Skin cancer is rated by what it leaves behind, not by the diagnosis. The codes contain no percentage tables; every excision resolves into scars, disfigurement characteristics, or lost function, and a single painful scar is 10 percent no matter how small it is. Veterans with decades of removed lesions are often sitting on a stack of unclaimed ratings.
How VA rates skin cancer
Malignant skin neoplasms, including basal cell and squamous cell carcinoma, are rated under diagnostic code 7818, and malignant melanoma under DC 7833 (38 CFR 4.118). Both codes work the same unusual way: they contain no percentage table of their own. Instead, VA rates skin cancer by what it leaves behind: disfigurement of the head, face, or neck (DC 7800), scars (DC 7801 through 7805), or impairment of function of the affected body part, whichever applies.
When the 100 percent rating applies
A note to both codes reserves a temporary 100 percent rating for skin malignancies that require therapy comparable to that used for systemic cancers: systemic chemotherapy, X-ray therapy more extensive than to the skin, or surgery more extensive than wide local excision. The 100 percent runs from the date treatment begins, with a mandatory VA examination six months after treatment ends; any reduction after that exam must follow the procedural protections of 38 CFR 3.105(e). If treatment does not rise to the level of therapy comparable to that used for systemic cancers, the 100 percent provision does not apply and the rating rests on the residuals. That comparability standard is a fact-specific judgment; excision limited to the skin, Mohs surgery, cryotherapy, and topical agents are common examples that typically do not qualify, but what matters is the nature and scope of the treatment, not its name alone.
Every removal leaves something ratable
The practical center of a skin cancer claim is the scar rating. A scar that is painful or unstable rates at least 10 percent under DC 7804, and multiple painful scars rate higher. Scars on the head, face, or neck are rated on characteristics of disfigurement under DC 7800, where visible tissue loss, elevation or depression, and abnormal pigmentation each count. Deep scars elsewhere rate on the area they cover. Veterans who have had multiple lesions removed over the years should have every scar examined and measured, because each one contributes.
Service connection usually runs through sun exposure
Most skin cancer claims rest on cumulative sun exposure during service: years of duty in the field, at sea, or on flight lines, decades before diagnosis. Service connection does not require the disease to appear in service; 38 CFR 3.303(d) allows connection for a disease first diagnosed after separation when the evidence links it to service. Deployment locations, MOS, and photographs documenting outdoor duty, plus a dermatologist's opinion connecting the exposure pattern to the cancer type and site, do the work.
Melanoma and metastasis
Melanoma that spreads is no longer just a skin condition. Metastatic disease is rated under the body system it invades, and active metastatic malignancy carries a 100 percent rating under the malignancy provisions until treatment concludes. The six month exam and 3.105(e) protections apply the same way.
Common rating details veterans overlook
- A single painful scar is 10 percent. Say at the exam whether each scar is painful or breaks down; silence gets rated as painless.
- New primaries are new claims. Skin cancer recurs; each new lesion and removal can add to the picture.
- Facial lesions rate on disfigurement characteristics, which the examiner must document with measurements and photographs.
- The reduction after remission is not automatic. The mandatory exam plus 3.105(e) notice gives you a chance to show the residuals before the 100 percent drops.