Skin system · 38 CFR 4.118
Skin Conditions and VA Disability
The skin is rated on how much of your body it affects and how much treatment it takes. Dermatitis and eczema, psoriasis, scars, and acne-type conditions are the claims we see most. Some skin conditions are tied to Agent Orange and to burn-pit exposure, so the cause can matter as much as the rash.
Patriot Path handles the medical side of these claims. Our physicians write the nexus letters and independent medical opinions that connect a skin condition to your service or to a toxic exposure. The fee is a flat $1,500, and the first consultation is free.
Medically reviewed by the Patriot Path Medical Team
Licensed MD reviewers • Last updated: June 2026
Conditions in this system
These are the skin conditions veterans claim most. Dermatitis and eczema have a full guide now. The rest are on the way.
- Dermatitis and eczema
Itchy, inflamed skin. Rated on how much of your body is affected and the treatment it takes.
DC 7806
- PsoriasisGuide in progress
Scaly patches from an overactive immune response. Rated like dermatitis, on area and treatment.
DC 7816
- ScarsGuide in progress
Disfiguring or painful scars, including from burns or surgery. Rated on size, location, and whether they are painful or unstable.
DC 7800
- ChloracneGuide in progress
An acne-like condition tied to Agent Orange. A presumptive condition for herbicide-exposed veterans.
DC 7829
- Tinea and fungal infectionsGuide in progress
Ringworm and other fungal skin infections. Rated like dermatitis, on area and treatment.
DC 7813
- AcneGuide in progress
Severe or deep acne with scarring. Rated on how deep it is and how much of the face or body it covers.
DC 7828
How the VA rates skin conditions
Most inflammatory skin conditions share one formula. The VA rates them on the greater of two things: how much of your body or exposed skin the condition covers, or how much treatment it takes over a 12-month period. The key line is whether you need systemic treatment, like pills or injections, or only creams.
That treatment line drives the rating. Constant or near-constant systemic treatment, or coverage of more than 40 percent of the body, reaches the top of the scale. Shorter courses of systemic treatment, or smaller areas, rate lower. Creams alone with a small area is the bottom.
Scars are handled on their own. They are rated by size, location, and whether they are painful or unstable, and they can be rated separately from an active skin disease. A disfiguring scar on the face has its own scale.
Connecting a skin condition to service
There are a few ways to tie a skin condition to your service:
- Direct. The condition started in service, or an in-service cause led to it. Photos, sick-call records, or a diagnosis from your service years help establish it.
- Presumptive (Agent Orange). Chloracne and similar acne-type conditions are presumptive for Agent Orange (38 CFR 3.309(e)), if they appeared within a year of exposure. The VA accepts the link, so you do not have to prove the cause.
- Secondary. Another service-connected condition or its treatment caused it (38 CFR 3.310). A rash driven by a service-connected medication is one example.
For a direct or secondary claim, the VA needs a current diagnosis, an in-service cause, and a medical opinion linking them (38 CFR 3.303). That opinion has to clear the “at least as likely as not” standard, a 50 percent or better chance. That standard is the benefit-of-the-doubt rule under 38 U.S.C. 5107(b), carried out in 38 CFR 3.102. A nexus letter is that linking opinion.
Frequently asked questions
How does the VA rate eczema or dermatitis?
Under Diagnostic Code 7806. The VA rates it on the greater of two things: how much of your body or exposed skin it covers, or how much treatment it takes over the past year. Needing systemic treatment, like pills or injections, rates higher than needing creams alone. The scale runs 0, 10, 30, and 60 percent.
Is my skin condition connected to Agent Orange?
It may be. Chloracne and similar acne-type conditions are presumptive for veterans exposed to Agent Orange under 38 CFR 3.309(e), if they appeared within a year of exposure. For other skin conditions, you would connect them directly or as secondary to another service-connected condition.
How does the VA rate scars?
Scars are rated on their own, by size, location, and whether they are painful or unstable. Disfiguring scars of the head, face, or neck have a separate scale. Scars can be rated in addition to an active skin disease, not folded into it.
Why does the type of treatment matter so much?
Because the rating turns on it. The skin formula separates systemic treatment, like pills or injections, from topical creams. Constant systemic treatment, or coverage of more than 40 percent of the body, reaches 60 percent. Creams alone on a small area sit at the bottom. Your treatment records set the rating.
Do I need a nexus letter for a skin claim?
If your condition is a presumptive like chloracne, you may not. For a direct or secondary skin claim, a nexus letter that ties the condition to your service or to a service-connected cause is often what decides it.
A skin condition from service?
Tell us what you are dealing with. The first consultation is free, and we will tell you straight whether a nexus letter can strengthen your claim.
Sources & regulatory references
- VA disability compensation (VA.gov) https://www.va.gov/disability/
- 38 CFR 4.118, Schedule of ratings, skin (eCFR) https://www.ecfr.gov/current/title-38/section-4.118
- 38 CFR 3.309, Disease subject to presumptive service connection (eCFR) https://www.ecfr.gov/current/title-38/section-3.309
- 38 CFR 3.310, Secondary service connection (eCFR) https://www.ecfr.gov/current/title-38/section-3.310
- Agent Orange and chloracne (VA.gov) https://www.publichealth.va.gov/exposures/agentorange/conditions/chloracne.asp
- Agent Orange exposure and disability compensation (VA.gov) https://www.va.gov/disability/eligibility/hazardous-materials-exposure/agent-orange/