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7808
§ 4.118 Schedule of ratings—skin.

Old World leishmaniasis (cutaneous)

A parasitic skin infection causing sores or ulcers, found in parts of Africa, Asia, and the Mediterranean.

What the rating means

Old World leishmaniasis (cutaneous, Oriental sore) does not have its own rating formula. VA rates it based on whichever skin problem it causes most — disfigurement of the head, face, or neck (DC 7800); scars not on the head, face, or neck (DC 7801, 7802, or 7804); or dermatitis (DC 7806).

Under DC 7800, ratings of 10%, 30%, 50%, or 80% depend on how many facial features are grossly distorted or show visible tissue loss, or how many of eight defined characteristics of disfigurement are present. Under DC 7801, ratings of 10% to 40% depend on the total area of scars with underlying soft tissue damage. Under DC 7802, a 10% rating applies when scars without soft tissue damage cover 144 or more square inches. Under DC 7804, ratings of 10% to 30% depend on how many scars are unstable or painful. Under DC 7806, ratings of 0% to 60% depend on how much of the body is covered by lesions or how much systemic therapy was needed in the past 12 months. If two skin conditions involve the same area of skin, only the highest rating applies.

Evidence that helps

For DC 7800, medical records and unretouched color photographs showing visible or palpable tissue loss and distortion of facial features are important, as are exam findings documenting specific characteristics such as scar width, length, pigment changes, abnormal skin texture, induration, or missing soft tissue in measured areas.

For DC 7801 and 7802, records that measure the total area of scars on the body — and imaging or exam findings that confirm whether underlying soft tissue is damaged — help establish which rating level applies. For DC 7804, records showing how often skin covering breaks down over a scar, or statements describing pain at scar sites, support an unstable or painful scar rating.

For DC 7806, dermatology records showing the percentage of body or exposed areas covered by lesions, along with prescription records documenting what systemic therapies were used and for how long in the past 12 months, are directly tied to each rating level. Your own statements about how active skin disease affects your ability to work and carry out daily activities can also help show the extent of your symptoms.

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.