Filing a VA Disability Claim for Skin Conditions

Veterans can file claims for a variety of skin conditions that may be service-connected. Common skin conditions recognized by the VA include dermatitis, eczema, psoriasis, acne, rosacea, skin cancer, urticaria (hives), seborrheic dermatitis, vitiligo, actinic keratosis, chronic skin ulcers, fungal infections, scars, and burns. To prepare for a successful claim, veterans should thoroughly document their condition with photographs and medical records, obtain a nexus letter from a healthcare provider linking the condition to their military service, and gather personal and buddy statements detailing the onset and impact of the condition. Proper documentation and detailed evidence can significantly improve the likelihood of a favorable VA decision..

Common Service-Connected Skin Conditions

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• Dermatitis (including atopic dermatitis and contact dermatitis):

  • Characterized by inflammation of the skin resulting in itchy, red, and swollen areas.

  • Can be caused by allergic reactions, irritants, or underlying health conditions.

  • Symptoms may include itching, redness, swelling, and blistering.

  • Requires continuous treatment to manage symptoms and prevent flare-ups.

• Eczema:

  • Causes patches of skin to become inflamed, itchy, cracked, and rough.

  • Commonly occurs on the face, hands, and feet.

  • Can be triggered by environmental factors, stress, and allergens.

  • Often requires topical treatments, lifestyle changes, and avoiding triggers.

• Psoriasis:

  • An autoimmune condition that results in red, itchy, scaly patches.

  • Most commonly affects the knees, elbows, trunk, and scalp.

  • Symptoms include thick, red patches of skin covered with silvery scales.

  • Management may include topical treatments, systemic medications, and light therapy.

• Acne (including chloracne):

  • Occurs when hair follicles become plugged with oil and dead skin cells.

  • Chloracne is specifically linked to exposure to certain chemicals, such as dioxins.

  • Symptoms include pimples, blackheads, cysts, and scarring.

  • Treatment options range from topical and oral medications to lifestyle modifications.

• Rosacea:

  • A chronic skin condition causing redness and visible blood vessels in the face.

  • May also produce small, red, pus-filled bumps.

  • Can be triggered by hot drinks, spicy foods, alcohol, and stress.

  • Treatments may include topical medications, antibiotics, and laser therapy.

• Skin Cancer (including basal cell carcinoma, squamous cell carcinoma, and melanoma):

  • Types of cancer that arise from the skin.

  • Basal cell carcinoma is the most common and arises from the basal cells.

  • Squamous cell carcinoma arises from squamous cells, and melanoma originates from melanocytes.

  • Symptoms vary by type but can include new growths, sores that don’t heal, and changes in existing moles.

  • Treatment may involve surgical removal, radiation therapy, or chemotherapy.

• Urticaria (Hives):

  • Causes itchy welts, which can vary in size and can occur anywhere on the body.

  • Often a result of an allergic reaction.

  • Symptoms include red, raised, and itchy welts.

  • Treatments can include antihistamines and avoiding known triggers.

• Seborrheic Dermatitis:

  • Mainly affects the scalp, causing scaly patches, red skin, and stubborn dandruff.

  • Can also affect oily areas of the body such as the face, upper chest, and back.

  • Symptoms include yellow or white scales, redness, and itching.

  • Management includes medicated shampoos, topical treatments, and sometimes antifungal medications.

• Vitiligo:

  • Causes the skin to lose its pigment cells, resulting in discolored patches.

  • Commonly affects the face, neck, hands, and body folds.

  • Symptoms include patchy loss of skin color and premature whitening of hair.

  • Treatments may include topical corticosteroids, light therapy, and cosmetic solutions.

• Actinic Keratosis:

  • A rough, scaly patch on the skin that develops from years of sun exposure.

  • Considered a precancerous skin condition.

  • Symptoms include rough, dry, or scaly patches of skin, often on sun-exposed areas.

  • Treatments can include cryotherapy, topical medications, and surgical removal.

• Chronic Skin Ulcers:

  • Persistent open sores that fail to heal.

  • Can be caused by underlying conditions such as venous insufficiency and diabetes.

  • Symptoms include pain, swelling, redness, and discharge from the affected area.

  • Treatment often involves wound care, managing underlying conditions, and sometimes surgery.

• Fungal Infections:

  • Infections caused by fungi, such as athlete’s foot, ringworm, and jock itch.

  • Symptoms vary by type but can include itching, redness, and scaling.

  • Common in warm, moist areas of the body.

  • Treatment involves antifungal medications and maintaining good hygiene.

• Scars and Disfigurement:

  • Resulting from injuries, surgeries, or other conditions.

  • Can be service-connected if they occurred during or were aggravated by service.

  • Symptoms include changes in skin texture, color, and raised or depressed scars.

  • Treatment options include surgical revision, laser therapy, and topical treatments.

• Burns:

  • Includes both thermal burns from heat exposure and chemical burns from contact with harmful substances.

  • Symptoms vary by severity but can include redness, swelling, blisters, and pain.

  • Severe burns can lead to scarring and functional impairment.

  • Treatment ranges from wound care and pain management to reconstructive surgery.

Secondary Conditions and Comorbidities

Secondary conditions and comorbidities associated with skin conditions can include:

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• Infections:

  • Bacterial, viral, or fungal infections that occur due to breaks in the skin.

  • Symptoms may include redness, warmth, swelling, and discharge.

  • Require prompt treatment to prevent complications.

• Mental Health Conditions:

  • Such as depression or anxiety due to chronic skin conditions.

  • Can result from the social stigma and physical discomfort associated with skin conditions.

  • May require counseling, medication, or support groups.

• Sleep Disturbances:

  • Due to itching or pain.

  • Can lead to fatigue and decreased quality of life.

  • Managing underlying skin condition can improve sleep quality.

• Autoimmune Disorders:

  • Certain skin conditions like psoriasis can be associated with other autoimmune diseases.

  • Symptoms may overlap and complicate treatment.

  • Require comprehensive management plans involving multiple specialists.

Plan for Action

1. Document Current Condition:

   • Encourage the veteran to document their current skin condition with photographs and detailed descriptions of symptoms.

   • Keep a symptom diary to track flare-ups and their triggers.

   • Include notes on the severity and frequency of symptoms.

2. Medical Records:

   • Gather all relevant medical records, including those from military service and current treatments.

   • Ensure records include diagnosis, treatment plans, and any specialist consultations.

   • Regularly update records with new treatments or changes in condition.

3. Nexus Letter:

   • Obtain a nexus letter from a healthcare provider that links the skin condition to military service.

   • The letter should explain how the condition is related to or aggravated by service.

   • Ensure the letter is detailed and cites specific medical evidence.

4. Personal Statements:

   • Write a personal statement detailing how the skin condition began or was aggravated during service and how it affects daily life.

   • Include specific examples of how the condition impacts work, social life, and daily activities.

   • Highlight any challenges faced in managing the condition.

5. Buddy Statements:

   • Collect statements from fellow service members or family who can corroborate the veteran’s account of the condition.

   • These statements should describe their observations of the veteran’s symptoms and any impact on their life.

   • Ensure statements are detailed and consistent with the veteran’s account.

6. Continuous Treatment:

   • Ensure continuous medical treatment and documentation of the skin condition to establish a history and severity of the condition.

   • Regular follow-ups with healthcare providers can help document the progression and management of the condition.

   • Consistently follow prescribed treatment plans and report any changes to the doctor.

7. File the Claim:

   • Submit a comprehensive claim with all the gathered evidence to the VA.

   • Include all medical records, personal and buddy statements, and the nexus letter.

   • Ensure the claim is complete and accurate to avoid delays.

8. Prepare for C&P Exam:

   • Advise the veteran to prepare for the Compensation & Pension (C&P) exam by reviewing their symptoms, treatments, and how the condition impacts their daily life.

   • Bring all relevant documents and be ready to discuss the condition in detail.

   • Practice explaining the impact of the condition on daily activities and overall well-being.