60% (General Rating Formula for the Skin, ceiling)
Highest listed pathwayCharacteristic lesions involving more than 40 percent of the entire body or exposed areas, or constant/near-constant systemic therapy required over the past 12 months.
What separates the next level: 30 percent applies once involvement or therapy duration falls into the next band down.
Review CFR criteria, examples, and evidence
- Official CFR language
- 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 therapeutic doses of corticosteroids, phototherapy, retinoids, biologics, photochemotherapy (PUVA), or other immunosuppressive drugs) required over the past 12-month period.
- Qualification explanation
- Reached by any one of 9 diagnoses (dermatitis/eczema, discoid lupus erythematosus, dermatophytosis, bullous disorders, psoriasis, and others) that share this identical formula.
- Examples
- Records document psoriasis affecting 45 percent of the body surface, with continuous biologic therapy.
- Medical evidence
- Skin Diseases DBQ; Records documenting body/exposed-area percentage and systemic therapy
- Functional impact examples
- Most severe documented involvement reachable under the shared formula.
- Common misconceptions
- This same formula and tier text applies identically to 9 different diagnostic codes -- confirmed via two independent sources, cross-checked during this build's own verbatim re-verification, not assumed from RSCH-034 alone.
- Related topics
- rating-criteria
- Source context
- 38 CFR 4.118; 7806; Current DC 7806-7824 educational pathway. Last amended August 7, 2018. No pending rulemaking found touching this range as of 2026-07-25 (RSCH-034).
0% (General Rating Formula for the Skin, floor)
Next: 10%No more than topical therapy required over the past 12 months, with lesions under 5 percent of the entire body or exposed areas.
What separates the next level: 10 percent applies once involvement reaches 5 percent, or intermittent systemic therapy is required.
Review CFR criteria, examples, and evidence
- Official CFR language
- No more than topical therapy required over the past 12-month period, and at least one of the following: characteristic lesions involving less than 5 percent of the entire body affected; or characteristic lesions involving less than 5 percent of exposed areas affected.
- Qualification explanation
- The shared formula's real, explicit 0 percent floor.
- Examples
- Records document mild dermatophytosis affecting 2 percent of the body, treated with topical antifungal cream only.
- Medical evidence
- Skin Diseases DBQ; Treatment records documenting therapy type
- Functional impact examples
- Minimal documented involvement, topical treatment only.
- Related topics
- rating-criteria
- Source context
- 38 CFR 4.118; 7813; Current DC 7806-7824 educational pathway.
100% (DC 7817, Erythroderma, ceiling)
Highest listed pathwayGeneralized skin involvement with systemic manifestations (fever, weight loss, or hypoproteinemia), and constant systemic therapy or a documented history of treatment failure with 2 or more regimens.
What separates the next level: 60 percent applies without systemic manifestations.
Review CFR criteria, examples, and evidence
- Official CFR language
- Generalized involvement of the skin with systemic manifestations (such as fever, weight loss, or hypoproteinemia) AND one of the following: constant or near-constant systemic therapy required over the past 12 month period; or no current treatment due to a documented history of treatment failure with 2 or more treatment regimens.
- Qualification explanation
- DC 7817's ceiling tier -- the only independent table in this hub with both a real 100 percent ceiling and a real 0 percent floor.
- Examples
- Records document generalized erythroderma with documented fever and weight loss, on constant systemic immunosuppressive therapy.
- Medical evidence
- Skin Diseases DBQ; Records documenting systemic manifestations and treatment history
- Functional impact examples
- Most severe documented erythroderma presentation.
- Related topics
- rating-criteria
- Source context
- 38 CFR 4.118; 7817; Current DC 7817 educational pathway.
10% (DC 7823, Vitiligo, ceiling)
Highest listed pathwayVitiligo with exposed areas affected.
What separates the next level: 0 percent applies when no exposed areas are affected.
Review CFR criteria, examples, and evidence
- Official CFR language
- With exposed areas affected -- 10.
- Qualification explanation
- DC 7823's simple 2-tier table.
- Examples
- Records document vitiligo patches on the hands and face.
- Medical evidence
- Skin Diseases DBQ
- Functional impact examples
- Documented vitiligo affecting visible/exposed skin.
- Related topics
- rating-criteria
- Source context
- 38 CFR 4.118; 7823; Current DC 7823 educational pathway.
60% (DC 7825, Chronic urticaria, ceiling -- no real 0 percent tier)
Highest listed pathwayChronic urticaria requiring third-line treatment (e.g., plasmapheresis, immunotherapy, immunosuppressives).
What separates the next level: 30 percent applies for second-line treatment instead.
Review CFR criteria, examples, and evidence
- Official CFR language
- Chronic refractory urticaria that requires third line treatment for control (e.g., plasmapheresis, immunotherapy, immunosuppressives) due to ineffectiveness with first and second line treatments -- 60.
- Qualification explanation
- DC 7825's ceiling tier.
- Examples
- Records document chronic urticaria unresponsive to antihistamines and corticosteroids, now on immunotherapy.
- Medical evidence
- Skin Diseases DBQ; Treatment records documenting which treatment line is required
- Functional impact examples
- Most treatment-resistant documented chronic urticaria.
- Common misconceptions
- Confirmed via two independent sources: DC 7825 has no explicit 0 percent row -- 10 percent (first-line treatment) is the floor, not 0 percent.
- Related topics
- rating-criteria
- Source context
- 38 CFR 4.118; 7825; Current DC 7825 educational pathway.
60% (DC 7826, Vasculitis, ceiling -- no real 0 percent tier)
Highest listed pathwayPersistent vasculitis episodes refractory to continuous immunosuppressive therapy.
What separates the next level: 30 percent applies for 4+ recurrent episodes with intermittent therapy instead of persistent refractory disease.
Review CFR criteria, examples, and evidence
- Official CFR language
- Persistent documented vasculitis episodes refractory to continuous immunosuppressive therapy -- 60.
- Qualification explanation
- DC 7826's ceiling tier.
- Examples
- Records document ongoing vasculitis flares despite continuous immunosuppressive medication.
- Medical evidence
- Skin Diseases DBQ; Records documenting episode frequency and therapy
- Functional impact examples
- Most treatment-resistant documented cutaneous vasculitis.
- Common misconceptions
- Confirmed via two independent sources: DC 7826 has no explicit 0 percent row -- 10 percent is the floor.
- Related topics
- rating-criteria
- Source context
- 38 CFR 4.118; 7826; Current DC 7826 educational pathway.
60% (DC 7827, Erythema multiforme/TEN, ceiling -- no real 0 percent tier)
Highest listed pathwayRecurrent mucosal, palmar, or plantar involvement impairing mastication, hand use, or ambulation, 4+ times over 12 months despite ongoing immunosuppressive therapy.
What separates the next level: 30 percent applies when the same frequency of involvement does not impair mastication, hand use, or ambulation.
Review CFR criteria, examples, and evidence
- Official CFR language
- Recurrent mucosal, palmar, or plantar involvement impairing mastication, use of hands, or ambulation occurring four or more times over the past 12-month period despite ongoing immunosuppressive therapy -- 60.
- Qualification explanation
- DC 7827's ceiling tier.
- Examples
- Records document 5 documented episodes of oral mucosal involvement impairing eating, despite ongoing immunosuppressive therapy.
- Medical evidence
- Skin Diseases DBQ; Records documenting episode frequency and functional impact
- Functional impact examples
- Most severe documented erythema multiforme/TEN presentation.
- Common misconceptions
- Confirmed via two independent sources: DC 7827 has no explicit 0 percent row -- 10 percent is the floor. For this DC only, systemic therapy may include antihistamines or sympathomimetics, not only immunosuppressives.
- Related topics
- rating-criteria
- Source context
- 38 CFR 4.118; 7827; Current DC 7827 educational pathway.
30% (DC 7828, Acne, ceiling)
Highest listed pathwayDeep acne (nodules/cysts) affecting 40 percent or more of the face and neck.
What separates the next level: 10 percent applies for less extensive or non-facial deep acne.
Review CFR criteria, examples, and evidence
- Official CFR language
- Deep acne (deep inflamed nodules and pus-filled cysts) affecting 40 percent or more of the face and neck -- 30.
- Qualification explanation
- DC 7828's ceiling tier.
- Examples
- Records document deep inflamed nodules and cysts across most of the face and neck.
- Medical evidence
- Skin Diseases DBQ; Records documenting acne depth and location
- Functional impact examples
- Most extensive documented deep acne.
- Related topics
- rating-criteria
- Source context
- 38 CFR 4.118; 7828; Current DC 7828 educational pathway.
20% (DC 7829, Chloracne, intertriginous-area tier)
Next: 30%Deep chloracne affecting intertriginous areas (axilla, anogenital region, breast skin folds, or between digits).
What separates the next level: 30 percent applies for 40 percent or more of the face and neck instead; 10 percent applies for less extensive or non-intertriginous deep acne.
Review CFR criteria, examples, and evidence
- Official CFR language
- Deep acne (deep inflamed nodules and pus-filled cysts) affecting the intertriginous areas (the axilla of the arm, the anogenital region, skin folds of the breasts, or between digits) -- 20.
- Qualification explanation
- DC 7829's own distinctive tier -- the one respect its ladder genuinely differs in shape from Acne's (DC 7828), which has no equivalent 20 percent row.
- Examples
- Records document deep chloracne lesions in the axilla and groin folds.
- Medical evidence
- Skin Diseases DBQ; Records documenting chloracne depth and location
- Functional impact examples
- Documented intertriginous-area chloracne.
- Common misconceptions
- Do not assume Chloracne (DC 7829) is identical to Acne (DC 7828) -- confirmed via two independent sources that DC 7829 has a genuinely different 4-tier structure with this unique 20 percent carve-out.
- Related topics
- rating-criteria
- Source context
- 38 CFR 4.118; 7829; Current DC 7829 educational pathway.
20% (DC 7830, Scarring alopecia, ceiling)
Highest listed pathwayScarring alopecia affecting more than 40 percent of the scalp.
What separates the next level: 10 percent applies for 20-40 percent of the scalp.
Review CFR criteria, examples, and evidence
- Official CFR language
- Affecting more than 40 percent of the scalp -- 20.
- Qualification explanation
- DC 7830's ceiling tier.
- Examples
- Records document scarring alopecia across most of the scalp.
- Medical evidence
- Skin Diseases DBQ; Records documenting percentage of scalp affected
- Functional impact examples
- Most extensive documented scarring alopecia.
- Related topics
- rating-criteria
- Source context
- 38 CFR 4.118; 7830; Current DC 7830 educational pathway.
10% (DC 7831, Alopecia areata, ceiling)
Highest listed pathwayAlopecia areata with loss of all body hair.
What separates the next level: 0 percent applies when hair loss is limited to the scalp and face.
Review CFR criteria, examples, and evidence
- Official CFR language
- With loss of all body hair -- 10.
- Qualification explanation
- DC 7831's simple 2-tier table.
- Examples
- Records document total body hair loss, not limited to the scalp.
- Medical evidence
- Skin Diseases DBQ
- Functional impact examples
- Most extensive documented alopecia areata.
- Related topics
- rating-criteria
- Source context
- 38 CFR 4.118; 7831; Current DC 7831 educational pathway.
30% (DC 7832, Hyperhidrosis, the only tier above 0 percent)
Highest listed pathwayUnable to handle paper or tools because of moisture, and unresponsive to therapy.
What separates the next level: 0 percent applies once the veteran is able to handle paper or tools after therapy -- there is no intermediate 10 or 20 percent tier.
Review CFR criteria, examples, and evidence
- Official CFR language
- Unable to handle paper or tools because of moisture, and unresponsive to therapy -- 30.
- Qualification explanation
- DC 7832's table is deliberately just two rows: 30 percent and 0 percent.
- Examples
- Records document severe palmar hyperhidrosis unresponsive to iontophoresis or anticholinergic treatment.
- Medical evidence
- Skin Diseases DBQ; Records documenting functional impact and treatment response
- Functional impact examples
- Documented inability to handle paper or tools due to excessive sweating, unresponsive to treatment.
- Common misconceptions
- Confirmed via two independent sources: DC 7832 has NO 10 or 20 percent tier -- do not assume a missing middle tier is an oversight in this hub's build.
- Related topics
- hyperhidrosis-two-tier
- Source context
- 38 CFR 4.118; 7832; Current DC 7832 educational pathway.
100% (DC 7818, Malignant skin neoplasms other than melanoma, active-treatment phase)
Highest listed pathwayA 100 percent rating applies from the date treatment begins for a malignant skin neoplasm requiring systemic chemotherapy, extensive X-ray therapy, or extensive surgery, continuing until a mandatory VA exam 6 months after treatment ends.
What separates the next level: If treatment is confined to the skin (not systemic chemotherapy, extensive X-ray therapy, or extensive surgery), this 100 percent Note does not apply -- the baseline rating instead dispatches to disfigurement (DC 7800), scars (DC 7801/7802/7803/7804/7805), or impairment of function.
Review CFR criteria, examples, and evidence
- Official CFR language
- If a skin malignancy requires therapy that is comparable to that used for systemic malignancies, i.e., systemic chemotherapy, X-ray therapy more extensive than to the skin, or surgery more extensive than wide local excision, a 100-percent evaluation will be assigned from the date of onset of treatment, and will continue, with a mandatory VA examination six months following the completion of such antineoplastic treatment... If treatment is confined to the skin, the provisions for a 100-percent evaluation do not apply.
- Qualification explanation
- Stated directly in DC 7818's own Note -- unlike DC 7811's inferred 100 percent, this is literal regulatory text, confirmed via two independent sources during this build's re-verification, not an inference.
- Examples
- Records document a malignant skin neoplasm treated with systemic chemotherapy, with a 100 percent evaluation assigned from the date treatment began.
- Medical evidence
- Skin Diseases DBQ; Oncology/treatment records documenting the type and extent of therapy (systemic vs. skin-confined)
- Functional impact examples
- Active systemic-treatment phase for a malignant skin neoplasm.
- Common misconceptions
- This code is often assumed to have no percentage of its own because its baseline (non-active-treatment) rating dispatches to disfigurement/scars/impairment-of-function -- but the active-treatment-phase 100 percent Note is DC 7818's own literal text, not a dispatch and not an inference. Confirmed via two independent sources.
- Related topics
- dispatch-only-codes
- Source context
- 38 CFR 4.118; 7818; Current DC 7818 educational pathway.
100% (DC 7833, Malignant melanoma, active-treatment phase)
Highest listed pathwayA 100 percent rating applies from the date treatment begins for malignant melanoma requiring systemic chemotherapy, extensive X-ray therapy, or extensive surgery, continuing until a mandatory VA exam 6 months after treatment ends.
What separates the next level: If treatment is confined to the skin (not systemic chemotherapy, extensive X-ray therapy, or extensive surgery), this 100 percent Note does not apply -- the baseline rating instead dispatches to scars (DC 7801/7802/7803/7804/7805), disfigurement (DC 7800), or impairment of function.
Review CFR criteria, examples, and evidence
- Official CFR language
- If a skin malignancy requires therapy that is comparable to that used for systemic malignancies, i.e., systemic chemotherapy, X-ray therapy more extensive than to the skin, or surgery more extensive than wide local excision, a 100-percent evaluation will be assigned from the date of onset of treatment, and will continue, with a mandatory VA examination six months following the completion of such antineoplastic treatment... If treatment is confined to the skin, the provisions for a 100-percent evaluation do not apply.
- Qualification explanation
- Stated directly in DC 7833's own Note -- unlike DC 7811's inferred 100 percent, this is literal regulatory text, confirmed via two independent sources during this build's re-verification, not an inference.
- Examples
- Records document malignant melanoma treated with extensive surgery beyond wide local excision, with a 100 percent evaluation assigned from the date treatment began.
- Medical evidence
- Skin Diseases DBQ; Oncology/treatment records documenting the type and extent of therapy (systemic vs. skin-confined)
- Functional impact examples
- Active systemic-treatment phase for malignant melanoma.
- Common misconceptions
- This code is often assumed to have no percentage of its own because its baseline (non-active-treatment) rating dispatches to scars/disfigurement/impairment-of-function -- but the active-treatment-phase 100 percent Note is DC 7833's own literal text, not a dispatch and not an inference. Confirmed via two independent sources.
- Related topics
- dispatch-only-codes
- Source context
- 38 CFR 4.118; 7833; Current DC 7833 educational pathway.