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7816
§ 4.118 Schedule of ratings—skin.

Psoriasis

A chronic skin condition causing thick, scaly patches that may itch or be painful.

What the rating means

Psoriasis is rated under the General Rating Formula for the Skin (Diagnostic Code 7816). The formula has four possible rating levels based on how much of your body or exposed areas are covered by characteristic lesions, and on how much systemic therapy you needed over the past 12 months. Systemic therapy means treatment given by any route other than the skin — such as pills, injections, or suppositories — including corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs. Topical therapy means treatment applied directly to the skin.

A 60% rating applies if lesions cover more than 40% of your entire body or more than 40% of exposed areas, or if you required constant or near-constant systemic therapy over the past 12 months. A 30% rating applies if lesions cover 20 to 40% of your entire body or exposed areas, or if systemic therapy was needed for a total of 6 weeks or more (but not constantly) over the past 12 months. A 10% rating applies if lesions cover at least 5% but less than 20% of your entire body or exposed areas, or if intermittent systemic therapy was needed for less than 6 weeks total over the past 12 months. A 0% rating applies if no more than topical therapy was required and lesions cover less than 5% of your entire body or exposed areas.

Complications such as psoriatic arthritis or involvement of the oral mucosa or nails are rated separately under their own diagnostic codes. VA may also rate psoriasis as disfigurement of the head, face, or neck or as scars, whichever better captures the predominant disability.

Evidence that helps

Medical records that document the extent of your psoriasis lesions are central to establishing which rating level applies. Records showing the percentage of your body surface area or exposed areas affected — such as notes from dermatology visits that use a body surface area measurement or a severity scoring tool — directly address the area-based criteria at each level.

For the therapy-based criteria, records showing what treatments were prescribed and for how long over the past 12 months are equally important. Pharmacy records, prescription histories, or physician notes showing that you took systemic medications — such as oral corticosteroids, biologics, or other immunosuppressive drugs — and whether that use was constant, lasted 6 weeks or more, or lasted less than 6 weeks, tie directly to the 60%, 30%, and 10% levels respectively. Records showing only topical treatments were used support the 0% criteria.

Statements from you or people who know you about how your symptoms affect your daily life, such as the impact of flares on work, sleep, or physical activity, can help give context to the medical findings. For any complications like psoriatic arthritis, separate medical documentation of those conditions would support a separate rating claim under the applicable diagnostic code.

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.