Malignant Melanoma — VA Disability Rating (DC 7833)
Diagnostic Code 7833 · 38 CFR §4.118
What Is It?
Malignant melanoma is the most dangerous form of skin cancer, arising from melanocytes and capable of metastasizing early. Veterans carry elevated risk from sustained sun exposure during service, and studies of certain cohorts — aircrew and personnel with high-altitude or high-ultraviolet duty — have reported higher incidence. Like the non-melanoma code above it, DC 7833 assigns no rating percentage of its own; it directs that the condition be rated as scars (DC 7801, 7802, 7804, or 7805), as disfigurement of the head, face, or neck (DC 7800), or on impairment of function. The 100 percent provision applies where the malignancy requires therapy comparable to that used for systemic malignancies — systemic chemotherapy, X-ray therapy more extensive than to the skin, or surgery more extensive than wide local excision — running from the date treatment begins, with a mandatory VA examination six months after that treatment ends. Melanoma reaches that threshold far more often than basal or squamous cell carcinoma does, because sentinel node biopsy, lymph node dissection, immunotherapy, and targeted therapy are standard in anything beyond the earliest stage.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Assigned from the date of onset of treatment where the malignancy requires therapy comparable to that used for systemic malignancies — systemic chemotherapy, X-ray therapy more extensive than to the skin, or surgery more extensive than wide local excision. A mandatory VA examination follows six months after completion of that antineoplastic treatment, and any resulting change is subject to 38 CFR §3.105(e). If there has been no local recurrence or metastasis, the evaluation is then based on residuals. If treatment is confined to the skin, the 100 percent provision does not apply. |
| 0% | DC 7833 carries no rating table of its own. Rate as scars (DC 7801, 7802, 7804, or 7805), disfigurement of the head, face, or neck (DC 7800), or impairment of function — whichever reflects the actual residual. After treatment and the mandatory six-month examination, the evaluation is based entirely on those residuals, which for melanoma commonly include wide excision scars, lymphedema after node dissection, and the lasting effects of immunotherapy. |
Evidence Needed
Pathology establishes the diagnosis, and the report's staging details — Breslow depth, ulceration, mitotic rate — establish severity. Operative reports are decisive for the 100 percent question, because they show whether surgery went beyond wide local excision into sentinel node biopsy or completion lymph node dissection. Oncology records document systemic therapy: immunotherapy agents such as pembrolizumab, nivolumab, and ipilimumab, and targeted agents for BRAF-mutated disease. For the residual rating you need measured excision scars, dated photographs — especially of the head, face, and neck for DC 7800 — lymphedema measurements after node dissection, and records of any lasting immunotherapy toxicity, which commonly includes thyroid dysfunction, adrenal insufficiency, colitis, and neuropathy. Service records supporting sun or ultraviolet exposure carry the nexus.
C&P Exam Tips
Which examination you need depends on where you are in the course. During active treatment, the point is documenting that therapy meets the systemic-malignancy comparison — bring the operative report and the oncology treatment plan. After treatment, the exam that matters is the residuals examination, and it is worth being systematic: measured scars, the DC 7800 characteristics of disfigurement for anything on the head, face, or neck, limb circumference measurements if lymph nodes were removed, and a full accounting of immunotherapy side effects. Immune-related endocrine damage is permanent and frequently overlooked; if you are on thyroid or steroid replacement after immunotherapy, that is a separately ratable condition and it should be named at the exam.
How to File
File on VA Form 21-526EZ as malignant melanoma under DC 7833, describing the in-service sun or ultraviolet exposure and your duty environment. Attach the pathology report with staging, operative reports, and oncology records. If treatment went beyond skin-confined surgery, claim the 100 percent provision by name and give the treatment start and end dates. File the residuals as separate issues: scars under DC 7801 through 7805, disfigurement under DC 7800, lymphedema under DC 7121, and each immunotherapy sequela — hypothyroidism, adrenal insufficiency, colitis, neuropathy — under its own code as secondary to treatment for a service-connected condition.
Common Mistakes
The first mistake is not claiming the 100 percent provision when the treatment qualified. Sentinel lymph node biopsy and completion lymph node dissection go beyond wide local excision, and immunotherapy is systemic antineoplastic treatment — but the provision runs from the date of onset of treatment, so a claim filed years later loses that period unless the dates are documented and the effective-date argument is made. The second mistake is missing the mandatory six-month examination and any reduction that follows it without response; a proposed reduction under 38 CFR §3.105(e) carries procedural rights worth exercising. The third is leaving lymphedema unclaimed after node dissection. The fourth, and the largest in volume, is never claiming immunotherapy sequelae — permanent thyroid and adrenal damage from checkpoint inhibitors is common, lifelong, and independently compensable.
Frequently Asked Questions
Does every melanoma get a 100 percent rating?
No. The 100 percent provision applies only where treatment is comparable to that used for systemic malignancies — systemic chemotherapy, X-ray therapy more extensive than to the skin, or surgery more extensive than wide local excision — and the regulation states expressly that if treatment is confined to the skin the provision does not apply. A thin melanoma removed by wide local excision alone generally does not trigger it. Sentinel node biopsy, node dissection, immunotherapy, and targeted therapy generally do.
What happens at the six-month examination?
It is mandatory and it is scheduled six months after antineoplastic treatment is completed. If there has been no local recurrence or metastasis, the evaluation shifts from 100 percent to a rating based on residuals. Any reduction that follows is subject to 38 CFR §3.105(e), which requires a proposed-reduction notice and gives you 60 days to submit evidence and 30 days to request a predetermination hearing — rights worth using rather than letting the reduction take effect unopposed.
Is melanoma presumptive for Agent Orange?
Melanoma is not on the Agent Orange presumptive list at 38 CFR §3.309(e), and it is not among the PACT Act burn-pit presumptives. Direct service connection is the route, and sun and ultraviolet exposure during service is the usual theory, supported by duty environment, deployment locations, MOS, and a nexus opinion. Veterans with documented ionizing-radiation exposure should also review the radiation provisions at §3.309(d) and §3.311.
What residuals should I claim after melanoma treatment?
Wide excision scars under DC 7801 through 7805, and disfigurement under DC 7800 if the site was on the head, face, or neck. Lymphedema under DC 7121 if lymph nodes were removed — it is common, permanent, and frequently unclaimed. And every lasting effect of systemic therapy: checkpoint inhibitors cause permanent hypothyroidism, adrenal insufficiency, colitis, and peripheral neuropathy, each rated under its own code as a consequence of treatment for a service-connected condition.