38 CFR Ch. I (7–1–12 Edition) § 4.118

§ 4.118 38 CFR Ch. I (7–1–12 Edition)

Rating Rating

Requiring transfusion of platelets or red 7710 Adenitis, tuberculous, active or inactive. cells at least once every three months, Rate under §§ 4.88c or 4.89 of this part, or; infections recurring at least once whichever is appropriate. every three months ...... 60 7714 Sickle cell anemia: Requiring transfusion of platelets or red With repeated painful crises, occurring in cells at least once per year but less than skin, joints, bones or any major organs once every three months, or; infections caused by hemolysis and sickling of red recurring at least once per year but less blood cells, with anemia, thrombosis and than once every three months ...... 30 infarction, with symptoms precluding Requiring continuous medication for control 10 even light manual labor ...... 100 With painful crises several times a year or NOTE: The 100 percent rating for bone marrow transplant shall be assigned as of the date of hospital admission and with symptoms precluding other than shall continue with a mandatory VA examination six light manual labor ...... 60 months following hospital discharge. Any change in eval- Following repeated hemolytic sickling cri- uation based upon that or any subsequent examination ses with continuing impairment of health 30 shall be subject to the provisions of § 3.105(e) of this Asymptomatic, established case in remis- chapter. sion, but with identifiable organ impairment ...... 10 7703 Leukemia: With active disease or during a treatment NOTE: Sickle cell trait alone, without a history of directly at- phase ...... 100 tributable pathological findings, is not a ratable disability. Cases of symptomatic sickle cell trait will be forwarded to Otherwise rate as anemia (code 7700) or the Director, Compensation and Pension Service, for con- aplastic anemia (code 7716), whichever sideration under § 3.321(b)(1) of this chapter. would result in the greater benefit. 7715 Non-Hodgkin’s lymphoma: NOTE: The 100 percent rating shall continue beyond the ces- With active disease or during a treatment sation of any surgical, radiation, antineoplastic chemo- phase ...... 100 therapy or other therapeutic procedures. Six months after discontinuance of such treatment, the appropriate disability NOTE: The 100 percent rating shall continue beyond the ces- rating shall be determined by mandatory VA examination. sation of any surgical, radiation, antineoplastic chemo- Any change in evaluation based upon that or any subse- therapy or other therapeutic procedures. Six months after quent examination shall be subject to the provisions of discontinuance of such treatment, the appropriate disability § 3.105(e) of this chapter. If there has been no recurrence, rating shall be dtermined by mandatory VA examination. rate on residuals. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of 7704 Polycythemia vera: § 3.105(e) of this chapter. If there has been no local recur- During periods of treatment with rence or metastasis, rate on residuals. myelosuppressants and for three months following cessation of myelosuppressant 7716 Aplastic anemia: therapy ...... 100 Requiring bone marrow transplant, or; re- Requiring phlebotomy ...... 40 quiring transfusion of platelets or red Stable, with or without continuous medica- cells at least once every six weeks, or; tion ...... 10 infections recurring at least once every six weeks ...... 100 NOTE: Rate complications such as hypertension, gout, stroke Requiring transfusion of platelets or red or thrombotic disease separately. cells at least once every three months, 7705 Thrombocytopenia, primary, idiopathic or im- or; infections recurring at least once mune: every three months ...... 60 Platelet count of less than 20,000, with ac- Requiring transfusion of platelets or red tive bleeding, requiring treatment with cells at least once per year but less than medication and transfusions ...... 100 once every three months, or; infections Platelet count between 20,000 and 70,000, recurring at least once per year but less not requiring treatment, without bleeding 70 than once every three months ...... 30 Stable platelet count between 70,000 and Requiring continuous medication for control 10 100,000, without bleeding ...... 30 NOTE: The 100 percent rating for bone marrow transplant Stable platelet count of 100,000 or more, shall be assigned as of the date of hospital admission and without bleeding ...... 0 shall continue with a mandatory VA examination six 7706 Splenectomy ...... 20 months following hospital discharge. Any change in eval- NOTE: Rate complications such as systemic infections with uation based upon that or any subsequent examination encapsulated bacteria separately. shall be subject to the provisions of § 3.105(e) of this chapter. 7707 Spleen, injury of, healed. 7717 AL amyloidosis (primary amyloidosis) 100 Rate for any residuals. 7709 Hodgkin’s disease: With active disease or during a treatment [60 FR 49227, Sept. 22, 1995, as amended at 77 phase ...... 100 FR 6467, Feb. 8, 2012] NOTE: The 100 percent rating shall continue beyond the cessation of any surgical, radiation, antineoplastic chemo- THE SKIN therapy or other therapeutic procedures. Six months after discontinuance of such treatment, the appropriate disability rating shall be determined by mandatory VA examination. § 4.118 Schedule of ratings—skin. Any change in evaluation based upon that or any subse- A veteran whose scars were rated by quent examination shall be subject to the provisions of § 3.105(e) of this chapter. If there has been no local recur- VA under a prior version of diagnostic rence or metastasis, rate on residuals. codes 7800, 7801, 7802, 7803, 7804, or 7805,

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as in effect before October 23, 2008, may Rat- request review under diagnostic codes ing 7800, 7801, 7802, 7804, and 7805, irrespec- Note (2): Rate tissue loss of the auricle tive of whether his or her disability has under DC 6207 (loss of auricle) and anatomical loss of the eye under DC 6061 worsened since the last review.VA will (anatomical loss of both eyes) or DC review that veteran’s disability rating 6063 (anatomical loss of one eye), as ap- to determine whether the veteran may propriate. be entitled to a higher disability rating Note (3): Take into consideration unretouched color photographs when under diagnostic codes 7800, 7801, 7802, evaluating under these criteria. 7804, and 7805. A request for review pur- Note (4): Separately evaluate disabling ef- suant to this rulemaking will be treat- fects other than disfigurement that are associated with individual scar(s) of the ed as a claim for an increased rating head, face, or neck, such as pain, insta- for purposes of determining the effec- bility, and residuals of associated muscle tive date of an increased rating award- or nerve injury, under the appropriate diagnostic code(s) and apply § 4.25 to com- ed as a result of such review; however, bine the evaluation(s) with the evaluation in no case will the award be effective assigned under this diagnostic code. before October 23, 2008. Note (5): The characteristic(s) of disfigurement may be caused by one scar or by multiple scars; the characteristic(s) re- Rat- ing quired to assign a particular evaluation need not be caused by a single scar in 7800 Burn scar(s) of the head, face, or neck; order to assign that evaluation. scar(s) of the head, face, or neck due to other 7801 Burn scar(s) or scar(s) due to other causes, causes; or other disfigurement of the head, face, not of the head, face, or neck, that are deep and or neck: nonlinear: With visible or palpable tissue loss and ei- Area or areas of 144 square inches (929 sq. ther gross distortion or asymmetry of cm.) or greater ...... 40 three or more features or paired sets of Area or areas of at least 72 square inches features (nose, chin, forehead, eyes (in- (465 sq. cm.) but less than 144 square cluding eyelids), ears (auricles), cheeks, inches (929 sq. cm.) ...... 30 lips), or; with six or more characteristics of Area or areas of at least 12 square inches disfigurement ...... 80 (77 sq. cm.) but less than 72 square With visible or palpable tissue loss and ei- inches (465 sq. cm.) ...... 20 ther gross distortion or asymmetry of two Area or areas of at least 6 square inches features or paired sets of features (nose, (39 sq. cm.) but less than 12 square chin, forehead, eyes (including eyelids), inches (77 sq. cm.) ...... 10 ears (auricles), cheeks, lips), or; with four Note (1): A deep scar is one associated or five characteristics of disfigurement ...... 50 with underlying soft tissue damage. With visible or palpable tissue loss and ei- Note (2): If multiple qualifying scars are ther gross distortion or asymmetry of one present, or if a single qualifying scar af- feature or paired set of features (nose, fects more than one extremity, or a single chin, forehead, eyes (including eyelids), qualifying scar affects one or more ex- ears (auricles), cheeks, lips), or; with two tremities and either the anterior portion or or three characteristics of disfigurement ... 30 posterior portion of the trunk, or both, or a With one characteristic of disfigurement ...... 10 single qualifying scar affects both the an- Note (1):The 8 characteristics of disfigure- terior portion and the posterior portion of ment, for purposes of evaluation under the trunk, assign a separate evaluation for § 4.118, are: each affected extremity based on the total Scar 5 or more inches (13 or more cm.) in area of the qualifying scars that affect that length. extremity, assign a separate evaluation Scar at least one-quarter inch (0.6 cm.) based on the total area of the qualifying wide at widest part. scars that affect the anterior portion of the trunk, and assign a separate evaluation Surface contour of scar elevated or de- based on the total area of the qualifying pressed on palpation. scars that affect the posterior portion of Scar adherent to underlying tissue. the trunk. The midaxillary line on each Skin hypo-or hyper-pigmented in an area side separates the anterior and posterior exceeding six square inches (39 sq. cm.). portions of the trunk. Combine the sepa- Skin texture abnormal (irregular, atrophic, rate evaluations under § 4.25. Qualifying shiny, scaly, etc.) in an area exceeding scars are scars that are nonlinear, deep, six square inches (39 sq. cm.). and are not located on the head, face, or Underlying soft tissue missing in an area ex- neck. ceeding six square inches (39 sq. cm.). 7802 Burn scar(s) or scar(s) due to other causes, Skin indurated and inflexible in an area ex- not of the head, face, or neck, that are superficial ceeding six square inches (39 sq. cm.). and nonlinear: Area or areas of 144 square inches (929 sq. cm.) or greater ...... 10

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Note (1): A superficial scar is one not asso- Less than 5 percent of the entire body or ciated with underlying soft tissue damage less than 5 percent of exposed areas af- Note (2): If multiple qualifying scars are fected, and; no more than topical therapy present, or if a single qualifying scar af- required during the past 12-month period 0 fects more than one extremity, or a single Or rate as disfigurement of the head, face, qualifying scar affects one or more ex- or neck (DC 7800) or scars (DC’s 7801, tremities and either the anterior portion or 7802, 7803, 7804, or 7805), depending posterior portion of the trunk, or both, or a upon the predominant disability. single qualifying scar affects both the an- 7807 American (New World) leishmaniasis terior portion and the posterior portion of (mucocutaneous, espundia): the trunk, assign a separate evaluation for Rate as disfigurement of the head, face, or each affected extremity based on the total neck (DC 7800), scars (DC’s 7801, 7802, area of the qualifying scars that affect that 7803, 7804, or 7805), or dermatitis (DC extremity, assign a separate evaluation 7806), depending upon the predominant based on the total area of the qualifying disability. scars that affect the anterior portion of the Note: Evaluate non-cutaneous (visceral) trunk, and assign a separate evaluation leishmaniasis under DC 6301 (visceral based on the total area of the qualifying leishmaniasis). scars that affect the posterior portion of the trunk. The midaxillary line on each 7808 Old World leishmaniasis (cutaneous, Oriental side separates the anterior and posterior sore): portions of the trunk. Combine the sepa- Rate as disfigurement of the head, face, or rate evaluations under § 4.25. Qualifying neck (DC 7800), scars (DC’s, 7801, 7802, scars are scars that are nonlinear, super- 7803, 7804, or 7805), or dermatitis (DC ficial, and are not located on the head, 7806), depending upon the predominant face, or neck. disabililty. 7804 Scar(s), unstable or painful:. Note: Evaluate non-cutaneous (visceral) Five or more scars that are unstable or leishmaniasis under DC 6301 (visceral painful ...... 30 leishmaniasis). Three or four scars that are unstable or 7809 Discoid lupus erythematosus or subacute cu- painful ...... 20 taneous lupus erythematosus: One or two scars that are unstable or pain- Rate as disfigurement of the head, face, or ful ...... 10 neck (DC 7800), scars (DC’s 7801, 7802, Note (1): An unstable scar is one where, for 7803, 7804, or 7805), or dermatitis (DC any reason, there is frequent loss of cov- 7806), depending upon the predominant ering of skin over the scar. disability. Do not combine with ratings Note (2): If one or more scars are both un- under DC 6350. stable and painful, add 10 percent to the 7811 Tuberculosis luposa (lupus vulgaris), active or evaluation that is based on the total num- inactive: ber of unstable or painful scars Rate under §§ 4.88c or 4.89, whichever is Note (3): Scars evaluated under diagnostic appropriate. codes 7800, 7801, 7802, or 7805 may 7813 Dermatophytosis (ringworm: of body, tinea also receive an evaluation under this di- corporis; of head, tinea capitis; of feet, tinea pedis; agnostic code, when applicable of beard area, tinea barbae; of nails, tinea 7805 Scars, other (including linear scars) and other unguium; of inguinal area (jock itch), tinea cruris): effects of scars evaluated under diagnostic codes 7800, 7801, 7802, and 7804: Rate as disfigurement of the head, face, or Evaluate any disabling effect(s) not consid- neck (DC 7800), scars (DC’s 7801, 7802, ered in a rating provided under diagnostic 7803, 7804, or 7805), or dermatitis (DC codes 7800–04 under an appropriate di- 7806), depending upon the predominant agnostic code.. disability. 7806 Dermatitis or eczema. 7815 Bullous disorders (including pemphigus More than 40 percent of the entire body or vulgaris, pemphigus foliaceous, bullous more than 40 percent of exposed areas pemphigoid, dermatitis herpetiformis, epidermolysis affected, or; constant or near-constant bullosa acquisita, benign chronic familial systemic therapy such as corticosteroids pemphigus (Hailey-Hailey), and porphyria cutanea or other immunosuppressive drugs re- tarda): quired during the past 12-month period .... 60 More than 40 percent of the entire body or 20 to 40 percent of the entire body or 20 to more than 40 percent of exposed areas 40 percent of exposed areas affected, or; affected, or; constant or near-constant systemic therapy such as corticosteroids systemic therapy such as corticosteroids or other immunosuppressive drugs re- or other immunosuppressive drugs required for a total duration of six weeks or quired during the past 12-month period .... 60 more, but not constantly, during the past 20 to 40 percent of the entire body or 20 to 12-month period ...... 30 40 percent of exposed areas affected, or; At least 5 percent, but less than 20 percent, systemic therapy such as corticosteroids of the entire body, or at least 5 percent, or other immunosuppressive drugs re- but less than 20 percent, of exposed quired for a total duration of six weeks or areas affected, or; intermittent systemic more, but not constantly, during the past therapy such as corticosteroids or other 12-month period ...... 30 immunosuppressive drugs required for a total duration of less than six weeks during the past 12-month period ...... 10

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At least 5 percent, but less than 20 percent, Any extent of involvement of the skin, and; of the entire body, or at least 5 percent, systemic therapy such as therapeutic but less than 20 percent, of exposed doses of corticosteroids, immuno- areas affected, or; intermittent systemic suppressive retinoids, PUVA (psoralen therapy such as corticosteroids or other with long-wave ultraviolet-A light) or UVB immunosuppressive drugs required for a (ultraviolet-B light) treatments, or electron total duration of less than six weeks dur- beam therapy required for a total duration ing the past 12-month period ...... 10 of six weeks or more, but not constantly, Less than 5 percent of the entire body or during the past 12-month period ...... 30 exposed areas affected, and; no more Any extent of involvement of the skin, and; than topical therapy required during the systemic therapy such as therapeutic past 12-month period ...... 0 doses of corticosteroids, immuno- Or rate as disfigurement of the head, face, suppressive retinoids, PUVA (psoralen or neck (DC 7800) or scars (DC’s 7801, with long-wave ultraviolet-A light) or UVB 7802, 7803, 7804, or 7805), depending (ultraviolet-B light) treatments, or electron upon the predominant disability. beam therapy required for a total duration 7816 Psoriasis: of less than six weeks during the past 12- More than 40 percent of the entire body or month period ...... 10 more than 40 percent of exposed areas Any extent of involvement of the skin, and; affected, or; constant or near-constant no more than topical therapy required dur- systemic therapy such as corticosteroids ing the past 12-month period ...... 0 or other immunosuppressive drugs re- 7818 Malignant skin neoplasms (other than malig- quired during the past 12-month period .... 60 nant melanoma): 20 to 40 percent of the entire body or 20 to Rate as disfigurement of the head, face, or 40 percent of exposed areas affected, or; neck (DC 7800), scars (DC’s 7801, 7802, systemic therapy such as corticosteroids 7803, 7804, or 7805), or impairment of or other immunosuppressive drugs re- function. quired for a total duration of six weeks or Note: If a skin malignancy requires therapy more, but not constantly, during the past that is comparable to that used for sys- 12-month period ...... 30 temic malignancies, i.e., systemic chemo- At least 5 percent, but less than 20 percent, therapy, X-ray therapy more extensive of the entire body, or at least 5 percent, than to the skin, or surgery more exten- but less than 20 percent, of exposed sive than wide local excision, a 100-per- areas affected, or; intermittent systemic cent evaluation will be assigned from the therapy such as corticosteroids or other date of onset of treatment, and will con- immunosuppressive drugs required for a tinue, with a mandatory VA examination total duration of less than six weeks dur- six months following the completion of ing the past 12-month period ...... 10 such antineoplastic treatment, and any Less than 5 percent of the entire body or change in evaluation based upon that or exposed areas affected, and; no more any subsequent examination will be sub- than topical therapy required during the ject to the provisions of § 3.105(e) of this past 12-month period ...... 0 chapter. If there has been no local recur- Or rate as disfigurement of the head, face, rence or metastasis, evaluation will then or neck (DC 7800) or scars (DC’s 7801, be made on residuals. If treatment is con- 7802, 7803, 7804, or 7805), depending fined to the skin, the provisions for a 100- upon the predominant disability. percent evaluation do not apply. 7817 Exfoliative dermatitis (erythroderma): 7819 Benign skin neoplasms: Generalized involvement of the skin, plus Rate as disfigurement of the head, face, or systemic manifestations (such as fever, neck (DC 7800), scars (DC’s 7801, 7802, weight loss, and hypoproteinemia), and; 7803, 7804, or 7805), or impairment of constant or near-constant systemic ther- function. apy such as therapeutic doses of 7820 Infections of the skin not listed elsewhere (in- corticosteroids, immunosuppressive cluding bacterial, fungal, viral, treponemal and retinoids, PUVA (psoralen with long-wave parasitic diseases): ultraviolet-A light) or UVB (ultraviolet-B Rate as disfigurement of the head, face, or light) treatments, or electron beam ther- neck (DC 7800), scars (DC’s 7801, 7802, apy required during the past 12-month pe- 7803, 7804, or 7805), or dermatitis (DC riod ...... 100 7806), depending upon the predominant Generalized involvement of the skin without disability. systemic manifestations, and; constant or 7821 Cutaneous manifestations of collagen-vas- near-constant systemic therapy such as cular diseases not listed elsewhere (including therapeutic doses of corticosteroids, im- scleroderma, calcinosis cutis, and dermato- munosuppressive retinoids, PUVA myositis): (psoralen with long-wave ultraviolet-A More than 40 percent of the entire body or light) or UVB (ultraviolet-B light) treat- more than 40 percent of exposed areas ments, or electron beam therapy required affected, or; constant or near-constant during the past 12-month period ...... 60 systemic therapy such as corticosteroids or other immunosuppressive drugs required during the past 12-month period .... 60

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20 to 40 percent of the entire body or 20 to With localized or episodic cutaneous in- 40 percent of exposed areas affected, or; volvement and intermittent systemic medi- systemic therapy such as corticosteroids cation, such as immunosuppressive or other immunosuppressive drugs re- retinoids, required for a total duration of quired for a total duration of six weeks or less than six weeks during the past 12- more, but not constantly, during the past month period ...... 10 12-month period ...... 30 No more than topical therapy required dur- At least 5 percent, but less than 20 percent, ing the past 12-month period ...... 0 of the entire body, or at least 5 percent, 7825 Urticaria: but less than 20 percent, of exposed Recurrent debilitating episodes occurring at areas affected, or; intermittent systemic least four times during the past 12-month therapy such as corticosteroids or other period despite continuous immuno- immunosuppressive drugs required for a suppressive therapy ...... 60 total duration of less than six weeks dur- Recurrent debilitating episodes occurring at ing the past 12-month period ...... 10 least four times during the past 12-month Less than 5 percent of the entire body or period, and; requiring intermittent sys- exposed areas affected, and; no more temic immunosuppressive therapy for than topical therapy required during the control ...... 30 past 12-month period ...... 0 Or rate as disfigurement of the head, face, Recurrent episodes occurring at least four or neck (DC 7800) or scars (DC’s 7801, times during the past 12-month period, 7802, 7803, 7804, or 7805), depending and; responding to treatment with antihis- upon the predominant disability. tamines or sympathomimetics ...... 10 7822 Papulosquamous disorders not listed else- 7826 Vasculitis, primary cutaneous: where (including lichen planus, large or small Recurrent debilitating episodes occurring at plaque parapsoriasis, pityriasis lichenoides et least four times during the past 12-month varioliformis acuta (PLEVA), lymphomatoid period despite continuous immuno- papulosus, and pityriasis rubra pilaris (PRP)): suppressive therapy ...... 60 More than 40 percent of the entire body or Recurrent debilitating episodes occurring at more than 40 percent of exposed areas least four times during the past 12-month affected, and; constant or near-constant period, and; requiring intermittent sys- systemic medications or intensive light temic immunosuppressive therapy for therapy required during the past 12-month control ...... 30 period ...... 60 Recurrent episodes occurring one to three 20 to 40 percent of the entire body or 20 to times during the past 12-month period, 40 percent of exposed areas affected, or; and; requiring intermittent systemic im- systemic therapy or intensive light therapy munosuppressive therapy for control ...... 10 required for a total duration of six weeks Or rate as disfigurement of the head, face, or more, but not constantly, during the or neck (DC 7800) or scars (DC’s 7801, past 12-month period ...... 30 7802, 7803, 7804, or 7805), depending At least 5 percent, but less than 20 percent, upon the predominant disability. of the entire body, or at least 5 percent, 7827 Erythema multiforme; Toxic epidermal but less than 20 percent, of exposed necrolysis: areas affected, or; systemic therapy or in- Recurrent debilitating episodes occurring at tensive light therapy required for a total least four times during the past 12-month duration of less than six weeks during the period despite ongoing immuno- past 12-month period ...... 10 suppressive therapy ...... 60 Less than 5 percent of the entire body or Recurrent episodes occurring at least four exposed areas affected, and; no more times during the past 12-month period, than topical therapy required during the and; requiring intermittent systemic im- past 12-month period ...... 0 munosuppressive therapy ...... 30 Or rate as disfigurement of the head, face, Recurrent episodes occurring during the or neck (DC 7800) or scars (DC’s 7801, past 12-month period that respond to 7802, 7803, 7804, or 7805), depending treatment with antihistamines or upon the predominant disability. sympathomimetics, or; one to three epi- 7823 Vitiligo: sodes occurring during the past 12-month With exposed areas affected ...... 10 period requiring intermittent systemic im- With no exposed areas affected ...... 0 munosuppressive therapy ...... 10 7824 Diseases of keratinization (including icthyoses, Darier’s disease, and palmoplantar keratoderma): Or rate as disfigurement of the head, face, With either generalized cutaneous involve- or neck (DC 7800) or scars (DC’s 7801, ment or systemic manifestations, and; 7802, 7803, 7804, or 7805), depending constant or near-constant systemic medi- upon the predominant disability. cation, such as immunosuppressive 7828 Acne: retinoids, required during the past 12- Deep acne (deep inflamed nodules and pus- month period ...... 60 filled cysts) affecting 40 percent or more With either generalized cutaneous involve- of the face and neck ...... 30 ment or systemic manifestations, and; Deep acne (deep inflamed nodules and pus- intermittent systemic medication, such as filled cysts) affecting less than 40 percent immunosuppressive retinoids, required for of the face and neck, or; deep acne other a total duration of six weeks or more, but than on the face and neck ...... 10 not constantly, during the past 12-month Superficial acne (comedones, papules, period ...... 30 pustules, superficial cysts) of any extent .. 0

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Or rate as disfigurement of the head, face, Thyroid enlargement, tachycardia (more than 100 or neck (DC 7800) or scars (DC’s 7801, beats per minute), eye involvement, muscular 7802, 7803, 7804, or 7805), depending weakness, loss of weight, and sympathetic upon the predominant disability. nervous system, cardiovascular, or 7829 Chloracne: astrointestinal symptoms ...... 100 Deep acne (deep inflamed nodules and pus- Emotional instability, tachycardia, fatigability, and filled cysts) affecting 40 percent or more increased pulse pressure or blood pressure ...... 60 of the face and neck ...... 30 Tachycardia, tremor, and increased pulse pres- Deep acne (deep inflamed nodules and pus- sure or blood pressure ...... 30 filled cysts) affecting less than 40 percent Tachycardia, which may be intermittent, and trem- of the face and neck, or; deep acne other or, or; continuous medication required for con- than on the face and neck ...... 10 trol ...... 10 Superficial acne (comedones, papules, NOTE (1): If disease of the heart is the predomi- pustules, superficial cysts) of any extent .. 0 nant finding, evaluate as hyperthyroid heart dis- Or rate as disfigurement of the head, face, ease (DC 7008) if doing so would result in a or neck (DC 7800) or scars (DC’s 7801, higher evaluation than using the criteria above. 7802, 7803, 7804, or 7805), depending NOTE (2): If ophthalmopathy is the sole finding, upon the predominant disability. evaluate as field vision, impairment of (DC 7830 Scarring alopecia: 6080); diplopia (DC 6090); or impairment of Affecting more than 40 percent of the scalp 20 central visual acuity (DC 6061–6079). Affecting 20 to 40 percent of the scalp ...... 10 7901 Thyroid gland, toxic adenoma of Affecting less than 20 percent of the scalp .. 0 Thyroid enlargement, tachycardia (more than 100 7831 Alopecia areata: beats per minute), eye involvement, muscular With loss of all body hair ...... 10 weakness, loss of weight, and sympathetic nervous system, cardiovascular, or gastro- With loss of hair limited to scalp and face .... 0 intestinal symptoms ...... 100 7832 Hyperhidrosis: Emotional instability, tachycardia, fatigability, and Unable to handle paper or tools because of increased pulse pressure or blood pressure ...... 60 moisture, and unresponsive to therapy ..... 30 Tachycardia, tremor, and increased pulse pres- Able to handle paper or tools after therapy .. 0 sure or blood pressure ...... 30 7833 Malignant melanoma: Tachycardia, which may be intermittent, and trem- Rate as scars (DC’s 7801, 7802, 7803, or, or; continuous medication required for con- 7804, or 7805), disfigurement of the head, trol ...... 10 face, or neck (DC 7800), or impairment of NOTE (1): If disease of the heart is the predomi- function (under the appropriate body sys- nant finding, evaluate as hyperthyroid heart dis- tem). ease (DC 7008) if doing so would result in a Note: If a skin malignancy requires therapy higher evaluation than using the criteria above. that is comparable to that used for sys- NOTE (2): If ophthalmopathy is the sole finding, temic malignancies, i.e., systemic chemo- evaluate as field vision, impairment of (DC therapy, X-ray therapy more extensive 6080); diplopia (DC 6090); or impairment of than to the skin, or surgery more exten- central visual acuity (DC 6061–6079). sive than wide local excision, a 100-per- 7902 Thyroid gland, nontoxic adenoma of cent evaluation will be assigned from the With disfigurement of the head or neck ...... 20 date of onset of treatment, and will con- Without disfigurement of the head or neck ...... 0 tinue, with a mandatory VA examination NOTE: If there are symptoms due to pressure on six months following the completion of adjacent organs such as the trachea, larynx, or such antineoplastic treatment, and any esophagus, evaluate under the diagnostic code change in evaluation based upon that or for disability of that organ, if doing so would re- any subsequent examination will be sub- sult in a higher evaluation than using this diag- ject to the provisions of § 3.105(e). If there nostic code. has been no local recurrence or metas- 7903 Hypothyroidism tasis, evaluation will then be made on re- Cold intolerance, muscular weakness, cardio- siduals. If treatment is confined to the vascular involvement, mental disturbance (de- skin, the provisions for a 100-percent mentia, slowing of thought, depression), evaluation do not apply. bradycardia (less than 60 beats per minute), and sleepiness ...... 100 (Authority: 38 U.S.C. 1155) Muscular weakness, mental disturbance, and weight gain ...... 60 [67 FR 49596, July 31, 2002; 67 FR 58448, 58449, Fatigability, constipation, and mental sluggishness 30 Sept. 16, 2002; 73 FR 54710, Oct. 23, 2008; 77 FR Fatigability, or; continuous medication required for 2910, Jan. 20, 2012] control ...... 10 7904 Hyperparathyroidism Generalized decalcification of bones, kidney THE ENDOCRINE SYSTEM stones, gastrointestinal symptoms (nausea, vomiting, anorexia, constipation, weight loss, or § 4.119 Schedule of ratings—endocrine peptic ulcer), and weakness ...... 100 system. Gastrointestinal symptoms and weakness ...... 60 Continuous medication required for control ...... 10 Rat- NOTE: Following surgery or treatment, evaluate as ing digestive, skeletal, renal, or cardiovascular residuals or as endocrine dysfunction. 7900 Hyperthyroidism 7905 Hypoparathyroidism

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