What Is the VA Rating for Raynaud’s Disease? DC 7117 Criteria, Secondary Connection, and the Documentation Gap Most Veterans Miss

DC 7117 Rating Ladder: 10% to 100%

Raynaud’s syndrome is rated under Diagnostic Code 7117 within the Cardiovascular System schedule (38 CFR § 4.104). The rating is based on how frequently attacks occur, the severity of those attacks, and the presence of tissue damage. Per VA training materials (Medical EPSS), evaluations under DC 7117 consider the syndrome as a whole regardless of which extremities are involved.

Notice the sharp jump from 40% to 60%: the only difference is the presence of “trophic changes.” That single clinical finding is worth an additional 20 percentage points and potentially hundreds of dollars per month in compensation. Yet the VA rating schedule does not define what trophic changes means. This is the documentation gap that costs veterans money.

Primary vs. Secondary Raynaud’s: The DC 7117 vs. DC 7124 Distinction

The VA makes a critical regulatory distinction that many veterans, and even some VSO representatives, do not fully understand.

• DC 7117 is specifically for secondary Raynaud’s (Raynaud’s syndrome or Raynaud’s phenomenon). The regulatory text explicitly states: “Raynaud’s syndrome (also known as secondary Raynaud’s phenomenon or secondary Raynaud’s).” This occurs secondary to an underlying condition such as lupus (SLE), scleroderma, CREST syndrome, or another autoimmune/connective tissue disease.
• DC 7124 is for primary Raynaud’s (Raynaud’s disease). Note (3) in the CFR states: “This section is for evaluating Raynaud’s disease (primary Raynaud’s). For evaluation of Raynaud’s syndrome… see DC 7117.” DC 7124 falls under “Other peripheral vascular diseases” and likely uses different rating criteria.

Presumptive Service Connection for Primary Raynaud’s

If you have primary Raynaud’s (not caused by another condition), presumptive service connection may be available if the condition manifested within one year of discharge from active duty. This falls under the VA’s presumptive period for chronic diseases. You would need medical records showing onset of symptoms within that one-year window.

Trophic Changes: The Undefined Term That Controls Your Rating

The single most important documentation issue in Raynaud’s claims is the term “trophic changes.” This is the threshold between a 40% rating (daily attacks) and a 60% rating (daily attacks with trophic changes). The VA rating schedule uses the term but never defines it.

Medical literature defines trophic changes in Raynaud’s as tissue damage resulting from chronic ischemia (reduced blood flow from repeated vasospasm). Specific clinical findings include:

• Skin thinning and atrophy — loss of subcutaneous tissue in affected digits
• Fissuring and cracking — dry, brittle skin that splits open
• Digital ulceration — open sores on fingertips or toes
• Hair loss — loss of fine hair on affected digits or hands
• Nail deformities — pitting, ridging, brittleness, or nail loss
• Skin discoloration — permanent color changes beyond the acute attack

This is the gap our research identified between the medical community and the VA regulatory community. Clinicians describe what they see using precise medical terminology. VA raters look for the specific terms in the rating schedule. The veteran’s documentation must bridge these two vocabularies explicitly.

Pyramiding: Separate Raynaud’s Rating vs. Underlying Autoimmune Condition

Because secondary Raynaud’s is by definition caused by an underlying condition, the VA’s anti-pyramiding regulation (38 CFR § 4.14) creates a potential barrier to receiving a separate rating for Raynaud’s in addition to the underlying condition.

The pyramiding prohibition states that “the evaluation of the same manifestation under different diagnoses is to be avoided.” Here is how this applies to Raynaud’s:

To overcome this, you must demonstrate that your Raynaud’s causes additional functional impairment that is not already captured in the underlying condition’s rating. Specific arguments include:

• Digital ulcers requiring separate treatment — if your Raynaud’s causes ulcers that need wound care, medications, or procedures independent of your lupus treatment
• Tissue loss or autoamputation — permanent anatomical damage that is distinct from the systemic symptoms rated under the autoimmune condition
• Functional limitations in the hands or feet — inability to grip, type, or perform fine motor tasks due to Raynaud’s attacks that is not captured in the underlying condition’s rating criteria

How to Establish Service Connection for Raynaud’s

Secondary Service Connection (Most Common Path)

The vast majority of veterans who receive VA ratings for Raynaud’s do so through secondary service connection. If you have a service-connected autoimmune or connective tissue disease, and that disease causes Raynaud’s phenomenon, the Raynaud’s is service-connected on a secondary basis under 38 CFR § 3.310.

Common service-connected conditions that cause secondary Raynaud’s:

• Lupus (SLE) — approximately 10–45% of lupus patients develop Raynaud’s
• Scleroderma / CREST syndrome — Raynaud’s is present in over 90% of scleroderma patients; the “R” in CREST stands for Raynaud’s
• Rheumatoid arthritis — secondary Raynaud’s occurs in a subset of RA patients
• Sjögren’s syndrome — another autoimmune condition associated with Raynaud’s
• Mixed connective tissue disease (MCTD) — Raynaud’s is a defining feature

You will need a nexus letter from a rheumatologist or internist explicitly stating that your Raynaud’s syndrome is caused by or aggravated by your service-connected condition.

Direct Service Connection

Direct service connection requires:

1. An in-service event, injury, or onset of symptoms documented in service treatment records
2. A current diagnosis of Raynaud’s
3. A medical nexus linking the current diagnosis to service

In-service triggers can include prolonged cold exposure (cold weather operations, flight line work, shipboard duties), vibration injury from operating heavy equipment or power tools (hand-arm vibration syndrome, which can cause secondary Raynaud’s), and chemical exposure to certain agents during military service.

Presumptive Service Connection

For primary Raynaud’s disease, presumptive service connection may be available if the condition manifested to a compensable degree (10% or higher, meaning at least 1–3 attacks per week) within one year of discharge from active duty.

Secondary Conditions Linked to Raynaud’s

Conditions You Can Claim Secondary TO Raynaud’s

If your Raynaud’s is already service-connected, these downstream conditions may be claimable:

• Digital ulcers / chronic wounds — if severe enough to require ongoing treatment beyond what the Raynaud’s rating captures
• Peripheral neuropathy — chronic ischemia from repeated vasospasm can damage peripheral nerves in the digits
• Depression / anxiety — chronic pain and functional limitation from Raynaud’s attacks; rated under DC 9434/9413 (30–70%)
• Occupational impairment — if Raynaud’s prevents you from working in your occupation, consider TDIU (Total Disability Individual Unemployability)

Conditions That May Cause Raynaud’s (Secondary Connection Pathways)

If you have one of these service-connected conditions and develop Raynaud’s, file a secondary claim:

• Carpal tunnel syndrome — nerve entrapment can trigger vasospastic episodes in the affected hand
• Thoracic outlet syndrome — compression of vascular structures can cause Raynaud’s-like symptoms
• Beta-blocker medications — if you take beta-blockers for a service-connected heart condition, these medications are known to worsen or trigger Raynaud’s symptoms
• Cold injury residuals — veterans with service-connected cold injury (frostbite) may develop Raynaud’s as a secondary condition

Documentation Strategy: Bridging Medical Records to VA Criteria

The central challenge in Raynaud’s claims is translating clinical medical documentation into the VA’s rating criteria vocabulary. Based on our review, here is what your medical records need to contain:

For Any Rating (10%+)

• Attack frequency log: Track every Raynaud’s attack for at least 30 days. Record the date, time, duration, triggers, digits affected, and color changes observed. This directly maps to the frequency-based rating ladder (1–3/week = 10%, 4–6/week = 20%, daily = 40%).
• Color change documentation: Photograph your hands/feet during an attack showing the white → blue → red color sequence. Time-stamped photos are powerful evidence that you experience “characteristic attacks.”
• Pain and numbness description: Document the pain level (0–10 scale), numbness, tingling, and any functional limitation during attacks (e.g., “unable to grip objects,” “cannot button shirt”).

For 60% Rating (Daily Attacks + Trophic Changes)

• Use the term “trophic changes” explicitly in medical notes alongside the clinical findings.
• List specific findings: “Trophic changes present, including digital skin atrophy, nail pitting bilaterally, loss of hair on digits 2–5, and fissuring of fingertip skin.”
• Photograph trophic changes: Close-up photos of nail deformities, skin thinning, ulcers, and hair loss on digits.

For 100% Rating (Ulcers + Autoamputation)

• Document digital ulcers: Size, location, duration, treatment required, and whether they are recurrent.
• Document autoamputation: Medical records showing tissue loss, digit shortening, or surgical amputation resulting from Raynaud’s-related ischemia.

C&P Exam Tips for Raynaud’s

1. Bring Your Attack Log

The C&P examiner needs to assess attack frequency to assign a rating percentage. A written log showing daily or near-daily attacks over a sustained period is far more persuasive than verbal testimony alone. Bring your log and ask the examiner to note it in the examination report.

2. Bring Photographs of Attacks and Trophic Changes

Raynaud’s attacks are episodic — you may not be having one during your exam. Time-stamped photographs showing color changes (white/blue/red sequence) during attacks provide evidence the examiner can reference. If you have trophic changes, bring photos of those as well, even if they are visible during the exam.

3. Request Examination of All Affected Extremities

DC 7117 evaluates Raynaud’s syndrome “as a whole regardless of the number of extremities involved,” but the examiner should still document which extremities are affected and the severity in each. If your feet are affected in addition to your hands, make sure the examiner examines and documents both.

4. Ask the Examiner to Document Trophic Changes

If you have any of the clinical findings that constitute trophic changes (skin atrophy, nail deformities, hair loss, ulceration), specifically ask the examiner to note them and use the term “trophic changes” in the report. If the examiner does not use the term, the rater may not connect the clinical findings to the 60% threshold.

5. Describe Functional Impact

Tell the examiner how Raynaud’s affects your daily life: inability to work in cold environments, difficulty with fine motor tasks during attacks, need to avoid air conditioning, impact on employment. This supports higher ratings and potential TDIU consideration.

Your Action Steps

1. Determine if your Raynaud’s is primary or secondary. This dictates whether you are rated under DC 7117 (secondary) or DC 7124 (primary). If you have an underlying autoimmune condition, your Raynaud’s is secondary. Make this explicit in your claim.
2. File an Intent to File (VA Form 21-0966) immediately to lock in your effective date while you gather evidence.
3. Start an attack frequency log today. Track every attack for at least 30 consecutive days. Include date, time, duration, triggers, digits affected, and color changes.
4. Photograph attacks and trophic changes. Use your phone’s timestamp feature. Capture the white → blue → red color sequence during attacks. Photograph any nail deformities, skin atrophy, or ulcers.
5. Ask your doctor to use the term “trophic changes” alongside specific clinical findings in your medical notes. This is the single most impactful documentation step for pushing from 40% to 60%.
6. Get a nexus letter from a rheumatologist or internist. For secondary Raynaud’s, the letter must explicitly connect Raynaud’s syndrome to your service-connected underlying condition. For direct service connection, the letter must link to an in-service event.
7. If you have a separate rating for lupus, scleroderma, or another autoimmune condition, prepare to address the pyramiding issue. Document how your Raynaud’s causes functional impairment beyond what the underlying condition’s rating already captures.
8. File secondary claims for downstream conditions if applicable (peripheral neuropathy, depression from chronic pain, etc.).
9. If your Raynaud’s was triggered by beta-blocker medication prescribed for a service-connected heart condition, file a secondary claim specifically identifying the medication pathway.
10. At the C&P exam: bring your attack log, photographs, and a written personal statement. Ask the examiner to document trophic changes by name and note the frequency of your attacks.

Frequently Asked Questions

What is the VA rating for Raynaud’s disease?

VA rates secondary Raynaud’s (Raynaud’s syndrome) under Diagnostic Code 7117 within 38 CFR § 4.104. Ratings range from 10% to 100%: 10% for characteristic attacks 1–3 times per week, 20% for 4–6 attacks per week, 40% for daily attacks, 60% for daily attacks with trophic changes, and 100% for two or more digital ulcers plus autoamputation. Primary Raynaud’s disease is rated under DC 7124, though this code is rarely used and its criteria are not widely published.

What is the difference between primary Raynaud’s and secondary Raynaud’s for VA rating purposes?

DC 7117 is specifically for secondary Raynaud’s (caused by an underlying condition like lupus or scleroderma). Primary Raynaud’s (occurring without an underlying cause) is rated under DC 7124. If you file a claim for “Raynaud’s disease” without specifying a secondary cause, the VA may apply DC 7124 with potentially different criteria. Always clarify in your claim whether your Raynaud’s is primary or secondary, and specify the underlying cause if secondary.

What are trophic changes in Raynaud’s for VA rating purposes?

Trophic changes are the key threshold between the 40% and 60% ratings under DC 7117. The term is not defined in the VA rating schedule, but medically it includes skin thinning and atrophy, fissuring and cracking, digital ulceration, hair loss on affected digits, and nail deformities (pitting, ridging, brittleness). These result from chronic ischemia caused by repeated vasospasm. Your medical records must use the specific term “trophic changes” alongside the clinical descriptions to map directly to the DC 7117 criteria.

Can I get a separate VA rating for Raynaud’s if I already have a rating for lupus or scleroderma?

Potentially, but you must overcome the anti-pyramiding rule (38 CFR § 4.14). If your autoimmune condition’s rating already accounts for circulatory symptoms including Raynaud’s, the VA may deny a separate rating. To succeed, you must demonstrate that Raynaud’s causes additional functional impairment beyond the underlying condition’s rated criteria — for example, digital ulcers requiring independent treatment, tissue loss, or specific functional limitations in the hands or feet not captured in the autoimmune rating.

Legal References

• 38 CFR § 4.104, DC 7117 — Raynaud’s syndrome (secondary Raynaud’s phenomenon)
• 38 CFR § 4.104, DC 7124 — Other peripheral vascular diseases (primary Raynaud’s disease)
• 38 CFR § 4.14 — Avoidance of pyramiding
• 38 CFR § 3.310 — Secondary service connection
• 38 CFR § 3.307 / 3.309 — Presumptive service connection for chronic diseases
• VA Medical EPSS — 7117: Raynaud’s syndrome evaluation guidance
• VA Adjudication Manual (M21-1) — DC 7117 rating criteria and procedures