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Eczema, dermatitis, psoriasis and similar conditions — rated by percentage of body affected and the type of therapy required. This guide quotes the actual rating criteria from 38 CFR Part 4 for diagnostic code 7806 etc., explains what the C&P examiner measures, covers the presumptive and secondary routes to service connection, and lists the reasons these claims come back denied — and how each gets fixed.
How the VA rates skin conditions in 2026 — the exact criteria
These are the criteria a VA rater applies, quoted from the rating schedule (§ 4.118). Your rating is the highest level whose wording your evidence meets — and evidence that never uses these words tends to be rated at the bottom.
General Rating Formula for the Skin (DC 7806 dermatitis/eczema, 7816 psoriasis, 7813 dermatophytosis and others)
| Rating | Criteria (38 CFR Part 4 wording) |
|---|---|
| 60% | Characteristic lesions involving more than 40 percent of the entire body or more than 40 percent of exposed areas affected; or constant or near-constant systemic therapy (such as corticosteroids, other immunosuppressives, retinoids, PUVA, UVB, biologics or electron beam therapy) required over the past 12-month period |
| 30% | Characteristic lesions involving 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected; or systemic therapy required for a total duration of 6 weeks or more, but not constantly, over the past 12-month period |
| 10% | Characteristic lesions involving at least 5 percent, but less than 20 percent, of the entire body or of exposed areas affected; or intermittent systemic therapy required for a total duration of less than 6 weeks over the past 12-month period |
| 0% | Less than 5 percent of the entire body and less than 5 percent of exposed areas affected; and no more than topical therapy required over the past 12-month period |
"Exposed areas" means the head, face, neck and hands. Systemic therapy means corticosteroids, immunosuppressives, retinoids, phototherapy, biologics and similar — topical creams do not count, no matter how long they are used.
Scars are rated separately (DC 7800–7805) and can be combined with the skin rating.
Honest ceiling: 30% at 20–40% of the body, or systemic therapy.
What the C&P examiner measures
The examiner estimates the percentage of total body and of exposed areas (head, face, neck, hands) affected, and records every systemic therapy in the past 12 months with dates. Schedule the exam during a flare if you can, and bring photographs of flares with dates.
The questions that get at the rating criteria — answer them for yourself before the exam:
- Anything that flares up and then calms down? Do you use a cream for it?
Service connection: presumptive, direct, or secondary
Chloracne within one year of Agent Orange exposure is presumptive (38 CFR 3.309(e)). Eczema, dermatitis and psoriasis are claimed directly (in-service treatment) or secondary to PTSD, medications, or burn-pit exposure with a supporting opinion.
Every service-connection claim has three legs: a current diagnosis (the C&P exam can supply it), an in-service event, injury, exposure or an already-connected condition, and a link between the two — which the VA's own examiner addresses at the exam for direct and secondary claims, and which the law supplies for presumptive ones. You do not need a private opinion to file; you need one only if the VA denies for lack of nexus, and a supplemental claim within one year keeps your effective date.
Secondary conditions veterans miss
This condition is more often the secondary in a chain than the anchor — see the secondary-claims guides for the recognized pathways.
What the medical literature says
38 CFR 3.303(b) — chronicity and continuity of symptomatology
A chronic condition noted in service with continuity since is service-connectable without a nexus opinion. Why it matters: Skin conditions with in-service onset (photos, buddy statements, STR entries).
Why skin conditions claims get denied — and the fix
- Examined between flares and rated on a clear-skin day — schedule during a flare and bring dated photographs.
- Topical steroids counted as "systemic" (or the reverse) — the formula counts only systemic therapy (corticosteroids, immunosuppressives, biologics, phototherapy).
A denial is a grade on the evidence packet, not a verdict on you. Filed as a supplemental claim within one year, the fix keeps your original effective date.
Filing it right the first time
- Intent to File first. It locks your effective date for a year — back pay runs from that day, not from the day the package is ready.
- File everything at once. Every condition with a real symptom and a plausible route — direct, presumptive, secondary, increase — goes in one claim. The VA's duty to assist schedules the exam and pulls your records; a condition held back "for more evidence" only starts its clock later.
- Your statement in the criteria's words. A Statement in Support of Claim (VA Form 21-4138) that describes your worst days and your typical days using the language in the table above is the evidence the rater reads first.
- Your records. VA records through Blue Button, decision letters and code sheet from VA.gov, and private records from each doctor's office or patient portal — or a signed 21-4142 so the VA pulls them.
- Prepare for the exam. Know what the examiner measures (above) and answer honestly, including the bad days.
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See If You Qualify →Frequently asked questions
What is the VA rating for skin conditions?
Skin Conditions is rated under diagnostic code 7806 etc. (§ 4.118) at 0%, 10%, 30%, 60%. The percentage depends on which criteria in the rating schedule your evidence meets — the full table is on this page.
What is the highest VA rating for skin conditions?
The highest schedular rating available is 60%. Typical grants land around 10%, but every case is decided on its own evidence.
Is skin conditions a presumptive condition?
Chloracne within one year of Agent Orange exposure is presumptive (38 CFR 3.309(e)). Eczema, dermatitis and psoriasis are claimed directly (in-service treatment) or secondary to PTSD, medications, or burn-pit exposure with a supporting opinion.
Do I need a nexus letter for skin conditions?
Not to file. The VA's duty to assist schedules a C&P exam where its own examiner addresses the connection, and presumptive conditions need no opinion at all. A private opinion becomes worth buying only if the VA denies for lack of nexus — a supplemental claim within one year keeps your original effective date.
Rating criteria verified against eCFR (38 CFR Part 4) — last reviewed 2026-09-19. Regulations change; confirm anything decision-critical at ecfr.gov.