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Morphea / Localized Scleroderma

A condition where patches of skin become hard, thickened, and discolored due to excess collagen. Morphea is the localized form affecting only the skin, as opposed to systemic scleroderma which affects internal organs. DC 7821 names scleroderma by name and is evaluated under the General Rating Formula for the Skin, which rates on the percentage of your body or exposed areas covered by characteristic lesions OR the duration of systemic therapy required over the past 12-month period — whichever gives the higher level — and tops out at 60 percent. Loss of joint motion caused by skin tightening is a separate disability rated under the musculoskeletal system.

Code: 7821
Criteria: 38 CFR 4.118, DC 7821
Exam length: ~30 minutes
Form: Skin Diseases DBQ

Rating steps

The percentages this diagnostic code can be rated at. Which one applies depends on the findings — no tool here can tell you in advance.

What happens at the appointment

The examiner will inspect your skin for morphea patches — hardened, waxy, discolored areas where the skin feels tight or thick.
They will measure the total body surface area affected and note areas of skin tightening or atrophy.
You will be asked about joint or muscle limitation caused by skin tightening.
Treatment history will be reviewed: topical steroids, light therapy, methotrexate, or other immunosuppressants.
The examiner will check for functional limitation — whether tightened skin restricts movement of your hands, arms, or face.

What the examiner is actually filling in

01Percentage of total body surface area affected by morphea patches.
02Whether skin tightening causes limitation of motion in any body part.
03Whether treatment requires systemic therapy or topical therapy only.
04Whether the condition is progressing, stable, or in remission.
05Whether there are features suggesting systemic scleroderma (Raynaud phenomenon, organ involvement).

Rated under 38 CFR 4.118, DC 7821. The examiner records findings on the DBQ; a rating specialist makes the decision.

A complete answer sounds like

If skin tightening limits your movement, ask the examiner to measure range of motion before and document the restriction.
Describe how the condition has changed over time — spreading, new patches, increasing tightness.
If you are on systemic medications like methotrexate, emphasize this — it qualifies for a higher rating.
Mention any Raynaud phenomenon (fingers turning white in cold) or difficulty swallowing — these suggest systemic disease.
Show the examiner how tight or immovable the affected skin is compared to normal skin nearby.

What costs veterans points

Not reporting that tightened skin limits your movement. Functional limitation from morphea may be rated under joint or musculoskeletal codes.
Forgetting to mention systemic medications used for treatment.
Not documenting the spread or progression of patches over time.
Missing the overlap with systemic scleroderma — if you have internal organ involvement, that is a separate and serious claim.

The rating criteria, in plain language

Rating levels for Morphea / Localized Scleroderma under 38 CFR 4.118, DC 7821
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.	No more than topical therapy over the past 12-month period, and characteristic lesions cover less than 5 percent of your entire body or less than 5 percent of exposed areas. DC 7821 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 — any loss of joint motion from skin tightening is rated under its own code.
0%	What supports this level Characteristic lesions measured at less than 5 percent of the entire body affected Less than 5 percent of exposed areas affected Topical therapy only over the past 12-month period, with no systemic corticosteroids, methotrexate, phototherapy, or other immunosuppressive drugs Morphea or localized scleroderma diagnosis confirmed by skin biopsy A dated record of the condition so that a later increase claim has a starting point
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.	Characteristic lesions cover at least 5 percent but less than 20 percent of your entire body, or at least 5 percent but less than 20 percent of exposed areas, or you needed intermittent systemic therapy for a total of less than 6 weeks over the past 12-month period. Any one of these on its own is enough.
10%	What supports this level Body surface area measured at 5 percent to less than 20 percent of the entire body affected 5 percent to less than 20 percent of exposed areas affected Treatment records adding up to a total of less than 6 weeks of intermittent systemic therapy over the past 12-month period Phototherapy or UVA1 treatment records showing the dates of each course Dermatology specialist notes with measured plaque size
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 cover 20 to 40 percent of your entire body or 20 to 40 percent 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. Either one on its own is enough. Note that 40 percent exactly falls in this band; the 60 percent level asks for MORE than 40 percent.
30%	What supports this level Body surface area measured at 20 to 40 percent of the entire body or of exposed areas affected Treatment records adding up to a total of 6 weeks or more of systemic therapy over the past 12-month period, but not constant Prescription records for methotrexate, corticosteroids, or other immunosuppressive drugs with start and stop dates Phototherapy or photochemotherapy course records with dates Dermatology notes documenting measured skin thickening and induration
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 cover 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.
60%	What supports this level Body surface area measured at more than 40 percent of the entire body, or more than 40 percent of exposed areas affected Records showing constant or near-constant systemic therapy across the past 12-month period Continuous prescription history — methotrexate, corticosteroids, biologics, or other immunosuppressive drugs — with no meaningful gap Dermatology notes describing the therapy as ongoing rather than intermittent, and documenting extensive skin thickening

The middle column is our transcription of the criteria at 38 CFR 4.118, DC 7821, 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.

Mistakes we see most often

Not claiming joint limitation separately — when morphea crosses over a joint, it can restrict range of motion. This functional limitation should be rated separately under the musculoskeletal system.

Confusing localized morphea with systemic scleroderma — systemic scleroderma affects internal organs and may warrant much higher ratings under different diagnostic codes. Make sure your diagnosis is accurate.

Not documenting skin texture changes — the examiner should document skin induration, thickening, and inflexibility, as these are key characteristics that affect the rating.

Failing to get a biopsy — a skin biopsy confirms the diagnosis and strengthens your claim significantly.

Before & after your exam

These apply to every C&P exam, whatever the condition.

Do not miss the appointment: Missing your C&P exam without a good reason can cost you. Under 38 CFR § 3.655, a missed exam can cause a claim for an increased rating or a reopened claim to be denied, and can cause an original claim to be decided on the evidence already in your file. If you cannot make it, call the VA or the exam company right away to reschedule — a documented good reason (illness, work conflict, no transportation, a family emergency) protects your claim.
Your examiner may be a contractor: Many C&P exams are performed by VA-contracted companies — QTC, Optum Serve (LHI), VES, or MSLA — not at a VA hospital. They will call, text, or mail you to schedule. Do not ignore an unknown number or letter while your claim is pending, and confirm the exam location and time before you go.
The examiner does not decide your claim: The examiner's job is to record findings on the Disability Benefits Questionnaire (DBQ). A rating specialist at the Regional Office makes the actual decision, using the exam together with your full record — service records, medical records, and lay statements. One appointment does not settle everything.
Get a copy of your exam report: After the exam you can request the report (often called the DBQ or C&P exam results) through VA.gov, the Blue Button tool, or your accredited representative. Reading it lets you catch errors while you still have time to respond.
If the exam was inadequate, you have options: If the examiner rushed you, evaluated the wrong condition, or the report is inaccurate, you can submit a statement and new evidence, and — after a decision — request a review (a Supplemental Claim or Higher-Level Review). A single bad exam is not the end of your claim.

View condition guide →View evidence checklist →

Folder readiness

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C&P Exam Preparation Guides

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.

Source forms
Coverage

Morphea / Localized Scleroderma

Rating steps

What happens at the appointment

What the examiner is actually filling in

A complete answer sounds like

What costs veterans points

The rating criteria, in plain language

What supports this level

What supports this level

What supports this level

What supports this level

Mistakes we see most often

Before & after your exam

Morphea / Localized Scleroderma

Rating steps

What happens at the appointment

What the examiner is actually filling in

A complete answer sounds like

What costs veterans points

The rating criteria, in plain language

What supports this level

What supports this level

What supports this level

What supports this level

Mistakes we see most often

Before & after your exam