Diagnostic Code 7806 · 38 CFR §4.118
Eczema (atopic dermatitis) and contact dermatitis are chronic inflammatory skin conditions that cause dry, itchy, inflamed, sometimes blistering or cracked patches of skin. The VA rates them under DC 7806 using the General Rating Formula for the Skin, which offers two separate paths to a rating: the percentage of skin affected, or the type and duration of systemic therapy required. You get whichever path produces the higher rating. Veterans commonly develop or worsen skin conditions from service exposures — solvents, fuels such as JP-8, industrial chemicals, plants, sand and extreme climates, prolonged sweating under protective gear, and frequent washing with harsh field soaps. Dermatitis can also arise secondary to another service-connected condition or as a side effect of a medication taken for one.
| Rating | Criteria |
|---|---|
| 0% | Characteristic lesions involving less than 5 percent of the entire body and less than 5 percent of exposed areas, with no more than topical therapy required over the past 12-month period. |
| 10% | Characteristic lesions involving at least 5 percent but less than 20 percent of the entire body, or at least 5 percent but less than 20 percent of exposed areas; or intermittent systemic therapy (such as corticosteroids, phototherapy, retinoids, biologics, PUVA, or other immunosuppressive drugs) required for a total duration of less than six weeks over the past 12-month period. |
| 30% | Characteristic lesions involving 20 to 40 percent of the entire body, or 20 to 40 percent of exposed areas; or systemic therapy (such as corticosteroids, phototherapy, retinoids, biologics, PUVA, or other immunosuppressive drugs) required for a total duration of six weeks or more, but not constantly, over the past 12-month period. |
| 60% | Characteristic lesions involving more than 40 percent of the entire body, or more than 40 percent of exposed areas; or constant or near-constant systemic therapy (such as corticosteroids, phototherapy, retinoids, biologics, PUVA, or other immunosuppressive drugs) required over the past 12-month period. This is the maximum schedular rating under DC 7806. |
You need a current diagnosis of eczema or dermatitis, a link to service (direct exposure, onset in service, or secondary to another condition or medication), and documentation of severity. Severity is measured two ways — the percentage of your total body and of exposed areas (face, neck, hands) affected, and the systemic therapy you require. Photographs taken during flare-ups showing the extent of coverage are among the most valuable evidence you can submit, because skin conditions wax and wane and the C&P exam may catch you on a good day. Medical records should document the affected areas and every medication prescribed; and if you use systemic therapy, record the total number of weeks per year you are on it, because that duration is what separates the 10%, 30%, and 60% levels.
Under the current rule (effective August 2018), systemic therapy is treatment given by a route other than the skin — for example oral corticosteroids, injected biologics, retinoids, or light-based treatments such as PUVA. Topical creams and ointments applied to the skin are topical therapy, not systemic, so they do not move you up the systemic-therapy path. Claims that were pending before August 2018 may be judged under an older interpretation in which topical corticosteroids could count.
Skin conditions flare and remit, and the VA rates what the examiner sees together with your documented history. If your exam falls during a clear period, bring date-stamped photographs from prior flares and records of your treatment so the rating reflects your condition at its worst, not its best.
Whichever is higher. The VA measures both the percentage of your entire body affected and the percentage of exposed areas (face, neck, hands) affected, and assigns the rating based on the larger of the two figures.
60% is the maximum schedular rating under DC 7806. A higher combined rating is possible only through separately ratable conditions, such as disfiguring scars under DC 7800, or through TDIU if the condition keeps you from working.
Generally no — you must show it began in or was caused by service, or is secondary to a service-connected condition. One exception: Gulf War veterans may claim chronic skin symptoms as part of an undiagnosed illness or a medically unexplained chronic multisymptom illness.
It can support an exposed-area rating, and if the condition prevents you from holding substantially gainful employment, it can factor into a TDIU claim even though the schedular maximum for DC 7806 is 60%.
Common ones include fuels and solvents (such as JP-8), industrial chemicals and cleaners, plants and environmental allergens, sand and extreme heat or cold, prolonged sweating under protective gear, and harsh field soaps and detergents. Documenting the exposure tied to your job or deployment, plus a nexus opinion, supports direct service connection.