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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 severe skin condition where most or all of the skin becomes red, inflamed, and starts peeling off in large sheets. It can be life-threatening and usually requires systemic treatment. 38 CFR § 4.118 names this code Erythroderma; exfoliative dermatitis is the older name for the same condition. The lower levels turn on how many WEEKS of systemic therapy you needed over the past 12-month period; the top two levels turn on whether skin involvement is generalized and whether you have systemic manifestations.
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 7817. The examiner records findings on the DBQ; a rating specialist makes the decision.
| Rating | Rating criteria | What that means for you |
|---|---|---|
| 0% | Any extent of involvement of the skin, and no more than topical therapy required over the past 12-month period. | Whatever the extent of skin involvement, you needed no more than topical therapy over the past 12-month period. DC 7817 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 code is 10 percent. Note what this code turns on — under DC 7817 the extent of skin involvement alone does not move you off 0 percent; the systemic therapy required is what the lower rungs measure. |
What supports this level
| ||
| 10% | Any extent of involvement of the skin, and any of the following therapies required for a total duration of less than 6 weeks over the past 12-month period: systemic therapy such as therapeutic doses of corticosteroids, other immunosuppressive drugs, retinoids, PUVA, UVB treatments, biologics, or electron beam therapy. | Any extent of involvement of the skin, and you needed systemic therapy — therapeutic doses of corticosteroids, other immunosuppressive drugs, retinoids, PUVA, UVB treatments, biologics, or electron beam therapy — for a total duration of LESS THAN 6 WEEKS over the past 12-month period. The extent of skin involvement does not matter at this level; only the total weeks of systemic therapy do. |
What supports this level
| ||
| 30% | Any extent of involvement of the skin, and any of the following therapies required for a total duration of 6 weeks or more, but not constantly, over the past 12-month period: systemic therapy such as therapeutic doses of corticosteroids, other immunosuppressive drugs, retinoids, PUVA, UVB treatments, biologics, or electron beam therapy. | Any extent of involvement of the skin, and you needed systemic therapy for a total of 6 WEEKS OR MORE, but not constantly, over the past 12-month period. Count the weeks, not the months — two months of systemic therapy is a 30 percent picture under this code, not a 10 percent one. |
What supports this level
| ||
| 60% | Generalized involvement of the skin without systemic manifestations and one of the following: Constant or near-constant systemic therapy such as therapeutic doses of corticosteroids, other immunosuppressive drugs, retinoids, PUVA, UVB treatments, biologics, or electron beam therapy required over the past 12-month period; or No current treatment due to a documented history of treatment failure with 1 treatment regimen. | You have generalized involvement of the skin WITHOUT systemic manifestations, and either you needed constant or near-constant systemic therapy over the past 12-month period, or you are on no current treatment because of a documented history of treatment failure with 1 treatment regimen. That second path matters: stopping a drug that did not work does not drop you off this level. The Note to DC 7817 defines treatment failure as disease progression, or less than a 25 percent reduction in the extent and severity of disease after four weeks of prescribed therapy, as documented by medical records. |
What supports this level
| ||
| 100% | Generalized involvement of the skin with systemic manifestations (such as fever, weight loss, or hypoproteinemia) AND one of the following: Constant or near-constant systemic therapy such as therapeutic doses of corticosteroids, other immunosuppressive drugs, retinoids, PUVA (psoralen with long-wave ultraviolet-A light), UVB (ultraviolet-B light) treatments, biologics, or electron beam therapy required over the past 12 month period; or No current treatment due to a documented history of treatment failure with 2 or more treatment regimens. | You have generalized involvement of the skin WITH systemic manifestations such as fever, weight loss, or protein loss (hypoproteinemia), and either you needed constant or near-constant systemic therapy over the past 12-month period, or you are on no current treatment because of a documented history of treatment failure with 2 or more treatment regimens. The Note to DC 7817 defines treatment failure as disease progression, or less than a 25 percent reduction in the extent and severity of disease after four weeks of prescribed therapy, as documented by medical records. |
What supports this level
| ||
The middle column is our transcription of the criteria at 38 CFR 4.118, DC 7817, 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.
Counting months instead of weeks — DC 7817 measures systemic therapy in WEEKS. Less than 6 weeks over the past 12-month period is 10 percent; 6 weeks or more but not constant is 30 percent. Two months of therapy meets the 30 percent criterion, so add up your treatment dates in weeks before you assume you are at 10 percent.
Not documenting systemic manifestations — the difference between 60% and 100% depends on whether you have systemic symptoms like fever, weight loss, or low protein levels. Get lab work to document these.
Assuming that stopping treatment ends your claim — the 60 and 100 percent levels can both be met with NO current treatment when there is a documented history of treatment failure (1 regimen for 60 percent, 2 or more for 100 percent). The Note to DC 7817 defines treatment failure as disease progression, or less than a 25 percent reduction in the extent and severity of disease after four weeks of prescribed therapy, as documented by medical records. Make sure each failed regimen and the four-week response are in your records.
Missing the underlying cause — erythroderma is often caused by another condition (psoriasis, drug reaction, lymphoma). Make sure the underlying condition is also claimed and rated.
Failing to document hospitalization — severe erythroderma often requires hospitalization. These records are critical evidence of severity, though the rating levels themselves turn on skin involvement and therapy, not on admissions.
These apply to every C&P exam, whatever the condition.