VA Diagnostic Code 7817Erythroderma:

VA Disability Ratings for Erythroderma (Diagnostic Code 7817)

Skin conditions rated under 38 CFR § 4.118

What Is Erythroderma?

Erythroderma is a skin condition that can involve the skin across the body. In its most severe form, it may be accompanied by systemic manifestations such as fever, weight loss, or hypoproteinemia (low protein levels in the blood).

The VA rates erythroderma under Diagnostic Code 7817 in the skin body system. Ratings are based largely on how extensive the skin involvement is, whether there are systemic manifestations, and the type and duration of treatment required over the past 12-month period.

Available Rating Levels

The VA assigns one of five rating levels for erythroderma:

100%

Generalized involvement of the skin with systemic manifestations (such as fever, weight loss, or hypoproteinemia) and one of the following:

• Constant or near-constant systemic therapy — such as therapeutic doses of corticosteroids, other immunosuppressive drugs, retinoids, PUVA (psoralen with long-wave ultraviolet-A light), UVB (ultraviolet-B light) treatments, biologics, or electron beam therapy — required over the past 12-month period; or
• No current treatment due to a documented history of treatment failure with 2 or more treatment regimens.

60%

Generalized involvement of the skin without systemic manifestations, and one of the following:

• Constant or near-constant systemic therapy (as listed above) required over the past 12-month period; or
• No current treatment due to a documented history of treatment failure with 1 treatment regimen.

30%

Any extent of skin involvement, and any of the systemic therapies listed above required for a total duration of 6 weeks or more, but not constantly, over the past 12-month period.

10%

Any extent of skin involvement, and any of the systemic therapies listed above required for a total duration of less than 6 weeks over the past 12-month period.

0%

Any extent of skin involvement, and no more than topical therapy required over the past 12-month period.

What the VA Looks For

When rating erythroderma, the VA considers:

• Extent of skin involvement — whether the condition is generalized or covers any extent of the skin.
• Systemic manifestations — such as fever, weight loss, or hypoproteinemia.
• Type of treatment — for example, systemic therapy (therapeutic doses of corticosteroids, other immunosuppressive drugs, retinoids, PUVA, UVB, biologics, or electron beam therapy) versus topical therapy only.
• Duration and frequency of treatment over the past 12-month period (constant/near-constant, 6 weeks or more, or less than 6 weeks).
• Documented treatment failure, where applicable.

Note on Treatment Failure

Treatment failure is defined as either disease progression, or less than a 25 percent reduction in the extent and severity of disease after four weeks of prescribed therapy, as documented by medical records.