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7809
§ 4.118 Schedule of ratings—skin.

Discoid lupus

A chronic autoimmune condition causing scaly, disk-shaped patches on sun-exposed skin.

What the rating means

Discoid lupus erythematosus is rated under the General Rating Formula for the Skin, shared with several other skin conditions. VA looks at two main factors: 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 applies when characteristic lesions cover more than 40% of your entire body or more than 40% of exposed areas, or when you have needed constant or near-constant systemic therapy — such as corticosteroids, biologics, retinoids, phototherapy, PUVA, or other immunosuppressive drugs — throughout the past year. A 30% rating applies when lesions cover 20 to 40% of the body or exposed areas, or when systemic therapy was needed for a total of 6 weeks or more but not constantly. A 10% rating applies when lesions cover at least 5% but less than 20% of the body or exposed areas, or when intermittent systemic therapy was needed for less than 6 weeks total. A 0% rating applies when lesions cover less than 5% of the body or exposed areas and no more than topical therapy was required.

VA may also rate this condition as disfigurement of the head, face, or neck or as scars, whichever reflects the predominant disability. This condition cannot be combined with a rating under DC 6350.

Evidence that helps

Because the rating turns on lesion coverage and treatment history, the most useful evidence directly documents both of those things over the past 12 months.

Medical records showing the extent of your lesions — including dermatology notes, photographs, or body-surface-area measurements — help establish whether coverage falls below 5%, between 5 and 20%, between 20 and 40%, or above 40% of your entire body or exposed areas. Records that identify which areas are exposed skin versus covered skin can also matter.

Treatment records are equally important. Prescription records, pharmacy printouts, or physician notes showing what systemic therapies you received — corticosteroids, biologics, retinoids, phototherapy, PUVA, or other immunosuppressive drugs — and for how long help show whether your treatment was constant or near-constant, lasted 6 weeks or more, lasted less than 6 weeks, or was limited to topical therapy only. If lesions have caused scarring or disfigurement on your head, face, or neck, records and photographs documenting that can support evaluation under the scar or disfigurement diagnostic codes. Statements from you or people who know you describing how your symptoms affect daily activities can round out the picture.

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.