Scleroderma VA disability rating & claim guide

Yes. The VA rates Scleroderma under VASRD diagnostic code 7821 (Skin Conditions). The schedule has no diagnostic code of its own titled scleroderma. DC 7821 covers "cutaneous manifestations of collagen-vascular diseases not listed elsewhere," and names scleroderma, calcinosis cutis, subacute cutaneous lupus erythematosus, and dermatomyositis inside that title. What this code evaluates is the skin involvement, under the General Rating Formula for the Skin: how much of the body or of the exposed areas the characteristic lesions cover, and how much systemic therapy the condition has required over the past 12 months.

Possible VA ratings for Scleroderma are 60%, 30%, 10%, 0%. Examples: 60%: At least one of the following: characteristic lesions involving more than 40 percent of the entire body or more than 40 percent of exposed areas affected; or constant or near-constant systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, psoralen with long-wave ultraviolet-A light (PUVA), or other immunosuppressive drugs required over the past 12-month period; 30%: At least one of the following: characteristic lesions involving 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected; or systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required for a total duration of 6 weeks or more, but not constantly, over the past 12-month period; 10%: At least one of the following: characteristic lesions involving at least 5 percent, but less than 20 percent, of the entire body affected; or at least 5 percent, but less than 20 percent, of exposed areas affected; or intermittent systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required for a total duration of less than 6 weeks over the past 12-month period.

Strong evidence for a Scleroderma claim includes: Dermatology notes stating the percentage of the entire body and the percentage of exposed areas affected — the two measurements every tier of the formula uses; A 12-month medication history showing which systemic drugs were required and for how long, since duration over the past 12-month period is the formula's second route to each tier; Photographs of the lesions with the affected percentages recorded, from more than one visit rather than a single one, since the extent of the lesions is the formula's other route; Where disfigurement or scarring predominates, an exam addressing DC 7800's characteristics of disfigurement or the scar measurements DCs 7801, 7802, and 7804 use, since the formula allows rating under those codes instead.

VA's Skin Diseases Disability Benefits Questionnaire (DBQ) is on its public list of DBQs. VA's page says: "You can use these forms to submit medical evidence from your health care providers."

Common pitfalls when filing for Scleroderma: Building the claim on organ involvement under this code. DC 7821 rates the cutaneous manifestations, and its criteria measure skin area and systemic therapy — no tier here turns on lung, esophageal, or kidney findings. Organ involvement is evaluated under the codes that cover it: DC 7204's note reaches "impairment of the esophagus caused by systemic conditions such as. scleroderma," and DC 7539's note reaches renal involvement caused by systemic diseases including scleroderma; Submitting an autoimmune antibody panel as the core evidence. Serology may support the diagnosis, but no tier in the formula turns on a lab value; Leaving the treatment history out. Constant or near-constant systemic therapy over the past 12 months meets the 60 percent criterion on its own, independently of how much of the body is involved.

Conditions that can be service-connected as secondary to Scleroderma, when a medical opinion links them, include: GERD. A secondary condition gets its own rating, which VA combines with the veteran's other ratings under 38 CFR 4.25.