38 CFR Part 4 — 38 CFR § 4.118
Chronic Urticaria
dc-7825-chronic-urticaria
Skin
Diagnostic code
7825
Why your DC matters: DC 7825 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 7825 — Chronic Urticaria — 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 (7825) in the correct body-system subpart, or use Find in Page (Ctrl+F / ⌘F) for “7825”. 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 7825 (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 7825 in the subpart for your body system (use Find in Page if needed).
DC 7825 (chronic urticaria) rates on a treatment-tier ladder — first-line antihistamines (10%), second-line treatment (30%), third-line treatment for refractory disease (60%). Critical differential from DC 7118 (angioneurotic edema / angioedema): urticaria is superficial dermal hives (welts, wheals) lasting minutes to hours; angioedema is deep dermal/subcutaneous/submucosal swelling lasting hours to days, often affecting face, lips, larynx. Both can coexist — rate separately if both diagnosed. Urticaria is considered chronic when persistent or recurrent for 6+ weeks. Most chronic urticaria is idiopathic (chronic spontaneous urticaria / chronic idiopathic urticaria); some is autoimmune (chronic autoimmune urticaria), physical (cold, heat, pressure, exercise), or secondary to chronic infection / autoimmune disease.
Rating Tiers — What Each Percentage Requires
| Rating | What It Takes | Evidence That Supports It |
|---|---|---|
| 60% | Chronic refractory urticaria that requires third-line treatment (e.g., omalizumab, cyclosporine, other immunomodulators) due to ineffectiveness of first- and second-line treatments. | Allergy/immunology treatment records documenting failure of antihistamines and second-line agents; prescription for omalizumab (Xolair), cyclosporine, or other immunomodulator. |
| 30% | Chronic urticaria that requires second-line treatment (e.g., higher-dose antihistamines, H1 + H2 combination, leukotriene antagonists, oral corticosteroids) for control. | Prescription history showing second-line regimens; allergy/immunology consult notes documenting escalation from first-line. |
| 10% | Chronic urticaria that requires first-line treatment (antihistamines) for control. | Antihistamine prescription history (cetirizine, fexofenadine, loratadine, etc.) with diagnosis of chronic urticaria documented for 6+ weeks. |
What Qualifies Under DC 7825?
Chronic urticaria (6+ weeks duration)
Persistent or recurrent urticaria for 6+ weeks. Subtypes: chronic spontaneous urticaria (most common, idiopathic), chronic autoimmune urticaria, chronic inducible urticaria (cold, heat, pressure, exercise, cholinergic).
Treatment-tier ladder
DC 7825 tiers map directly to treatment intensity:
- • 10% — First-line treatment (antihistamines)
- • 30% — Second-line treatment (higher-dose antihistamines, H1+H2 combination, leukotriene antagonists, oral corticosteroids)
- • 60% — Third-line treatment (omalizumab, cyclosporine, other immunomodulators) for refractory disease
Distinct from angioedema (DC 7118)
Urticaria = superficial dermal wheals (hives). Angioedema = deep dermal/subcutaneous swelling. Different DCs, different schedules. Can coexist — rate separately.
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.
“Chronic refractory urticaria requiring third-line treatment (omalizumab, cyclosporine, other immunomodulator) due to ineffectiveness of first- and second-line treatments”
60% gate. Anchor with allergy/immunology consult documenting failure of antihistamines AND second-line agents, AND prescription for biologics or other immunomodulators.
“Chronic urticaria requiring second-line treatment for control”
30% gate. Second-line = higher-dose antihistamines (4x standard dose per current allergy guidelines), H1 + H2 combination, leukotriene antagonists, oral corticosteroids for breakthrough.
“Chronic urticaria requiring first-line treatment (antihistamines)”
10% floor — chronic urticaria controlled by antihistamines alone. Don't accept 0% for a documented chronic diagnosis with ongoing treatment requirement.
“Chronic urticaria (superficial hives) — distinct from angioneurotic edema / angioedema (DC 7118, deep swelling)”
DC 7825 = urticaria (superficial dermal wheals, minutes to hours). DC 7118 = angioedema (deep dermal/subcutaneous swelling, hours to days, often face/lips/larynx). Different codes, different schedules. Can coexist — rate separately if both diagnosed.
Evidence Checklist — Specific to This Condition
Allergy / immunology consult documenting chronic urticaria (6+ weeks)
CRITICALChronic urticaria is defined as persistent or recurrent for 6+ weeks. Specialist diagnosis anchors the rating.
Treatment regimen history — first-line, second-line, third-line
CRITICALDrives tier directly. Pharmacy printout showing escalation from antihistamines (first-line) to higher doses / combinations (second-line) to biologics or immunomodulators (third-line).
Symptom diary — frequency, duration, distribution of hives
IMPORTANTDocuments activity level and treatment response.
Photographs of wheals during active flares
IMPORTANTVisual documentation of urticaria. Dated photographs.
Etiology workup — autoimmune (CU index, thyroid antibodies), physical (provocation testing)
SUPPORTINGIdentifies subtype. May affect treatment intensity needed.
Service exposure documentation (if SC nexus pursued)
SUPPORTINGBurn pit exposure, chemical exposure, in-service stress / triggers. Establishes direct SC pathway if not pursued under presumption.
C&P Exam Tips
Bring prescription history showing treatment escalation
First-line → second-line → third-line escalation drives tier directly. Pharmacy printout is the cleanest anchor.
Bring allergy/immunology consult documenting chronic diagnosis
6+ weeks of persistent or recurrent disease anchors chronic classification.
Bring symptom diary + photographs of active flares
Documents disease activity even during inter-flare periods.
Don't confuse with angioedema (DC 7118) — different code
Urticaria = superficial hives. Angioedema = deep swelling, often face/lips/larynx. Different DCs, different schedules. Can coexist — file each separately if both diagnosed.
Common Mistakes That Cost Veterans Points
Settling for 10% when second-line treatment is required
Higher-dose antihistamines (e.g., 4x cetirizine 10mg = 40mg daily, per current allergy guidelines), H1 + H2 combination, leukotriene antagonists, or oral corticosteroid bursts all qualify as second-line = 30%. Don't settle for 10% if the regimen has escalated.
Missing the 60% gate via omalizumab or other biologic
Omalizumab (Xolair) is FDA-approved for chronic spontaneous urticaria refractory to antihistamines. Prescription for omalizumab, cyclosporine, dupilumab, or other immunomodulator anchors third-line = 60%.
Filing as 'allergies' or 'rash'
Generic terms don't anchor DC 7825. Need formal 'chronic urticaria' or 'chronic spontaneous urticaria' diagnosis with 6+ weeks duration documented.
Conflating urticaria with angioedema
Urticaria (DC 7825) = superficial dermal hives. Angioedema (DC 7118) = deep tissue swelling, often face/lips/larynx, lasting hours to days. Different DCs. If both present, file each separately.
Tactical Plays
⚡ Anchor treatment-line via specialty consult — escalation drives tier
DC 7825 tiers map directly to treatment intensity: first-line (antihistamines) = 10%, second-line (higher-dose / combination / leukotriene / oral steroids) = 30%, third-line (omalizumab, cyclosporine, immunomodulators) = 60%. Allergy/immunology consult notes documenting escalation are the cleanest anchor — primary care prescriptions may be misclassified by raters.
⚡ Pursue omalizumab path for refractory disease — anchors 60%
Omalizumab (Xolair) is FDA-approved for chronic spontaneous urticaria refractory to antihistamines. Prescription anchors third-line = 60% under DC 7825. If your urticaria is refractory and not yet on omalizumab, push your allergist for the referral — it's the cleanest path to 60%.
⚡ File angioedema separately if both present
Urticaria (DC 7825) and angioedema (DC 7118) commonly coexist. Each rates under its own DC — no pyramiding because they're distinct conditions per the schedule. Up to 50% of chronic urticaria patients have angioedema episodes; if you have both, file each separately.
⚡ Audit autoimmune comorbidities (especially thyroid)
Chronic autoimmune urticaria is associated with autoimmune thyroid disease (Hashimoto's hypothyroidism) and other autoimmunity. Document thyroid antibodies + TSH. If Hashimoto's hypothyroidism is present, file under DC 7903 as a related autoimmune condition.
Secondary Conditions to File With This One
Angioneurotic edema (angioedema)
STRONGDC 7118
Urticaria and angioedema commonly coexist (50%+ of chronic urticaria patients have at least episodic angioedema). Rate separately under DC 7118 if angioedema documented.
Autoimmune thyroid disease (Hashimoto's)
MODERATEDC 7903
Chronic autoimmune urticaria is associated with autoimmune thyroid disease. Hashimoto's → hypothyroidism (DC 7903). Document thyroid antibodies + TSH.
Depression / anxiety secondary to chronic disease
STRONGDC 9434 / 9400
Chronic urticaria with unpredictable flares + treatment burden + visible disfigurement drives anxiety / depression. Well-documented secondary.
Sleep disturbance from nocturnal itching / flares
MODERATENocturnal urticaria flares disrupt sleep. Document with sleep diary or formal sleep study.
Treatment-related side effects (immunosuppression, weight gain from steroids, etc.)
SITUATIONALLong-term high-dose corticosteroids, cyclosporine, or immunosuppressants have well-documented side effects. Rate emerging secondary conditions separately.
Compensation Scenarios
2026 rates (effective Dec 1, 2025, per va.gov)
10% — single, no dependents
Base rating
$180.42
TOTAL
$180.42/mo
Antihistamines control symptoms (first-line).
30% — single, no dependents
Base rating
$552.47
TOTAL
$552.47/mo
Higher-dose / combination antihistamines or leukotriene antagonists (second-line).
60% — single, no dependents
Base rating
$1,435.02
TOTAL
$1,435.02/mo
Omalizumab, cyclosporine, or other immunomodulator for refractory disease (third-line).
60% DC 7825 + 40% DC 7118 angioedema (coexisting)
Base rating
$2,102.15
TOTAL
$2,102.15/mo
Urticaria + angioedema coexisting = separate ratings under each DC.
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 is Chronic Urticaria?
Chronic urticaria is persistent or recurrent urticaria (hives) for 6+ weeks. Most common subtype: chronic spontaneous urticaria (idiopathic). Wheals are typically pruritic, transient (each lesion lasting <24 hours), and migratory. Distinguishes from acute urticaria (<6 weeks, often triggered by identifiable allergen or infection).
↔️Urticaria vs. Angioedema — what's the difference?
Urticaria (DC 7825) = superficial dermal hives (wheals, welts), lasting minutes to hours each. Angioedema (DC 7118) = deep dermal/subcutaneous/submucosal swelling, lasting hours to days, often affecting face, lips, throat, larynx, abdomen. Both rate under different DCs with different schedules. Up to 50% of chronic urticaria patients also have angioedema — rate separately if both diagnosed.
💊What treatments anchor each tier?
First-line (10%): standard-dose H1 antihistamines (cetirizine, fexofenadine, loratadine). Second-line (30%): higher-dose H1 antihistamines (e.g., 4x standard dose per allergy guidelines), H1 + H2 combination, leukotriene antagonists (montelukast), oral corticosteroid bursts. Third-line (60%): omalizumab (Xolair), cyclosporine, dupilumab, other immunomodulators for refractory disease.
🧬Is autoimmune comorbidity relevant?
Yes — chronic autoimmune urticaria is associated with autoimmune thyroid disease (Hashimoto's), other autoimmunity. Document thyroid antibodies (anti-TPO, anti-thyroglobulin) + TSH. If Hashimoto's hypothyroidism develops, file under DC 7903 as a related autoimmune condition.
How to File Your Claim
Get allergy/immunology consult documenting chronic urticaria (6+ weeks)
Specialist diagnosis anchors the rating. Primary care diagnosis may be insufficient.
Pull prescription history showing treatment-line escalation
First-line → second-line → third-line drives tier directly.
Document angioedema separately if present
Up to 50% of chronic urticaria patients have angioedema. File DC 7118 separately.
File 21-526EZ specifying 'chronic urticaria (DC 7825)'
Identify treatment line in the claim narrative.
Audit autoimmune comorbidities (especially thyroid)
Anti-TPO, TSH. Hashimoto's hypothyroidism rates separately under DC 7903.
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
Treatment-line escalation drives tier directly
First-line (antihistamines) = 10%; second-line (higher dose / combination) = 30%; third-line (omalizumab, cyclosporine) = 60%. Match prescriptions to tier.
Distinct from angioedema (DC 7118)
Different DCs, different schedules. Can coexist — rate each separately.
Pursue omalizumab if refractory — anchors 60%
FDA-approved for chronic spontaneous urticaria refractory to antihistamines. Cleanest path to 60%.
Audit autoimmune comorbidities
Hashimoto's thyroid disease commonly comorbid. Document anti-TPO + TSH.
Related Tools & Resources
Frequently Asked Questions
What's the difference between urticaria (DC 7825) and angioedema (DC 7118)?
Urticaria (DC 7825) is superficial dermal hives (wheals, welts) lasting minutes to hours per lesion. Angioedema (DC 7118) is deep dermal/subcutaneous/submucosal swelling lasting hours to days, often affecting face, lips, throat, larynx, abdomen. Both rate under different DCs with different schedules. Up to 50% of chronic urticaria patients also experience angioedema — if both are diagnosed, file each separately under its own DC.
How is 'second-line treatment' defined for the 30% gate?
Second-line treatment includes: higher-dose H1 antihistamines (current allergy guidelines recommend up to 4x standard dose), H1 + H2 antihistamine combination, leukotriene receptor antagonists (montelukast), oral corticosteroid bursts for breakthrough. The 30% gate is escalation BEYOND standard-dose first-line antihistamines, but BEFORE biologics or immunomodulators (which are third-line = 60%).
What anchors the 60% third-line gate?
Third-line treatment for refractory chronic urticaria includes: omalizumab (Xolair, FDA-approved for chronic spontaneous urticaria), cyclosporine, dupilumab, other immunomodulators. Allergy/immunology specialist prescription anchors third-line. If your urticaria is refractory and not yet on omalizumab, push for the referral — it's typically the cleanest path to 60%.
Can chronic urticaria be service-connected?
Yes — chronic urticaria can be service-connected via direct (in-service onset, in-service stressor / trigger documentation), secondary (related to SC autoimmune disease like Hashimoto's thyroid), or via toxic exposure framework (burn pit, chemical exposure). Chronic spontaneous urticaria is often idiopathic but can be triggered by chronic stress, infection, or environmental factors during service.
Does the diagnosis need to be by an allergist?
Strongly recommended — allergy/immunology specialists are the cleanest anchor for chronic urticaria diagnosis and treatment-line classification. Primary care diagnoses may be insufficient, and raters may misclassify treatment lines. Allergy/immunology consult notes documenting (a) 6+ weeks chronic diagnosis and (b) treatment-line escalation are the strongest evidence.
Official Regulatory Source
Chronic urticaria rates under 38 CFR § 4.118, DC 7825 — 10/30/60% based on treatment-line tier.
38 CFR § 4.118 — Skin (eCFR) →Scroll to DC 7825. Compare DC 7118 (angioneurotic edema / angioedema) for differential — distinct code, different schedule.
Next Steps
If your rating decision lists DC 7825, 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 7825 • 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.