§ 4.118 Schedule of ratings—skin.

Skin infections

Bacterial, fungal, viral, or parasitic infections affecting the skin.

What the rating means

Skin infections not listed elsewhere — including bacterial, fungal, viral, treponemal, and parasitic diseases — are rated under the General Rating Formula for the Skin at 0%, 10%, 30%, or 60%.

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

Systemic therapy means treatment given by any route other than the skin — such as orally, by injection, by suppository, or intranasally. Topical therapy means treatment applied directly to the skin. VA may also rate the condition as disfigurement of the head, face, or neck or as scars, depending on which disability is predominant.

Evidence that helps

Medical records that document the extent of your skin lesions are central to establishing the right rating level. Records showing the percentage of your total body surface or exposed areas affected — measured at examinations over the past 12 months — directly address the area-based thresholds at each level.

Treatment records are equally important. Prescription records, clinic notes, and pharmacy histories can show whether you required systemic therapy (such as oral corticosteroids, biologics, retinoids, or other immunosuppressive drugs) and for how long. For the 60% level, records should reflect constant or near-constant systemic therapy across the past year. For the 30% level, they should show systemic therapy totaling 6 or more weeks. For the 10% level, they should show systemic therapy totaling less than 6 weeks. For the 0% level, records should show only topical treatments were used.

Statements from you or people who know you — describing how open sores, lesions, or treatment side effects affect your work, sleep, or daily activities — can support the overall picture when paired with clinical findings. If your condition has caused scarring or disfigurement of the head, face, or neck, those findings may be relevant to how VA evaluates the predominant disability.

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.

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What the rating means

Evidence that helps

Secondary conditions

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