LOADING
Skin conditions including eczema, psoriasis, dermatitis, and other chronic skin disorders affect many veterans, often developing or worsening due to environmental exposures during military service. Exposure to chemicals, harsh weather conditions, tropical climates, contaminated water, and prolonged use of military equipment that irritates the skin can all contribute to chronic dermatological problems. The VA rates most common skin conditions under Diagnostic Code 7806, which uses a framework based on the percentage of body area affected and the type of treatment required.
Under DC 7806, a 0% rating is assigned when less than 5% of the entire body or less than 5% of exposed areas (face, neck, hands) are affected, and no more than topical therapy was required during the past 12-month period. This is the baseline rating for a diagnosed skin condition that is minimal in its extent and managed with over-the-counter or prescription topical treatments only.
A 10% rating requires 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 such as corticosteroids or other immunosuppressive drugs required for a total duration of less than six weeks during the past 12-month period. The key factors at this level are either the extent of skin involvement crossing the 5% threshold or the need for systemic (oral or injected) medications rather than just topical treatments.
A 30% rating requires 20% to 40% of the entire body or 20% to 40% of exposed areas affected, or systemic therapy such as corticosteroids or other immunosuppressive drugs required for a total duration of six weeks or more but not constantly during the past 12-month period. The treatment element is significant here. If your skin condition requires courses of oral corticosteroids or other systemic immunosuppressive medications totaling six weeks or more in a year, you may qualify for a 30% rating even if the body area percentage is below 20%.
A 60% rating, the maximum under DC 7806, requires more than 40% of the entire body or more than 40% of exposed areas affected, or constant or near-constant systemic therapy such as corticosteroids or other immunosuppressive drugs required during the past 12-month period. The distinction between the 30% and 60% levels for systemic therapy is the difference between intermittent courses (30%) and constant or near-constant use (60%). Veterans whose skin conditions require year-round immunosuppressive medication may qualify for this highest rating.
The definition of "systemic therapy" has been the subject of significant legal interpretation. The VA and the courts have grappled with whether certain treatments, such as topical corticosteroids, qualify as "systemic therapy" for rating purposes. Generally, systemic therapy refers to medications that affect the entire body, such as oral prednisone, methotrexate, or biologics like Humira. Topical corticosteroids, even potent ones, are generally considered topical therapy rather than systemic therapy. However, this distinction has been litigated, and some decisions have expanded the interpretation. Knowing the current status of this legal question is important when preparing your claim.
Psoriasis, rated under DC 7816, uses the same percentage and treatment-based criteria as DC 7806 for eczema and dermatitis. The rating levels and thresholds are identical. This means the same body area percentage calculations and systemic therapy considerations apply. Some psoriasis cases may alternatively be rated under DC 7806 or another diagnostic code depending on the specific manifestation.
The C&P exam for skin conditions is unique because the examiner needs to visually assess the extent of skin involvement. This creates a timing challenge because many skin conditions fluctuate in severity. If your exam is scheduled during a period of remission, the examiner may observe minimal skin involvement even though your condition is severe during flare-ups. If possible, scheduling your exam during an active period, or at minimum bringing photographs of your skin during active flare-ups, can help ensure the examiner has an accurate picture of your condition at its worst.
Photographing your skin condition during active flares is some of the most powerful evidence you can provide. Date-stamped photographs showing the extent and severity of skin involvement during outbreaks document what the examiner might not see on the day of the exam. Photographs should capture the affected areas clearly, with enough context to estimate the percentage of body area involved. A series of photographs over time showing the chronic, recurring nature of the condition is far more persuasive than a single snapshot.
The body area percentage calculation is based on the Rule of Nines or a similar estimation method. The head and neck represent approximately 9% of total body surface area, each upper extremity about 9%, the anterior trunk about 18%, the posterior trunk about 18%, each lower extremity about 18%, and the perineum about 1%. When calculating your percentage, consider all areas that are affected at any given time during a flare, not just the areas that happen to be active on a particular day.
Disfigurement of the head, face, or neck is rated separately under DC 7800, which uses specific criteria based on the characteristics of disfigurement including scar size, surface contour, skin color, and tissue loss. If your skin condition causes visible scarring or disfigurement on the head, face, or neck, a separate rating under DC 7800 may be warranted in addition to the DC 7806 rating for the underlying skin condition.
Secondary service connection for skin conditions can involve several pathways. Some veterans develop skin conditions secondary to medications taken for other service-connected conditions. Environmental exposures during service, including exposure to burn pits, can cause or aggravate skin conditions. Stress from PTSD and other mental health conditions can trigger or worsen inflammatory skin conditions like eczema and psoriasis, a connection well-documented in medical literature.
The ClaimRecon Rating Calculator helps you estimate how a skin condition rating combines with your other service-connected disabilities. The C&P Exam Simulator prepares you for the dermatological examination and helps you understand what the examiner will assess. The Health Logger is particularly valuable for skin conditions because it allows you to log flare-ups with dates, affected areas, and severity, creating a documented pattern that supports your claim. Ask Intel AI can explain the nuances of body area percentage calculations and the systemic therapy criteria. The Secondary Condition Finder identifies conditions commonly linked to skin conditions, including mental health conditions worsened by visible skin symptoms and medication-related pathways.
This guide is for educational purposes only and does not constitute legal or medical advice. VA rating criteria are subject to change. Always consult with a VSO or VA-accredited attorney for case-specific guidance.
Written by ClaimRecon Editorial