VA Disability for Squamous Cell Carcinoma: Ratings and PACT Act

The VA squamous cell carcinoma disability rating is 100% while the cancer is being treated with systemic therapy, radiation beyond the skin, or extensive surgery, and then shifts to a rating between 0% and 80% based on the scars, disfigurement, or other lasting effects the cancer and its treatment leave behind. Squamous cell carcinoma falls under Diagnostic Code 7818 in 38 CFR § 4.118, which covers malignant skin neoplasms other than melanoma.¹

The 100% Rating While You Are in Treatment

A 100% rating is assigned when the cancer requires treatment comparable to what is used for systemic malignancies: systemic chemotherapy, radiation therapy extending beyond the skin, or surgery more extensive than a wide local excision. The rating begins on the date treatment starts and continues for six months after the last antineoplastic treatment ends.¹

There is a limit that catches many veterans off guard. If treatment is confined to the skin, meaning biopsies, cryotherapy, electrodesiccation and curettage, or standard Mohs surgery, the 100% provisions do not apply.² In those cases the VA goes directly to rating the condition on its residuals.

How Residuals Are Rated After Treatment Ends

Six months after treatment ends, the VA schedules a mandatory Compensation and Pension exam. If there is no local recurrence or metastasis, the temporary 100% rating is replaced with a rating based on what the cancer left behind.³

Residuals are rated under a set of diagnostic codes that depend on where the cancer was and what treatment did to that area:

Disfigurement of the head, face, or neck (DC 7800) is rated from 10% to 80% based on the number of “characteristics of disfigurement” present, such as scar length, width, surface depression, abnormal skin texture, or missing soft tissue. One characteristic earns 10%; six or more characteristics, or gross distortion of three or more facial features, earns 80%.²
Deep scars elsewhere on the body (DC 7801) are rated 10% to 40% based on total scarring area, starting at six square inches.
Superficial scars elsewhere on the body (DC 7802) receive 10% for coverage of 144 square inches or more.
Painful or unstable scars (DC 7804) are rated 10% to 30% depending on the number of qualifying scars, with an additional 10% if a scar is both painful and unstable.³
Other disabling effects (DC 7805) are rated by the functional limitation the scar imposes on the affected body part.

Scars in different areas of the body can each be rated separately and then combined using the VA’s combined ratings formula. When evaluating disfigurement, the VA is required to consider unretouched photographs.³

What Each Rating Pays

As of December 1, 2025, monthly VA disability compensation for a veteran with no dependents ranges from $171.23 at 10% to $3,938.58 at 100%. Rates most relevant to squamous cell carcinoma claims include:

100% (active treatment period): $3,938.58 per month
50%: $1,132.90 per month
30%: $552.47 per month

Payments are higher for veterans with dependents. A 100% rated veteran with a spouse receives $4,158.17 per month. Rates are adjusted annually to match Social Security cost-of-living increases.⁴

Establishing Service Connection

A rating only matters if the VA agrees the cancer is service-connected. There are three main routes.

PACT Act Presumption

Under 38 CFR § 3.320, veterans who served in the Southwest Asia theater during the Persian Gulf War, or in Afghanistan, Syria, Djibouti, or Uzbekistan on or after September 19, 2001, are presumed to have been exposed to fine particulate matter unless evidence affirmatively shows otherwise.⁵

Squamous cell carcinoma of the larynx and of the trachea are specifically listed as presumptive cancers.⁶ The VA also groups squamous cell carcinoma within broader presumptive categories including mouth, neck, throat, nose, gastrointestinal, pancreatic, and respiratory cancers.⁷ With a presumptive condition, you do not have to independently prove a medical link between service and the cancer.

Direct Service Connection

If your cancer does not fall under a presumption, most commonly cutaneous squamous cell carcinoma tied to sun exposure, you can still establish service connection by proving three elements: a current diagnosis, an in-service event or exposure, and a medical nexus linking the two.⁸

Sun exposure claims succeed regularly at the Board of Veterans’ Appeals. In a February 2025 decision, the Board granted service connection based on documented outdoor field exposure during 1964–1966 service, noting that sun exposure need not be the sole cause of the cancer, only a contributing factor.⁹ A March 2025 decision granted service connection for a Marine Corps Vietnam veteran who reported 10 to 12 hours of daily sun exposure, with the Board crediting a private dermatologist’s opinion over VA examiners because of the specialist’s long familiarity with the veteran’s medical history.¹⁰ Another March 2025 decision followed the same pattern, favoring a private dermatologist who had treated the veteran for over 20 years and who stated the cancer was “directly caused” by service in Vietnam.¹¹

A detailed nexus letter from a treating physician is often the deciding factor. The Board has repeatedly given more weight to a doctor familiar with the veteran’s clinical history than to a VA examiner relying on generalized medical information.

Ionizing Radiation

Skin cancer, including squamous cell carcinoma, is classified as a “radiogenic disease” under 38 CFR § 3.311. This covers veterans who took part in atmospheric nuclear testing, served in the occupation of Hiroshima or Nagasaki before July 1, 1946, or had other documented radiation exposure. The regulation triggers special development procedures: the VA must obtain a dose estimate and, if certain criteria are met, request an advisory medical opinion on causation.¹² The cancer must generally manifest five or more years after exposure.¹³

Agent Orange

Squamous cell carcinoma is not on the VA’s list of conditions presumptively associated with Agent Orange exposure.¹⁴ You can still file, but you must provide independent evidence, such as a medical opinion or scientific studies, linking herbicide exposure to your specific cancer.

TDIU and Secondary Conditions Can Raise Your Total Compensation

If squamous cell carcinoma or its residuals prevent you from holding down substantially gainful employment, you may qualify for Total Disability Individual Unemployability, which pays at the 100% rate even when your combined schedular rating is lower. Under 38 CFR § 4.16, TDIU requires either one service-connected disability rated at 60% or more, or multiple service-connected disabilities with at least one rated at 40% or more and a combined rating of 70% or more.¹⁵ Veterans who fall short of those thresholds but are still unemployable due to service-connected conditions can be referred for extra-schedular consideration.¹⁶

“Substantially gainful employment” generally means earning above the poverty threshold. Work in a sheltered workshop or family business may be treated as marginal even if income exceeds that threshold. Age and nonservice-connected disabilities cannot be considered.

Under 38 CFR § 3.310, you can also claim conditions that develop as a result of the cancer or its treatment. Mental health conditions are common secondary claims. In a 2021 Board decision involving a veteran with service-connected prostate cancer, the Board granted secondary service connection for anxiety and depression, finding that the stress of “dealing with multiple medical problems, chronic pain and oncology treatment” established the required nexus.¹⁷ Surgical scars from cancer excision are also entitled to separate service connection once the underlying cancer is service-connected.⁸

When the VA Proposes to Reduce Your Rating

Most squamous cell carcinoma cases reach a point where the VA wants to move the veteran off the 100% rate. Before that happens, 38 CFR § 3.105(e) requires the VA to prepare a proposed rating explaining the reasons for the reduction and to notify the veteran in writing at their address of record.¹⁸

After that notice, you have 60 days to submit evidence showing why the rating should stay where it is, and 30 days to request a predetermination hearing. If you request the hearing within 30 days, the VA must keep paying at the current rate until a final decision is made. The hearing must be conducted by VA personnel who were not involved in proposing the reduction.¹⁹

If Your Claim Is Denied

You have three options under the VA’s decision review system:

A Supplemental Claim, filed on VA Form 20-0995, lets you submit new and relevant evidence the VA has not considered, or request review based on a change in law such as the PACT Act. Average processing time in early 2026 was about 61 days.²⁰
A Higher-Level Review, filed on VA Form 20-0996, asks a senior VA reviewer to reexamine the existing record for errors. You can request an informal conference call to point out factual or legal mistakes. The VA’s processing target is 125 days.²¹
A Board Appeal sends the case to a Veterans Law Judge at the Board of Veterans’ Appeals.

The February 2025 Board decision granting service connection for squamous cell carcinoma based on sun exposure only reached the Board after the claim had been denied three times and remanded multiple times by the U.S. Court of Appeals for Veterans Claims.⁹ Persistence and a detailed nexus opinion from a treating physician are recurring factors in claims that succeed on appeal.

1
eCFR. 38 CFR 4.118 – Schedule of Ratings, Skin
2
U.S. Court of Appeals for Veterans Claims. BVA Decision, Citation Nr 22004113
3
Cornell Law Institute. 38 CFR 4.118 – Ratings for the Skin
4
VA.gov. VA Disability Compensation Rates
5
eCFR. 38 CFR 3.320 – Presumptions of Service Connection
6
VA.gov. Presumptive Cancers Related to Burn Pit Exposure
7
Military.com. PACT Act Presumptive Conditions
8
U.S. Court of Appeals for Veterans Claims. BVA Decision, Citation Nr A22004903
9
U.S. Court of Appeals for Veterans Claims. BVA Decision, Citation Nr 25002242
10
U.S. Court of Appeals for Veterans Claims. BVA Decision, Citation Nr A25026747
11
U.S. Court of Appeals for Veterans Claims. BVA Decision, Citation Nr A25024535
12
Cornell Law Institute. 38 CFR 3.311 – Claims Based on Exposure to Ionizing Radiation
13
GovInfo. 38 CFR 3.311
14
VA.gov. Agent Orange Exposure and VA Disability Compensation
15
eCFR. 38 CFR Part 4 – Schedule for Rating Disabilities
16
Cornell Law Institute. 38 CFR 4.16 – Total Disability Ratings for Compensation
17
U.S. Court of Appeals for Veterans Claims. BVA Decision, Citation Nr 21011843
18
eCFR. 38 CFR 3.105 – Revision of Decisions
19
Cornell Law Institute. 38 CFR 3.105 – Revision of Decisions
20
VA.gov. Supplemental Claims
21
VA.gov. Higher-Level Reviews