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7119
§ 4.104 Schedule of ratings—cardiovascular system.

Erythromelalgia

A rare condition causing intense burning pain, redness, and warmth in the hands or feet, often triggered by heat or exercise.

What the rating means

Erythromelalgia is rated under diagnostic code 7119 in VA's schedule for cardiovascular conditions. The ratings are based entirely on how often characteristic attacks occur, how long they last, whether they respond to treatment, and whether they restrict most routine daily activities. These ratings cover the disease as a whole, no matter how many limbs are affected.

A 10% rating applies when characteristic attacks happen less than daily but at least three times a week and respond to treatment. A 30% rating applies when attacks occur daily or more often but respond to treatment. A 60% rating applies when attacks occur more than once a day, last an average of more than two hours each, and respond poorly to treatment, but do not restrict most routine daily activities. A 100% rating applies when attacks meet those same criteria and also restrict most routine daily activities.

A characteristic attack, as defined by the regulation, consists of burning pain in the hands, feet, or both — usually bilateral and symmetrical — with increased skin temperature and redness, occurring at warm ambient temperatures.

Evidence that helps

Medical records that document the frequency of attacks are central to this rating. Records showing how many attacks occur per day or per week, and how long each episode typically lasts, directly map to the rating criteria. Notes from treating providers about whether treatment controls the attacks — or whether attacks respond poorly despite treatment — support the distinction between the 30% and 60% or 100% levels.

Examination findings that record increased skin temperature, redness, and the bilateral or symmetrical nature of burning pain in the hands or feet help confirm that attacks are characteristic under the regulation's definition.

Statements from you or people who know you that describe how attacks affect your ability to carry out routine daily activities are relevant to the difference between 60% and 100%. Records from employers, caregivers, or others who observe your functioning during attacks can also help show the degree to which daily activities are restricted. Treatment records showing prescribed medications, therapies tried, and the outcome of those efforts help establish whether your attacks respond to treatment or respond poorly.

Secondary conditions

Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.