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The VA orders this exam to verify your diagnosis and measure how severe it is right now. It can shape your rating and your monthly compensation — but it does not decide your claim. A rating specialist weighs it against your full record, and if the exam does not reflect your condition, you can say so and ask the VA to correct it.
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A group of autoimmune skin conditions that cause blisters on the skin and mucous membranes. Pemphigus vulgaris is the most common type. DC 7815 is evaluated under the General Rating Formula for the Skin, which rates on body area affected or the duration of systemic therapy required — whichever gives the higher level — and tops out at 60 percent. The Note to DC 7815 directs that complications and residuals of mucosal involvement be rated separately under their own diagnostic codes.
The percentages this diagnostic code can be rated at. Which one applies depends on the findings — no tool here can tell you in advance.
Rated under 38 CFR 4.118, DC 7815. The examiner records findings on the DBQ; a rating specialist makes the decision.
| Rating | Rating criteria | What that means for you |
|---|---|---|
| 0% | No more than topical therapy required over the past 12-month period and at least one of the following: Characteristic lesions involving less than 5 percent of the entire body affected; or Characteristic lesions involving less than 5 percent of exposed areas affected. | Your bullous disorder needed no more than topical therapy over the past 12 months, and characteristic lesions cover less than 5 percent of your entire body or less than 5 percent of exposed areas. DC 7815 is evaluated under the General Rating Formula for the Skin, and that formula prints this 0 percent level directly: no monthly payment, but the condition is on record and a later increase runs from it. The lowest compensable level under this formula is 10 percent. A 0 percent here covers the skin only — the Note to DC 7815 directs that complications and residuals of mucosal involvement be rated separately. |
What supports this level
| ||
| 10% | Evaluate under the General Rating Formula for the Skin. At least one of the following: Characteristic lesions involving at least 5 percent, but less than 20 percent, of the entire body affected; or At least 5 percent, but less than 20 percent, of exposed areas affected; or Intermittent systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required for a total duration of less than 6 weeks over the past 12-month period. | At least 5 percent but less than 20 percent of your entire body or of exposed areas is affected, or you needed intermittent systemic therapy for a total of less than 6 weeks over the past 12-month period. Either one on its own is enough. |
What supports this level
| ||
| 30% | Evaluate under the General Rating Formula for the Skin. At least one of the following: Characteristic lesions involving 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected; or Systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required for a total duration of 6 weeks or more, but not constantly, over the past 12-month period. | Characteristic lesions involve 20 to 40 percent of your entire body or of exposed areas, or you needed systemic therapy for a total of 6 weeks or more, but not constantly, over the past 12-month period. |
What supports this level
| ||
| 60% | Evaluate under the General Rating Formula for the Skin. At least one of the following: Characteristic lesions involving more than 40 percent of the entire body or more than 40 percent of exposed areas affected; or Constant or near-constant systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, psoralen with long-wave ultraviolet-A light (PUVA), or other immunosuppressive drugs required over the past 12-month period. | Characteristic lesions involve more than 40 percent of your entire body or more than 40 percent of exposed areas, or you needed constant or near-constant systemic therapy over the past 12-month period. This is the highest level the General Rating Formula for the Skin provides. |
What supports this level
| ||
The middle column is our transcription of the criteria at 38 CFR 4.118, DC 7815, condensed for reading. Read the section itself on eCFR before relying on the exact wording. The items under each level are the kinds of evidence that document it — not a VA checklist, and not a prediction of which level applies to you.
Not documenting oral and mucosal involvement — pemphigus often affects the mouth, throat, and other mucous membranes. This does not raise the DC 7815 level, which measures skin; the Note to DC 7815 directs that complications and residuals of mucosal involvement (ocular, oral, gastrointestinal, respiratory, or genitourinary) be rated SEPARATELY under the appropriate diagnostic code. Undocumented mucosal damage is a rating you never get, not a lower one.
Not understanding that most pemphigus patients require constant systemic therapy — drugs like prednisone, mycophenolate, or rituximab used for pemphigus are systemic immunosuppressives, potentially qualifying you for the 60% level.
Failing to get a biopsy — a skin biopsy with direct immunofluorescence is the gold standard for confirming pemphigus and strengthens your claim.
Not documenting secondary infections — blistering skin is prone to bacterial infections that require antibiotics, adding to the overall disability picture.
These apply to every C&P exam, whatever the condition.