Psoriasis and eczema (also called dermatitis) are among the most common chronic skin conditions affecting veterans, yet they are also among the most consistently underrated disabilities in the VA system. Veterans with severe, treatment-resistant psoriasis covering large portions of their body, or eczema requiring immunosuppressive biologics, frequently receive 10% or 0% ratings when they clearly qualify for 30% or 60%. The gap between what veterans are receiving and what the law actually requires is often enormous.
The root cause of this underrating problem is twofold: First, C&P examiners assess skin conditions based on how they appear on the day of the exam — often after a veteran has been managing their condition with treatment for weeks. Second, many veterans and even some raters do not understand that requiring continuous biologic therapy automatically qualifies a veteran for the 60% rating, regardless of how controlled their skin looks at any given moment.
This guide covers everything you need to know about how the VA rates psoriasis, eczema, and other skin conditions under 38 CFR Part 4, Subpart B, the Skin Conditions rating schedule — including the specific diagnostic codes, body surface area thresholds, the systemic therapy trigger, biologic medications, Agent Orange and burn pit connections, secondary mental health claims, and the DBQ strategy that can make the difference between a 10% and a 60% rating.
All VA disability ratings for skin conditions are governed by 38 CFR Part 4, Subpart B — specifically the Skin section of the Schedule for Rating Disabilities. Under the current rating schedule, skin conditions are evaluated based on three primary factors:
The governing regulation for systemic therapy is 38 CFR 4.118(c), which defines systemic therapy as treatment affecting the entire body rather than a localized area. This distinction — topical vs. systemic — is the single most important factor in determining whether a veteran qualifies for the higher rating tiers.
It is also important to understand that under the VA's general rating principles, a veteran who requires treatment to maintain a controlled state is still entitled to a rating reflecting the underlying severity of the condition — not the artificially improved appearance created by that treatment. This principle, rooted in 38 U.S.C. § 1155, means that a psoriasis patient on continuous biologics whose skin is currently clear is still entitled to the 60% rating because the biologic treatment is what is keeping the disease at bay.
Under 38 U.S.C. § 5107(b), when there is approximate balance between positive and negative evidence, the VA must resolve the matter in the veteran's favor. For skin conditions, this means that if documentation of BSA is incomplete or contradictory — some records showing 15% affected, others showing 25% — the VA must assign the higher rating. Veterans should ensure their dermatology records consistently document BSA percentage at every visit.
Diagnostic Code 7806 covers dermatitis or eczema, including atopic dermatitis (the most common form, often called atopic eczema), contact dermatitis, nummular eczema, and seborrheic dermatitis. The term "dermatitis" in VA parlance is broad and encompasses a range of inflammatory skin conditions characterized by redness, itching, scaling, and skin barrier dysfunction.
The VA rates DC 7806 conditions using the following schedule, based on body surface area and treatment requirements:
| Rating | Body Surface Area Affected | OR Treatment Criteria |
|---|---|---|
| 60% | More than 40% of entire body OR more than 40% of exposed areas affected | OR constant systemic therapy required (including biologics used continuously) |
| 30% | 20–40% of entire body OR 20–40% of exposed areas affected | OR systemic therapy required for 6 or more weeks per year but not constantly |
| 10% | At least 5% but less than 20% of entire body affected | OR intermittent systemic therapy less than 6 weeks per year |
| 0% | Less than 5% BSA, or only localized involvement | No systemic therapy required; topical treatment only |
Understanding the "or" language is critical: a veteran qualifies for a given rating tier if they meet either the BSA threshold or the treatment criteria. A veteran with 15% BSA affected who requires constant biologic treatment still qualifies for 60% under the systemic therapy prong — even though their BSA is below the 60% threshold.
Atopic dermatitis is the most prevalent form of eczema affecting veterans. It is a chronic, relapsing inflammatory skin disease characterized by intense itching, dry skin, and eczematous patches that can affect any body area. It often co-occurs with asthma and allergic rhinitis (the "atopic triad"), and is associated with a dysregulated immune response. Military environments — particularly tropical deployments, chemical exposures, harsh hygiene products, and stress — can trigger and maintain atopic dermatitis flares. Veterans who developed or worsened atopic dermatitis during service have strong grounds for direct service connection.
Allergic contact dermatitis from military occupational exposures is another common service-connected skin condition. Sources of contact sensitization in the military include: nickel in dog tags, belt buckles, and uniform components; rubber compounds in gas masks and protective gear; chromate in leather boots and uniforms; chemical solvents in cleaning agents and aviation fuel; epoxy resins in maintenance work; and latex in medical gloves for healthcare MOSs. Veterans who develop contact dermatitis can establish direct service connection by linking their sensitization to a specific military exposure through a dermatologist's nexus opinion. See how to file a VA disability claim for the full process.
Diagnostic Code 7816 covers psoriasis — a chronic autoimmune skin condition characterized by rapid skin cell turnover that produces thick, scaly plaques. Psoriasis can manifest as plaque psoriasis (most common), guttate psoriasis, inverse psoriasis, pustular psoriasis, or erythrodermic psoriasis. The VA rates DC 7816 using the identical rating criteria as DC 7806 (the same BSA thresholds and systemic therapy prongs), but the condition carries its own diagnostic code because of its distinct pathophysiology and treatment profile.
Psoriasis is particularly relevant for veterans because:
Approximately 30% of people with psoriasis develop psoriatic arthritis — an inflammatory joint disease causing pain, swelling, and stiffness. Veterans with service-connected psoriasis who develop psoriatic arthritis can claim the arthritis as a secondary condition under 38 CFR 3.310. Psoriatic arthritis is rated separately under the musculoskeletal diagnostic codes and can add significant additional compensation. A rheumatologist's nexus opinion is typically required. See VA disability rating for rheumatoid arthritis for context on inflammatory arthritis ratings.
Many veterans with psoriasis or eczema are getting 10% when they should be getting 30–60%. Take our free 2-minute eligibility check to see if you qualify for a higher rating.
Check My Eligibility →Body surface area (BSA) is the primary objective metric for rating skin conditions under the VA schedule. The standard tool for calculating BSA is the Rule of Nines, a well-established dermatological measurement framework:
| Body Region | BSA Percentage | Notes |
|---|---|---|
| Head and neck | 9% | Including scalp psoriasis — often overlooked |
| Each upper extremity (arm) | 9% each | 18% total for both arms |
| Chest (anterior trunk, upper) | 9% | Front upper torso |
| Abdomen (anterior trunk, lower) | 9% | Front lower torso |
| Upper back (posterior trunk, upper) | 9% | Shoulder blades to mid-back |
| Lower back (posterior trunk, lower) | 9% | Mid-back to gluteal fold |
| Each thigh | 9% each | 18% total for both thighs |
| Each lower leg | 9% each | 18% total for both lower legs |
| Genitalia | 1% | Inverse psoriasis commonly affects this area |
To build a strong claim, veterans should request their dermatologist document BSA at each visit using the Rule of Nines or a similar validated tool. A veteran with psoriasis on both arms (18%), the upper back (9%), and scalp (9%) has approximately 36% BSA affected — this qualifies for the 30% rating tier (20–40%). If that same veteran also develops involvement on their thighs during a flare-up, total BSA crosses 40%, triggering the 60% rating threshold.
Document your worst-day BSA, not your average or current state. The VA must rate based on the full picture of your condition, including flares. If your psoriasis regularly covers more than 40% of your body during flares but appears controlled at your C&P exam, bring photographs showing the flares and ask your dermatologist to document the maximum extent of involvement in the DBQ. The DBQ guide explains how to use this tool effectively.
Note that the rating criteria refer to "the entire body" or "exposed areas." Exposed areas means areas visible in normal clothing (face, neck, hands, forearms). If 20–40% of a veteran's exposed areas are affected — even if the total body percentage is lower — the higher rating tier still applies. This provision is specifically designed to capture the functional impairment and social stigma caused by skin conditions on visible areas.
The systemic therapy prong is the most important and most commonly missed pathway to the 60% rating. Under 38 CFR 4.118(c), if a veteran's skin condition requires constant systemic therapy — meaning they must take systemic medications continuously to prevent the condition from being uncontrolled — they automatically qualify for the 60% rating regardless of BSA.
Systemic therapy includes any of the following when prescribed for skin conditions:
What does NOT count as systemic therapy:
Biologic medications represent the current gold standard for moderate-to-severe psoriasis and, increasingly, for atopic dermatitis. Their relevance to VA ratings is enormous: every biologic currently prescribed for psoriasis or eczema qualifies as systemic therapy under 38 CFR 4.118(c), meaning any veteran on continuous biologic treatment is entitled to the 60% rating — period.
The major biologics used for psoriasis and eczema, with their mechanism and VA relevance:
| Biologic (Brand) | Generic Name | Target | Conditions Treated |
|---|---|---|---|
| Humira | Adalimumab | TNF-α inhibitor | Psoriasis, psoriatic arthritis |
| Stelara | Ustekinumab | IL-12/IL-23 inhibitor | Plaque psoriasis, psoriatic arthritis |
| Cosentyx | Secukinumab | IL-17A inhibitor | Plaque psoriasis, psoriatic arthritis |
| Taltz | Ixekizumab | IL-17A inhibitor | Plaque psoriasis, psoriatic arthritis |
| Tremfya | Guselkumab | IL-23 inhibitor | Plaque psoriasis, psoriatic arthritis |
| Skyrizi | Risankizumab | IL-23 inhibitor | Plaque psoriasis, psoriatic arthritis |
| Dupixent | Dupilumab | IL-4/IL-13 receptor | Atopic dermatitis (eczema) |
| Adbry | Tralokinumab | IL-13 inhibitor | Atopic dermatitis (eczema) |
The single biggest rating mistake for veterans on biologics is the "controlled appearance" trap: a veteran whose biologic is working well will have minimal visible skin involvement at their C&P exam. An examiner who simply looks at the veteran's current skin and rates based on visual appearance alone will assign 0% or 10%, completely ignoring the biologic treatment that is the only thing keeping the disease at bay.
The correct approach, and the one required by regulation, is to rate based on the requirement for systemic therapy — not just current appearance. If a veteran must take Stelara every 12 weeks or their psoriasis will return severely, they require constant systemic therapy and the rating must reflect that. The DBQ completed by your dermatologist should explicitly state: "Patient requires continuous biologic therapy (Stelara/Dupixent/etc.). Discontinuation would result in return of moderate-to-severe disease affecting [X]% BSA."
If you are currently on biologic therapy for psoriasis or eczema, your most powerful move is obtaining a completed DBQ from your private dermatologist that explicitly states: (1) the biologic medication name and dosing schedule; (2) that it is required continuously/constantly to prevent return of active disease; (3) what the BSA was before biologic therapy began; and (4) a professional assessment that the veteran meets criteria for the 60% rating tier under DC 7806/7816. Submit this with your claim or as new evidence in a Supplemental Claim.
VA disability compensation rates for 2026 reflect the annual COLA adjustment. The following rates apply to a veteran with no dependents (rates increase with dependents). These rates apply to the veteran's combined disability rating, not the skin condition rating alone — secondary conditions like psoriatic arthritis or depression can push the combined rating significantly higher.
| Combined Rating | Monthly (No Dependents) | Monthly (Spouse Only) |
|---|---|---|
| 10% | $175.51 | $175.51 (no dependent supplement at 10%) |
| 20% | $346.95 | $346.95 (no dependent supplement at 20%) |
| 30% | $537.42 | $601.58 |
| 40% | $774.16 | $856.41 |
| 50% | $1,102.04 | $1,201.54 |
| 60% | $1,395.93 | $1,512.56 |
| 70% | $1,759.43 | $1,893.29 |
| 80% | $2,044.89 | $2,196.03 |
| 90% | $2,297.96 | $2,465.29 |
| 100% | $3,737.85 | $3,946.25 |
A veteran with 60% for psoriasis on constant biologic therapy, plus 30% for secondary depression from visible disfigurement, would have a combined rating of approximately 72% (rounds to 70%), yielding $1,759.43/month tax-free. Adding a secondary condition like psoriatic arthritis at 20% pushes the combined to approximately 78% (rounds to 80%), yielding $2,044.89/month. See VA combined ratings formula explained for how the math works.
Two major toxic exposure pathways can lead to service-connected skin conditions for veterans:
For Vietnam-era veterans exposed to Agent Orange (including dioxin/TCDD), chloracne is listed as a presumptive condition under 38 CFR 3.309(e). Chloracne is a distinct skin condition — characterized by comedones, cysts, and pustules — that is pathognomonic of dioxin exposure. It is not the same as ordinary acne or psoriasis. Veterans who developed chloracne after Agent Orange exposure can establish presumptive service connection without proving a direct link.
For veterans with psoriasis or eczema rather than chloracne, Agent Orange exposure can still support service connection, but the direct link must be established through a dermatologist's nexus opinion. Some research supports a connection between dioxin exposure and worsened autoimmune skin conditions. Blue Water Navy veterans who became eligible for Agent Orange benefits through the Blue Water Navy Vietnam Veterans Act should review their skin condition claims as well. See full Agent Orange presumptive conditions list for context.
The PACT Act (2022) dramatically expanded presumptive service connection for veterans who served in Southwest Asia, Afghanistan, or other covered locations since August 2, 1990. Burn pit smoke contains a toxic mixture of dioxins, heavy metals, polycyclic aromatic hydrocarbons (PAHs), and other chemicals known to cause or exacerbate skin conditions.
While no specific skin conditions are currently listed as PACT Act presumptives (unlike respiratory and certain cancers), burn pit veterans with skin conditions can still establish service connection under the PACT Act's toxic exposure pathway. The VA must give favorable consideration to "Gulf War veterans" with undiagnosed illnesses, including skin manifestations, under 38 CFR 3.317. Additionally, veterans with a dermatologist's nexus opinion linking their skin condition to burn pit chemical exposure can pursue direct service connection. See PACT Act presumptive conditions guide for the full list.
To establish service connection for psoriasis or eczema, a veteran must demonstrate three elements under 38 U.S.C. § 1110:
For skin conditions, the in-service evidence often includes: sick call records documenting treatment for skin rashes, dermatitis, or similar complaints; buddy statements from fellow service members who witnessed the condition; service records showing deployment to areas with known chemical or allergen exposures; and unit records documenting exposure to specific substances. See how to document service-connected conditions years later if your records are incomplete.
A strong nexus opinion for a skin condition claim should address: (1) the veteran's diagnosis and current severity; (2) the biological plausibility of the claimed in-service cause (stress, chemical exposure, infection); (3) the known connection between military exposures and the specific condition; and (4) the physician's professional opinion — using the "at least as likely as not" standard — that the condition is related to service. See nexus letter vs IMO guide for what to request from your physician.
Veterans with pre-existing skin conditions (prior to service) can still receive service connection if their condition was aggravated beyond its natural progression by military service. Under 38 CFR 3.306, the VA may not reduce a rating for conditions aggravated by service based solely on the pre-service baseline. Veterans who entered service with mild psoriasis and left with severe treatment-resistant disease affecting 40% of BSA are entitled to compensation for the aggravated portion.
Visible skin conditions like psoriasis and eczema cause profound psychological impact. The National Psoriasis Foundation reports that psoriasis patients have rates of depression and anxiety significantly higher than the general population — driven by stigma, visible disfigurement, itching-induced sleep disruption, social withdrawal, and reduced quality of life. For veterans, this psychological burden compounds the pre-existing mental health challenges many carry from service.
Veterans with service-connected psoriasis or eczema who develop depression, anxiety, PTSD (with skin condition as a secondary stressor), or other mental health conditions have strong grounds to claim those conditions as secondary service-connected disabilities under 38 CFR 3.310. The secondary mental health condition must be directly linked to the skin condition by a psychiatrist or psychologist's nexus opinion.
VA rates mental health conditions on the Global Assessment of Functioning (GAF) scale under the General Rating Formula for Mental Disorders. A 30% mental health rating requires occupational and social impairment with occasional decrease in work efficiency; 50% requires reduced reliability and productivity; 70% requires deficiencies in most areas. See VA disability rating for anxiety and depression and depression secondary to chronic conditions for rating details.
Struggling with psoriasis, eczema, or service-connected skin conditions? REE Medical connects veterans with physicians who understand VA disability claims and can provide nexus letters and DBQ support.
Get Medical Support →The VA Disability Benefits Questionnaire (DBQ) for skin conditions (VA Form 21-0960F-1) is one of the most powerful tools available to veterans seeking an accurate rating for psoriasis or eczema. The DBQ can be completed by your private dermatologist and submitted directly as evidence — it does not need to come from a VA examiner.
Key sections of the skin condition DBQ include:
For veterans on biologics, instruct your dermatologist to explicitly check the "constant systemic therapy" box and note the biologic name and frequency. For veterans with high BSA involvement, ensure the dermatologist measures and documents percentage using the Rule of Nines at the time of the exam. See complete DBQ guide for how to download and use the form.
The Compensation and Pension (C&P) exam for skin conditions is your opportunity to have the VA assess the current severity of your condition. However, C&P exams are notoriously prone to underrating skin conditions for several reasons: examiners may see the veteran on a good day, after treatment has temporarily controlled symptoms; examiners may not ask about systemic therapy; and examiners may fail to document BSA using the correct methodology. Here's how to prepare:
For more general C&P guidance, see complete C&P exam guide 2026 and how to prepare for your C&P exam.
If your psoriasis or eczema claim was denied or rated lower than it should be, you have three primary appeal pathways under the Appeals Modernization Act (AMA):
If you have new evidence — a private DBQ from your dermatologist, photographs showing higher BSA involvement, documentation of biologic treatment that wasn't previously on file — file a Supplemental Claim. This is the fastest path when new evidence is available. The VA must consider new and relevant evidence under this lane. See Supplemental Claim guide and VA Form 20-0995 instructions.
If the rater made a clear error — applied the wrong diagnostic code, failed to consider systemic therapy, incorrectly calculated BSA — file an HLR. A senior rater will review the existing record for clear and unmistakable error. You can request an informal conference to explain the specific error. See Higher-Level Review guide.
For more complex cases — particularly those involving significant back pay potential from years of underpayment at a lower tier — consider appealing to the BVA. You can request a hearing before a Veterans Law Judge. See BVA appeal guide and how to appeal a VA denial.
A private physician review through REE Medical can provide an independent medical opinion that specifically addresses the VA's errors and documents your current severity in the format VA raters need to see. A strong private IMO/nexus letter addressing BSA, systemic therapy, and the 60% criteria is often the deciding factor in a successful appeal.
The VA rates eczema and dermatitis under Diagnostic Code 7806, which covers dermatitis or eczema. Psoriasis is rated under Diagnostic Code 7816. Both codes fall under 38 CFR 4.118 and use identical rating criteria: 0%, 10%, 30%, or 60% based on body surface area affected and systemic therapy requirements.
Under DC 7816 (and DC 7806 for eczema): 0% for less than 5% BSA, topical treatment only; 10% for 5–19% BSA or intermittent systemic therapy less than 6 weeks/year; 30% for 20–40% BSA or systemic therapy 6+ weeks/year; 60% for more than 40% BSA or constant systemic therapy required. The maximum schedular rating for skin conditions is 60% under these diagnostic codes.
Yes — if you require those biologics continuously (i.e., you cannot safely stop them without your condition returning to a severe state), you meet the "constant systemic therapy" criterion for the 60% rating under DC 7806 or DC 7816, regardless of how your skin currently looks. Your dermatologist's DBQ or nexus letter should clearly state that the biologic is required continuously to prevent return of moderate-to-severe disease.
BSA is typically measured using the Rule of Nines or the Lund-Browder chart. The examiner should physically examine all body areas and document what percentage of each region is affected. If you are on effective treatment at the time of the exam, remind the examiner of your pre-treatment BSA and ask them to document your maximum flare BSA as well. Bringing photographs of flare-ups is highly recommended.
Yes. Psoriatic arthritis (inflammatory arthritis affecting the joints) is a well-recognized complication of psoriasis, affecting approximately 30% of people with the condition. Veterans with service-connected psoriasis who develop psoriatic arthritis can claim it as a secondary condition. The arthritis is rated separately under the musculoskeletal diagnostic codes and can add substantial additional monthly compensation.
Yes, though skin conditions are not currently listed as PACT Act presumptives, burn pit veterans with psoriasis or eczema that began or worsened after toxic exposures can establish direct service connection with a dermatologist's nexus opinion. The PACT Act also requires VA to consider toxic exposure history when evaluating claims. See burn pit exposure VA claims guide.
Bring dated photographs (preferably from your smartphone photo library or from your dermatologist's records) showing: (1) flare-up presentations at maximum BSA involvement; (2) all affected body areas including scalp, torso, limbs, and any genital involvement; (3) before-and-after photos showing what your skin looked like before biologic treatment. Photos should be clear, well-lit, and show the extent of involvement.
For VA rating purposes, all of these terms map to DC 7806 (dermatitis or eczema). Atopic dermatitis, contact dermatitis, eczema, and seborrheic dermatitis are all rated under DC 7806 using the same BSA/systemic therapy criteria. The specific medical term used in your diagnosis doesn't change your rating eligibility — what matters is the severity (BSA) and treatment requirements.
Many skin conditions are latent — they may not manifest clinically until months or years after service, particularly autoimmune conditions like psoriasis. The key is demonstrating that the condition's onset is related to service even if the diagnosis came later. Evidence includes: service records documenting skin complaints or exposures; a dermatologist's expert opinion stating the condition "is at least as likely as not" related to service; and a continuous treatment history showing the condition's course. See documenting conditions years after service.
Even if a skin condition pre-dated service, veterans can receive compensation if the condition was aggravated by service beyond its natural progression. Under 38 CFR 3.306, VA bears the burden of showing that a pre-existing condition was not aggravated by service. If you entered service with mild psoriasis and left with severe, treatment-requiring disease, the aggravation theory may support service connection for the worsened condition. A dermatologist's opinion comparing pre-service and current severity is key to this argument.
Veterans on biologics often qualify for 60% — but most are getting 10% or less. Take our free 2-minute screener to see if your rating should be higher.
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