Diagnostic Code 7827 · 38 CFR §4.118
Erythema nodosum is an inflammatory condition causing painful, red, tender nodules (bumps) typically on the shins, though they can appear on other areas. The condition is a reactive process, meaning the body is responding to an underlying trigger — commonly infections, medications, or autoimmune conditions. For veterans, triggers may include infections acquired during service, medication reactions, or underlying conditions that developed during military service.
| Rating | Criteria |
|---|---|
| 0% | Less than 5% of the entire body or less than 5% of exposed areas affected, AND no more than topical therapy required during the past 12-month period. |
| 10% | At least 5% but less than 20% of the entire body, OR at least 5% but less than 20% of exposed areas affected, OR intermittent systemic therapy (corticosteroids or other immunosuppressive drugs) required for a total duration of less than 6 weeks during the past 12 months. |
| 30% | 20 to 40% of the entire body or 20 to 40% of exposed areas affected, OR systemic therapy (corticosteroids or other immunosuppressives) required for a total duration of 6 weeks or more, but not constantly, during the past 12 months. |
| 60% | More than 40% of the entire body or more than 40% of exposed areas affected, OR constant or near-constant systemic therapy (corticosteroids or other immunosuppressives) required during the past 12 months. |
Clinical examination during an active episode documents the characteristic nodules. Biopsy can confirm the diagnosis if needed. Blood work and other testing to identify the underlying trigger support the claim. Treatment records showing what is needed to control episodes demonstrate severity. Records connecting the triggering condition to military service establish the nexus.
Common triggers include infections (streptococcal, tuberculosis, fungal), medications (sulfonamides, oral contraceptives), inflammatory bowel disease, and sarcoidosis. Identifying and treating the underlying cause is important both medically and for your VA claim, since the triggering condition may itself be service-connected and separately ratable.
Individual episodes usually resolve in 3-6 weeks. However, if the underlying cause persists, episodes recur. Some veterans experience chronic relapsing erythema nodosum that continues for months or years. The chronic recurrent pattern supports a higher VA rating than a single resolved episode.