Alopecia Areata — VA Disability Rating (DC 7831)

Diagnostic Code 7831 · 38 CFR §4.118

What Is It?

Alopecia areata is an autoimmune condition in which the immune system attacks hair follicles, producing round, smooth patches of hair loss that appear abruptly. Unlike scarring alopecia, the follicle survives, so regrowth is possible — but the disease relapses, and in some people it progresses to alopecia totalis (all scalp hair) or alopecia universalis (all body hair, including eyebrows and eyelashes). Onset is strongly associated with severe physical or emotional stress, which is why it appears in veterans with documented in-service trauma, and it clusters with other autoimmune conditions, thyroid disease in particular. DC 7831 is a two-line code and its structure surprises most veterans: 10 percent requires loss of ALL body hair, while hair loss limited to the scalp and face — including complete loss of all scalp hair — is rated 0 percent. That is a harsh line, and it means the compensable value of an alopecia areata claim usually lies elsewhere: in the secondary mental health claim, and in the associated autoimmune disease.

Rating Criteria

Evidence Needed

A dermatology diagnosis of alopecia areata, and — where the distinction is unclear — a scalp biopsy showing the peribulbar inflammation of a non-scarring alopecia rather than the follicular destruction of a scarring one. That distinction matters because scarring alopecia is rated under DC 7830 with a higher ceiling. For the 10 percent evaluation the record must document loss of all body hair, so photographs and an examination note addressing eyebrows, eyelashes, and body hair specifically are what carry it. Beyond the skin claim, the useful evidence is thyroid function testing and other autoimmune screening, and mental health records connecting the hair loss to depression or anxiety. Service records documenting the stressor or the in-service onset support the nexus.

C&P Exam Tips

If your hair loss is complete, make sure the examiner documents all of it — eyebrows, eyelashes, and body hair, not just the scalp. That is the entire difference between 0 percent and 10 percent, and an examiner focused on the scalp will not necessarily record the rest. Bring photographs. If the loss is limited to the scalp and face, understand that DC 7831 will produce 0 percent and use the appointment to build the claims that matter: describe the psychological impact specifically and ask that it be documented, and report any fatigue, weight change, or temperature intolerance that might point to thyroid disease. Ask whether the alopecia is scarring or non-scarring, since a scarring picture moves the claim to DC 7830.

How to File

File on VA Form 21-526EZ as alopecia areata under DC 7831, stating the extent of loss and specifically whether all body hair is affected. Because the code caps at 10 percent, file the associated claims in the same submission: depression or anxiety as a secondary mental health condition under 38 CFR §3.310 where the visible loss has caused it, thyroid disease if diagnosed, and — if a biopsy shows follicular destruction — scarring alopecia under DC 7830 instead. Attach the dermatology diagnosis, biopsy, photographs, and thyroid testing.

Common Mistakes

The most common mistake is not documenting total body hair loss when it exists. A veteran with alopecia universalis who is examined for scalp involvement alone receives 0 percent for a condition that qualifies for 10 percent, and the fix is simply asking the examiner to note the absence of eyebrows, eyelashes, and body hair. The second mistake is not pursuing the secondary mental health claim, which is routinely worth several times the skin rating; sudden total hair loss has a documented psychological impact and depression secondary to a service-connected condition is compensable. The third is accepting an alopecia areata diagnosis without a biopsy when the pattern suggests scarring, since DC 7830 rates by scalp percentage up to 20 percent. The fourth is not screening for thyroid disease.

Frequently Asked Questions

Why does complete scalp hair loss rate 0 percent?

Because DC 7831 is written to compensate only loss of all body hair. Hair loss limited to the scalp and face — including alopecia totalis, which is complete scalp loss — falls in the 0 percent line as the code is drafted. It is a narrow criterion and a frequent source of frustration. The productive responses are to document any body hair loss beyond the scalp and face, and to develop the secondary and associated claims.

What is alopecia universalis?

Complete loss of hair from the entire body — scalp, eyebrows, eyelashes, and body hair. It is the most extensive form of alopecia areata and it is the condition DC 7831 compensates at 10 percent. Because the criterion is all body hair, the examination needs to address eyebrows, eyelashes, and body hair explicitly rather than describing scalp involvement alone.

Can stress in service cause alopecia areata?

The association between severe physical or emotional stress and the onset of alopecia areata is well documented in the medical literature, and it is a recognized theory of service connection. Where onset followed a documented in-service stressor, or where hair loss appeared during service and is reflected in the treatment records, a nexus opinion citing that association supports a direct service-connection claim.

Should I claim depression with alopecia areata?

If the hair loss has affected you psychologically, yes, and it is usually the higher-value part of the claim. Secondary service connection under 38 CFR §3.310 covers a mental health condition proximately caused by a service-connected disability. Sudden, visible, unpredictable hair loss has a documented association with depression and social anxiety — get that connection stated in a treatment record or nexus opinion rather than leaving it to inference.