38 CFR Part 4 — 38 CFR § 4.118
Malignant Skin Neoplasms
dc-7818-malignant-skin-neoplasms
Skin
Diagnostic code
7818
Why your DC matters: DC 7818 is the exact code the VA uses to rate this condition. It determines which symptoms unlock which percentage, what evidence the rater looks for, and which secondaries are most likely to be approved.
Last verified against 38 CFR (eCFR Part 4):
Rating criteria (38 CFR Part 4)
Diagnostic code 7818 — Malignant Skin Neoplasms — is listed under 38 CFR § 4.118 in 38 CFR Part 4. The paragraphs below summarize how this code is used; the official schedule text controls exact percentages, formulas, and notes.
Schedule summary (educational, not a substitute for the regulation): Educational index row from the rating schedule naming convention; confirm exact diagnostic code, effective date, and criteria in the current eCFR Part 4.
Exact rating criteria: Open Part 4 in the eCFR (link under “Official source” below). Locate your diagnostic code number (7818) in the correct body-system subpart, or use Find in Page (Ctrl+F / ⌘F) for “7818”. Copy the verbatim rating table, including any parenthetical notes, exceptions, and cross-references, for the version of Part 4 that applies to your effective date.
Effective dates & which schedule version applies
Which diagnostic code, percentage, and effective date apply depends on the facts of your claim and the version of the rating schedule in force for the period being decided. Generally, VA applies the schedule in effect at the specified time under 38 U.S.C. § 5110 and implementing rules, subject to exceptions (e.g., protected ratings, liberalizing law changes—see regulation and VA manual policy as applicable).
For older claims, the **current** eCFR may not match the text that applied years ago. If your decision references a prior percentage or code, compare against the Part 4 text **as of** your claim’s relevant dates; historical Federal Register / CFR snapshots may be needed for precise comparison.
The “Last verified” date on this page is when we last checked this educational summary against the electronic CFR—not the date of any VA policy or your personal claim decision.
Notes for your claim
Evidence: Show that your diagnosis and severity match the factors the schedule names for DC 7818 (e.g., measurements, frequency, treatment, functional loss), with medical and lay evidence as appropriate.
C&P exams: Results should reflect the schedule’s requirements (correct joints measured, correct formulas). If the exam omits required findings, consider submitting records or requesting clarification.
If you disagree with the DC, percentage, or effective date, review the Part 4 text for your period and consider a supplemental claim or appeal with a VA-accredited representative.
This site does not provide legal advice.
Official source
38 CFR Part 4 (eCFR) — locate diagnostic code 7818 in the subpart for your body system (use Find in Page if needed).
DC 7818 covers malignant skin neoplasms OTHER THAN malignant melanoma (which rates under DC 7833). DC 7818 grants automatic 100% if the skin malignancy requires therapy comparable to that used for internal malignancies — systemic chemotherapy, X-ray therapy more extensive than skin-limited, or surgery more extensive than wide local excision. Otherwise, rate as disfigurement (DC 7800), scars (DC 7801-7805), or impairment of function. Critical service-connection lanes: (1) PACT Act presumptive — melanoma (DC 7833) was added to the PACT Act presumptive list for post-9/11 qualifying SW Asia / Afghanistan service per 38 CFR § 3.320 (covered separately under DC 7833, but cross-reference here as the most common burn-pit-presumptive skin cancer), (2) AO presumptive for soft tissue sarcomas (some skin-adjacent cancers under § 3.309(e)), (3) atomic veteran radiation-exposure path for skin cancers under § 3.309(d). DC 7818 is the catch-all for non-melanoma skin cancers (basal cell carcinoma, squamous cell carcinoma, Merkel cell carcinoma, cutaneous lymphomas, others) when they require systemic-level therapy.
Rating Tiers — What Each Percentage Requires
| Rating | What It Takes | Evidence That Supports It |
|---|---|---|
| 100% | Skin malignancy requires therapy comparable to that used for internal malignancies (systemic chemotherapy, X-ray therapy more extensive than to the skin, or surgery more extensive than wide local excision). 100% from date of treatment onset. Re-evaluate 6 months after completion of treatment. | Oncology treatment records — systemic chemotherapy regimen, radiation therapy fields and doses, surgery operative reports showing more than wide local excision (e.g., flap reconstruction, lymphadenectomy, Mohs micrographic surgery extensive cases). |
| 0% | Skin malignancy not requiring systemic-level therapy. Rate as disfigurement (DC 7800), scars (DC 7801-7805), or impairment of function instead — DC 7818 may yield 0% but stack with the analog code. | Excisional biopsy + treatment limited to wide local excision; rate residuals (scar, disfigurement, functional impairment) under analog DCs. |
What Qualifies Under DC 7818?
Malignant skin neoplasm OTHER THAN melanoma
Basal cell carcinoma (BCC), squamous cell carcinoma (SCC), Merkel cell carcinoma, cutaneous T-cell lymphoma (mycosis fungoides), Kaposi sarcoma, others. EXCLUDES melanoma (which is DC 7833).
Treatment-intensity 100% trigger
100% automatic if treatment requires therapy comparable to internal malignancies — systemic chemotherapy, X-ray therapy more extensive than to the skin, OR surgery more extensive than wide local excision.
Re-evaluate 6 months post-treatment
Mandatory re-evaluation 6 months after completion of treatment. Then rate on residuals — disfigurement (DC 7800), scars (DC 7801-7805), functional impairment.
Presumption lanes — atomic veteran, PACT (melanoma via DC 7833)
Skin cancers on § 3.309(d) radiogenic presumptive for atomic veterans. Melanoma on PACT Act presumptive (DC 7833 specifically, but cross-reference here).
Language Your Rater Needs to See
These are the exact (or near-exact) regulatory phrases that unlock specific tiers. If your DBQ or C&P report doesn't use this vocabulary, the rater may default to a lower percentage even when symptoms qualify.
“Therapy comparable to that used for internal malignancies — systemic chemotherapy, extensive X-ray therapy, or surgery more extensive than wide local excision”
Anchors automatic 100% under DC 7818. ANY ONE of the three treatment categories triggers 100%. Don't accept rating-by-residuals if the treatment intensity meets this threshold.
“Re-evaluate 6 months after completion of therapy”
Standard malignancy post-treatment evaluation. After 6-month mark, rate on residuals (scars, disfigurement, functional impairment, treatment late effects). Don't let VA prematurely reduce.
“Disfigurement (DC 7800), scars (DC 7801-7805), or impairment of function”
Even after treatment completion, residuals are rateable. Surgical scars under DC 7804 (painful) and DC 7805 (limitation of function), disfigurement of head/face/neck under DC 7800. Stack.
“Malignant melanoma rates separately under DC 7833 — same 100%-during-treatment mechanic but distinct code”
DC 7818 excludes malignant melanoma. Melanoma (DC 7833) has its own listing and is the most commonly PACT-presumptive skin cancer. Match the biopsy histology to the correct code.
Evidence Checklist — Specific to This Condition
Excisional biopsy with pathology report
CRITICALConfirms diagnosis and subtype (basal cell, squamous cell, Merkel cell, cutaneous T-cell lymphoma, etc.). Distinguishes from melanoma (DC 7833) which has its own code.
Oncology treatment records — systemic chemo, extensive radiation, extensive surgery
CRITICALAny of the three treatment categories triggers 100% under DC 7818. Document specific regimens, radiation doses/fields, surgical procedures.
PACT Act presumption documentation (for melanoma — file under DC 7833)
CRITICALIf melanoma diagnosis: DD-214 + qualifying post-9/11 SW Asia / Afghanistan service triggers presumption under 38 CFR § 3.320. (Cross-reference — melanoma is DC 7833, not DC 7818.)
Atomic veteran radiation exposure (if applicable)
CRITICALSkin cancers on the radiogenic § 3.309(d) presumptive list for atomic veterans. RECA + service records.
Sun exposure / occupational documentation
IMPORTANTOutdoor military duty (aviation, naval bridge watch, field operations) supports occupational sun exposure nexus for non-presumptive cases.
Surgical operative reports + scar / disfigurement photographs
IMPORTANTAnchors residuals rating after treatment completion. Date all photos.
Recurrence surveillance — periodic dermatology / oncology exams
SUPPORTINGRecurrence triggers another 100% cycle. Document each new lesion or recurrence event.
C&P Exam Tips
Bring pathology + treatment records — anchor 100%-during-treatment trigger
Systemic chemo OR extensive radiation OR surgery more extensive than wide local excision = 100% automatic.
Bring service-period documentation for presumption (especially if melanoma)
Post-9/11 qualifying service for PACT Act melanoma presumption. Atomic veteran radiation for § 3.309(d).
Document all post-treatment residuals — scars, disfigurement, functional impairment
After 6-month re-evaluation, rate on residuals. Each residual is a separate analog DC.
Don't accept 0% for treated skin cancer
Even non-systemic treatment leaves scars / disfigurement rateable under analog DCs. Push for stacking — DC 7804 painful scars, DC 7800 disfigurement, DC 7805 functional limitation.
Common Mistakes That Cost Veterans Points
Filing melanoma under DC 7818 instead of DC 7833
DC 7818 specifically EXCLUDES malignant melanoma. Melanoma has its own dedicated DC 7833. Match the biopsy histology to the correct code. PACT Act melanoma presumption applies to DC 7833.
Accepting rating-by-residuals when treatment intensity supports 100%
DC 7818 grants automatic 100% if treatment requires systemic chemo OR extensive radiation OR more-than-wide-local-excision surgery. Don't let VA skip to residuals-only rating during the active treatment period and 6-month tail.
Missing the atomic veteran radiogenic presumption
Skin cancers (including basal cell carcinoma, squamous cell carcinoma) are on the § 3.309(d) radiogenic presumptive list for atomic veterans. If you participated in atmospheric nuclear testing, Hiroshima/Nagasaki occupation, or DOE radiation work, this lane applies.
Not stacking post-treatment residuals
After 6-month re-evaluation, file each residual separately: scars (DC 7804 painful, DC 7805 functional), disfigurement (DC 7800 head/face/neck), functional impairment. Each stacks.
Tactical Plays
⚡ Match biopsy histology to correct DC — melanoma = 7833, NOT 7818
DC 7818 explicitly excludes malignant melanoma. Melanoma rates under DC 7833 with its own schedule. The PACT Act melanoma presumption applies to DC 7833 specifically — pull the pathology report and match the histology to the correct code before filing.
⚡ Anchor 100% via treatment intensity, not just diagnosis
DC 7818 grants automatic 100% if treatment requires (a) systemic chemotherapy, OR (b) X-ray therapy more extensive than to the skin, OR (c) surgery more extensive than wide local excision. Document the treatment intensity meeting any one of these thresholds — that's the 100% gate.
⚡ Pursue atomic veteran radiogenic presumption if applicable
Skin cancers are on the § 3.309(d) radiogenic presumptive list for atomic veterans. Participation in atmospheric nuclear testing, Hiroshima/Nagasaki occupation forces, DOE radiation work — establish radiation exposure and pursue presumption.
⚡ Stack post-treatment residuals aggressively
After the 6-month post-treatment re-evaluation, residuals are the rating path. Disfigurement (DC 7800, up to 80% for head/face/neck), painful or unstable scars (DC 7804, up to 30%), functional limitation (DC 7805 by affected function). Each rates separately. Don't accept 0% post-treatment for cancers with visible residuals.
⚡ Surveillance for recurrence — each new lesion = new 100% cycle
Skin cancers carry significant recurrence risk. Each new primary or recurrence triggers another 100%-during-treatment cycle. Annual dermatology surveillance + file each new event as a claim.
Secondary Conditions to File With This One
Disfigurement of head, face, neck (post-surgical)
STRONGDC 7800
Post-surgical disfigurement after skin cancer excision rates under DC 7800. Up to 80% for severe disfigurement with 6+ characteristics.
Painful or unstable scars
STRONGDC 7804
Post-surgical scars often painful. ≥3 painful or unstable scars = 30% (10% per scar up to 30% cap).
Scars with limitation of function
MODERATEDC 7805
Surgical excision near joints or critical anatomy may limit function. Rates under DC 7805 by the affected function (e.g., joint ROM).
Lymphedema (post-lymphadenectomy)
MODERATESentinel lymph node biopsy or completion lymphadenectomy may cause secondary lymphedema. Rates under appropriate extremity DC.
Radiation dermatitis / chronic radiation skin effects
MODERATERadiation therapy fields cause chronic skin changes — telangiectasia, atrophy, ulceration. Rates under analog skin DC.
Depression secondary to disfigurement / cancer diagnosis
STRONGDC 9434
Visible disfigurement + cancer survivorship drive depression. Well-documented secondary.
Recurrence triggers new 100% cycle
SITUATIONALEach new malignancy diagnosis or recurrence triggers another 100%-during-treatment cycle. File the recurrence as a new claim event.
Special Monthly Compensation (SMC-K (statutory specific loss))
Disfigurement or anatomical loss after skin cancer surgery may qualify for SMC K (loss of nose, ear, etc.) at $139.87/mo. Add to schedular rating. Higher SMC tiers (L+) require additional combining disabilities.
SMC-K (statutory specific loss) monthly add-on
+$139.87
Added on top of your schedular rating.
Compensation Scenarios
2026 rates (effective Dec 1, 2025, per va.gov)
100% — single, no dependents
Base rating
$3,938.58
TOTAL
$3,938.58/mo
Skin malignancy requiring systemic chemo, extensive radiation, OR more-than-wide-local-excision surgery.
100% during treatment → 30% DC 7804 painful scars + 60% DC 7800 disfigurement (post-treatment)
Base rating
$2,102.15
TOTAL
$2,102.15/mo
Post-treatment residuals stack.
Note: Amounts are approximations rounded to nearest dollar. Actual comp varies with effective date, dependents (spouse, children, parents — each adds), Aid & Attendance, and additional disabilities. Combined ratings use VA Math (§ 4.25), not simple addition.
Key Definitions
↔️What's the Difference Between DC 7818 and DC 7833?
DC 7818 covers malignant skin neoplasms OTHER THAN melanoma (basal cell, squamous cell, Merkel cell, cutaneous lymphomas, etc.). DC 7833 covers malignant melanoma specifically. Both grant 100% during active disease/treatment + post-treatment residuals stacking. Melanoma is the most commonly PACT-presumptive skin cancer. Match biopsy histology to the correct DC.
💯What treatment intensity triggers 100% under DC 7818?
ANY ONE of three categories: (1) systemic chemotherapy (oral or IV antineoplastic agents administered for systemic effect, not topical), (2) X-ray therapy more extensive than to the skin (regional radiation, not just skin-targeted superficial radiation), (3) surgery more extensive than wide local excision (lymphadenectomy, flap reconstruction, Mohs surgery in extensive cases, regional resection).
🔗What residuals are rateable after the 6-month re-evaluation?
Disfigurement (DC 7800, up to 80% for head/face/neck), painful or unstable scars (DC 7804, up to 30%), scars with limitation of function (DC 7805 by affected function), lymphedema (post-lymphadenectomy), chronic radiation skin effects, depression secondary to disfigurement / cancer survivorship. Each rates separately.
🎖️Is non-melanoma skin cancer a PACT Act presumptive?
The PACT Act presumptive list for skin cancers focuses on melanoma (DC 7833) rather than basal cell or squamous cell carcinoma. However, atomic veteran skin cancers (any type) rate under the § 3.309(d) radiogenic presumptive. Sun-exposure-related skin cancers may pursue direct service connection via occupational MOS / unit history.
How to File Your Claim
Pull biopsy + pathology report — match histology to correct DC
Melanoma → DC 7833 (not 7818). All other skin cancers → DC 7818.
Pull oncology treatment records anchoring treatment intensity
Systemic chemo OR extensive radiation OR more-than-wide-local-excision surgery = 100% gate.
Identify presumption lane — atomic veteran, PACT (melanoma), occupational sun exposure
Each lane has different documentation requirements.
File 21-526EZ specifying correct DC + cite presumption lane if applicable
For melanoma + post-9/11 qualifying service, cite PACT Act presumption (§ 3.320) on DC 7833. For atomic veteran, cite § 3.309(d).
Build residuals secondary file proactively
Disfigurement (DC 7800), painful scars (DC 7804), functional limitation (DC 7805), lymphedema, depression. Each stacks post-treatment.
Typical Claim Timeline
File initial claim
Day 0–7: Submit VA Form 21-526EZ with all medical evidence on file
VA acknowledges claim
Week 1–2: Receive confirmation letter and claim tracking number
C&P examination scheduled
Month 1–3: VA contracts an exam vendor and sends you appointment notice
Attend C&P exam
Bring your full evidence package; describe symptoms on your worst days, not your best
Decision & rating notice
Month 3–6: Decision letter with rating percentage and effective date
First payment & retro back pay
Within 15 days of decision; retroactive to claim date (or effective date if earlier)
Timeline varies by case complexity and VA regional office workload. Some claims resolve faster; others take longer.
Important Considerations
Match biopsy to correct DC — melanoma = 7833
DC 7818 explicitly excludes melanoma. File the correct code.
100% gate is treatment intensity
Systemic chemo OR extensive radiation OR more-than-wide-local-excision surgery. ANY ONE triggers automatic 100%.
PACT Act presumption for melanoma — file under DC 7833
Post-9/11 qualifying service triggers PACT presumption for melanoma. DC 7833, not 7818.
Atomic veteran radiogenic presumption for any skin cancer
Atmospheric nuclear testing, Hiroshima/Nagasaki occupation, DOE radiation work → § 3.309(d) presumptive.
Related Tools & Resources
Frequently Asked Questions
What's the difference between DC 7818 and DC 7833?
DC 7818 covers malignant skin neoplasms OTHER THAN malignant melanoma — basal cell carcinoma, squamous cell carcinoma, Merkel cell carcinoma, cutaneous T-cell lymphoma (mycosis fungoides), Kaposi sarcoma, others. DC 7833 covers malignant melanoma specifically. Both have similar rating mechanics (100% during active treatment + post-treatment residuals stacking) but are distinct codes. Match the biopsy histology to the correct DC. The PACT Act melanoma presumption applies to DC 7833, not DC 7818.
Is melanoma a PACT Act presumptive condition?
Yes — malignant melanoma was added to the PACT Act presumptive list for post-9/11 qualifying SW Asia / Afghanistan service per 38 CFR § 3.320. File under DC 7833 (the melanoma-specific code), not DC 7818. Vietnam-era veterans may pursue Agent Orange presumption for certain skin-adjacent conditions (soft tissue sarcoma under § 3.309(e)).
When does DC 7818 grant automatic 100%?
DC 7818 grants automatic 100% if the skin malignancy requires therapy comparable to that used for internal malignancies — ANY ONE of: (1) systemic chemotherapy, (2) X-ray therapy more extensive than to the skin, (3) surgery more extensive than wide local excision. The 100% continues through treatment and for 6 months after completion. Then mandatory re-evaluation determines residual rating.
What if my treatment was just wide local excision — do I get a rating?
Yes, but not 100% under DC 7818. For non-systemic-level treatment, rate the residuals: scars under DC 7801-7805, disfigurement of head/face/neck under DC 7800, functional impairment under DC 7805. Stack each rateable residual. DC 7818 itself may yield 0% but the residuals can add meaningful percentage.
What presumptive lanes apply to skin cancers?
Multiple lanes: (1) PACT Act melanoma — DC 7833, post-9/11 qualifying service, § 3.320. (2) Atomic veteran skin cancers — § 3.309(d) radiogenic presumptive (any skin cancer type, including BCC and SCC). (3) AO presumption for soft tissue sarcoma under § 3.309(e). (4) Direct SC for occupational sun exposure (outdoor military duty). Pursue the strongest applicable lane.
Official Regulatory Source
Malignant skin neoplasms (other than melanoma) rate under 38 CFR § 4.118, DC 7818 — automatic 100% if treatment requires systemic chemo, extensive radiation, or more-than-wide-local-excision surgery.
38 CFR § 4.118 — Skin (eCFR) →Scroll to DC 7818. Compare DC 7833 (malignant melanoma) — distinct code with PACT Act presumption (§ 3.320). Residuals rate under DC 7800-7805.
Next Steps
If your rating decision lists DC 7818, compare your current symptoms and documentation against the criteria above. Consider:
- Requesting a copy of your rating decision and C&P exam report from the VA
- Gathering all relevant medical records (VA and private providers)
- Documenting functional limitations and how they impact work and daily activities
- Obtaining a nexus letter if needed to establish or strengthen service connection
- Filing for secondary conditions that may be related to this primary condition
- Contacting a VA-accredited VSO, claims agent, or attorney to review your file
This is general educational information only — not legal or medical advice.
Also: DC code lookup (tools) lists the same index in a compact layout.
Source: 38 CFR Part 4, Diagnostic Code 7818 • va.gov
⚠️ Important Disclaimer
This page provides general educational information only based on public VA regulations (38 CFR) and va.gov resources. It is not legal, medical, or claims assistance. Ratings and service connections are decided case-by-case by the VA based on the individual veteran’s evidence. We do not prepare claims, generate documents, or provide personalized advice. Always consult a VA-accredited Veterans Service Organization (VSO), attorney, or your physician for help with your specific situation. Verify the latest rules on va.gov.