A veteran whose scars were rated by VA under a prior version of diagnostic codes 7800, 7801, 7802, 7803, 7804, or 7805, as in effect before October 23, 2008, may request review under diagnostic codes 7800, 7801, 7802, 7804, and 7805, irrespective of whether his or her disability has worsened since the last review. VA will review that veteran's disability rating to determine whether the veteran may be entitled to a higher disability rating under diagnostic codes 7800, 7801, 7802, 7804, and 7805. A request for review pursuant to this rulemaking will be treated as a claim for an increased rating for purposes of determining the effective date of an increased rating awarded as a result of such review; however, in no case will the award be effective before October 23, 2008. ------------------------------------------------------------------------
Rating------------------------------------------------------------------------7800 Burn scar(s) of the head, face, or neck; scar(s) of the
head, face, or neck due to other causes; or other disfigurement
of the head, face, or neck:
With visible or palpable tissue loss and either gross 80
distortion or asymmetry of three or more features or paired
sets of features (nose, chin, forehead, eyes (including
eyelids), ears (auricles), cheeks, lips), or; with six or
more characteristics of disfigurement......................
With visible or palpable tissue loss and either gross 50
distortion or asymmetry of two features or paired sets of
features (nose, chin, forehead, eyes (including eyelids),
ears (auricles), cheeks, lips), or; with four or five
characteristics of disfigurement...........................
With visible or palpable tissue loss and either gross 30
distortion or asymmetry of one feature or paired set of
features (nose, chin, forehead, eyes (including eyelids),
ears (auricles), cheeks, lips), or; with two or three
characteristics of disfigurement...........................
With one characteristic of disfigurement.................... 10
Note (1):The 8 characteristics of disfigurement, for
purposes of evaluation under Sec. 4.118, are:
Scar 5 or more inches (13 or more cm.) in length.
Scar at least one-quarter inch (0.6 cm.) wide at widest
part.
Surface contour of scar elevated or depressed on palpation.
Scar adherent to underlying tissue.
Skin hypo-or hyper-pigmented in an area exceeding six square
inches (39 sq. cm.).
Skin texture abnormal (irregular, atrophic, shiny, scaly,
etc.) in an area exceeding six square inches (39 sq. cm.).
Underlying soft tissue missing in an area exceeding six
square inches (39 sq. cm.).
Skin indurated and inflexible in an area exceeding six
square inches (39 sq. cm.).
Note (2): Rate tissue loss of the auricle under DC 6207
(loss of auricle) and anatomical loss of the eye under DC
6061 (anatomical loss of both eyes) or DC 6063 (anatomical
loss of one eye), as appropriate.
Note (3): Take into consideration unretouched color
photographs when evaluating under these criteria.
Note (4): Separately evaluate disabling effects other than
disfigurement that are associated with individual scar(s)
of the head, face, or neck, such as pain, instability, and
residuals of associated muscle or nerve injury, under the
appropriate diagnostic code(s) and apply Sec. 4.25 to
combine the evaluation(s) with the evaluation assigned
under this diagnostic code.
Note (5): The characteristic(s) of disfigurement may be
caused by one scar or by multiple scars; the
characteristic(s) required to assign a particular
evaluation need not be caused by a single scar in order to
assign that evaluation.7801 Burn scar(s) or scar(s) due to other causes, not of the
head, face, or neck, that are deep and nonlinear:
Area or areas of 144 square inches (929 sq. cm.) or greater. 40
Area or areas of at least 72 square inches (465 sq. cm.) but 30
less than 144 square inches (929 sq. cm.)..................
Area or areas of at least 12 square inches (77 sq. cm.) but 20
less than 72 square inches (465 sq. cm.)...................
Area or areas of at least 6 square inches (39 sq. cm.) but 10
less than 12 square inches (77 sq. cm.)....................
Note (1): A deep scar is one associated with underlying soft
tissue damage.
Note (2): If multiple qualifying scars are present, or if a
single qualifying scar affects more than one extremity, or
a single qualifying scar affects one or more extremities
and either the anterior portion or posterior portion of the
trunk, or both, or a single qualifying scar affects both
the anterior portion and the posterior portion of the
trunk, assign a separate evaluation for each affected
extremity based on the total area of the qualifying scars
that affect that extremity, assign a separate evaluation
based on the total area of the qualifying scars that affect
the anterior portion of the trunk, and assign a separate
evaluation based on the total area of the qualifying scars
that affect the posterior portion of the trunk. The
midaxillary line on each side separates the anterior and
posterior portions of the trunk. Combine the separate
evaluations under Sec. 4.25. Qualifying scars are scars
that are nonlinear, deep, and are not located on the head,
face, or neck.7802 Burn scar(s) or scar(s) due to other causes, not of the
head, face, or neck, that are superficial and nonlinear:
Area or areas of 144 square inches (929 sq. cm.) or greater. 10
Note (1): A superficial scar is one not associated with
underlying soft tissue damage
Note (2): If multiple qualifying scars are present, or if a
single qualifying scar affects more than one extremity, or
a single qualifying scar affects one or more extremities
and either the anterior portion or posterior portion of the
trunk, or both, or a single qualifying scar affects both
the anterior portion and the posterior portion of the
trunk, assign a separate evaluation for each affected
extremity based on the total area of the qualifying scars
that affect that extremity, assign a separate evaluation
based on the total area of the qualifying scars that affect
the anterior portion of the trunk, and assign a separate
evaluation based on the total area of the qualifying scars
that affect the posterior portion of the trunk. The
midaxillary line on each side separates the anterior and
posterior portions of the trunk. Combine the separate
evaluations under Sec. 4.25. Qualifying scars are scars
that are nonlinear, superficial, and are not located on the
head, face, or neck.7804 Scar(s), unstable or painful:..............................
Five or more scars that are unstable or painful............. 30
Three or four scars that are unstable or painful............ 20
One or two scars that are unstable or painful............... 10
Note (1): An unstable scar is one where, for any reason,
there is frequent loss of covering of skin over the scar.
Note (2): If one or more scars are both unstable and
painful, add 10 percent to the evaluation that is based on
the total number of unstable or painful scars
Note (3): Scars evaluated under diagnostic codes 7800, 7801,
7802, or 7805 may also receive an evaluation under this
diagnostic code, when applicable7805 Scars, other (including linear scars) and other effects of
scars evaluated under diagnostic codes 7800, 7801, 7802, and
7804:
Evaluate any disabling effect(s) not considered in a rating
provided under diagnostic codes 7800-04 under an
appropriate diagnostic code................................7806 Dermatitis or eczema.
More than 40 percent of the entire body or more than 40 60
percent of exposed areas affected, or; constant or near-
constant systemic therapy such as corticosteroids or other
immunosuppressive drugs required during the past 12-month
period.....................................................
20 to 40 percent of the entire body or 20 to 40 percent of 30
exposed areas affected, or; systemic therapy such as
corticosteroids or other immunosuppressive drugs required
for a total duration of six weeks or more, but not
constantly, during the past 12-month period................
At least 5 percent, but less than 20 percent, of the entire 10
body, or at least 5 percent, but less than 20 percent, of
exposed areas affected, or; intermittent systemic therapy
such as corticosteroids or other immunosuppressive drugs
required for a total duration of less than six weeks during
the past 12-month period...................................
Less than 5 percent of the entire body or less than 5 0
percent of exposed areas affected, and; no more than
topical therapy required during the past 12-month period...
Or rate as disfigurement of the head, face, or neck (DC
7800) or scars (DC's 7801, 7802, 7803, 7804, or 7805),
depending upon the predominant disability.7807 American (New World) leishmaniasis (mucocutaneous,
espundia):
Rate as disfigurement of the head, face, or neck (DC 7800),
scars (DC's 7801, 7802, 7803, 7804, or 7805), or dermatitis
(DC 7806), depending upon the predominant disability.......
Note: Evaluate non-cutaneous (visceral) leishmaniasis under
DC 6301 (visceral leishmaniasis).7808 Old World leishmaniasis (cutaneous, Oriental sore):
Rate as disfigurement of the head, face, or neck (DC 7800),
scars (DC's, 7801, 7802, 7803, 7804, or 7805), or
dermatitis (DC 7806), depending upon the predominant
disabililty................................................
Note: Evaluate non-cutaneous (visceral) leishmaniasis under
DC 6301 (visceral leishmaniasis).7809 Discoid lupus erythematosus or subacute cutaneous lupus
erythematosus:
Rate as disfigurement of the head, face, or neck (DC 7800),
scars (DC's 7801, 7802, 7803, 7804, or 7805), or dermatitis
(DC 7806), depending upon the predominant disability. Do
not combine with ratings under DC 6350.....................7811 Tuberculosis luposa (lupus vulgaris), active or inactive:
Rate under Sec. Sec. 4.88c or 4.89, whichever is
appropriate................................................7813 Dermatophytosis (ringworm: of body, tinea corporis; of
head, tinea capitis; of feet, tinea pedis; of beard area, tinea
barbae; of nails, tinea unguium; of inguinal area (jock itch),
tinea cruris):
Rate as disfigurement of the head, face, or neck (DC 7800),
scars (DC's 7801, 7802, 7803, 7804, or 7805), or dermatitis
(DC 7806), depending upon the predominant disability.......7815 Bullous disorders (including pemphigus vulgaris, pemphigus
foliaceous, bullous pemphigoid, dermatitis herpetiformis,
epidermolysis bullosa acquisita, benign chronic familial
pemphigus (Hailey-Hailey), and porphyria cutanea tarda):
More than 40 percent of the entire body or more than 40 60
percent of exposed areas affected, or; constant or near-
constant systemic therapy such as corticosteroids or other
immunosuppressive drugs required during the past 12-month
period.....................................................
20 to 40 percent of the entire body or 20 to 40 percent of 30
exposed areas affected, or; systemic therapy such as
corticosteroids or other immunosuppressive drugs required
for a total duration of six weeks or more, but not
constantly, during the past 12-month period................
At least 5 percent, but less than 20 percent, of the entire 10
body, or at least 5 percent, but less than 20 percent, of
exposed areas affected, or; intermittent systemic therapy
such as corticosteroids or other immunosuppressive drugs
required for a total duration of less than six weeks during
the past 12-month period...................................
Less than 5 percent of the entire body or exposed areas 0
affected, and; no more than topical therapy required during
the past 12-month period...................................
Or rate as disfigurement of the head, face, or neck (DC
7800) or scars (DC's 7801, 7802, 7803, 7804, or 7805),
depending upon the predominant disability.7816 Psoriasis:
More than 40 percent of the entire body or more than 40 60
percent of exposed areas affected, or; constant or near-
constant systemic therapy such as corticosteroids or other
immunosuppressive drugs required during the past 12-month
period.....................................................
20 to 40 percent of the entire body or 20 to 40 percent of 30
exposed areas affected, or; systemic therapy such as
corticosteroids or other immunosuppressive drugs required
for a total duration of six weeks or more, but not
constantly, during the past 12-month period................
At least 5 percent, but less than 20 percent, of the entire 10
body, or at least 5 percent, but less than 20 percent, of
exposed areas affected, or; intermittent systemic therapy
such as corticosteroids or other immunosuppressive drugs
required for a total duration of less than six weeks during
the past 12-month period...................................
Less than 5 percent of the entire body or exposed areas 0
affected, and; no more than topical therapy required during
the past 12-month period...................................
Or rate as disfigurement of the head, face, or neck (DC
7800) or scars (DC's 7801, 7802, 7803, 7804, or 7805),
depending upon the predominant disability.7817 Exfoliative dermatitis (erythroderma):
Generalized involvement of the skin, plus systemic 100
manifestations (such as fever, weight loss, and
hypoproteinemia), and; constant or near-constant systemic
therapy such as therapeutic doses of corticosteroids,
immunosuppressive retinoids, PUVA (psoralen with long-wave
ultraviolet-A light) or UVB (ultraviolet-B light)
treatments, or electron beam therapy required during the
past 12-month period.......................................
Generalized involvement of the skin without systemic 60
manifestations, and; constant or near-constant systemic
therapy such as therapeutic doses of corticosteroids,
immunosuppressive retinoids, PUVA (psoralen with long-wave
ultraviolet-A light) or UVB (ultraviolet-B light)
treatments, or electron beam therapy required during the
past 12-month period.......................................
Any extent of involvement of the skin, and; systemic therapy 30
such as therapeutic doses of corticosteroids,
immunosuppressive retinoids, PUVA (psoralen with long-wave
ultraviolet-A light) or UVB (ultraviolet-B light)
treatments, or electron beam therapy required for a total
duration of six weeks or more, but not constantly, during
the past 12-month period...................................
Any extent of involvement of the skin, and; systemic therapy 10
such as therapeutic doses of corticosteroids,
immunosuppressive retinoids, PUVA (psoralen with long-wave
ultraviolet-A light) or UVB (ultraviolet-B light)
treatments, or electron beam therapy required for a total
duration of less than six weeks during the past 12-month
period.....................................................
Any extent of involvement of the skin, and; no more than 0
topical therapy required during the past 12-month period...7818 Malignant skin neoplasms (other than malignant melanoma):
Rate as disfigurement of the head, face, or neck (DC 7800),
scars (DC's 7801, 7802, 7803, 7804, or 7805), or impairment
of function................................................
Note: If a skin malignancy requires therapy that is
comparable to that used for systemic malignancies, i.e.,
systemic chemotherapy, X-ray therapy more extensive than to
the skin, or surgery more extensive than wide local
excision, a 100-percent evaluation will be assigned from
the date of onset of treatment, and will continue, with a
mandatory VA examination six months following the
completion of such antineoplastic treatment, and any change
in evaluation based upon that or any subsequent examination
will be subject to the provisions of Sec. 3.105(e) of
this chapter. If there has been no local recurrence or
metastasis, evaluation will then be made on residuals. If
treatment is confined to the skin, the provisions for a 100-
percent evaluation do not apply.7819 Benign skin neoplasms:
Rate as disfigurement of the head, face, or neck (DC 7800),
scars (DC's 7801, 7802, 7803, 7804, or 7805), or impairment
of function................................................7820 Infections of the skin not listed elsewhere (including
bacterial, fungal, viral, treponemal and parasitic diseases):
Rate as disfigurement of the head, face, or neck (DC 7800),
scars (DC's 7801, 7802, 7803, 7804, or 7805), or dermatitis
(DC 7806), depending upon the predominant disability.......7821 Cutaneous manifestations of collagen-vascular diseases not
listed elsewhere (including scleroderma, calcinosis cutis, and
dermatomyositis):
More than 40 percent of the entire body or more than 40 60
percent of exposed areas affected, or; constant or near-
constant systemic therapy such as corticosteroids or other
immunosuppressive drugs required during the past 12-month
period.....................................................
20 to 40 percent of the entire body or 20 to 40 percent of 30
exposed areas affected, or; systemic therapy such as
corticosteroids or other immunosuppressive drugs required
for a total duration of six weeks or more, but not
constantly, during the past 12-month period................
At least 5 percent, but less than 20 percent, of the entire 10
body, or at least 5 percent, but less than 20 percent, of
exposed areas affected, or; intermittent systemic therapy
such as corticosteroids or other immunosuppressive drugs
required for a total duration of less than six weeks during
the past 12-month period...................................
Less than 5 percent of the entire body or exposed areas 0
affected, and; no more than topical therapy required during
the past 12-month period...................................
Or rate as disfigurement of the head, face, or neck (DC
7800) or scars (DC's 7801, 7802, 7803, 7804, or 7805),
depending upon the predominant disability.7822 Papulosquamous disorders not listed elsewhere (including
lichen planus, large or small plaque parapsoriasis, pityriasis
lichenoides et varioliformis acuta (PLEVA), lymphomatoid
papulosus, and pityriasis rubra pilaris (PRP)):
More than 40 percent of the entire body or more than 40 60
percent of exposed areas affected, and; constant or near-
constant systemic medications or intensive light therapy
required during the past 12-month period...................
20 to 40 percent of the entire body or 20 to 40 percent of 30
exposed areas affected, or; systemic therapy or intensive
light therapy required for a total duration of six weeks or
more, but not constantly, during the past 12-month period..
At least 5 percent, but less than 20 percent, of the entire 10
body, or at least 5 percent, but less than 20 percent, of
exposed areas affected, or; systemic therapy or intensive
light therapy required for a total duration of less than
six weeks during the past 12-month period..................
Less than 5 percent of the entire body or exposed areas 0
affected, and; no more than topical therapy required during
the past 12-month period...................................
Or rate as disfigurement of the head, face, or neck (DC
7800) or scars (DC's 7801, 7802, 7803, 7804, or 7805),
depending upon the predominant disability.7823 Vitiligo:
With exposed areas affected................................. 10
With no exposed areas affected.............................. 07824 Diseases of keratinization (including icthyoses, Darier's
disease, and palmoplantar keratoderma):
With either generalized cutaneous involvement or systemic 60
manifestations, and; constant or near-constant systemic
medication, such as immunosuppressive retinoids, required
during the past 12-month period............................
With either generalized cutaneous involvement or systemic 30
manifestations, and; intermittent systemic medication, such
as immunosuppressive retinoids, required for a total
duration of six weeks or more, but not constantly, during
the past 12-month period...................................
With localized or episodic cutaneous involvement and 10
intermittent systemic medication, such as immunosuppressive
retinoids, required for a total duration of less than six
weeks during the past 12-month period......................
No more than topical therapy required during the past 12- 0
month period...............................................7825 Urticaria:
Recurrent debilitating episodes occurring at least four 60
times during the past 12-month period despite continuous
immunosuppressive therapy..................................
Recurrent debilitating episodes occurring at least four 30
times during the past 12-month period, and; requiring
intermittent systemic immunosuppressive therapy for control
Recurrent episodes occurring at least four times during the 10
past 12-month period, and; responding to treatment with
antihistamines or sympathomimetics.........................7826 Vasculitis, primary cutaneous:
Recurrent debilitating episodes occurring at least four 60
times during the past 12-month period despite continuous
immunosuppressive therapy..................................
Recurrent debilitating episodes occurring at least four 30
times during the past 12-month period, and; requiring
intermittent systemic immunosuppressive therapy for control
Recurrent episodes occurring one to three times during the 10
past 12-month period, and; requiring intermittent systemic
immunosuppressive therapy for control......................
Or rate as disfigurement of the head, face, or neck (DC
7800) or scars (DC's 7801, 7802, 7803, 7804, or 7805),
depending upon the predominant disability.7827 Erythema multiforme; Toxic epidermal necrolysis:
Recurrent debilitating episodes occurring at least four 60
times during the past 12-month period despite ongoing
immunosuppressive therapy..................................
Recurrent episodes occurring at least four times during the 30
past 12-month period, and; requiring intermittent systemic
immunosuppressive therapy..................................
Recurrent episodes occurring during the past 12-month period 10
that respond to treatment with antihistamines or
sympathomimetics, or; one to three episodes occurring
during the past 12-month period requiring intermittent
systemic immunosuppressive therapy.........................
Or rate as disfigurement of the head, face, or neck (DC
7800) or scars (DC's 7801, 7802, 7803, 7804, or 7805),
depending upon the predominant disability.7828 Acne:
Deep acne (deep inflamed nodules and pus-filled cysts) 30
affecting 40 percent or more of the face and neck..........
Deep acne (deep inflamed nodules and pus-filled cysts) 10
affecting less than 40 percent of the face and neck, or;
deep acne other than on the face and neck..................
Superficial acne (comedones, papules, pustules, superficial 0
cysts) of any extent.......................................
Or rate as disfigurement of the head, face, or neck (DC
7800) or scars (DC's 7801, 7802, 7803, 7804, or 7805),
depending upon the predominant disability.7829 Chloracne:
Deep acne (deep inflamed nodules and pus-filled cysts) 30
affecting 40 percent or more of the face and neck..........
Deep acne (deep inflamed nodules and pus-filled cysts) 10
affecting less than 40 percent of the face and neck, or;
deep acne other than on the face and neck..................
Superficial acne (comedones, papules, pustules, superficial 0
cysts) of any extent.......................................
Or rate as disfigurement of the head, face, or neck (DC
7800) or scars (DC's 7801, 7802, 7803, 7804, or 7805),
depending upon the predominant disability.7830 Scarring alopecia:
Affecting more than 40 percent of the scalp................. 20
Affecting 20 to 40 percent of the scalp..................... 10
Affecting less than 20 percent of the scalp................. 07831 Alopecia areata:
With loss of all body hair.................................. 10
With loss of hair limited to scalp and face................. 07832 Hyperhidrosis:
Unable to handle paper or tools because of moisture, and 30
unresponsive to therapy....................................
Able to handle paper or tools after therapy................. 07833 Malignant melanoma:
Rate as scars (DC's 7801, 7802, 7803, 7804, or 7805),
disfigurement of the head, face, or neck (DC 7800), or
impairment of function (under the appropriate body system).
Note: If a skin malignancy requires therapy that is
comparable to that used for systemic malignancies, i.e.,
systemic chemotherapy, X-ray therapy more extensive than to
the skin, or surgery more extensive than wide local
excision, a 100-percent evaluation will be assigned from
the date of onset of treatment, and will continue, with a
mandatory VA examination six months following the
completion of such antineoplastic treatment, and any change
in evaluation based upon that or any subsequent examination
will be subject to the provisions of Sec. 3.105(e). If
there has been no local recurrence or metastasis,
evaluation will then be made on residuals. If treatment is
confined to the skin, the provisions for a 100-percent
evaluation do not apply.------------------------------------------------------------------------ (Authority: 38 U.S.C. 1155) [67 FR 49596, July 31, 2002; 67 FR 58448, 58449, Sept. 16, 2002; 73 FR 54710, Oct. 23, 2008; 77 FR 2910, Jan. 20, 2012]
The Endocrine System