Skin§ 4.118Updated
Rating criteria

VA Diagnostic Code 7827Erythema multiforme; Toxic epidermal necrolysis:

Rated from 10% to 60% under § 4.118. Here is what the VA requires at each level.

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Not the right code?

In short

Summary

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

The ladder

What each rating requires

The VA assigns the highest level your evidence actually supports. Read up the stack until your records stop matching.

  1. 60%

    Recurrent mucosal, palmar, or plantar involvement impairing mastication, use of hands, or ambulation occurring four or more times over the past 12-month period despite ongoing immunosuppressive therapy

  2. 30%

    All of the following

  3. 30%

    Recurrent mucosal, palmar, or plantar involvement not impairing mastication, use of hands, or ambulation, occurring four or more times over the past 12-month period; and requiring intermittent systemic therapy

  4. 10%

    At least one of the following

  5. 10%

    One to three episodes of mucosal, palmar, or plantar involvement not impairing mastication, use of hands, or ambulation, occurring over the past 12-month period AND requiring intermittent systemic therapy; or

  6. 10%

    Without recurrent episodes, but requiring continuous systemic medication for control

From the schedule

Notes on this code

These notes are part of the regulation. They change how the levels above are applied.

  • Note: For the purposes of this DC only, systemic therapy may consist of one or more of the following treatment agents: immunosuppressives, antihistamines, or sympathomimetics

Erythema Multiforme & Toxic Epidermal Necrolysis (VA Diagnostic Code 7827)

Skin conditions rated under 38 CFR § 4.118

Understanding the Condition

Erythema multiforme and toxic epidermal necrolysis are skin conditions that the VA evaluates under Diagnostic Code 7827. These conditions can involve the mucosal areas (such as the mouth), the palms of the hands, or the soles of the feet. Depending on how the condition presents, the VA may evaluate it based on the frequency of episodes, the type of treatment required, and whether it interferes with everyday functions like chewing (mastication), using your hands, or walking (ambulation).

A note on treatment: For the purposes of this diagnostic code only, "systemic therapy" may consist of one or more of the following treatment agents: immunosuppressives, antihistamines, or sympathomimetics.

Rating Levels

The VA assigns a disability rating based on the criteria met. The available rating levels under DC 7827 are:

60%

Recurrent mucosal, palmar, or plantar involvement impairing mastication, use of hands, or ambulation, occurring four or more times over the past 12-month period despite ongoing immunosuppressive therapy.

30%

Recurrent mucosal, palmar, or plantar involvement not impairing mastication, use of hands, or ambulation, occurring four or more times over the past 12-month period; and requiring intermittent systemic therapy.

10%

At least one of the following:

  • One to three episodes of mucosal, palmar, or plantar involvement not impairing mastication, use of hands, or ambulation, occurring over the past 12-month period and requiring intermittent systemic therapy; or
  • Without recurrent episodes, but requiring continuous systemic medication for control.

What the VA Looks For

When evaluating a claim under DC 7827, the VA considers:

  • How often episodes occur over the past 12-month period (for example, one to three episodes versus four or more).
  • Whether the involvement impairs function such as mastication, use of the hands, or ambulation.
  • The type of treatment required, such as intermittent systemic therapy, ongoing immunosuppressive therapy, or continuous systemic medication for control.

Alternative Rating Approach

Depending on the predominant disability, these conditions may instead be rated as:

  • Disfigurement of the head, face, or neck (DC 7800), or
  • Scars (DCs 7801, 7802, 7804, or 7805).

The VA evaluates based on the predominant disability.

These criteria are a rendering of § 4.118, diagnostic code 7827. The official version is the one that governs your rating.

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What next

How to claim this

Knowing the criteria is the first half. Getting your file to show them is the second.

  1. Find your level in the stack

    Read each rung against what your medical records already say. The level your records document today is the one the VA can support today.

  2. Name the gap

    Look at the rung above yours and write down exactly what it asks for that your file does not show yet — a diagnosis, a measurement, a prescribed brace, a doctor’s opinion linking it to service.

  3. Claim it by code

    File under diagnostic code 7827 and attach the evidence for the level you are asking for. Other Skin codes may cover your secondary conditions.

Find out which rating your evidence supports.

Six reads your records against these exact criteria and tells you what the VA is still missing.

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