Eczema / Dermatitis — VA Disability Rating Criteria (DC 7806)
Diagnostic Code 7806 · 38 CFR §4.118
What Is It?
Eczema (atopic dermatitis) and contact dermatitis are chronic inflammatory skin conditions that cause dry, itchy, inflamed, sometimes blistering or cracked patches of skin. The VA rates them under DC 7806 using the General Rating Formula for the Skin, which offers two separate paths to a rating: the percentage of skin affected, or the type and duration of systemic therapy required. You get whichever path produces the higher rating. Veterans commonly develop or worsen skin conditions from service exposures — solvents, fuels such as JP-8, industrial chemicals, plants, sand and extreme climates, prolonged sweating under protective gear, and frequent washing with harsh field soaps. Dermatitis can also arise secondary to another service-connected condition or as a side effect of a medication taken for one.
Rating Criteria
| Rating | Criteria |
|---|---|
| 60% | Characteristic lesions involving more than 40 percent of the entire body, or more than 40 percent of exposed areas; or constant or near-constant systemic therapy (such as corticosteroids, phototherapy, retinoids, biologics, PUVA, or other immunosuppressive drugs) required over the past 12-month period. This is the maximum schedular rating under DC 7806. |
| 30% | Characteristic lesions involving 20 to 40 percent of the entire body, or 20 to 40 percent of exposed areas; or systemic therapy (such as corticosteroids, phototherapy, retinoids, biologics, PUVA, or other immunosuppressive drugs) required for a total duration of six 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 at least 5 percent but less than 20 percent of exposed areas; or intermittent systemic therapy (such as corticosteroids, phototherapy, retinoids, biologics, PUVA, or other immunosuppressive drugs) required for a total duration of less than six weeks over the past 12-month period. |
| 0% | Characteristic lesions involving less than 5 percent of the entire body and less than 5 percent of exposed areas, with no more than topical therapy required over the past 12-month period. |
Evidence Needed
You need a current diagnosis of eczema or dermatitis, a link to service (direct exposure, onset in service, or secondary to another condition or medication), and documentation of severity. Severity is measured two ways — the percentage of your total body and of exposed areas (face, neck, hands) affected, and the systemic therapy you require. Photographs taken during flare-ups showing the extent of coverage are among the most valuable evidence you can submit, because skin conditions wax and wane and the C&P exam may catch you on a good day. Medical records should document the affected areas and every medication prescribed; and if you use systemic therapy, record the total number of weeks per year you are on it, because that duration is what separates the 10%, 30%, and 60% levels.
C&P Exam Tips
The C&P exam should ideally fall during a flare-up, since the examiner assesses the condition as it presents that day. If your dermatitis is seasonal or cyclical, try to schedule during your worst period, and do not apply topical medication right before the exam, which can mask the inflammation. The examiner estimates the percentage of total body area and of exposed areas (face, neck, hands) affected; the higher of the two figures drives the rating. Bring date-stamped photographs from previous flares to show the condition at its worst, and list every medication you use — topical and systemic — and how often, since the route and duration of treatment matter as much as the coverage.
How to File
File on VA Form 21-526EZ. Describe the in-service exposure that caused or worsened your skin condition (fuels, solvents, chemicals, sand, climate, protective gear), or identify the primary service-connected condition if you are claiming secondary service connection. Submit photographs taken during flares, medical records showing diagnosis and treatment, and a complete medication list. If you use systemic therapy, document the total duration of use over the past year — that figure determines whether you land at 10%, 30%, or 60%.
Common Mistakes
The most common mistake is accepting a C&P exam during a remission, when the skin looks clear; if your condition is cyclical, push for an active-flare exam and bring photographs from prior flares. A second, costly mistake is misunderstanding 'systemic therapy.' Under the current rule (effective August 2018), systemic therapy means treatment given by a route other than the skin — oral, injected, and the like — so daily topical steroid creams do not count as systemic therapy and will not, on their own, move you up the systemic-therapy path. (For claims pending before August 2018, an older interpretation may apply in which topical corticosteroids could count, so the date of your claim matters.) Third, veterans often forget that exposed areas — face, neck, and hands — are scored separately from total-body coverage, and the higher of the two percentages is the one used.
Frequently Asked Questions
What counts as systemic therapy for an eczema rating?
Under the current rule (effective August 2018), systemic therapy is treatment given by a route other than the skin — for example oral corticosteroids, injected biologics, retinoids, or light-based treatments such as PUVA. Topical creams and ointments applied to the skin are topical therapy, not systemic, so they do not move you up the systemic-therapy path. Claims that were pending before August 2018 may be judged under an older interpretation in which topical corticosteroids could count.
What if my skin is clear during the C&P exam?
Skin conditions flare and remit, and the VA rates what the examiner sees together with your documented history. If your exam falls during a clear period, bring date-stamped photographs from prior flares and records of your treatment so the rating reflects your condition at its worst, not its best.
Is total-body or exposed-area coverage used for the rating?
Whichever is higher. The VA measures both the percentage of your entire body affected and the percentage of exposed areas (face, neck, hands) affected, and assigns the rating based on the larger of the two figures.
What is the highest eczema rating?
60% is the maximum schedular rating under DC 7806. A higher combined rating is possible only through separately ratable conditions, such as disfiguring scars under DC 7800, or through TDIU if the condition keeps you from working.
Is eczema a presumptive condition?
Generally no — you must show it began in or was caused by service, or is secondary to a service-connected condition. One exception: Gulf War veterans may claim chronic skin symptoms as part of an undiagnosed illness or a medically unexplained chronic multisymptom illness.
Can hand eczema that affects my job raise my rating?
It can support an exposed-area rating, and if the condition prevents you from holding substantially gainful employment, it can factor into a TDIU claim even though the schedular maximum for DC 7806 is 60%.
What in-service exposures support an eczema claim?
Common ones include fuels and solvents (such as JP-8), industrial chemicals and cleaners, plants and environmental allergens, sand and extreme heat or cold, prolonged sweating under protective gear, and harsh field soaps and detergents. Documenting the exposure tied to your job or deployment, plus a nexus opinion, supports direct service connection.