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Nexus Letters for Dermatitis and Eczema
Licensed Physician, MD | Patriot Path Medical Team
Specializing in VA dermatology evaluations and independent medical opinions • Last updated: June 2026
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Skin conditions are easy to underrate, because they come and go. The VA rates dermatitis and eczema on how much of your body they cover and how much treatment they take over a full year, not on how your skin looks on one good day. The treatment you need is often what decides the rating.
Many service-connected skin conditions trace back to chemical or sun exposure, or to another condition. Our physicians connect your skin condition to your service in the language the VA expects. One flat fee of $1,500, and the first consultation is free.
How VA Rates Dermatitis and Eczema
The VA rates dermatitis and eczema under 38 C.F.R. § 4.118, Diagnostic Code 7806. The rating is the greater of two things: how much of your body or exposed skin is affected, or how much treatment you needed over the past 12 months.
| Rating | What it generally takes | Monthly pay (approx) |
|---|---|---|
| 60% | More than 40 percent of the whole body or of exposed skin is affected, or you needed constant or near-constant systemic treatment (pills or injections) over the past year. | ~$1,435/mo |
| 30% | 20 to 40 percent of the whole body or of exposed skin is affected, or you needed systemic treatment for 6 weeks or more, but not constantly, over the past year. | ~$552/mo |
| 10% | At least 5 but less than 20 percent of the body or exposed skin is affected, or you needed brief systemic treatment, under 6 weeks, over the past year.Most Common | ~$180/mo |
| 0% | Less than 5 percent of the body or exposed skin, managed with creams alone over the past year. | $0 |
Two things set the rating: how much skin is affected, and whether you need systemic treatment (pills or injections) rather than just creams. The VA uses whichever gives the higher rating. The 12-month treatment history matters as much as a single flare, so keep your records.
Pay figures are approximate 2026 rates (effective December 1, 2025) for a single veteran with no dependents. Check VA.gov for current amounts.
Estimate your skin rating (DC 7806)
Answer based on how much skin is affected and your treatment over the past 12 months. The VA uses whichever gives the higher rating. This is a rough orientation, not a rating decision.
Making a VA Disability Claim for Dermatitis and Eczema
A VA disability claim for dermatitis or eczema needs three things to line up:
A current diagnosis
A dermatitis or eczema diagnosis in your records, ideally with notes on how much skin is affected.
A service connection
A skin condition that began in service, an exposure-related cause, or a link to another service-connected condition or its treatment.
A medical nexus
A qualified opinion that your skin condition is 'at least as likely as not' connected to your service, or to a service-connected cause.
Skin claims are won on the record over time. Because the rating turns on the past year of treatment and the area affected, photos during flares and a consistent treatment history matter. A nexus letter ties the condition to your service. The 'at least as likely as not' standard (a 50% or better chance) comes from the benefit-of-the-doubt rule in 38 U.S.C. § 5107(b), carried out in 38 C.F.R. § 3.102.
How to Connect Dermatitis and Eczema to Service
There are a few ways to tie a skin condition to your service.
Direct connection
The skin condition began in service, or an in-service cause led to it.
- Symptoms in service. Sick-call visits, photos, or a diagnosis of a rash or skin condition while you served.
- Exposure in service. Chemicals, sun, heat, or environmental exposures during service that can trigger lasting skin conditions.
Secondary connection
Another service-connected condition, or its treatment, caused or worsened your skin condition (38 C.F.R. § 3.310).
- Medication reactions. Some medications for service-connected conditions cause or worsen skin conditions.
- Related conditions. Skin conditions can flow from other service-connected diseases.
Presumptive (Agent Orange)
Certain acne-type skin conditions are presumptive for Agent Orange exposure.
- Chloracne. Chloracne and similar acne-type conditions are presumptive for herbicide-exposed veterans if they appeared within a year of exposure (38 C.F.R. § 3.309(e)).
Secondary Conditions
Skin conditions can be the result of service exposures, a service-connected medication, or another condition. The right path depends on your history.
A skin condition may be secondary to
- Medication for a service-connected condition. Some medications cause or worsen rashes and other skin reactions.
- Other service-connected conditions. Certain diseases bring skin problems with them, which can support a secondary claim.
What a skin condition can lead to
- Scarring and disfigurement. Lasting scars from a skin condition are rated on their own, by size and location.
- Infection. Open or broken skin can lead to infections that need their own treatment.
What to Gather - Evidence Checklist
Gather these before you file or ask for a letter. For a skin condition, the area affected and your 12-month treatment history do the heavy lifting.
Frequently Asked Questions
How does the VA rate eczema or dermatitis?
Under 38 C.F.R. 4.118, Diagnostic Code 7806. The rating is the greater of two things: how much of your body or exposed skin is affected, or how much treatment you needed over the past year. The scale is 0, 10, 30, and 60 percent. Needing systemic treatment, like pills or injections, rates higher than creams alone.
Why does my rating seem low when my skin is bad?
Because the rating uses your worst-affected area as a percent of your body and your treatment over a full year. A condition that flares badly but covers a small area, and is managed with creams, can still rate low. Photos during flares and a full treatment history help show the true picture.
Does the type of treatment change the rating?
Yes, a lot. The 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.
Are scars rated separately from the rash?
Yes. Scars are rated on their own, by size, location, and whether they are painful or unstable. A lasting scar from a skin condition can carry its own rating in addition to the active disease.
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 claim, a nexus letter tying the condition to your service or to a service-connected cause is often what decides it.
Skin conditions are rated over a year, not a day. Document it.
Let our physicians connect your skin condition to your service, and help your records show the full picture the VA rates on.
Sources & Regulatory References
- VA disability compensation (VA.gov) https://www.va.gov/disability/
- 2026 VA disability compensation rates (VA.gov) https://www.va.gov/disability/compensation-rates/veteran-rates/
- 38 CFR 4.118, Schedule of ratings, skin, including DC 7806 (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
- 38 U.S.C. 5107, Benefit of the doubt (Cornell LII) https://www.law.cornell.edu/uscode/text/38/5107