What happens during a C&P exam for Chronic Pruritus (Generalized Itching)?

Most skin ratings turn on the percentage of body area affected (38 CFR 4.118) - ask the examiner to estimate the percent of your entire body and of exposed areas covered by lesions. Schedule your exam during a flare if you can; the percent affected is measured at the time of the exam, so a clear-skin day can understate your disability.

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Chronic Pruritus (Generalized Itching)

Q: What are the VA rating percentages for Chronic Pruritus (Generalized Itching)?

Chronic Pruritus (Generalized Itching) (DC 7806) is rated at 60%, 30%, 10%, 0% under 38 CFR § 4.118, DC 7806 (analogous). At least one of the following: Characteristic lesions involving more than 40 percent of the entire body or more than 40 percent of exposed areas affected; or Constant or near-constant systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, psoralen with long-wave ultraviolet-A light (PUVA), or other immunosuppressive drugs required over the past 12-month period

Q: What rates 60% for Chronic Pruritus (Generalized Itching) under 38 CFR § 4.118, DC 7806 (analogous)?

Under 38 CFR § 4.118, DC 7806 (analogous) (DC 7806), a 60% rating for Chronic Pruritus (Generalized Itching) requires: At least one of the following: Characteristic lesions involving more than 40 percent of the entire body or more than 40 percent of exposed areas affected; or Constant or near-constant systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, psoralen with long-wave ultraviolet-A light (PUVA), or other immunosuppressive drugs required over the past 12-month period

Q: What rates 30% for Chronic Pruritus (Generalized Itching) under 38 CFR § 4.118, DC 7806 (analogous)?

Under 38 CFR § 4.118, DC 7806 (analogous) (DC 7806), a 30% rating for Chronic Pruritus (Generalized Itching) requires: At least one of the following: Characteristic lesions involving 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected; or Systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required for a total duration of 6 weeks or more, but not constantly, over the past 12-month period

Q: What rates 10% for Chronic Pruritus (Generalized Itching) under 38 CFR § 4.118, DC 7806 (analogous)?

Under 38 CFR § 4.118, DC 7806 (analogous) (DC 7806), a 10% rating for Chronic Pruritus (Generalized Itching) requires: At least one of the following: Characteristic lesions involving at least 5 percent, but less than 20 percent, of the entire body affected; or At least 5 percent, but less than 20 percent, of exposed areas affected; or Intermittent systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required for a total duration of less than 6 weeks over the past 12-month period

Q: What rates 0% for Chronic Pruritus (Generalized Itching) under 38 CFR § 4.118, DC 7806 (analogous)?

Under 38 CFR § 4.118, DC 7806 (analogous) (DC 7806), a 0% rating for Chronic Pruritus (Generalized Itching) requires: No more than topical therapy required over the past 12-month period and at least one of the following: Characteristic lesions involving less than 5 percent of the entire body affected; or Characteristic lesions involving less than 5 percent of exposed areas affected

Q: What evidence do I need for a Chronic Pruritus (Generalized Itching) VA claim?

Key evidence for a Chronic Pruritus (Generalized Itching) claim includes: Dermatology records estimating the percent of total body area and exposed area affected; Records of systemic therapy (corticosteroids, biologics, retinoids, phototherapy, immunosuppressants) with start/stop dates over the past 12 months; Unretouched color photographs of the affected skin during a flare; Biopsy or pathology reports confirming the diagnosis, where applicable; Documentation of any painful or unstable scars and their count. All evidence should document both the condition and its impact on daily functioning.

DC 780638 C.F.R. § 4.118

Diagnostic Code

DC 7806

38 C.F.R. § 4.118

Rating Range

0–60%

4 severity tiers

Source

Verified

38 C.F.R. § 4.118

Chronic Pruritus (Generalized Itching) is rated by the U.S. Department of Veterans Affairs under DC 7806 of 38 CFR § 4.118, DC 7806 (analogous) across 4 severity tiers (60% / 30% / 10% / 0%). Service connection requires (1) a current diagnosis, (2) an in-service event, injury, or exposure, and (3) a medical nexus opinion linking the two under 38 C.F.R. § 3.303.

Educational tool only. Not legal or medical advice. Not affiliated with the VA.

Overview

Persistent generalized itching without identifiable primary skin disease, causing significant distress

Rating Criteria

60%

At least one of the following: Characteristic lesions involving more than 40 percent of the entire body or more than 40 percent of exposed areas affected; or Constant or near-constant systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, psoralen with long-wave ultraviolet-A light (PUVA), or other immunosuppressive drugs required over the past 12-month period

30%

At least one of the following: Characteristic lesions involving 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected; or Systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required for a total duration of 6 weeks or more, but not constantly, over the past 12-month period

10%

At least one of the following: Characteristic lesions involving at least 5 percent, but less than 20 percent, of the entire body affected; or At least 5 percent, but less than 20 percent, of exposed areas affected; or Intermittent systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required for a total duration of less than 6 weeks over the past 12-month period

No more than topical therapy required over the past 12-month period and at least one of the following: Characteristic lesions involving less than 5 percent of the entire body affected; or Characteristic lesions involving less than 5 percent of exposed areas affected

Key Evidence

—Dermatology records estimating the percent of total body area and exposed area affected

—Records of systemic therapy (corticosteroids, biologics, retinoids, phototherapy, immunosuppressants) with start/stop dates over the past 12 months

—Unretouched color photographs of the affected skin during a flare

—Biopsy or pathology reports confirming the diagnosis, where applicable

—Documentation of any painful or unstable scars and their count

—Complete list of prescribed topical and systemic skin medications

C&P Exam Tips

1Most skin ratings turn on the percentage of body area affected (38 CFR 4.118) - ask the examiner to estimate the percent of your entire body and of exposed areas covered by lesions.

2Schedule your exam during a flare if you can; the percent affected is measured at the time of the exam, so a clear-skin day can understate your disability.

3Systemic therapy is a separate path to a rating - the total weeks of systemic treatment (corticosteroids, biologics, retinoids, phototherapy, immunosuppressants) over the past 12 months drives the level. Treatment administered through the skin is topical, not systemic.

4Document constant or near-constant systemic therapy over the past 12 months - that supports the 60% level for many skin conditions.

5Painful or unstable scars are rated separately by count (38 CFR 4.118, DC 7804) - report each painful or unstable scar.

6Bring unretouched color photographs of your skin at its worst, and report how the condition affects work and daily activity.

Tools

Rating Calculator →Secondaries Explorer →C&P Exam Prep →PACT Act Scanner →2026 Rates →

Sources & Editorial

Rating criteria text quoted verbatim from 38 C.F.R. § 4.118 (Skin). Source verified 2026-06-04 by ClaimRecon Editorial Team against the Cornell Law CFR mirror; eCFR.gov is the authoritative government source.

View § 4.118 on eCFR →Cornell Law mirror →Editorial Standards →Suggest a correction →

EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026

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