Skin Infections Not Listed Elsewhere — VA Disability Rating (DC 7820)
Diagnostic Code 7820 · 38 CFR §4.118
What Is It?
DC 7820 is the catch-all for infections of the skin that are not listed elsewhere in the schedule — bacterial, fungal, viral, treponemal, and parasitic. In practice it captures recurrent cellulitis, chronic folliculitis and furunculosis, impetigo, hidradenitis suppurativa in many rating decisions, recurrent herpes simplex and zoster of the skin, scabies and other parasitic infestations, and the tropical skin infections veterans bring back from deployment. Fungal infections specifically named as dermatophytosis go under DC 7813 instead. The VA rates DC 7820 under the General Rating Formula for the Skin, so the evaluation turns on the percentage of the body or of exposed areas involved, or on the total duration of systemic therapy over the past twelve months — and for recurrent bacterial infections that second path is usually the productive one, because repeated courses of oral antibiotics add up. Chronic and recurrent infections are also frequently secondary to something else: diabetes, lymphedema, immunosuppressive therapy, or the chronic moisture of hyperhidrosis.
Rating Criteria
| Rating | Criteria |
|---|---|
| 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 required over the past 12-month period. This is the maximum schedular evaluation under the General Rating Formula for the Skin. |
| 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 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 affected; or, intermittent systemic therapy — including but not limited to corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs — required for a total duration of less than six weeks over the past 12-month period. |
| 0% | No more than topical therapy required over the past 12-month period, and characteristic lesions involving less than 5 percent of the entire body or less than 5 percent of exposed areas affected. |
Evidence Needed
Identification of the organism helps: wound cultures, viral PCR, skin scrapings for parasites, or serology all convert "recurrent rash" into a documented infection. For the rating, two numbers again — the percentage of total body and of exposed areas involved during an active infection, and the total weeks of systemic antibiotic, antiviral, or antiparasitic therapy over the past twelve months, best proved by pharmacy fill records. Emergency department and urgent care visits for cellulitis, hospital admissions for severe infection, and incision-and-drainage procedure notes all document severity and frequency. Photographs during an active episode matter because these infections clear between flares. For deployment-acquired infections, service records placing you in the region and any in-theater treatment records are the nexus evidence.
C&P Exam Tips
Recurrent infections are usually quiet on exam day, so bring the record of the flares: dates, photographs, prescriptions, and any procedure notes. Ask the examiner to record total body and exposed-area percentages as they appear during an active episode and to note that the condition is recurrent rather than resolved. Give the systemic therapy duration in weeks over the past year, with the pharmacy printout in hand. If the infections are secondary to another condition — diabetes, lymphedema, chronic venous insufficiency, immunosuppression for another disability, or hyperhidrosis — say so explicitly, because that reframes the claim as a secondary one and often improves it. Report any residual scarring, and any sinus tracts or contractures if hidradenitis is involved.
How to File
File on VA Form 21-526EZ naming the infection as specifically as the record allows — recurrent cellulitis, chronic folliculitis, hidradenitis suppurativa, herpes zoster — under DC 7820. Attach cultures or other identification, photographs from active episodes, emergency and urgent care records, procedure notes, and a pharmacy record showing systemic therapy durations. If the infections are a consequence of a service-connected condition, file the claim as secondary under 38 CFR §3.310 and name the primary. Claim residual scarring under DC 7800 through 7805 as a separate issue.
Common Mistakes
The most common mistake is filing during a quiet period with no documentation of the flares, which leaves the examiner rating a normal-looking skin surface. Recurrent conditions are rated on a twelve-month look-back precisely so that intermittent disease counts, but only the documented part counts. The second mistake is not totalling systemic antibiotic courses — four separate two-week courses in a year is eight weeks of systemic therapy and satisfies the six-weeks-or-more criterion for 30 percent, but nobody adds them up unless you do. The third is missing the secondary pathway, which is the single most valuable move in this code: recurrent skin infections in a diabetic or lymphedematous limb are consequences of the primary condition. The fourth is leaving residual scarring unclaimed after years of abscesses and drainage procedures.
Frequently Asked Questions
Does recurrent cellulitis qualify under DC 7820?
Yes, as an infection of the skin not listed elsewhere. The rating is set by the General Rating Formula for the Skin — body-surface-area involvement during episodes, or the total duration of systemic therapy over the past twelve months. Because cellulitis is treated with oral or intravenous antibiotics, the therapy path is usually the stronger one; add up every course over the year and compare the total against the six-week threshold for 30 percent.
How is hidradenitis suppurativa rated?
Rating decisions most often place it under DC 7820 as a skin infection not listed elsewhere, evaluated on the General Rating Formula. Some decisions use an analogous built-up code instead. Whichever code applies, the high-value elements are the same: systemic therapy duration including antibiotics and biologics, body-surface-area involvement, and separately ratable residuals — scarring under DC 7801 through 7805, painful lesions under DC 7804, and any contracture limiting motion.
Do multiple short antibiotic courses add up?
Yes. The criteria are written as a total duration over the past 12-month period, not as a single continuous course. Four separate two-week courses total eight weeks, which is six weeks or more and therefore meets the 30 percent criterion. This is why pharmacy fill records — which show every prescription with its date and day supply — are often the most valuable document in the file.
Can skin infections be secondary to another condition?
Very commonly, and it is worth claiming that way. Diabetes impairs healing and immune response; lymphedema and chronic venous insufficiency create the conditions for recurrent cellulitis; immunosuppressive therapy for any service-connected disease raises infection risk; hyperhidrosis keeps skin macerated. Under 38 CFR §3.310 a condition proximately caused or aggravated by a service-connected disability is itself service-connected, and the secondary route is usually easier to prove than direct onset.