Diagnostic Code 7823 · 38 CFR §4.118
Vitiligo is an autoimmune condition where the immune system attacks melanocytes (pigment-producing cells), causing patches of skin to lose their color. The white patches can appear anywhere on the body and tend to expand over time. While vitiligo is not physically painful, it causes significant cosmetic concern and emotional distress, especially on visible areas like the face and hands. Veterans may develop vitiligo triggered by physical trauma to the skin, chemical exposures, severe sunburns, or stress during military service.
| Rating | Criteria |
|---|---|
| 0% | Vitiligo limited to unexposed body areas (covered by clothing) with no disfigurement of exposed areas. |
| 10% | Vitiligo affecting exposed areas — face, hands, or neck — OR widespread depigmentation across the body. This is the maximum schedular rating under DC 7823. |
Clinical examination documenting the location and extent of depigmented patches is the primary evidence. Photographs clearly showing the affected areas support the claim. Dermatology records confirming the vitiligo diagnosis differentiate it from other causes of skin color change. Documentation of treatments attempted (phototherapy, topical medications) demonstrates the chronic nature. Service records establishing when the condition first appeared connect it to service.
Vitiligo can be triggered by physical trauma to the skin (known as the Koebner phenomenon), chemical exposures, severe stress, and sunburn. If any of these triggers occurred during service and vitiligo developed during or shortly after, a service connection claim is viable. A dermatologist opinion linking the specific trigger to the condition strengthens the claim.
Under DC 7823 specifically, 10% is the maximum. However, if vitiligo causes facial disfigurement, it can also be rated under DC 7800, which goes up to 80%. The two ratings cannot be combined (that would be pyramiding), but the VA should assign whichever code gives the higher rating.