VA Disability Rating for Skin Conditions: Formula, Scars, and TDIU

The VA disability rating for skin conditions runs from 0% to 60% under the general rating formula in 38 CFR 4.118, and a few specific diagnoses — erythroderma and active skin cancer among them — can reach 100%. Two things drive most ratings: the percentage of your body covered by lesions and whether you need medication delivered by a route other than your skin. At December 2025 rates, a 60% rating pays a single veteran with no dependents $1,435.02 per month; a 10% rating pays $180.42.¹

How the General Rating Formula Works

The General Rating Formula for the Skin covers most service-connected skin diagnoses, including eczema and dermatitis (DC 7806), discoid lupus erythematosus (DC 7809), and psoriasis (DC 7816). The rater looks at two independent factors and assigns whichever produces the higher percentage: how much skin is affected, and how much systemic therapy you have needed in the past 12 months.²

Systemic therapy is any treatment given by a route other than your skin. Pills, injections, suppositories, and nasal sprays all count. Common examples include oral corticosteroids, biologics such as Remicade or Humira, retinoids, and phototherapy. Topical creams and ointments do not count, no matter how potent.

The tiers:

60%: lesions cover more than 40% of the entire body or more than 40% of exposed areas (head, face, neck, hands), or constant or near-constant systemic therapy was required in the past 12 months.
30%: lesions cover 20% to 40% of the body or exposed areas, or systemic therapy was required for six weeks or more (but not constantly) in the past 12 months.
10%: lesions cover 5% to less than 20% of the body or exposed areas, or intermittent systemic therapy was required for less than six weeks in the past 12 months.
0%: only topical therapy was needed and lesions cover less than 5% of the body or exposed areas.

Total body surface area and exposed area are measured separately, and that matters. A condition concentrated on the face and hands can earn a higher rating than one spread across the torso, even when the total area is smaller. Lesions on 25% of exposed areas qualify for 30%, regardless of how little of the whole body is involved.

Why Systemic Therapy Often Matters More Than Appearance

Many veterans get underrated because the rater focuses on visible skin at the exam and ignores the treatment history. The therapy prong is independent. A biologic injection every few weeks for psoriasis can qualify as constant or near-constant systemic therapy and push the rating to 60%, even if the skin looks relatively clear between doses. The Board of Veterans’ Appeals granted a 60% rating on that basis to a veteran receiving Remicade infusions every eight weeks.³

The takeaway is practical: document every systemic prescription, the route it takes, and how long you have been on it. A veteran using only topical steroids is stuck at 0% under the therapy prong. The moment treatment escalates to an oral medication or injection, the rating floor rises to 10% and can climb to 60% based on duration alone.

Conditions That Don’t Follow the General Formula

A few skin diagnoses have their own criteria, and filing under the wrong code can cost you a tier.

Acne (DC 7828) and Chloracne (DC 7829)

Both use severity rather than body-surface-area percentages, and their tiers differ. Standard acne under DC 7828 tops out at 30% for deep acne (inflamed nodules and pus-filled cysts) covering 40% or more of the face and neck, 10% for deep acne covering less than 40% of the face and neck or affecting other body parts, and 0% for superficial acne of any extent.²

Chloracne adds a middle tier standard acne lacks: 20% for deep acne affecting skin folds and creases such as the armpits, groin, or between the fingers. Because chloracne is a presumptive condition for veterans exposed to Agent Orange, that extra tier can be the difference between 10% and 20% compensation. Both conditions can also be rated under the disfigurement or scar codes if those would produce a higher evaluation.

Discoid Lupus Erythematosus (DC 7809)

Discoid lupus uses the general formula, but with a restriction: the VA will not combine a discoid lupus rating with a separate rating for systemic lupus erythematosus (DC 6350). If you have both, you get whichever single rating is higher. Stacking both would be pyramiding, which is prohibited.²

Skin Conditions That Can Reach 100%

The general formula caps at 60%. Two diagnostic codes produce a standalone 100% schedular rating.

Erythroderma (DC 7817)

Erythroderma is a severe inflammatory condition that leaves the skin red and inflamed across most of the body. A 100% rating is available in two situations. The first is when the condition involves the skin generally, produces systemic symptoms such as fever, weight loss, or low protein levels, and has required constant or near-constant systemic therapy in the past 12 months. The second is when the condition involves the skin generally without systemic symptoms but has failed at least one treatment regimen. Treatment failure means the disease progressed or improved by less than 25% after four weeks of prescribed therapy.²

Skin Cancer (DC 7818)

Malignant skin neoplasms receive a temporary 100% rating from the date treatment begins, provided the treatment is comparable to what is used for cancers that have spread throughout the body — chemotherapy, extensive radiation, or surgery beyond a simple excision. The 100% rating continues until a mandatory VA examination six months after treatment ends. If the cancer has not returned, the rating is then based on residual scarring or disfigurement. Skin cancers treated only with localized procedures do not trigger the automatic 100% rating.

Scars Are Rated Separately

Scars carry their own diagnostic codes, 7800 through 7805. When both a scar rating and a skin disease rating could apply to the same area, the VA generally assigns whichever is higher rather than both.

Head, Face, or Neck Disfigurement (DC 7800)

Facial scars are rated on cosmetic severity at 10%, 30%, 50%, or 80%. The evaluation counts “characteristics of disfigurement” — eight features that include a scar five or more inches long, a scar at least a quarter-inch wide, an elevated or depressed surface, adherence to underlying tissue, and areas exceeding six square inches with abnormal color, texture, missing soft tissue, or stiff inflexible skin. The tiers escalate with the number of characteristics present and with visible or palpable tissue loss that distorts facial features. Six or more characteristics, or tissue loss distorting three or more features, reaches 80%.²

Deep Scars on the Body (DC 7801)

Scars off the head, face, and neck that involve underlying soft tissue damage are rated by area: 10% for 6 to less than 12 square inches, 20% for 12 to less than 72, 30% for 72 to less than 144, and 40% for 144 square inches (929 sq. cm.) or more. Superficial scars on the body without underlying tissue damage (DC 7802) need at least 144 square inches to reach 10%.

Painful or Unstable Scars (DC 7804)

Any scar that is painful on examination or unstable (the skin covering frequently breaks down) qualifies for its own compensable rating: 10% for one or two, 20% for three or four, 30% for five or more. A scar that is both painful and unstable adds 10% on top of the count-based rating. This is one of the rare places where the VA allows overlap: a scar already rated for size or disfigurement under another code can still receive a separate rating under DC 7804 if it is painful or unstable.

Scars That Limit Motion (DC 7805)

When a scar restricts a nearby joint, the limitation is rated under the musculoskeletal code that fits, which often produces a higher rating than the scar codes alone. A burn scar across the elbow that limits arm extension gets rated from the elbow limitation-of-motion schedule.

Presumptive Service Connection

Some skin conditions qualify for presumptive service connection, meaning the VA assumes the link to service without a nexus letter. Three pathways matter most.

Chloracne is presumed service-connected for veterans exposed to Agent Orange or other tactical herbicides, but only if it appeared within one year of exposure to a degree at least 10% disabling. The one-year window is strict.⁴

The PACT Act added several skin cancers as presumptive for veterans who served in Southwest Asia, certain other locations, or near burn pits after August 2, 1990. Melanoma of the skin qualifies regardless of where on the body it appears. Basal cell carcinoma and squamous cell carcinoma qualify if located on the head or neck.

Gulf War veterans with chronic, unexplained skin symptoms that began during or after service in the Southwest Asia theater and have persisted for six months or more may qualify under the undiagnosed illness presumption. This covers rashes and skin problems that doctors cannot definitively diagnose.⁵

TDIU When the Schedular Rating Falls Short

If a skin condition prevents you from holding a job but your schedular rating is below 100%, you may qualify for Total Disability Based on Individual Unemployability. TDIU pays at the 100% rate — $3,938.58 per month for a single veteran — even when the combined rating is lower.¹

The schedular threshold is one service-connected disability rated at 60% or higher, or a combined rating of 70% with at least one disability at 40% or higher. Extraschedular TDIU is available for veterans who fall short of those thresholds but can show they cannot work.⁶

TDIU on a skin condition is uncommon but not unheard of. A veteran with severe hand eczema who cannot do manual work, or one with disfiguring facial scarring that blocks customer-facing employment, can have a viable case. What matters is showing the service-connected skin condition is what keeps you from substantially gainful work.

Documentation That Changes Your Rating

The gap between a 10% and a 30% rating usually lives in your medical file. A few categories carry the most weight.

Precise body surface area measurements, recorded separately for total and exposed areas, are essential. The VA’s Disability Benefits Questionnaire for Skin Diseases is the standard form; having your dermatologist complete one before your exam gives the rater a clear record to work from.⁷

Systemic therapy records matter independently. Pharmacy records, dosages, routes of administration, and start-and-stop dates for every non-topical medication support the therapy prong of the general formula. Twelve continuous months on a biologic injection supports a 60% rating on its own, even when visible symptoms are well-controlled.

Skin conditions flare and remit, and a C&P exam scheduled during a quiet period can produce a misleadingly low rating. Dated photographs taken during active flares, plus a symptom diary noting frequency, duration, and severity, give the examiner evidence of the condition at its worst. You can ask that your C&P exam be scheduled during an active period, though the VA does not guarantee it.

For conditions that are not presumptive, a nexus letter is required. An effective one states that the doctor reviewed your service and medical records, identifies the in-service event or exposure, provides a diagnosis, and offers a medical rationale using the “at least as likely as not” standard. Vague language that a condition “could be related” to service does not meet the threshold.

Appealing a Rating That’s Too Low

If the assigned rating does not match your condition’s severity, the Appeals Modernization Act gives you three options.⁸

Supplemental claim: file this when you have new and relevant evidence, such as an updated DBQ, new medical records, or a nexus letter.
Higher-level review: request this when you believe the VA erred on the existing record. A senior reviewer re-examines the file but cannot consider new evidence.
Board appeal: a Veterans Law Judge reviews your case, with your choice of submitting new evidence and requesting a hearing.

Higher-level reviews and Board appeals must be filed within one year of the decision letter’s date. Supplemental claims have no hard deadline as long as you have new evidence, but filing sooner preserves a potential earlier effective date for any increase. For skin ratings, the most productive move is often a supplemental claim paired with a fresh DBQ completed during an active flare, since that directly addresses the most common cause of underrating.

1
Department of Veterans Affairs. Current Veterans Disability Compensation Rates
2
eCFR. 38 CFR 4.118 Schedule of Ratings – Skin
3
Board of Veterans’ Appeals. BVA Decision Docket No. 19-34 865
4
Public Health. Chloracne or Acneform Disease and Agent Orange
5
Public Health. Gulf War Veterans Medically Unexplained Illnesses
6
GovInfo. 38 CFR 4.16 Total Disability Ratings for Compensation
7
Department of Veterans Affairs. Disability Benefits Questionnaire – Skin Diseases
8
Department of Veterans Affairs. Choosing a Decision Review Option