The Skin

Topics:

Skin Overveiw *IMPORTANT*
Skin Area Calculations
Skin Area Estimations
Dermatitis/Eczema
Urticaria (“Hives”)
Skin Discoloration
Skin Infections
Acne and Chloracne
Lupus
Psoriasis and other Autoimmune Disorders
Diseases affecting the Keratin
Conditions affecting the Pores and Hair
Cancer and Tumors of the Skin
Other Skin Conditions
DBQ for Skin Conditions
Principles that Apply

Reminder: The VA will give a Military Disability Rating for each service-connected condition a service member has, but the DoD will only rate service-connected conditions that make a service member Unfit for Duty.

 


Skin Overview

Note: There are a few times for these conditions that the VASRD uses vague terms like “debilitating.” The exact definition of terms like that is up to the opinion of the Rating Authorities deciding the rating, so unfortunately, we can’t really give you a more concrete definition than this. It may mean one thing to one person and something entirely different to someone else. What the Rating Authorities are supposed to be keeping in mind when deciding ratings, however, is how much that condition affects your overall health and ability to work. If that is severely affected, then the Rating Authorities should consider it a “debilitating” condition. Hope that helps!

Skin conditions are almost impossible to categorize exactly because each condition often has numerous different causes and symptoms. Half the time, the cause of the skin condition is not even known. Because of all this, there is rarely one definite, cut-and-dry definition for each condition. If your exact condition is not listed on this page, remember that the bottom line rule is to rate the condition under the code that BEST describes it, even if not exact.

Some of these conditions are rated on the amount of skin that is affected by the condition. There are two ways to determine this amount of skin: actual measurements and calculations, or by estimation. In some cases, it is much easier to just estimate how much skin is affected, but in others, a more proper rating will be assigned if the condition is thoroughly measured and calculated. We’ve provided guidance on both of these systems. Ultimately, it will be up to the examining physician and the Rating Authorities.

Some flaws with both: It is pretty obvious that the biggest flaw with estimation is just that—it is an estimation, a guess, even if it is an educated guess. The biggest flaw with measuring and calculating, though, is that all the calculations for the VASRD are made based on an average-sized person’s overall skin measurements. So, if you are 4’9” and weigh 100 pounds, or if you are 6’9” and weigh 400 pounds, the calculations won’t be truly accurate for your condition. Again, the ultimate, bottom line deciding factor is which of the systems will give the most accurate rating possible.

Before we get started, let’s define a few terms to make sure we are all on the same page. These terms will only be defined in this way on this page, so if the same term comes up on a different page, it is probably not meant in the exact same way.

Patch: A part of the skin that presents with symptoms of the condition. It could be covered in rashes, raised bumps, discoloration, loss of hair, etc. Sometimes different patches are clearly separate. In this case, measure each one. When there is a large area of lots of little patches, just consider the entire area as one patch.

Area: This is the mathematical term for the amount of surface space a thing covers (for us, it will mean how much of the skin is covered by a patch). To calculate an area, multiply the length of the patch by the width of the patch. Our calculations will all be in inches, so the formula will look like this: Length (inches) x Width (inches) = Area (squared inches, in2).

Division: The VASRD breaks down the body into various sections so that calculating the patch areas will be a little easier. On this page, each section of this breakdown will be called a Division. So there is a neck division, front upper arm division, etc.

Percentage of Divisions: This is the percentage of the skin in a single division that is covered by patches. The percentage of division is found by dividing the area of patches in the division by the total area of the division: Area of Patches (in2) ÷ Area of Division (in2) = Percentage of Division.

Percentage of Exposed Divisions: The “exposed” divisions include the face and the front and back of the hands and neck. These are the areas that are not covered by clothes or hair. The percentage of exposed divisions is just the percentage of the skin in these divisions that is covered by patches. Many of the following conditions are rated on the percentage of the exposed divisions or the percentage of total body (below).

The percentage of exposed divisions is found by adding together all the Areas of Patches in each division, adding the total Areas of each division, and then dividing the Areas of Patches by the Area of Division: Area of Patches in Division 1 + Area of Patches in Division 2 (etc.) = Total Area of Patches, Area of Division 1 + Area of Division 2 (etc.) = Total Area of Divisions, Total Area of Patches ÷ Total Area of Division = Percentage of Exposed Divisions. Don’t worry. We’ll do this in practice.

Note: all the Areas of each division are added to the Total Area of Divisions even if there are no patches in that area.

Percentage of Total Body: This is the percentage of the skin covering the entire body that is covered by patches. This is found by dividing the area of patches on the entire body by the total area of the entire body: Area of Patches (in2) ÷ Area of Total Body (in2) = Percentage of Total Body.
Scaly: A skin texture caused by many skin conditions that make the skin look like scales.

Military disability ratings for skin conditions

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Skin Area Calculations

Welcome to pretty complicated 6th grade math.

(6th grade! I don’t think I can remember that far back!!!)

Hang in there. It’s not that bad. The math itself is easy, but there are quite a few steps. Just follow along, and you’ll be fine…hopefully.

Not all conditions on this page need these calculations. Check your condition first, and if the math is needed, come back here and we’ll take you through it.

In the image below, the body is divided into its various divisions. Notice that each limb is divided by front and back. Imagine that there is a line up and down your sides that splits your entire body in half. If a patch crosses one of these lines, then the part of it that is in one division is calculated separately from the part of it in another division.

Military disability ratings for skin conditions

The labels in this picture tell us three things. The first is the amount of skin (in2) in each division. This is the number we use to calculate the Percentage of Division. The second thing this picture tells us is the percent of skin on the entire body that is in each division. The last is in the upper right corner. The entire amount of skin on the whole body is 2,636 in2, and the entire amount of skin on the exposed divisions is 276 in2.

So, how do you calculate how much of the skin on the entire body is affected by your condition? Let’s walk through a couple of examples.

Let’s say your condition causes patches of rashes on the stomach and left thigh.

Military disability ratings for skin conditions

Remember that, depending on the condition, it could be rated either as Percentage of Exposed Divisions or the Percentage of Total Body. Since the stomach and thigh are not considered exposed divisions, we only need to calculate the percentage of total body.

Step 1: Determine which division each patch is in. This case is pretty straight-forward: front of torso and front of thigh.

Step 2: Divide the patches into easily measurable chunks. We need to be able to easily measure a straight line from end to end and top to bottom. If the patch curves a lot or has odd bits, split it into parts that can later be added together. These patches are easily split into three parts.

Step 3: Measure each part from one end to the other and from top to bottom. The top patch measures 2 inches wide and 4 inches long. The next patch measures 3 inches wide and 6 inches long, and the final patch measures 3 inches wide and 4 inches long. Let’s do the math to find the area of each patch:

2 x 4 = 8 square inches (in2)
3 x 6 = 18 in2

3 x 4 = 12 in2

Step 4: Since none of the divisions in this example are exposed divisions, all we need to do is calculate the percentage of total body. So, add all the patch areas we calculated above:

8 + 18 + 12 = 38 in2

So 38 in2 is the total area of patches on the body.

Step 5: This is the last step! Calculate the percentage of total body by dividing the total area of patches by the total area of the body (which is given as 2,636 in2):

38 ÷ 2,636 = 0.014 (move the decimal point over two spots to get the percentage)

Percentage of Total Body = 1.4%

Yay! We got through one. Not too bad, huh?

Alright, let’s do one more example, a bit more complicated, and calculating both the percentage of division and the percentage of total body. Let’s say that your condition causes two patches, one on the front of the torso, and the other on the front of your left arm and back of the hand.

Military disability ratings for skin conditions

Step 1: Determine which division each patch is in. This is a bit more complicated since the patch on the arm is part of three different divisions: front upper arm, front forearm, and back of hand.

Step 2: Divide the patches into easily measurable chunks. In this case, the lines that separate the divisions also separate parts of the patches to measure. We need to be able to determine exactly how much of each patch is in each division.

Step 3: Measure each part of the patch from one end to the other and from top to bottom. (Remember that the area of triangles is found by dividing the area in half: length x width ÷ 2 = area of a triangle). Let’s do the math to find the area of each patch:

8 x 7 = 56 square inches (in2)
2 x 3 ÷ 2 = 3 in2
6 x 3 = 18 in2
8 x 2 = 16 in2
5 x 2 = 10 in2
20 x 5 = 50 in2
6 x 7 = 42 in2

Step 4: Let’s separate each of these measurements into the appropriate divisions and then add them in those divisions.

56 in2
3 in2
50 in2
+ 42 in2

Total torso division:          151 in2

Total upper arm division:       18 in2

Total forearm division:           16 in2

Total hand division:                10 in2

Step 5: Let’s go ahead and calculate the percentage of exposed divisions before moving on to total body. So the only exposed division in this case in the hand. The total patch area for the hand division is 10 in2. This number must now be divided by the total area of skin on exposed divisions (which is given as 276 in2):

10 ÷ 276 = 0.036 (move the decimal point over two spots to get the percentage)

Percentage of Exposed Divisions = 3.6%

Step 6: Now we also need to calculate the percentage of total body. Start by adding all the patch areas for each division together.

151 + 18 + 16 +10 = 195 in2

So 192 in2 is the total area of patches on the entire body.

Step 7: This is the last step! Calculate the percentage of total body by dividing the total area of patches by the total area of the body (which is given as 2,636 in2):

195 ÷ 2,636 = 0.074 (move the decimal point over two spots to get the percentage)

Percentage of Total Body = 7.4%

That’s it. Just follow these steps, and you should have no trouble with these calculations. When rating a condition that has rating options for both the percentage of exposed divisions and the percentage of total body, just choose the option that will give the higher rating.

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Skin Area Estimations

When estimating the area of patches affecting each division and the total body, we need to know exactly what percentage of the entire body each division is. The percentages in the following image are the percentage each division is of the total body for the average sized person. Regardless of size, however, each percentage should still be very accurate.

Military disability ratings for skin conditions

 

Conditions rated on the skin area often have two rating options: percentage of exposed divisions and percentage of total body. We’ll need to estimate/calculate each. So let’s try estimating an example.

Let’s say that your condition causes rashes along your upper right arm and the back of the left hand.

Military disability ratings for skin conditions

Step 1: Determine which division each patch is in. In this case, it’s pretty straightforward. The one is in the front of the right upper arm division, and the other is in the back of the left hand division.

Step 2: Now we need to estimate about how much of each of these divisions is covered by the patches. The one on the upper arm definitely looks like about half is covered, so an estimate of 50% would make sense. The one on that hand is a bit more complicated. Since it only covers one finger (the thumb) and only, maybe, a fourth of the back of the hand, a fair estimate could be 25% or so. Obviously, each of these estimated percentages will be different for every person analyzing the condition. Just be as close as possible.

Step 3: We now have all the information we need to determine the percentage of exposed divisions. The upper arm is not an exposed division, but the hand is. The first image in this section shows that the back of the hand is 12% of the exposed divisions, and we know that the patch is 25% of the back of the hand. So, we need to determine what 25% of 12% is. So, multiply 12% (0.12) by 25% (0.25):

0.12 x 0.25 = 0.03 (move the decimal point two spaces to the right)

Percentage of Exposed Divisions: 3%

Step 4: Great! Now let’s find the percentage of total body. Both patches are taken into account here. First, determine what percent of the total body each patch is individually. Just like in step 3, in the image above, find the percentage of total body for each division. The back of the hand is 1.25% of total body, and the front of the upper arm is 2% of total body. We know that the patch on the upper arm is 50% of the division, and the patch on the back of the hand is 25% of the division. So what is 50% of 2% and 25% or 1.25%?

0.5 x 0.02 = 0.01
0.25 x 0.0125 = 0.003

Now add them together.

0.01 + 0.003 = 0.013 (move the decimal point two spaces)

Percentage of Total Body: 1.3%

That’s it! Now we have both percentages. When choosing which to rate the condition on, choose the one that will give the highest rating.

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Dermatitis/Eczema

Code 7806: Dermatitis and eczema are essentially the same thing, although some doctors might describe them slightly different. For rating purposes, however, they are treated the same. Basically, dermatitis is a condition where the skin swells and turns red—the standard rash.

There are three different rating options for this condition. If the condition is so severe that it causes permanent scars, it can be rated as a scar condition. The final code in that case would look like this: 7806-7801. The first four-digit code defines the condition as dermatitis, and the second four-digit code tells how it is rated.

It can also be rated under this code either on calculations/estimations or on the required treatment of the condition itself.

Calculations/estimations: If there is more than 40% of total body or more than 40% of exposed divisions affected, it is rated 60%. If there is 20% to 40% of total body or 20% to 40% of exposed divisions affected, it is rated 30%. If there is 5% to 20% of total body or 5% to 20% of exposed divisions affected, it is rated 10%. If there is less than 5% of total body or less than 5% of exposed divisions affected, it is rated 0%.

Treatments: If the condition required the almost constant use of oral or injected medications to regulate the immune system over the past 12 months (methotrexate, steroids, etc.), it is rated 60%. If the condition required oral or injected medications to regulate the immune system for a total of 6 weeks or more during the past 12 months, it is rated 30%. If the condition required oral or injected medications to regulate the immune system for a total of less than 6 weeks over the past 12 months, it is rated 10%. If the condition only required topical medications over the past 12 months, it is rated 0%.

Code 7817: Exfoliative dermatitis (erythroderma) is a dermatitis that causes a scaly rash that covers the majority of the entire body. It is normally caused by another condition, like cancer or a reaction to a medication. If that condition is unfitting by itself, then the exfoliative dermatitis can only be rated as well if it contributes significantly to making the service member unfitting (super sensitive to motion, can’t wear his uniform, etc.).

If the majority of the skin is affected and things such as weight loss, fever, low protein in the blood, etc., are present, and continuous medications to regulate the immune system (methotrexate, steroids, etc.) were taken over the past 12 months or regular treatments of ultraviolet or other light wave/beam therapy were needed during the past 12 months, it is rated 100%.

If the majority of the skin is affected, and continuous medications to regulate the immune system were taken over the past 12 months or regular treatments of ultraviolet or other light wave/beam therapy were needed during the past 12 months, it is rated 60%.

Regardless of how much skin is affected, if medication to regulate the immune system or ultraviolet or other light wave/beam therapy was needed for a total of 6 weeks (does not need to be consecutive) or more during the past 12 months, it is rated 30%.

Regardless of how much skin is affected, if medication to regulate the immune system or ultraviolet or other light wave/beam therapy was needed for a total of less than 6 weeks (does not need to be consecutive) or more during the past 12 months, it is rated 10%.

Regardless of how much skin is affected, if only topical treatments were used during the past 12 months, it is rated 0%.

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Urticaria (“Hives”)

Code 7825: Chronic hives are pale red, itchy bumps on the skin that are caused either by allergic reactions or various other causes. To qualify as chronic, they must last for 6 weeks or more. If there were severe debilitating episodes that occurred at least 4 times over the past 12 months that could not be controlled by treatment, it is rated 60%. If there were severe debilitating episodes that occurred at least 4 times over the past 12 months but it could be controlled by medications that regulate the immune system (methotrexate, steroids, etc.) it is rated 30%. If there were episodes (not debilitating) that occurred at least 4 times over the past 12 months, but the condition could be controlled by medications that control swelling, it is rated 10%.

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Skin Discoloration

Code 7823: Vitiligo is a condition where the cells that give the skin color die. The skin then becomes a bleached, lighter color. If the exposed divisions are affected, it is rated 10%. If they are not affected, it is rated 0%.

Code 7826: Primary cutaneous vasculitis is a condition of the small blood vessels near the skin, which causes them to burst. The skin turns red or purple due to bleeding under the skin. If this condition is caused by other conditions, like infections, medications, cancer, autoimmune disorders, etc., it can only be rated as that condition. If it is not caused by another condition, then it can be rated here. Likewise, if the condition caused significant scarring, it can be rated under one of the scar codes. Choose the one rating system that would give the highest rating.

If there were at least 4 debilitating episodes over the past 12 months that did not respond to treatment, it is rated 60%. If there were at least 4 debilitating episodes over the past 12 months that were controlled by medications that regulate the immune system (methotrexate, steroids, etc.), then it is rated 30%. If there were 1 to 3 episodes (not debilitating) over the past 12 months that were controlled by medications that regulate the immune system, then it is rated 10%.

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Skin Infections

Code 7807: New World (“American”) mucocutaneous leishmaniasis is a parasitic skin infection that comes from the bite of an American sandfly. It causes large open skin sores that can leave severe scarring. This condition is either rated as dermatitis or as scars/disfigurement, whichever best describes the disability. The final code will look like this: 7807-7801. The first four-digit code defines the condition as New World leishmaniasis, and the second four-digit code tells how it is rated.

If the leishmaniasis does not affect the skin, it is rated under code 6301.

Code 7808: Old World cutaneous leishmaniasis (“Oriental sore”) is a parasitic skin infection that comes from the bite of a European, Asian or African sandfly. It causes large open skin sores that can leave severe scarring. This condition is either rated as dermatitis or as scars/disfigurement whichever best describes the disability. The final code will look like this: 7808-7801. The first four-digit code defines the condition as Old World leishmaniasis, and the second four-digit code tells how it is rated.

If the leishmaniasis does not affect the skin, it is rated under code 6301.

Code 7813: Dermatophytosis (“ringworm”) is a fungal infection that causes ring-shaped red and swollen patches on the skin. This condition is either rated under dermatitis or scars/disfigurement whichever best describes the disability. The final code will look like this: 7813-7801. The first four-digit code defines the condition as dermatophytosis, and the second four-digit code tells how it is rated.

Code 7827: Erythema multiforme (toxic epidermal necrolysis, “TENs”) is either caused by an infection or is a reaction to medication. It causes red skin rashes and bumps to appear all over the body. It then attacks and kills the skin all over the body, causing the top layer of skin to detach from the lower layers, which can send the organs into failure. If the condition caused significant scarring, it can either be rated under as a scar or this code. Choose the one that would give the highest rating.

If there were severe debilitating episodes that occurred at least 4 times over the past 12 months that could not be controlled by treatment, it is rated 60%. If there were episodes (not debilitating) that occurred at least 4 times over the past 12 months but it could be controlled by medications that regulate the immune system, it is rated 30%. If there were episodes (not debilitating) that occurred 2 or 3 times over the past 12 months that were controlled by medications that control swelling, it is rated 10%. A 10% rating is also given if there were 1 to 3 episodes that occurred over the past 12 months that were controlled by medications that regulate the immune system.

Code 7820: All other infections of the skin that are not listed elsewhere are rated under this code. These conditions are either rated as dermatitis or as scars/disfigurement, whichever best describes the disability. The final code will look like this: 7820-7801. The first four-digit code defines the condition as a skin infection, and the second four-digit code tells how it is rated.

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Acne and Chloracne

Both acne and chloracne are rated on the same system.

Code 7828: Acne is a skin condition that causes pussy raised bumps that can occur anywhere on the body.

Code 7829: Chloracne is a condition where acne erupts over patches of skin that have come in contact with chemicals that contain dioxins.

Some acne is very superficial, involving only one layer of the skin, while other acne can be very deep. Often acne causes scarring. If the scars are the main disability, then this condition can be rated under a scar code.

The ratings: If the acne is deep, causing inflammation and pussy cysts, and affects 40% or more of the face and neck, it is rated 30%. If the acne is deep, causing inflammation and pussy cysts, and affects less than 40% of the face and neck, or if deep acne is in areas other than the face and neck, it is rated 10%. If the acne is superficial, it is rated 0%.

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Lupus

Code 7809: Lupus is a condition where the immune system attacks the healthy cells of the skin, causing severe sores, tearing, and scarring of the skin. Most often, these occur on the head near the ears, eyes, nose, lips and cheeks, but in some cases lupus sores can affect other areas of the body. Lupus is either rated as dermatitis or as scars/disfigurement, whichever best describes the disability. The final code will look like this: 7809-7801. The first four-digit code defines the condition as lupus, and the second four-digit code tells how it is rated.

If the lupus affects parts of the body besides the skin, then it is rated under code 6350 for systematic lupus erythematosus. A rating cannot be given under both codes. Only one or the other.

If the lupus is caused by tuberculosis, it is rated under the next code.

Code 7811: Tuberculosis luposa is a lupus condition that is caused by a tuberculosis infection. It is rated as nonpulmonary tuberculosis.

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Psoriasis and other Autoimmune Disorders

The following conditions are all rated on the same rating system.

Code 7815: Bullous disorders cause blisters of clear liquid to form in between the layers of the skin, most often on the inner thighs and upper arms.

Code 7816: Psoriasis is an autoimmune condition that tells the body to produce more skin cells even though they are not needed. This can cause numerous different things to happen to the skin, including redness, swelling, scaly texture, patches of red bumps, and more.

Code 7821: Cutaneous manifestations of collagen-vascular diseases are skin conditions that occur when the immune system attacks the collagen. Collagen is all the proteins that are in the skin. Psoriasis is considered a collagen-vascular disease. This code is used to rate any collagen-vascular disease that is not listed elsewhere on this page.

 

The ratings:

There are three different rating options for these conditions. If the condition is so severe that it causes permanent scars, it can be rated as a scar condition. The final code in that case would look like this: 7816-7801. The first four-digit code defines the condition as one of the above conditions, and the second four-digit code tells how it is rated.

These conditions can also be rated under their own codes either on calculations/estimations or on the required treatment of the condition itself.

Calculations/estimations: If there is more than 40% of total body or more than 40% of exposed divisions affected, it is rated 60%. If there is 20% to 40% of total body or 20% to 40% of exposed divisions affected, it is rated 30%. If there is 5% to 20% of total body or 5% to 20% of exposed divisions affected, it is rated 10%. If there is less than 5% of total body or less than 5% of exposed divisions affected, it is rated 0%.

Treatments: If the condition required the almost constant use of medications to regulate the immune system (methotrexate, steroids, etc.) over the past 12 months, it is rated 60%. If the condition required medications to regulate the immune system for a total of 6 weeks or more during the past 12 months, it is rated 30%. If the condition required medications to regulate the immune system for a total of less than 6 weeks over the past 12 months, it is rated 10%. If the condition only required topical medications over the past 12 months, it is rated 0%.

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Diseases affecting the Keratin

Code 7824: Diseases of keratinization affect the process where the lower layers of the skin turn into the harder outer layer of skin. Keratin is the protein that causes the skin to harden. Any condition that affects the process of keratinization is rated under this code.

If the condition affects the whole body and required almost constant oral or injected medication over the past 12 months, it is rated 60%. If the condition affects the whole body and required the use of oral or injected medication for a total of at least 6 weeks during the past 12 months, it is rated 30%. If the condition only affects some areas of the body and required the use of oral or injected medication for a total of less than 6 weeks during the past 12 months, it is rated 10%. If only topical treatments were required during the past 12 months, it is rated 0%.

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Conditions affecting the Pores and Hair

Code 7830: Scarring alopecia is a condition where the hair follicles on the head are replaced by scar tissue, causing permanent hair loss and scarring. If it affects more than 40% of the scalp, it is rated 20%. If it affects 20% to 40% of the scalp, it is rated 10%. If it affects less than 20%, it is rated 0%.

Code 7831: Alopecia areata is a condition where there are circular patches of hair loss all over the body (including the head). If all the hair on the entire body is lost, it is rated 10%. If there is only hair loss on the head, it is rated 0%.

Code 7832: Hyperhidrosis is a condition where the body produces excessive amounts of sweat, even at rest. If the condition is severe enough that you are unable to handle tools or paper because of too much moisture on the hands and it doesn’t respond to treatment, it is rated 30%.

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Cancer and Tumors of the Skin

Cancer is the growth of abnormal cells. These cells can be benign—they do not attack the good cells around them—or they can be malignant—they attack the cells around them.

Code 7819: Benign tumors affecting the skin are rated either on scars/disfigurement or on how they affect the functioning of a body part. For example, if the condition interferes with the movement of the elbow, then it would be rated under the limitation of motion of the elbow. Most Basal Cell Cancers fit in this category.

Code 7833: Malignant melanoma is the most dangerous form of skin cancer. It causes dark patches to form on the skin and can also form in areas inside the body, including the eyes and bowels.

If it is active and requires intensive, invasive treatments like chemotherapy, extensive surgery (not just removal from the superficial skin), or x-ray therapy, it is rated 100% starting at the beginning of treatment. This 100% rating will continue for the first 6 months following the completion of the treatment. The condition will then be reevaluated and rated based on any continuing symptoms, like scarring.

Code 7818: All other malignant cancers of the skin are rated under this code. If it is active and requires intensive, invasive treatments like chemotherapy, extensive surgery (not just removal from the superficial skin), or x-ray therapy, it is rated 100% starting at the beginning of treatment. This 100% rating will continue for the first 6 months following the completion of the treatment. The condition will then be reevaluated and rated based on any continuing symptoms, like scarring. Most squamous cell cancers fit in this category.

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Other Skin Conditions

Code 7822: Any other skin conditions that cause hard, scaly bumps (“papulosquamous disorders”) to form on the skin that are not listed anywhere else on this page are rated under this code.

There are three different rating options for these conditions. If the condition is so severe that it causes permanent scars, it can be rated as a scar condition. The final code in that case would look like this: 7822-7801. The first four-digit code defines the condition as one of the papulosquamous disorder, and the second four-digit code tells how it is rated.

These conditions can also be rated under this code either on calculations/estimations or on the required treatment of the condition itself.

Calculations/estimations: If there is more than 40% of total body or more than 40% of exposed divisions affected, it is rated 60%. If there is 20% to 40% of total body or 20% to 40% of exposed divisions affected, it is rated 30%. If there is 5% to 20% of total body or 5% to 20% of exposed divisions affected, it is rated 10%. If there is less than 5% of total body or less than 5% of exposed divisions affected, it is rated 0%.

Treatments: If the condition required the almost constant use of medications or light therapy over the past 12 months, it is rated 60%. If the condition required medications or light therapy for a total of 6 weeks or more during the past 12 months, it is rated 30%. If the condition required medications or light therapy for a total of less than 6 weeks over the past 12 months, it is rated 10%. If the condition only required topical medications over the past 12 months, it is rated 0%.

All other skin conditions will be rated analogously (see the Analgous and Equivalent Codes page) with the above ratings. The bottom line rule is to rate any condition under the code that BEST describes it, even if it is not exact.

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DBQ for Skin Conditions

Here is the Disability Benefits Questionnaire (DBQ) used for skin conditions: Skin Conditions DBQ.

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Principles that Apply

Pyramiding: A single condition can only be rated once! However, if another condition exists that is additional to the skin condition (not simply caused by it), then it can also be rated.

Probative Value: If two exams record the condition differently, the exam with the most thorough data and performed by the most qualified person in that specialty will be the exam the rating is based on.

A Tie Goes to the Veteran: If there are two equally strong exams with conflicting information, or if the condition can be equally rated under two different codes, then the one that gives the highest rating will be assigned. Every conflict should be resolved in favor of the higher rating.

Accurate Measurements: It is essential that the necessary information to rate your condition is recorded by the physician in your exam. With the information on this page, you should know what needs to be measured and recorded. Make sure this happens correctly to ensure that you receive a proper rating.

Hospital or Convalescent Ratings: Some conditions require periods of hospitalization or constant medical care (at-home nurse, etc.). Any condition that requires this is rated 100% during this intensive treatment. Once it ends, then the 100% rating will continue for a certain period. This period is 3 months unless another length (6 months, 1 year, etc.) is directly specified in the condition ratings. Some patients may need more time to recover than others, so the physician or Rating Authorities can lengthen this time period if they see fit.

Please see the VASRD Principles page for further guidance.

For conditions caused by traumatic injury to the brain, see the Traumatic Brain Injury (TBI) page. For scar conditions, please see the Scars page. For conditions affecting the senses, see the Taste and Smell, The Ears, and The Eyes pages.

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