How To Service-Connect Skin Conditions
Is there a VA disability rating for skin conditions? Yes—there are actually numerous skin conditions for which VA assigns ratings, and for which veterans can receive monthly VA disability benefits—if those conditions can be linked to active-duty service.
There isn’t one “Skin Condition” rating but a range of possible ratings depending upon the condition, severity, and treatment prescribed.
The Department of Veterans Affairs awards disability compensation to veterans with diagnosable disabilities that can be connected to their military service (service connection). Skin conditions are among the many disabilities that can be caused or worsened by military service. If you have one, you should file a claim and pursue compensation!
Getting a VA disability rating for skin conditions is not always a straightforward prospect, however. This is because skin conditions have so many different symptoms and causes that can be hard to pinpoint. In this article, we explain how VA disability ratings for skin conditions work and what it takes to win your VA claim for a skin condition.
- How To Service-Connect Skin Conditions
- Establishing a direct or presumptive connection to service
- Presumptive Conditions & Your VA Claim
- How VA Assigns Disability Ratings for Skin Conditions
- Commonly Rated Skin Conditions
- VA Rating for Eczema
- VA Rating for Dermatitis
- VA Disability Ratings for Psoriasis
- VA Disability Rating for Skin Cancer
- Help with VA Claims for Skin Conditions
- About the Author
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Establishing a direct or presumptive connection to service
One way to obtain a VA disability rating for skin conditions is via direct service connection—linking your condition to injuries or incidents that occurred during your time of service. This is the method that most veterans think of when they file a claim.
For direct service connection, you’ll need:
- a current diagnosis of your skin condition or lesion
- evidence of an incident in service that led to a skin condition or disfigurement
- medical evidence (a doctor’s opinion) connecting the current skin condition to the incident in service (this is also called a nexus letter)
Another avenue for veterans who want to pursue disability benefits for skin conditions is through presumptive service connection. Some skin conditions are on VA presumptive lists.
What is the VA presumptive list?
The VA presumes that certain conditions are caused by military service. When there’s accumulated evidence of repeated associations between specific medical conditions and specific service environments, the VA presumes that these links are not coincidental and that the disability was caused by your service.
The presumptive list makes it easier for affected veterans to pursue their disability claims and receive benefits. While you still have to meet all the other requirements for service-connection, presumptive service connection eliminates the onus to prove the nexus or link (that your disability was caused or made worse by your service).
Eligibility for presumptive service connection related to the skin includes:
- Veterans exposed to herbicides during Vietnam service. Vietnam veterans who experience chloracne and/or porphyria cutanea tarda within a year of exposure are granted presumptive service connection if the condition is rated at least 10% disabling.
- Gulf War veterans with chronic skin conditions (for example, eczema), or with chronic undiagnosed skin disorders. Such veterans qualify for presumptive service connection at any time with a condition rated at 10% or higher.
IMPORTANT NOTE: A presumptive service connection only satisfies the requirement to prove the link or medical nexus, since the VA presumes the links causing your illness. All other claim requirements still apply.
Also, in order to qualify for a presumptive service connection, your condition must also be considered chronic. The VA defines chronic conditions as those lasting for at least six months.
Presumptive Conditions & Your VA Claim
How VA Assigns Disability Ratings for Skin Conditions
Many ratable skin conditions are rated based on the amount of skin that’s affected. The rating schedule offers two ways to determine how much skin is affected: calculations and estimations.
Skin area calculations measure the affected surface area in inches squared. Skin area estimations instead account for the percentage of skin that is affected.
The VA rates skin conditions under 38 CFR § 4.118, Diagnostic Codes 7800-7833.
The General Rating Formula for the Skin assigns ratings to most skin conditions as follows:
- 60%—at least one of the following: characteristic lesions involving more than 40% of the entire body or more than 40% 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 20-40% of the entire body, or 20-40% 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%, but less than 20%, of the entire body affected, or at least 5% but less than 20%, 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
- 0%—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% of the entire body affected; or characteristic lesions involving less than 5% of exposed areas affected; or rate as disfigurement of the head, face, or neck (DC 7800) or scars (DCs 7801, 7802, 7804, or 7805), depending upon the predominant disability”
Commonly Rated Skin Conditions
Let’s take a look at the common skin disorders that are most likely to get you a VA disability rating for skin conditions (if you can prove service connection or the condition is on the presumptive list).
Some of the most common skin conditions affecting veterans are:
- Dermatitis or eczema: general skin irritation that can cause dry skin, rashes, swelling, blisters, and redness.
- Urticaria (hives): skin welts that may be itchy, swollen, and red. While hives are often seen as an acute allergic reaction, they can also be considered chronic if they occur frequently or for periods over months or years.
- Acne and chloracne: inflamed nodules that can be red, swollen and painful. Chloracne can present as a mix of blackheads, nodules, and cysts, and is commonly linked to toxin exposure, particularly to dioxins (which is why it’s on the Agent Orange presumptive list).
- Psoriasis: a skin disorder that causes inflammation and raised plaques, or scales, on the skin.
- Pseudo-folliculitis barbae: an inflammatory condition that affects the beard area in men.
- Autoimmune skin diseases: Autoimmune disease occurs because the body’s natural defenses — the immune system — attack the body’s own healthy tissue. There are many autoimmune skin diseases, and psoriasis and eczema are sometimes considered autoimmune diseases. Scleroderma is an autoimmune disease that involves the hardening and tightening of the skin.
- Skin Cancer— Skin cancer is the most common cancer. There are multiple forms of skin cancer: basal cell carcinoma, squamous cell carcinoma, and the more deadly melanoma.
VA Rating for Eczema
Eczema isn’t a single condition with uniform signs and symptoms. There are several types of eczema, but all are believed to stem from an overactive immune reaction and cause inflamed, irritated skin. A red, scaly rash can appear anywhere on the body, and sufferers often experience persistent itching.
Treatments such as prescription creams and ointments, light therapy, and oral medications aim to break the cycle of inflammation and itching.
When eczema is severe, the skin all over your body may be affected and itching is extreme and constant. Rashes may split, bleed and ooze, creating entry points for infection. A doctor can assess your eczema’s severity based on how widespread, persistent, and intense your condition is.
A VA rating for eczema is based on these factors:
- the treatment prescribed;
- the type of medications needed and in what doses and frequencies; and
- how much of the body is impacted—for example, if it’s a minimum of 5% of the body and medical treatment is required, the rating will be 10%. A 60% rating is merited if at least 40% of the body is affected, or if your doctor has prescribed continuous medication for a year.
VA Rating for Dermatitis
The diagnostic code for eczema (7806) also includes dermatitis, a general term for skin irritation that can have many causes and usually involves itchy, dry skin and/or a rash.
“Razor bumps” are one form of skin irritation included in the VA rating for dermatitis. This condition, medically called Pseudofolliculitis barbae, is caused by trapped hairs beneath the surface of skin in the head, neck and face area. It results in rashes and bumps that can turn into pus-filled cysts. It’s sometimes a result of shaving, but can have other causes, including toxic chemical exposures—common for Gulf War veterans.
On its own, Pseudofolliculitis barbae is rated as a 30% VA disability under diagnostic code 7806. However, another cause can be scarring, which has separate diagnostic codes (7800 to 7805). The codes for scarring correspond to the physical locations of the scars, the nature of the scars, and whether there is underlying tissue damage.
VA Disability Ratings for Psoriasis
Psoriasis is a chronic skin condition in which skin cells grow too quickly. The cells build up and form thick scales and silvery or white patches. It can sometimes involve the nails or joints.
Like eczema, psoriasis is believed to stem from a malfunctioning immune system and can be triggered by illness or stress. Treatments range from topical ointments to immunosuppressive medication.
VA disability ratings for psoriasis are connected to diagnostic code 7816, which is specific to this condition. It’s evaluated under the general rating formula for the skin, but any related complications, such as psoriatic arthritis, are dealt with under separate diagnostic codes.
VA Disability Rating for Skin Cancer
The VA disability rating for skin cancer is based on diagnostic criteria under two categories: one for non-lethal basal and squamous cell carcinomas (7818) and the other for potentially lethal malignant melanoma (7833).
A 2009-2010 study of 100 veterans exposed to Agent Orange and enrolled in the Agent Orange Registry at the Veterans Affairs Hospital in Washington, D.C found that 51% had a basal or squamous cell carcinoma, but no increased risk for melanoma.
However, a significant relationship has been found between sun exposure during military service and skin cancers including melanoma.
All skin cancers are rated in the same way as scars (diagnostic codes 7801-7805), disfigurement of the head, face, or neck (diagnostic code 7800), or impairment of body system function. If systemic-type treatments like chemotherapy, radiotherapy and surgery are required, a 100% rating is applied.
VA Disability Ratings for Scars
You may qualify for service-connected disability compensation for scars from injuries or illnesses that occurred during your military service, since scars are considered to be disfiguring.
The percentage rating is based on the location of the scar or scars, and the corresponding size. Rating criteria for scars not on the head, face, or neck are generally based on size. Head, neck and face scars are rated on skin loss and the number of facial features experiencing disfigurement.
If a veteran has a scar on his or her nose, a 10% rating is given because a relatively small area of the face is affected. Higher ratings are merited for more profound symptoms of service-related disability.
Help with VA Claims for Skin Conditions
If you suffer from skin conditions related to your active-duty service, you deserve (and are owed) compensation for your disabilities. Because these VA claims for skin conditions can be tricky due to overlapping symptoms and the difficulty of proving causation, we recommend you get support in building your claim. We’ve helped thousands of veterans get a VA disability rating for skin conditions. Learn more with a FREE VA Claim Discovery Call.
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If you’ve filed your VA disability claim and have been denied or have received a low rating—or you’re unsure how to get started—reach out to us! Take advantage of a FREE VA Claim Discovery Call. Learn what you’ve been missing—so you can FINALLY get the disability rating and compensation you deserve!
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About the Author
About VA Claims Insider
VA Claims insider is an education-based coaching/consulting company. We’re here for disabled veterans exploring eligibility for increased VA disability benefits and who wish to learn more about that process. We also connect veterans with independent medical professionals in our referral network for medical examinations, disability evaluations, and credible independent medical opinions and nexus statements (medical nexus letters) for a wide range of disability conditions.