Eczema VA Rating

Across 6,245 decided Board rulings on eczema from 2021 to 2026, 21.0% were granted, 32.3% denied and 46.6% remanded. A ruling is one issue the Board decided in one decision; one decision often rules on several issues. Among the skin conditions with their own page, only scars draw more Board rulings. The grant rate is 3.7 points below the Board-wide grant rate of 24.7 percent, and remand is the most common outcome. The Board is not more generous with eczema than with the rest of its docket; it sends a lot of these appeals back for more work.

The diagnosis is usually obvious. The rating ladder under 38 CFR § 4.118 is mechanical: how much skin is affected, and how much treatment you need to keep it under control. But eczema flares and fades, so a single exam often misses it, which makes flare records and lay statements unusually important. This page covers the DC 7806 criteria for eczema and dermatitis, what they pay, the flare-up exam problem, the service connection routes, and why VA denies eczema claims.

TL;DR

• Eczema and dermatitis are rated under DC 7806 with the General Rating Formula for the Skin: 0, 10, 30 or 60 percent, set by the share of the body or of exposed areas affected, or by how long you needed systemic therapy in the past 12 months.
• Systemic therapy means treatment given by any route other than the skin. Oral steroids, injected biologics such as dupilumab, and phototherapy count; creams and ointments do not.
• Sixty percent is the schedular ceiling. TDIU, or in an exceptional case an extra-schedular rating, is the route past it.
• The exam sees one day. When a condition flares and fades, VA's duty to assist can require an exam during a flare, and flare photos, dermatologist notes and lay statements fill the gap.
• Eczema is not a PACT Act presumptive disease. A covered toxic exposure can support a direct claim and VA's duty to provide an exam and opinion.
• Remand is the most common Board outcome for eczema, and when the Board sent claims back it most often found the VA exam or opinion inadequate.

Eczema and dermatitis VA rating criteria (DC 7806)

DC 7806 is titled "Dermatitis or eczema," and it says to "Evaluate under the General Rating Formula for the Skin." That covers atopic dermatitis, contact dermatitis and other forms of eczema; seborrheic dermatitis is generally rated the same way. Here are the formula's four levels as they read in 38 CFR § 4.118.

60 percent: 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

30 percent: 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

10 percent: 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

0 percent: 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

Or rate as disfigurement of the head, face, or neck (DC 7800) or scars (DCs 7801, 7802, 7804, or 7805), depending upon the predominant disability.

Section 4.118(a) defines the key term: "systemic therapy is treatment that is administered through any route (orally, injection, suppository, intranasally) other than the skin, and topical therapy is treatment that is administered through the skin." This formula came from the skin rule that took effect August 13, 2018 (83 FR 32592). Appeals that reach back before that date can be weighed under both versions, as the Board did in Citation Nr. 25001078.

Reading the tiers: body area or treatment

Each compensable tier has independent paths, and you need only one. A veteran can meet a level by the share of skin affected or by the length of systemic treatment, whichever is higher. A veteran with 12 percent of the body affected who needed oral prednisone for a total of ten weeks in the past year meets 30 percent on the treatment path, even though the skin area alone fits 10 percent. Short prednisone tapers that add up to less than six weeks fit 10 percent. A biologic such as dupilumab or a drug such as methotrexate taken constantly or near-constantly over the past 12 months fits 60 percent on the treatment path alone. The 0 percent level is the only one that needs both conditions at once: under 5 percent affected and nothing more than topical therapy.

The schedule tops out at 60 percent. There is no 100 percent rating under DC 7806. If service-connected disabilities keep you from holding a substantially gainful job, TDIU under 38 CFR § 4.16 pays at the 100 percent rate, and a single disability rated 60 percent meets its threshold. In an exceptional case, an extra-schedular rating under 38 CFR § 3.321(b) is the other route.

Body surface area and why exam-day estimates fall short

Body surface area is where most rating disputes live. Clinicians estimate it with shortcuts such as the rule of nines, the rule of palms and the Lund-Browder chart, which assign set shares of the body to each region (PMID 33807630), and estimates of the same skin can differ widely between clinicians (PMID 23566430). Exposed areas are measured separately, so a flare limited to visible skin can reach a tier that the whole-body figure would not.

The C&P examiner measures body area at one moment. If the exam happens during a quiet period, the area on the day of the exam reads as a few percent and the rating lands at 0 or 10 percent, while the condition you live with, flaring across much more skin, never gets captured. That is the structural reason flare records matter so much for this condition.

How much VA pays for eczema

At the 2026 rates (effective December 1, 2025), a single veteran with no dependents receives $180.42 a month at 10 percent, $552.47 at 30 percent, and $1,435.02 at 60 percent. The step from 10 to 30 percent is worth $372.05 a month, and it can turn on whether your record shows six weeks of systemic treatment in a year. VA pays by your combined rating, so the eczema percentage adds money only when it changes the combined figure.

Pseudofolliculitis barbae and the skin-rating analogy

Pseudofolliculitis barbae, often called razor bumps, has no dedicated diagnostic code. DC 7806 can provide a skin-rating analogy when the affected functions, location, and symptoms fit. That does not make the diagnosis eczema. The analogy can vary; scars or disfigurement may be the relevant pathway when they are the predominant disability.

For your evidence, identify the diagnosis, affected skin areas, prescribed treatments, and any lasting scars. If shaving during service is the proposed link, include treatment records, shaving profiles if available, and a medical explanation connecting the current condition to that history. A shaving profile is useful evidence, not an automatic percentage. Do not count the same skin manifestations under multiple codes.

Sources: 38 CFR § 4.118, skin criteria (opens in a new tab) and § 4.20, analogous ratings (opens in a new tab).

The eczema C&P exam and flare-ups

When the Board sends an eczema claim back, the most common reason is an inadequate VA exam or opinion; the Board section below shows the breakdown. Once VA provides an exam, it must provide an adequate one (Barr v. Nicholson, 21 Vet. App. 303 (2007)). For a condition that flares and fades, the Board applies Ardison v. Brown, 6 Vet. App. 405 (1994): where there is a history of flare-ups, the duty to assist requires an evaluation during an active, rather than inactive, phase. In a January 2025 decision (Citation Nr. 25000699), the Board sent an eczema rating back again because VA had examined the veteran between flares without trying to schedule the exam during one, as the Board's earlier remand had asked.

The patterns repeat across the decisions I read. The examiner records the body area visible that day without engaging with the flare history, does not review the photographs you bring, or notes "topical steroids" without addressing the systemic medication history. A veteran on intermittent prednisone tapers or a biologic meets a treatment-path tier even with little skin involved on exam day, and an exam that skips that history leaves the rater without the evidence the criteria ask for.

The record can make up for a thin exam. In another January 2025 decision (Citation Nr. 25001078), five VA examiners over the years put the affected area at 5 to 20 percent, but treatment records and the veteran's own account showed flares covering 20 to 40 percent, and the Board raised the rating to 30 percent. These records build that kind of file.

• Timestamped flare photos showing the areas affected, taken at the worst of each flare.
• Dermatologist notes that record body area at peak severity, not only at quiet visits.
• A treatment history listing each systemic medication, its start and stop dates, and why it was prescribed, because the 10, 30 and 60 percent treatment paths are counted in weeks over the past 12 months.

Lay statements for eczema flares

The C&P examiner sees one snapshot and the treatment notes capture clinic visits. What is missing from the medical record is what the disease looks like during a flare: how long flares last, what triggers them, how much skin they cover, and how they affect work and sleep. A lay statement can document exactly that, from you, a spouse, or a fellow service member who saw the rash begin in service.

In the Board data, rulings where the Board found the veteran's lay statements credible were granted far more often than rulings where it did not. That is an association, and much of it reflects the decision itself, because a credibility finding is part of how the Board decides. The Board credits lay statements that are specific and consistent with the record. A detailed declaration about flare timing, the areas covered during flares (in plain words, "both forearms and elbows during the August flare"), treatments that failed, and the effect on work and sleep gives the Board something to credit. A generic statement gives it little to weigh.

Is eczema service connected? Direct, toxic exposure and secondary claims

Direct service connection

Direct service connection is the main route for eczema. When a rash began in service, the service treatment records may already document it, and that record is the foundation of the claim. The claim then needs a current diagnosis and a medical opinion that connects today's eczema to that onset, including its time course and chronicity. A private opinion from a treating dermatologist that walks through that history gives the Board something to weigh against a negative VA opinion. The Board section below shows how direct, secondary and presumptive claims compared.

Toxic exposure and Gulf War service

Eczema and atopic dermatitis are not listed diseases under 38 USC § 1120, 38 CFR § 3.320, § 3.320a, or § 3.320b. Section 1119 can establish covered toxic-exposure service, but it does not by itself create a disease presumption. A veteran with diagnosed eczema may still establish direct service connection, and when a claim shows a disability and participation in a toxic exposure risk activity that is not enough to establish service connection, 38 USC § 1168 requires VA to provide an exam and a medical opinion on the link, unless VA finds no indication of an association.

Presumptive theories do appear in Board decisions on eczema, but a presumptive theory alone rarely carries the claim, which fits the law. Under 38 USC § 1117 and 38 CFR § 3.317, signs or symptoms involving skin may be part of a qualifying Gulf War undiagnosed illness when they cannot be attributed to any known clinical diagnosis. Once the manifestations are attributed to diagnosed eczema, that undiagnosed-illness route does not apply, and a direct nexus or another exact service-connection path is still required. See the Gulf War illness page for that framework.

Eczema secondary to PTSD and other conditions

Secondary service connection under 38 CFR § 3.310 covers eczema caused by a service-connected condition, or aggravated by it, meaning it would be less severe but for that condition. The most common theory runs through stress: atopic dermatitis is often associated with psychological stress, which research ties to nerve and immune signaling in the skin, though the mechanisms are not fully understood (Suárez and colleagues, Acta Dermato-Venereologica, PMID 22101513). That supports an aggravation argument for eczema alongside service-connected PTSD or anxiety, but it is an association, so the opinion has to tie the flares in your records to the service-connected condition. Another theory is a skin reaction to a medication prescribed for a service-connected condition, which needs a clinician to tie the rash to the drug. Secondary claims are granted less often than direct ones, so a shared timeline is not enough without a medical explanation.

Why VA denies eczema claims

Remand is the most common outcome for eczema at the Board: 46.6% of decided rulings, close to the Board-wide remand share of 45.3 percent across 1,241,238 decided rulings. When the Board denied service connection, it most often found no link between the eczema and service; the Board section below shows how often each part of the claim failed and why claims were sent back. Rating appeals are a large share of the eczema docket, and the Board section below shows how they fared against service connection appeals; a rating appeal lives or dies on what the record shows about body area and treatment.

The gaps repeat across the claims I review.

No link to service. The rash is documented after separation, the service treatment records are silent, and no opinion explains the time course.

A quiet-day exam with nothing to counter it. The exam records a few percent of skin, and the file has no flare photos, peak-severity notes or lay statement to show the wider picture.

Systemic treatment not documented. Prednisone bursts, phototherapy or a biologic sit in pharmacy records the rater never sees, so the treatment path is never counted.

Topical therapy mistaken for systemic. Creams and ointments, however strong, are topical therapy under § 4.118(a) and do not count toward the treatment path.

Generic lay statements. A statement that says the rash "gets bad" gives the Board nothing specific to credit.

Relying on a presumption that does not exist. A claim argued only as a PACT Act presumption, with no direct nexus, fails because eczema is not on the list.

Questions veterans ask about eczema

What is the VA rating for eczema?

Eczema rates 0, 10, 30 or 60 percent under DC 7806. The level depends on the share of your body or exposed skin affected (under 5, 5 to under 20, 20 to 40, or over 40 percent) or on how long you needed systemic therapy in the past 12 months.

Does dupilumab or prednisone raise an eczema rating?

Yes, because both are systemic therapy. Systemic treatment for less than six weeks in the past year supports 10 percent, six weeks or more but not constantly supports 30 percent, and constant or near-constant treatment, such as a biologic taken all year, supports 60 percent.

Is eczema a presumptive condition for veterans?

No. Eczema is not on the PACT Act list or the fine particulate matter list, so you prove it on a direct or secondary theory. A covered toxic exposure can still require VA to get a medical opinion on the link.

How is dermatitis rated by the VA?

DC 7806 covers "dermatitis or eczema," so contact dermatitis, atopic dermatitis and other dermatitis are rated on the same General Rating Formula for the Skin. When scarring or disfigurement is the main problem, VA can rate under the scar or disfigurement codes instead.

Can eczema and psoriasis be rated separately?

Only if they affect separate areas of skin. Under 38 CFR § 4.118(b), two skin conditions on the same area get only the highest evaluation; see the psoriasis page for its rating.

What if my eczema is not flaring at the C&P exam?

Tell the examiner and bring flare photos, dermatologist notes and your treatment history. Where a condition flares and fades, VA's duty to assist can require an exam during an active phase, and the Board can rely on the treatment records when they show more than the exam did.

Bottom Line

Among the skin conditions with their own page, eczema draws more Board rulings than any but scars, at 6,245 decided rulings, and the grant rate is 21.0 percent, 3.7 points below the Board-wide grant rate of 24.7 percent, with remand the most common outcome. The rating ladder under 38 CFR § 4.118 DC 7806 has four tiers from 0 to 60 percent, with two independent paths to each compensable tier: body surface area or systemic treatment. A biologic or other systemic drug taken all year meets 60 percent on its own, and creams never count toward the treatment path. The schedular ceiling is 60 percent; TDIU, or in an exceptional case an extra-schedular rating under 38 CFR § 3.321(b), is the path to higher compensation on eczema alone. Because the exam sees one day, the record has to carry the flares: dated photos, peak-severity dermatologist notes, a systemic treatment history, and a specific lay statement. Eczema is not a disease presumption under 38 USC § 1120 or 38 CFR § 3.320; covered toxic exposure can instead support direct development under 38 USC § 1168.

Methodology and Limitations

• Data source: Rating criteria quoted from the eCFR text of 38 CFR § 4.118 (General Rating Formula for the Skin, DC 7806, and § 4.118(a) and (b)), current to October 2, 2026, with the 2018 skin rule (83 FR 32592, effective August 13, 2018). Service connection authority from 38 USC §§ 1117, 1119, 1120 and 1168 and 38 CFR §§ 3.310, 3.317, 3.320, 3.320a and 3.320b; none of those disease lists names eczema. TDIU and extra-schedular authority from 38 CFR §§ 4.16 and 3.321(b). Pay amounts are the 2026 VA rates (effective December 1, 2025) for a single veteran with no dependents. Board decisions cited by citation number come from the Board's 2025 decisions; case law is as the Board cites it.
• Sample size: Board figures come from Claim Raven's read of 511,036 Board decisions from 2021 to 2026, which contain 1,378,030 rulings, including 6,895 rulings on eczema (6,245 with decided outcomes). Across those 6,245 decided rulings, 21.0% were granted (1,314 rulings), 32.3% denied (2,020 rulings) and 46.6% remanded (2,911 rulings). Dismissed, withdrawn and moot rulings are excluded. The Board section on this page breaks these down by denial reason, remand reason, appeal type, claim theory, medical opinion and era; those figures are computed from the data, not typed here.
• Limitations:
• The decided rulings are appeals that reached the Board, not all eczema claims filed with VA. Claims granted at the regional office aren't in this data, and the overall VA grant rate for eczema is likely higher than the rate at the Board.
• Body surface area, treatment intensity and the rating tier a grant landed on are not coded in the data, so the rating discussion reflects the regulatory text, not data variables.
• Lay-statement credibility and medical opinion findings are the Board's own, so they partly restate the outcome. Evidence associations on this page are not causes, and the Board decisions cited are examples of reasoning, not measures of how often a result occurs.
• These observations describe BVA patterns and are not predictions of individual outcomes, and Claim Raven is data analysis, not legal, medical, or VA-accredited advice.