Skin Condition C&P Exam

Inside the exam room

1. You will be asked where the skin problem occurs, how often it flares, and how long flares last. Identify dated photos showing worse periods.

2. The examiner checks how much skin is affected, including areas usually uncovered, and reviews treatment over the past year. List each medicine, how you use it, and the treatment dates.

3. You will be asked about daily effects and any scars or changes in appearance. Explain itching, pain, clothing problems, and tasks you interrupt.

How VA rates skin condition

Explain where the rash appears, how much skin is affected, and which treatment you need. Record treatment dates because the length of treatment can change which row applies. The General Rating Formula for the Skin applies to specified codes, including dermatitis and eczema. It uses affected body or exposed area, or required treatment given another way, such as pills or injections (systemic therapy) and duration. Other skin diagnoses may use different codes. This general formula has 0%, 10%, 30%, and 60% levels, not a 50% level.

What each rating percentage means

Match the whole description with your exam and records. A single symptom or illustration does not decide your rating.

Rating	What the rule requires
0%	No more than treatment applied through the skin (topical therapy) required in the past 12 months, with areas of affected skin on less than 5% of the entire body OR less than 5% of exposed areas. Check every higher rating rule before using this level.
10%	Areas of affected skin on at least 5% but less than 20% of the entire body OR exposed areas; OR intermittent treatment given another way, such as pills or injections (systemic therapy) required for less than six weeks total in the past 12 months.
30%	Areas of affected skin on 20% to 40% of the entire body OR exposed areas; OR treatment given another way, such as pills or injections (systemic therapy) required for at least six weeks total, but not constantly, in the past 12 months.
60%	Areas of affected skin on more than 40% of the entire body OR exposed areas; OR constant or near-constant treatment given another way, such as pills or injections (systemic therapy) required in the past 12 months.

Check these details in your records

The examiner uses a condition form called a Disability Benefits Questionnaire (DBQ). Compare these items with your own records and explain what actually happens in daily life.

No more than treatment applied through the skin (topical therapy) required in the past 12 months, with areas of affected skin on less than 5% of the entire body OR less than 5% of exposed areas. Check every higher rating rule before using this level.0%Compare the whole description with your medical records. Choosing it here does not decide your VA rating.
Areas of affected skin on at least 5% but less than 20% of the entire body OR exposed areas; OR intermittent treatment given another way, such as pills or injections (systemic therapy) required for less than six weeks total in the past 12 months.10%Compare the whole description with your medical records. Choosing it here does not decide your VA rating.
Areas of affected skin on 20% to 40% of the entire body OR exposed areas; OR treatment given another way, such as pills or injections (systemic therapy) required for at least six weeks total, but not constantly, in the past 12 months.30%Compare the whole description with your medical records. Choosing it here does not decide your VA rating.
Areas of affected skin on more than 40% of the entire body OR exposed areas; OR constant or near-constant treatment given another way, such as pills or injections (systemic therapy) required in the past 12 months.60%Compare the whole description with your medical records. Choosing it here does not decide your VA rating.

What may happen in the exam room

Identification of the skin diagnosis and affected areas.
The examiner checks how you use each treatment, how long you needed it, and what happens when symptoms are worse.

What the measurements tell you

Percentage of the entire body and of exposed areas affected.
Which treatment you needed, how you used it, and for how long during the past 12 months.
Whether changes in appearance, scars, or another skin problem cause most of the difficulty and need a different rating rule.

Questions the examiner may cover

Where and how often does the condition appear?
What treatment was required and for how long?
Do dated photographs or records show flares not present today?

Questions to expect

Which areas are affected during an outbreak?

Explain: Identify locations, flare frequency and duration, and dated photographs. The examiner estimates total-body and exposed-area involvement.

Rating connection: The applicable skin rule depends on the diagnosis and affected area; scars or disfigurement may use different codes.

What treatment was used in the past year, by which route, and for how long?

Explain: List names, pills or injections versus skin-applied treatment, and dates or total weeks.

Rating connection: Treatment type and duration can establish a different pathway from body area. The route and actual regimen matter, not the medicine name alone.

Your answer outline

The condition appears on [actual areas]. Over [period], it has flared [frequency] for about [duration]. When symptoms are worse, [actual effect on activity]. I used [prescribed treatment and duration], with [result]. I have [dated photos or records, if available].

Mark approximate dates and counts as estimates.

My notes: ________________________

Service connection records

1. How is this connected to your service?

For a direct claim, identify your current disability, what happened in service, and evidence linking them. Being on active duty or orders alone does not prove that link.

Write the 5 Ws and how: who was there; what happened; when; where; why you were there; how the problem began. Add duty status, treatment, witnesses, and records. Mark uncertain dates as estimates.
Guard or Reserve: find your orders, dates, duty type, and any line-of-duty records. Active duty, training, and drills have different rules.
Secondary condition: it may start after service. Identify the service-connected condition and evidence that it caused or worsened this problem. A medical opinion may help explain the link.
Started before service? Record what changed during service. Presumptive condition? Check the required diagnosis and service history; qualifying claims do not require separate proof of a link.
Already service connected and seeking an increase? Focus on what has worsened and the records showing it.

If you do not know the cause, say so. Do not guess a medical connection.

Explain what changes in daily life

Describe both what you can do and what becomes difficult. Include how often it happens and how long it lasts.

Describe recorded flares, treatment, and practical impact.
Do not estimate a percentage from redness alone or alter treatment to provoke a flare.

Common mistakes to avoid

Assuming every treated skin condition has a minimum 10%.
Using an invented 50% band for the general formula.
Assuming treatment put on the skin counts as treatment given by another route, or counting the same symptoms twice.

Records to get ready before the exam

Dermatology diagnosis and treatment records.
Records showing how you take each medicine and how long you have used it.
Dated photographs of relevant flares when available.

Preparation notes

Section 4.118 separates treatment put on the skin (topical therapy) from treatment given another way, such as pills or injections (systemic therapy).
Use the code appropriate to the recorded condition, not whichever description appears to give the highest number.

Official rating rule and code numbers

Use this source to check the full rule and its medical terms: 38 CFR 4.118, General Rating Formula for the Skin. Source review recorded 2026-09-04.

Could one health problem have caused another?

A condition VA has already linked to your service may cause another health problem or make it worse. VA calls this secondary service connection. Having both conditions does not prove the link. Your records need to show a current diagnosis and explain how the first condition or its treatment affected the second.

Start with your records. Find the current diagnosis, the condition VA already linked to service, and evidence from someone qualified to explain the connection.
Ask about cause and worsening. Did the first condition or its treatment cause the new disability, or make an existing disability worse? These are different questions. The rules call them causation under 38 CFR § 3.310(a) and aggravation under § 3.310(b). If both are raised by your records, the medical opinion should address both; answering only the cause question may not be enough (El-Amin).
If treatment may be involved, collect the dates. List the medicine or surgery prescribed for the condition VA linked to service, the side effect, and the new diagnosis. Bring pharmacy records and dates when treatment started or stopped. A provider must explain the connection in your case; taking a medicine alone does not prove it.
If weight gain may be involved, ask how it fits. Weight gain or obesity can be a step between the first condition and another diagnosed disability under VAOPGCPREC 1-2017. Obesity itself does not receive a VA disability rating.
You do not need absolute certainty. VA uses the “at least as likely as not” standard and the reasonable-doubt rule under 38 CFR § 3.102. Ask a VA-accredited representative how the evidence applies to your claim.
The same symptom cannot be counted twice. This is the rule against pyramiding in 38 CFR § 4.14. Mental-health diagnoses generally share one § 4.130 rating when they affect the same work and social abilities. Trouble sleeping may be a symptom rather than a separate disability.
Check whether VA already assumes a link to service. Some conditions qualify based on where or when you served. These are called presumptive conditions. Examples can include chronic rhinitis, chronic sinusitis, hypertension after qualifying herbicide exposure, and type 2 diabetes. Sleep apnea (OSA) is not a PACT Act presumptive. Check eligibility before seeking a medical opinion about the link.
An exam form and a medical opinion do different jobs. A Disability Benefits Questionnaire (DBQ) records the diagnosis and how severe it is. It may not explain why it is linked to service, often called a nexus. A VA-accredited veterans service organization (VSO) can help you file at no charge.

If another prescribed treatment may have caused a problem, ask your health care provider to record what happened and explain the connection in your case.

Sources: 38 CFR § 3.310 · 38 CFR § 4.14 · VA-accredited representatives

C&P exam for skin condition: what to expect and how VA rates it.