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Squamous Cell Carcinoma Residuals

The lasting effects after treatment for squamous cell carcinoma, a type of skin cancer that can spread to other parts of the body if not treated. After treatment, the VA rates the remaining scars, disfigurement, or any recurrence.

Code: 7818
Criteria: 38 CFR 4.118, DC 7818
Exam length: ~20-30 minutes
Form: Skin Diseases DBQ

Rating steps

0%
10%
30%
100%

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 review your history of squamous cell carcinoma including location, stage, treatment method, and whether there has been any recurrence or metastasis.
All surgical scars from excision procedures will be measured and assessed for pain, tenderness, instability, and disfigurement.
The examiner will examine your skin for any new suspicious lesions, precancerous actinic keratoses, or signs of recurrence.
You will be asked about ongoing surveillance requirements, sun protection measures, and the frequency of dermatological follow-up.
If your cancer was related to sun exposure during service, the examiner will review the connection between your military duties and UV exposure.

What the examiner is actually filling in

01Whether the cancer is currently active or in remission — active malignancy with ongoing treatment is rated at 100% until stable.
02The characteristics of all excision scars, including pain, tenderness, instability, size, and whether they cause disfigurement or functional limitation.
03For head, face, and neck scars: evaluation against the eight characteristics of disfigurement for potential ratings up to 80%.
04Whether you have ongoing skin disease requiring treatment, such as actinic keratoses or field cancerization requiring topical chemotherapy.
05The need for ongoing medical surveillance and the functional impact of sun avoidance requirements on your daily life and employment.

Rated under 38 CFR 4.118, DC 7818. The examiner records findings on the DBQ; a rating specialist makes the decision.

A complete answer sounds like

If you are within six months of completing treatment for active skin cancer, you may qualify for the 100% active malignancy rating — make sure treatment completion dates are clearly documented.
Each painful or unstable excision scar can receive 10%, and scars on the face are rated under more favorable disfigurement criteria — have every scar documented individually.
If you require ongoing topical chemotherapy (like fluorouracil) for actinic keratoses, this constitutes systemic/topical treatment that supports ongoing skin disease ratings.
Describe how sun avoidance requirements limit your outdoor activities, employment options, and quality of life.
If you have had multiple squamous cell carcinomas, this pattern of recurrent cancer should be documented as it may support a higher ongoing rating for active skin disease management.

What costs veterans points

Assuming that successful excision means no residual rating — surgical scars, ongoing surveillance requirements, and the risk of recurrence all factor into your rating.
Not claiming each excision scar separately when painful, unstable, or disfiguring — multiple scars can result in multiple ratings.
Failing to mention precancerous actinic keratoses that require ongoing treatment, which demonstrates active skin disease.
Not reporting the psychological impact of skin cancer including anxiety about sun exposure, body checking, and fear of recurrence.
Forgetting to document functional limitations from scars — a scar on the hand that limits grip or one on the face that limits facial expressions is separately ratable.

The rating criteria, in plain language

Rating levels for Squamous Cell Carcinoma Residuals under 38 CFR 4.118, DC 7818
Rating	Rating criteria	What that means for you
0%	Rate as disfigurement of the head, face, or neck (DC 7800), scars (DC's 7801, 7802, 7803, 7804, or 7805), or impairment of function.	Your squamous cell carcinoma has been treated and there are no significant residual scars, disfigurement, or functional effects.
0%	What supports this level Squamous cell carcinoma in remission No significant residual scarring Post-treatment dermatology clearance Pathology showing clear surgical margins
10%	Rate as disfigurement of the head, face, or neck (DC 7800), scars (DC's 7801, 7802, 7803, 7804, or 7805), or impairment of function.	You have residual scars from surgical excision that are painful, unstable, or cover a qualifying area, or minor disfigurement of the head, face, or neck.
10%	What supports this level Painful or tender surgical scars documented Scar measurements (length, width, area) One characteristic of disfigurement if on face Photographs of residual scarring
30%	Rate as disfigurement of the head, face, or neck (DC 7800), scars (DC's 7801, 7802, 7803, 7804, or 7805), or impairment of function.	You have significant residual scarring or disfigurement, or recurrent squamous cell carcinoma requiring additional treatment.
30%	What supports this level Multiple surgical scars with tissue loss Two or three characteristics of disfigurement Recurrent squamous cell carcinoma documented Wide excision or Mohs surgery records Lymph node involvement or metastasis workup
100%	If a skin malignancy requires therapy that is comparable to that used for systemic malignancies, i.e., systemic chemotherapy, X-ray therapy more extensive than to the skin, or surgery more extensive than wide local excision, a 100-percent evaluation will be assigned from the date of onset of treatment. If treatment is confined to the skin, the provisions for a 100-percent evaluation do not apply.	You are currently receiving treatment for active or recurrent squamous cell carcinoma using systemic chemotherapy, extensive radiation, or surgery beyond simple excision.
100%	What supports this level Active squamous cell carcinoma requiring treatment Systemic chemotherapy, immunotherapy, or extensive radiation Surgery more extensive than wide local excision Oncology treatment records with dates Sentinel lymph node biopsy or staging results

The middle column is our transcription of the criteria at 38 CFR 4.118, DC 7818, 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 residual scars — squamous cell carcinoma excisions require wider margins than basal cell, leaving larger scars. Rate each scar under DC 7800-7805.

Not monitoring for recurrence or metastasis — squamous cell carcinoma can spread to lymph nodes. If it recurs or metastasizes, a new period of 100% rating begins during treatment.

Failing to connect to military exposures — sun exposure, radiation exposure, burn pits, and chemical exposure during service are risk factors. Document your service history and exposures.

Missing the connection to actinic keratosis — if you also have actinic keratosis (a precancerous condition), claim it separately as it may support a higher combined rating.

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

Tick these off as you gather them. Nothing here is required — the exam happens either way — but each one is something the examiner cannot record if it is not in front of them.

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Take it with you

Print the whole guide — what the examiner records, the folder list with your ticks, the criteria table and the mistakes to avoid — and bring it to the appointment.

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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

Squamous Cell Carcinoma Residuals

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

Squamous Cell Carcinoma Residuals

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