VA Disability for Raynaud’s Disease

Raynaud’s disease, also referred to as Raynaud’s phenomenon or Raynaud’s syndrome, is a condition that can be linked to several other conditions and often causes a pins and needles sensation in the extremities.

What is Raynaud’s Disease?

Raynaud’s Disease occurs when the blood flow to the fingers is decreased, though it can also happen in toes, ears, nose, knees, or nipples if the blood vessels in those areas spasm.  The spasms may be due to cold exposure, stress, or periods of heightened emotions.

There are generally two forms of Raynaud’s.  In the primary form,  the condition develops on its own, while the secondary form refers to cases in which Raynaud’s Disease occurs as the result of another condition.

Conditions Linked to Raynaud’s Disease

• Lupus
• Rheumatoid Arthritis
• Sjogren syndrome
• Pulmonary hypertension
• Occlusive vascular disease, or atherosclerosis
• Polymyositis
• Blood disorders, like cryoglobulinemia
• Thyroid disorders

What Causes Raynaud’s Disease?

There are certain risks which can make a person more likely to develop Raynaud’s Disease than others.  Risk factors can include:

• Autoimmune diseases
• Exposure to toxins or chemicals
• Injury or trauma
• Repeated exercises or actions
• Use of tools that vibrate, such as a jack hammer
• Use of some medications

Common Symptoms

• Swelling or pain in the hands
• White or blue fingers or fingertips when exposed to cold
• Reddening of the hands when warmed
• Numbness or prickly feeling in fingers or toes
• Sores on fingertip pads
• Gangrene, in more severe cases

Diagnosing Raynaud’s Disease

A doctor will likely need to physically examine the person to diagnose Raynaud’s Disease.  During this exam, the examiner could conduct a cold challenge test to see the color change in the extremities.  A doctor may also examine the blood vessels underneath a microscope.  Blood tests can also help to indicate if the Raynaud’s Disease is primary or secondary.

Treatment Options

Treatment for Raynaud’s Disease can be dependent upon the person’s age, symptoms, and overall general health.  While there is no complete cure for the disease, treatment can help manage symptoms.  Treatment methods could include:

• Blood pressure medication
• Protection from the cold
• Avoiding trauma, specifically vibrations

Service Connection for Raynaud’s Disease

In order to receive VA disability benefits for Raynaud’s Disease, veterans will need to become service connected, meaning they need to indicate to VA how their condition is linked to their service.

To prove service connection, usually veterans need to submit three things:

• An in-service event, injury, or illness;
• A current diagnosis by a medical professional; and
• A medical nexus, or link, between your in-service event, injury, or illness and your current diagnosis.

Veterans can submit a claim on VA Form 21-526EZ.  The form can submitted via mail to VA’s Evidence Intake Center or electronically through VA’s website.

Some examples of how a veteran’s Raynaud’s Disease may be service connected are if the veteran had to work with heavy, vibrating machinery throughout their service or if they were exposed to toxins through herbicides or burn pits.

Secondary Service Connection

A veteran’s Raynaud’s Disease could also be eligible for secondary service connection if the veteran is already service connected for a condition that caused or contributed to their Raynaud’s Disease.  Disabilities that are service connected on a secondary basis are rated the same way as other service-connected disabilities.

For example, if a veteran’s rheumatoid arthritis is service connected and the veteran developed Raynaud’s Disease as a result, the veteran could become service connected for their Raynaud’s Disease as secondary to rheumatoid arthritis.

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Compensation and Pension Exams for Raynaud’s Disease

In order to assess the veteran’s Raynaud’s Disease, VA may request a compensation and pension (C&P) exam.  This exam will likely be performed by VA contracted examiner.

Prior to the exam, the examiner should review the veteran’s c-file.  A c-file contains any documentation that VA has regarding previously submitted claims, as well as the veteran’s medical and service records.

During the exam, the examiner will usually physically examine the veteran.  They may ask questions about the veteran’s Raynaud’s Disease and their military service.  If the Raynaud’s Disease is not the primary condition, then the examiner may ask questions about how the Raynaud’s disease is related to the primary condition, as well as symptoms of both conditions.

Veterans may also use a DBQ, or Disability Benefits Questionnaire, to help support their claim.  This is a form created by VA which allows the veteran to address important aspects of their condition, such as symptoms, severity, and potential causes.  A private doctor that treats the veteran outside of a VA medical center can also fill out a DBQ for the veteran.

The most important thing about C&P exams is attendance.  If you fail to attend a C&P exam, VA may deny your claim.  If you did miss a C&P exam, you should contact VA as soon as possible to see if you can reschedule.

VA Ratings for Raynaud’s Disease

If a veteran is granted service connection for their Raynaud’s Disease, VA will assign a rating that corresponds to a rate of compensation.  Raynaud’s Disease, listed as Raynaud’s syndrome in the rating criteria, is rated under 38 CFR § 4.104 – Schedule of Ratings – Cardiovascular System, Diagnostic Code 7117.  Ratings can range anywhere from 10 percent to 100 percent.  Below are the criteria for each rating:

• 100%––This is the highest rating a veteran can receive for Raynaud’s Disease. The rating is given with two or more digital ulcers plus autoamputation of one or more digits and a history of characteristic attacks
• 60%––Veterans with two or more digital ulcers and a history of characteristic attacks are eligible for the 60 percent rating.
• 40%––The 40 percent rating is given to veterans with characteristic attacks that occur at least daily.
• 20%––Veterans who experience characteristic attacks that occur four to six times per day can receive the 20 percent rating.
• 10%––Lastly, this rating is assigned to veterans who experience characteristic attacks one to three times per week.

Importantly, characteristic attacks are defined as “sequential color changes of the digits of one or more extremities lasting minutes to hours.”  These attacks can by accompanied by pain or paresthesias.  Attacks may be brought on by a variety of factors, such as exposure to the cold or emotional upsets.  Additionally, it does not matter how may extremities are involved in the attacks or which ones are affected.

Burn Pit Exposure and Raynaud’s Disease

Military burn pits are large areas of land in which the military and its contractors incinerated all waste generated by military bases, including plastics, medical waste, rubber, human waste, and more.  These burn pits were used extensively during Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn and have affected many veterans who served in the Middle East.

Many U.S. Military veterans have suffered health consequences from burn pit exposure.

Sjorgen syndrome, rheumatoid arthritis, pulmonary conditions, and thyroid disorders have all been linked to burn pit exposure and are known to cause Raynaud’s Disease.  Additionally, exposure to toxins and chemicals can also cause Raynaud’s.  As such, veterans who were exposed to burn pits face a risk of developing Raynaud’s.

Research continues to be done into the variety of health conditions caused by burn pit exposure, however research conducted to date has indicated that one of the known chemical compounds released by burn pits includes the dioxin TCDD, which was also found in Agent Orange.

While VA does acknowledge certain conditions as being eligible for presumptive service connection if the veteran can prove exposure to Agent Orange, VA has not established the same presumptive list for veterans exposed to burn pits.  Currently, VA only adjudicates claims for chronic asthma, rhinitis, and sinusitis due to particular matter exposure as presumptive.  To be eligible for this presumption, veterans must have:

• Served in the Southwest Asia theater of operations beginning Aug. 2, 1990 to the present, or
• Served in Afghanistan, Uzbekistan, Syria or Djibouti beginning Sept. 19, 2001 to the present.

Aside from claims involving these three conditions, VA adjudicates burn pit claims on a case-by-case basis.  Lay evidence is often the key to winning burn pits claims, as statements from veterans themselves or buddy statements from fellow servicemembers can help prove exposure.

TDIU and Raynaud’s Disease

Veterans with this condition who experience many characteristic attacks may be prevented from working.  These veterans may be able to receive a monthly VA disability benefit called total disability based on individual unemployability, or TDIU.  This benefit compensates veterans at the 100 percent rating level, regardless of whether their disability rating is less than 100 percent.

In order to be awarded schedular TDIU, veterans need to meet the criteria outlined under 38 CFR § 4.16a.  The criteria requires that veterans must have one condition rated at 60 percent minimum OR two conditions that can be combined to reach 70 percent, where one condition is at minimum 40 percent.  As such, ratings for Raynaud’s Disease may help a veteran achieve either a minimum rating of 60 percent or a combined rating of 70 percent.  Importantly, if the veteran’s Raynaud’s Disease is secondary to another conditions, both ratings can be considered for the combined rating.

Veterans who do not meet these qualifications may be eligible for extraschedular TDIU.  For this form of TDIU, veterans must prove that their condition(s) uniquely hinders their ability to maintain substantially gainful employment.  Extraschedular TDIU is rated under 38 CFR § 4.16b.

Need Help Getting Your Benefits for Raynaud’s Disease?

Sometimes, VA can deny a veteran’s claim for Raynaud’s Disease.  This can happen if the veteran’s condition was the result of exposure to burn pits, as burn pit claims can be notoriously difficult to win.

If your claim for Raynaud’s Disease has been denied, it does not mean your case is unwinnable.  The team at Chisholm Chisholm & Kilpatrick has helped many veterans win the benefits they deserve and may be able to help you do the same!  If you need assistance with your appeal for Raynaud’s Disease, contact our office today for a free case evaluation.