Pellagra (niacin deficiency)

To support a rating at any level, medical records documenting a confirmed diagnosis of pellagra are the starting point. For the 10% level, records showing nonspecific symptoms — such as weight loss, poor appetite, abdominal discomfort, weakness, or difficulty concentrating — help establish the baseline picture.

For the 20% level, exam findings or clinical notes confirming stomatitis, achlorhydria, or diarrhea are relevant. Moving to 40% requires documentation of all three of those conditions together, along with evidence of symmetrical dermatitis, which a dermatology or primary care exam could capture. Photographs of skin findings can also be useful.

At 60%, mental health records or neuropsychiatric evaluations showing mental symptoms, combined with clinical findings of reduced physical strength or stamina, help show that level. For the 100% level, records reflecting marked mental deterioration, moist or weeping skin lesions, documented inability to retain food or nutrition, profound exhaustion, and cachexia — including weight measurements and nutritional assessments — speak directly to those criteria. Statements from you or people who observe you daily can also show how symptoms affect your ability to work and carry out normal activities.