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Exposure to Agent Orange during military service has long been associated with various cancers. While skin cancer is not classified as a presumptive condition by VA, studies suggest a link between Agent Orange exposure and certain types of skin cancer, and veterans can win service connection if they present the right evidence.
- A skin cancer rating reaches 100 percent only while treatment is at the level used for systemic cancers (surgery confined to the skin does not qualify), and VA then rates the disfigurement, scars, and lost function that remain.
- Of 2,113 Board of Veterans’ Appeals decisions Hill & Ponton reviewed on melanoma and skin cancer claims involving herbicide exposure, more than half were sent back (remanded) for further development rather than granted or denied.
- The Board remands melanoma and non-melanoma appeals for fixable reasons: unverified exposure, an opinion from the wrong specialty, or an opinion that never engaged the theory the veteran actually raised.
- Sun exposure is one of the most common alternative causes addressed in skin cancer claims, and a medical opinion that leaves it unanswered could result in a remand or a denial.
Does Agent Orange Cause Melanoma or Skin Cancer?
The National Academies of Sciences, Engineering, and Medicine (NASEM) concluded that current scientific evidence is not strong enough to establish that herbicide exposure causes melanoma or other skin cancer. NASEM, Veterans and Agent Orange: Update 11 (2018) places melanoma and basal cell or squamous cell skin cancers alike in the category of “inadequate or insufficient evidence to determine whether there is an association”. But research does suggest a possible connection.
Acral Melanoma and Agent Orange
The newest evidence, Hwang et al., “Identification of Risk Factors for Acral Melanoma in US Veterans,” JAMA Dermatology 2026;162(3):279-291, a nested case-control study of VA data covering 1,292 acral melanoma cases, reported that Agent Orange exposure was significantly associated with higher odds of acral melanoma vs cutaneous melanoma (AOR, 1.31; 95% CI, 1.06-1.62) and an adjusted odds ratio of 1.27 (95% CI, 1.04 to 1.56) for acral melanoma versus individuals without melanoma.
The authors describe acral melanoma, on the palms, soles, and nail units, as “a unique melanoma subtype less associated with UV radiation,” and treat this finding as a basis for further research (the study was observational and cannot by itself establish causation).
Basal Cell Carcinoma in Agent Orange
In a small retrospective pilot study of 100 male Agent Orange Registry participants (Clemens et al. 2014), 51% had nonmelanotic invasive skin cancer, compared with a published national age-matched figure of 23.8%.
VA disability for basal cell carcinomaSquamous Cell Carcinoma
Lee et al. 2023 reported an elevated incidence ratio for other malignant skin neoplasms among Korean Vietnam War veterans (1.18, 95% CI 1.12-1.25) compared with a matched general population. While it didn’t determine individual Agent Orange exposure, it supports further investigation into veteran-associated risk.
VA disability for squamous cell carcinomaIs Melanoma a Presumptive VA Disability?
Skin cancer, including melanoma, is not a presumptive VA disability for Agent Orange exposure. Melanoma is only presumptive for veterans who meet the VA’s qualifying Gulf War-era or post-9/11 service-location and timing requirements for exposure to burn pits and other toxins (under the PACT Act).
How to Get Melanoma Service Connected without a Presumption
Melanoma due to Agent Orange is claimed through direct service connection, the route for every non-presumptive disease. Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994) holds that a presumptive list “is not the exclusive means of proof of service connection” and that veterans “retain the opportunity to show direct service connection by establishing direct actual causation”.
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What Evidence Can Help Win an Agent Orange Melanoma or Skin Cancer Claim?
A confirmed diagnosis of the specific cancer, from a pathology report naming the anatomic site, plus treatment records showing medical interventions and any remaining scars, pain, recurrence, or functional limitations.
Proof of qualifying service, usually a DD214 and unit records plus deck logs where the location is contested, and lay and buddy statements describing spraying, drum handling, and the first appearance of the lesion.
A nexus opinion from a qualified medical provider, addressing the veteran’s exposure and explaining why it is at least as likely as not a cause or contributing cause to the skin cancer.
How Does VA Rate Melanoma and Skin Cancer?
VA rates malignant melanoma under diagnostic code 7833 and every other skin malignancy, including basal cell and squamous cell carcinoma, under DC 7818. Neither carries a percentage ladder of its own. Both assign 100 percent during treatment comparable to that used for systemic cancers, then rate the residuals.
| Rating basis | Criteria | Rating |
|---|---|---|
| Active antineoplastic treatment (DC 7833 melanoma, DC 7818 other skin malignancies) | Therapy comparable to that used for systemic malignancies, that is, systemic chemotherapy, X-ray therapy more extensive than to the skin, or surgery more extensive than wide local excision. Assigned from the date of onset of treatment | 100% |
| DC 7800, disfigurement of the head, face, or neck | With visible or palpable tissue loss and either gross 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 | 80% |
| DC 7800 | With visible or palpable tissue loss and either gross distortion or asymmetry of two features or paired sets of features, or; with four or five characteristics of disfigurement | 50% |
| DC 7800 | With visible or palpable tissue loss and either gross distortion or asymmetry of one feature or paired set of features, or; with two or three characteristics of disfigurement | 30% |
| DC 7800 | With one characteristic of disfigurement | 10% |
| DC 7801, scars with underlying soft tissue damage (not head, face, or neck) | Area or areas of 144 square inches (929 sq. cm.) or greater | 40% |
| DC 7801 | Area or areas of at least 72 square inches (465 sq. cm.) but less than 144 square inches (929 sq. cm.) | 30% |
| DC 7801 | Area or areas of at least 12 square inches (77 sq. cm.) but less than 72 square inches (465 sq. cm.) | 20% |
| DC 7801 | Area or areas of at least 6 square inches (39 sq. cm.) but less than 12 square inches (77 sq. cm.) | 10% |
| DC 7802, scars without underlying soft tissue damage (not head, face, or neck) | Area or areas of 144 square inches (929 sq. cm.) or greater | 10% |
| DC 7804, scars that are unstable or painful | Five or more scars that are unstable or painful | 30% |
| DC 7804 | Three or four scars that are unstable or painful | 20% |
| DC 7804 | One or two scars that are unstable or painful | 10% |
| DC 7805, other scars and other effects of scars rated under DC 7800 through 7804 | Any disabling effect not already considered under DC 7800 through 7804 is evaluated under an appropriate diagnostic code | Set by the code used |
| Impairment of function, including metastatic disease | Rated under the appropriate body system for the function lost | Set by that body system |
Source: 38 C.F.R. § 4.118, eCFR issue date July 28, 2026
Surgery Does Not Earn a 100% Rating
Repeated Mohs procedures or ordinary local excisions are generally not rated 100%, since treatment remains confined to the skin. More extensive surgery may be evaluated differently, but excisions with no systemic treatment are rated on residuals from the start, which is how a service-connected melanoma could end up at 0 or 10 percent.
What Does VA Rate after Melanoma Treatment Ends?
The temporary 100% rating for active cancer lasts 6 months after treatment ends, when VA schedules a mandatory examination. If there has been no local recurrence or metastasis, VA assigns ratings based on the residual effects of the condition, such as disfigurement, scarring, or functional limitations.
Scars resulting from skin cancer treatment are evaluated based on size, location, and disfigurement; scars on the face, head, or neck may receive higher ratings due to cosmetic and functional impacts.
Diagnostic codes 7801 and 7802 divide the body into six zones (each extremity, the anterior trunk, and the posterior trunk) and VA may assign separate evaluations for affected zones and combine them, or assign one evaluation based on the total affected area if that produces the higher benefit. Every affected zone should therefore be identified and measured.
How VA rates scarsHow Often Does the Board Grant Melanoma and Skin Cancer Claims?
Hill & Ponton identified 2,113 Board of Veterans’ Appeals cases of melanoma and skin cancer claims (issued between 2021 and 2025) in which herbicide exposure was part of the claim, and found that more than half included a remand.
| BVA Outcome | Melanoma (139) | Non-melanoma skin cancer (1,974) |
|---|---|---|
| Granted | 22.3% | 18.9% |
| Denied | 23.7% | 28.3% |
| Remanded | 53.2% | 52.6% |
Source: Hill & Ponton analysis of 2021-2025 Board of Veterans’ Appeals decisions involving melanoma and non-melanoma skin cancer, where herbicide exposure was raised. These numbers do not represent the probability that an individual claim will be granted and may include mixed-issue or repeated appellate decisions.
Remanded Melanoma Appeals
A remand means the Board of Veterans’ Appeals cannot make a final decision because important evidence is missing, incomplete, or legally inadequate. The claim is sent back to the VA regional office for more development.
After a remand, VA may request additional service records, obtain treatment records, verify an exposure, schedule a new examination, or ask for an addendum medical opinion. If the new examination fails to answer the questions the Board asked, the claim may have to be remanded again.
A veteran who obtains the missing records or medical opinion and submits them promptly may avoid delays and lower the risk of another remand.
When the VA Denies Melanoma and Skin Cancer Claims
VA Says Skin Cancer Is Not an Agent Orange Presumptive Condition
A veteran cannot rely on the Agent Orange presumption to establish service connection for melanoma or non-melanoma but is allowed under Combee v. Brown to prove direct service connection. The appeal should expressly state that the veteran is seeking direct service connection based on actual herbicide exposure. Another path is secondary service connection.
Skin cancer can potentially be connected to treatment for an already service-connected disability (such as immunosuppressive medication or radiation therapy for one of the presumptive Agent Orange cancers). A medical provider must explain the relationship in the individual veteran’s case.
VA Blames Sun Exposure, Age, Genetics, or Other Risk Factors
VA examiners frequently attribute skin cancer to factors other than military service. Common explanations include:
- Lifetime sun or ultraviolet exposure
- Older age
- Fair skin or a history of severe sunburn
- Family or genetic history
- Occupational exposure
- A weakened immune system
A veteran does not have to prove that Agent Orange was the only possible cause of the skin cancer. The legal question is whether the evidence shows that military service was at least as likely as not a cause or contributing cause.
How to Answer the Sun Exposure Argument
Sun exposure is an alternative cause that frequently appears in skin cancer claims: appeals are sent back when the examiner never addressed it and denied when the examiner blames it for the skin cancer.
In some cases, the veteran’s military duties may themselves have caused significant or prolonged sun exposure. At Hill & Ponton, we successfully argued sun exposure as part of service connection for a pilot and air field guard who had spent substantial time outdoors on flight lines and runways, resulting in cumulative ultraviolet exposure directly related to the conditions of military service.
A strong medical opinion should identify the tumor site and whether that area was regularly exposed to sunlight, address the veteran’s skin type, sunburn history, occupational exposure, and other material risk factors, and discuss whether UV exposure and herbicide-related mechanisms could both have contributed to the skin cancer.
The Cancer Did Not Appear Until Decades After Service
VA may emphasize that the veteran’s cancer was diagnosed many years after discharge, or that service treatment records do not show a suspicious lesion or skin cancer during active duty. Veterans can fight back with evidence showing:
- When the lesion was first noticed and whether it changed in size, shape, or color
- When treatment was first sought
- Whether earlier private dermatology records exist
- Testimony from a spouse, relative, or friend who observed the lesion
- Any prior biopsies, photographs, pathology reports, or surgical records
Get Help with a Melanoma or Skin Cancer Claim
Hill & Ponton’s Agent Orange lawyers focus on appeals for veterans and surviving spouses, including melanoma and non-melanoma claims that were denied because the condition is not on VA’s presumptive list, cases involving negative medical opinions, and cases rated at 0 percent despite repeated excisions, scars or other lasting residuals.
Contact our team for a free case evaluation before the next deadline runs. No attorney fees are charged until we win the appeal.
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