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7806
§ 4.118 Schedule of ratings—skin.

Dermatitis or eczema

Skin inflammation causing redness, itching, swelling, or rash that may be chronic or recurring.

What the rating means

Dermatitis or eczema is rated under the General Rating Formula for the Skin at 0%, 10%, 30%, or 60%. VA looks at two things: how much of your skin is covered by characteristic lesions, and what kind of treatment you have needed over the past 12 months.

A 60% rating requires either lesions covering more than 40 percent of your entire body or more than 40 percent of your exposed areas, or constant or near-constant systemic therapy during the past 12 months. A 30% rating requires lesions covering 20 to 40 percent of the body or exposed areas, or systemic therapy totaling 6 weeks or more (but not constantly) during the past 12 months. A 10% rating requires lesions covering at least 5 percent but less than 20 percent of the body or exposed areas, or intermittent systemic therapy for less than 6 weeks over the past 12 months. A 0% rating applies when only topical therapy was needed and lesions covered less than 5 percent of the body or exposed areas.

Systemic therapy means treatment given by any route other than the skin, such as by mouth, injection, suppository, or nasal spray. Topical therapy means treatment applied directly to the skin. VA may also rate this condition as disfigurement of the head, face, or neck or as scars, whichever reflects the predominant disability.

Evidence that helps

Medical records documenting the extent of your skin involvement are central to establishing a rating. Treatment records that show what therapies have been prescribed — and for how long — directly map to the rating levels. Records showing you received biologics, corticosteroids, retinoids, PUVA, phototherapy, photochemotherapy, or other immunosuppressive drugs by mouth, injection, suppository, or nasal spray help establish systemic therapy. Notes from a dermatologist or primary care provider describing the percentage of your body or exposed areas covered by lesions are especially useful.

For a 30% or 60% rating, records from the past 12 months showing the duration and frequency of systemic therapy, or clinical measurements of lesion coverage, carry significant weight. Prescription histories or pharmacy records can corroborate how long systemic treatment was required.

Statements from you or people who know you, describing how your skin condition affects daily activities such as work, sleep, or exposure to sunlight, can help show the real-world impact of your symptoms and support the clinical picture. These statements are most useful when they relate to specific symptoms or functional limitations tied to the rating criteria.

Secondary conditions

Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.