symptoms.