VA Disability for Skin Conditions

Many Gulf War veterans, among others, exposed to chemical and environmental hazards while serving, now face persistent skin conditions as a result. These can linger long after their service has ended, complicating health and VA claims for disability compensation.

Presumptive Skin Conditions

The VA presumes two skin conditions, chloracne and porphyria cutanea tarda, associated with Agent Orange exposure during the Vietnam War. Both conditions must manifest within one year of exposure to qualify for presumptive service connection.

The VA also recognizes 3 skin conditions that qualify as presumptive for Gulf War veterans: 

• Chronic Dermatitis: Inflamed, itchy, and red skin that causes significant discomfort. It sometimes requires long-term treatment.
• Eczema: Patches of skin become inflamed, itchy, cracked, and rough. Blisters may also appear in some cases, and flare-ups are often difficult to manage.
• Psoriasis: An autoimmune disease that causes red, scaly patches on the skin. Gulf War veterans often report particularly severe outbreaks that impact their quality of life.

VA Disability Ratings for Chloracne

Chloracne is an unusual skin condition characterized by blackheads, cysts, and nodules that resemble severe acne. Unlike typical acne, which is caused by overactive oil-producing glands, chloracne occurs due to toxic chemical accumulation in the skin’s glands.

Symptoms include: 

• Blackheads, cysts, and nodules
• Severe and potentially painful lesions
• Possible open sores and permanent scarring in severe cases

Chloracne commonly results from:

• Exposure to toxic substances like dioxin (Agent Orange)
• Contact through ingestion, inhalation, or skin absorption

The VA Disability Ratings for Chloracne are as follows:

VA Disability Rating	Criteria
30%	Deep acne with inflamed nodules and pus-filled cysts affecting 40% or more of the face and neck.
20%	Deep acne with inflamed nodules and pus-filled cysts affecting intertriginous areas (e.g., armpits, anogenital region, skin folds of the breasts or between digits).
10%	Deep acne with inflamed nodules and pus-filled cysts affecting less than 40% of the face and neck, OR deep acne affecting non-intertriginous areas of the body (other than the face and neck).
0%	Superficial acne (e.g., comedones, papules, pustules) of any extent.

VA Rating for Porphyria Cutanea Tarda (PCT)

Porphyria cutanea tarda (PCT) causes skin thinning and blistering, particularly in sun-exposed areas like the face, arms, and hands.

Symptoms include: 

• Blisters followed by crusting and scarring 
• Hyperpigmentation 
• Increased growth in sun-exposed areas 
• Potential liver damage

PCT commonly results from:

• Agent Orange exposure 
• Hereditary factors, though less common  
• A combination of genetic, lifestyle, and environmental factors.

The VA Disability Ratings for PCT are as follows:

VA Disability Rating	Criteria
60%	Characteristic lesions cover more than 40% of the body or exposed areas, OR the veteran requires constant or near-constant systemic therapy (e.g., corticosteroids, phototherapy, retinoids, biologics, PUVA) over the past 12 months.
30%	Characteristic lesions cover 20–40% of the body or exposed areas, OR the veteran undergoes systemic therapy for a total of 6 weeks or more intermittently over the past 12 months.
10%	Characteristic lesions cover 5–20% of the body or exposed areas, OR the veteran undergoes intermittent systemic therapy for less than 6 weeks over the past 12 months.

Establishing Direct Service Connection for Skin Conditions

To secure VA disability compensation for skin conditions directly caused by military service, veterans must provide three things:

• A current diagnosis of a skin condition.
• Evidence of an in-service incident leading to the skin condition.
• A medical nexus linking the current skin condition to the in-service incident.

To secure VA disability compensation for skin conditions directly caused by military service, veterans must provide three things.

Disability Ratings for Common Skin Conditions

The VA uses a general rating formula to assess the severity of skin conditions. Ratings are based on how much the body is affected and the severity of symptoms.

Ratings typically range from 0% to 60% to 100% for severe cases, depending on the degree of visible or symptomatic impairment and its impact on daily activities.

VA Disability Ratings for Psoriasis

Psoriasis is rated based on the frequency and severity of flare-ups and their response to treatment.

Ratings are as follows:

• 0% – No active disease, but with some residual effects like scarring.
• 10% – Mild flare-ups a few times a year, responsive to treatment.
• 30% – Frequent moderate flare-ups requiring continuous treatment.
• 60% – Constant severe flare-ups requiring frequent hospitalization.
• 100% – Incapacitating episodes with a significant impact on daily activities.

VA Disability Ratings for Scars and Disfigurement

Scars and disfigurement from military service are rated based on location, size, and cosmetic impact. Ratings are as follows:

• Scars on the head, face, or neck – Rated on the degree of disfigurement and skin loss.
• Other body areas – Typically rated based on the size of the scar.

VA Disability Benefits for Eczema

Eczema, or atopic dermatitis, often develops due to environmental factors encountered during service.

Ratings vary from 0%for minor residual effects to 100%for severe cases affecting the veteran’s ability to work and perform daily tasks.

VA Disability Ratings for Acne Vulgaris

Acne vulgaris is a common skin condition that stressful environments, such as those experienced during military service, can worsen.

Ratings are as follows:

• 0% – Mild acne without significant scarring or psychological effects.
• 10% – Moderate acne with frequent exacerbations requiring medical intervention.
• 30% – Severe acne with extensive scarring, painful cysts, and frequent infections requiring systemic treatment.

VA Disability Ratings for Dermatitis

Contact dermatitis and other forms of eczema can result from exposure to irritants or allergens in the military setting.

These are typical ratings:

• 10% – Intermittent dermatitis requiring topical medication.
• 30% – Persistent dermatitis with regular episodes affecting daily activities and requiring systemic medication.
• 60% – Chronic dermatitis with constant symptoms affecting a significant body area and requiring systemic steroids or other immunosuppressive treatment.

VA Disability Ratings for Vitiligo

Vitiligo involves skin depigmentation, which can be psychologically and socially distressing.

Here’s ratings for Vitiligo:

• 0% – Limited areas of depigmentation not affecting physical capabilities.
• 10% – More extensive skin involvement requiring cosmetic cover-ups and UV treatments.
• 30% – Extensive depigmentation affecting the face, hands, and other visible areas, significantly impacting social or occupational activities.

VA Disability Ratings for Fungal Infections

Chronic or recurring fungal infections are common among veterans exposed to tropical climates or unsanitary conditions.

Here are the ratings:

• 10% – Localized infections requiring intermittent treatment.
• 30% – Chronic widespread infections requiring continuous antifungal treatment.
• 60% – Infections with systemic involvement and frequent recurrences requiring long-term systemic therapy.

VA Disability Ratings for Urticaria (Hives)

Urticaria, or hives, can be chronic and debilitating, particularly when triggered by stress.

The ratings for hives are:

• 10% – Infrequent episodes that are easily controlled.
• 30% – Chronic urticaria that affects daily activities and requires regular antihistamine or corticosteroid treatment.
• 60% – Continuous, debilitating hives requiring immunosuppressive drugs or other systemic treatments.

VA Disability Ratings for Solar Keratosis

Solar keratosis commonly affects veterans who served in high-sun-exposure environments.

Here are the ratings for solar keratosis:

• 0% – Minimal impact, with lesions not requiring frequent treatment.
• 10% – Numerous lesions requiring regular cryotherapy or topical chemotherapy.
• 30% – Extensive lesions with frequent recurrences requiring regular dermatological intervention.

VA Ratings for Skin Cancers

Skin cancers are evaluated based on severity and required treatments. Here are the ratings for skin cancers:

• 0% – Benign tumors requiring minimal intervention.
• 100% – Malignant forms of cancer that need ongoing treatments such as surgery or chemotherapy. The VA applies this during active management.

VA Ratings for Melanoma

Melanoma is rated based on its aggressiveness and treatment complexity. Active treatment phases involving surgery, chemotherapy, or immunotherapy may qualify for a temporary 100% rating.

The VA adjusts subsequent ratings based on treatment residuals such as tissue loss or disfigurement, and the likelihood of recurrence.

VA Ratings for Carcinomas

Carcinomas, including basal cell and squamous cell types, are common but vary in aggression. The VA rates these cancers based on the frequency and type of treatment required.

Active phases of aggressive treatment may qualify for a temporary 100% rating. Continuous or repetitive treatment, significant disfigurement, or functional loss due to surgery or other treatments can also lead to higher ratings.

Eligibility for VA Disability Benefits

To receive VA disability benefits for skin conditions, veterans must meet two key requirements:

• A service-connected disability.
• Discharge under conditions other than dishonorable.

Veterans should seek a timely diagnosis and document all relevant medical treatment to support their claims effectively.