Body system: Infectious Diseases, Immune Disorders, and Nutritional DeficienciesRegulation: 38 CFR § 4.88bDBQ: DBQ INFECT Infectious Disease (Other than HIV-related illness, Chronic Fatigue Syndrome, and Tuberculosis)
Leprosy (Hansen's disease) is a bacterial infection caused by Mycobacterium leprae that primarily affects the skin, peripheral nerves, and mucous membranes, often leading to lasting nerve damage and disfigurement if untreated. The VA rates this condition at 100% during active disease, and the 100% rating CONTINUES past the end of treatment. Six months after treatment ends, the VA conducts a MANDATORY examination to determine the new rating, any reduction is subject to the due-process rules of 38 CFR § 3.105(e). After that exam, any lasting damage (skin lesions, peripheral neuropathy, amputations, etc.) is rated separately under the appropriate body-system codes and combined under § 4.25.
Rating levels
- 100% — You qualify for 100% during active leprosy (Hansen's disease, a bacterial infection caused by Mycobacterium leprae that primarily affects the skin, peripheral nerves, and mucous membranes). The 100% rating continues beyond the cessation of treatment for active disease (see Note below). Active disease typically presents with skin lesions, sensory loss in affected skin patches, nerve thickening, or muscle weakness from peripheral nerve involvement.
- -1% — Two important timing rules apply after active treatment ends. RULE 1: the 100% rating CONTINUES past the cessation of treatment, even after the active phase is gone, the rating does NOT immediately drop. RULE 2: six months after treatment ends, the VA must perform a MANDATORY examination to determine the new rating going forward. Any rating reduction from that exam (or later exams) is subject to the due-process protections of 38 CFR § 3.105(e), the veteran gets advance notice and an opportunity to submit evidence before any reduction takes effect. After that point, any lasting damage (residuals) is rated SEPARATELY under whichever body-system code best captures the deficit, skin lesions under the skin codes, peripheral neuropathy under the peripheral nerve codes in 38 CFR § 4.124a, amputations under the musculoskeletal amputation codes, and so on, then combined under § 4.25.