Malignant skin neoplasms (DC 7818)

Rating levels

• 100% — A 100% rating applies during active treatment only when the treatment is comparable to what is used for systemic cancers, not when treatment is confined to the skin. Qualifying therapies: systemic chemotherapy (chemo drugs given by IV or pill that affect the whole body), X-ray (radiation) therapy that goes deeper than the skin, or surgery more extensive than wide local excision (a simple cut-out with a margin of normal skin). The 100% runs from the date the treatment starts. A VA exam is mandatory six months after treatment ends. If a reduction is then proposed, the protections of 38 CFR § 3.105(e) apply (advance notice, opportunity to respond, hearing on request). After 100% ends, the rating is based on residuals, scars, disfigurement, or functional loss, see the residuals tier below.
• -1% — For most basal cell and squamous cell skin cancers, where treatment is confined to the skin (Mohs surgery, wide local excision, topical 5-FU, superficial radiation, cryotherapy), there is no 100% rating during treatment. The rating is based on what is left behind once the cancer is removed: a visible scar or disfigurement on the head, face, or neck rated under DC 7800; scars elsewhere on the body rated under DCs 7801-7805 (by size, painful/unstable, deep, linear, etc.); or loss of function if the cancer or its removal affected an underlying structure (e.g., a muscle, nerve, or joint), rated under the appropriate body-system code. The same residuals-only approach applies after the 100% systemic-treatment period ends, if there is no local recurrence or metastasis.