Raynaud's Progression

[jlrith]

I am currently rated 40% for primary Raynaud's disease.

The past two winters I have had numerous chilblains form, something like 250 each winter and upwards of 30 at a time.

Sometimes these turn into little ulcers, just like small, deep blisters popping.

The 60% rating level requires "2 or more digital ulcers"

Chilblains are acral ulcers, and many of them occur on my fingers, making them digital ulcers.

I have had one of the nasty ulcers, but I don't know if the chilblains are considered ulcers on their own, if they are considered ulcers when they burst or if they must be what you normally think of ulcers as being: Nasty, rotting flesh.

Does anyone know what type of ulcer is considered qualifying in this case?

[Berta]

This 2011 BVA decision shows how Raynald's is rated as to affects to digits and skin::

http://www.va.gov/vetapp/wraper_bva.asp?file=/vetapp11/Files4/1140278.txt

In Part:

1. 
   Raynaud's syndrome
   
   “Briefly, the Veteran contends that the severity of her service-connected Raynaud's syndrome of the bilateral hands warrants a higher disability rating. Historically, service connection was granted for the Veteran's Raynaud's syndrome in an October 2005 rating decision and assigned a 10 percent disability rating, effective February 12, 2005, under 38 C.F.R. § 4.104, Diagnostic Code 7117.
   
   Under Diagnostic Code 7117, a rating of 10 percent is warranted for Raynaud's syndrome with characteristic attacks occurring one to three times a week. A rating of 20 percent is warranted for characteristic attacks occurring four to six times a week. A rating of 40 percent is warranted for attacks occurring at least daily. A rating of 60 percent is warranted for Raynaud's syndrome with two or more digital ulcers and history of characteristic attacks. A maximum rating of 100 percent is warranted for Raynaud's syndrome with two or more digital ulcers plus autoamputation of one or more digits and history of characteristic attacks.
   
   NOTE: For purposes of this section, characteristic attacks consist of sequential color changes of the digits of one or more extremities lasting minutes to hours, sometimes with pain and paresthesias, and precipitated by exposure to cold or by emotional upsets. These evaluations are for the disease as a whole, regardless of the number of extremities involved or whether the nose and ears are involved. “
   

This decision never mentions chilblains, but this one from BVA does:

http://www.va.gov/vetapp/wraper_bva.asp?file=/vetapp09/Files3/0921449.txt

It appears you were rated under Diagnostic code 7117 under the revised schedule for this disability.

“Does anyone know what type of ulcer is considered qualifying in this case? “

It seems to be that VA (you could search the BVA for more decisions on Raynalds) makes a big distinction between chilblains and the digital ulcers.

There is also a medical association from diabetes to chilblains:

http://www.ncbi.nlm.nih.gov/pubmed/19258859

With 80 % now, have you applied for TDIU (paid at the 100^ rate of Comp) or are you still gainfully employed?

Welcome to Hadit.

[jlrith]

Thanks for the quick reply Berta.

Your search came up with the same kind of information mine did.

Apparently veterans either don't get ulcers due to Raynaud's or it is so black and white that there are never any appeals on those claims, thus no documentation available to us.

My Raynaud's is primary, meaning that it has no underlying cause such as a cold weather injury, which is the only place that Chilblains are mentioned in the ratings schedule.

Chilblains are a type of Ulcer, especially when they pop like mine do, but there is no information on what the VA considers a skin ulcer.

Is it the chilblain level (medically speaking they are)? Is it the burst chilblains that I get, where they are like deep burst blisters - deep enough to bleed openly? Or is it just the open sore, non-healing type?

As for TDIU, I am gainfully employed. My service connection is for Raynaud's and lumbar spine issues with secondary nerve problems.

"Lucky" for me my disabilities don't prevent me from working in my chosen field, engineering.

I am able to function well, although I pay for it with pain, misery and pain killers.