38 CFR Part 4 — 38 CFR § 4.118
Malignant Melanoma
dc-7833-malignant-melanoma
Skin
Diagnostic code
7833
Why your DC matters: DC 7833 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 7833 — Malignant Melanoma — 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 (7833) in the correct body-system subpart, or use Find in Page (Ctrl+F / ⌘F) for “7833”. 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 7833 (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 7833 in the subpart for your body system (use Find in Page if needed).
DC 7833 covers malignant melanoma — the most aggressive skin cancer and one of the most clearly-presumptive cancers for post-9/11 veterans under the PACT Act. Critical: melanoma was added to the PACT Act presumptive list (38 USC § 1120, codified at 38 CFR § 3.320) — qualifying SW Asia / Afghanistan service triggers an automatic presumption, no nexus letter required. DC 7833 rates by analogy to scars (DC 7800-7805), disfigurement of head/face/neck (DC 7800), or impairment of function (under the appropriate body system) — BUT grants automatic 100% if the melanoma requires therapy comparable to that used for internal malignancies (systemic chemotherapy, immunotherapy, targeted therapy, X-ray therapy more extensive than to the skin, OR surgery more extensive than wide local excision). 100% continues through treatment + 6-month mandatory post-treatment re-evaluation. Critical pathways: (1) PACT Act presumption for post-9/11 SW Asia / Afghanistan service (§ 3.320), (2) atomic veteran radiogenic presumption (§ 3.309(d)) for older claims, (3) direct SC for occupational sun exposure (outdoor MOS — aviation, naval bridge watch, field operations) or known carcinogen exposure, (4) Camp Lejeune contaminated water lane for 1953-1987 service. Modern melanoma treatment routinely includes immunotherapy (pembrolizumab, nivolumab, ipilimumab) and targeted therapy (BRAF/MEK inhibitors) — both anchor the 100% systemic-treatment gate. Cross-references DC 7818 (other malignant skin neoplasms) which explicitly excludes melanoma.
Rating Tiers — What Each Percentage Requires
| Rating | What It Takes | Evidence That Supports It |
|---|---|---|
| 100% | Melanoma requires therapy comparable to that used for internal malignancies — systemic chemotherapy, immunotherapy, targeted therapy, extensive radiation, OR surgery more extensive than wide local excision. 100% from date of treatment onset through completion of treatment, then mandatory VA examination 6 months after completion. | Oncology treatment records — systemic chemotherapy regimen, immunotherapy (pembrolizumab, nivolumab, ipilimumab), targeted therapy (BRAF/MEK inhibitors like dabrafenib/trametinib), radiation therapy fields and doses, surgery operative reports showing lymphadenectomy, sentinel lymph node biopsy + completion lymphadenectomy, or wide excision with flap reconstruction. |
| 0% | Melanoma treated with wide local excision only (skin-confined treatment). Rate residuals — scars (DC 7801-7805), disfigurement of head/face/neck (DC 7800), or impairment of function. 100% systemic-treatment trigger does not apply. | Excisional biopsy + wide local excision operative report; pathology showing clear margins; no sentinel lymph node biopsy or systemic treatment required. |
What Qualifies Under DC 7833?
Malignant melanoma — confirmed by biopsy + pathology
Histopathologic confirmation of melanoma (not basal cell carcinoma, squamous cell carcinoma, or other skin cancer — those rate under DC 7818). Includes cutaneous melanoma, mucosal melanoma, ocular melanoma, melanoma of unknown primary.
PACT Act presumption — automatic for post-9/11 SW Asia / Afghanistan service
Per 38 USC § 1120 / 38 CFR § 3.320. Melanoma is on the presumptive cancer list. Post-9/11 qualifying service triggers automatic presumption — no nexus letter required.
Atomic veteran radiogenic presumption — § 3.309(d)
Skin cancers (including melanoma) on the radiogenic presumptive list for atomic veterans (atmospheric nuclear testing, Hiroshima/Nagasaki occupation, DOE radiation work).
Treatment-intensity 100% trigger
100% automatic if treatment requires therapy comparable to internal malignancies — systemic chemotherapy, immunotherapy, targeted therapy, X-ray therapy more extensive than to the skin, OR surgery more extensive than wide local excision. 100% from treatment onset through 6-month post-treatment re-evaluation.
Residuals rating after 6-month re-evaluation
If treatment is skin-confined (wide local excision only), 100% does not apply — rate residuals (scars, disfigurement, functional impairment). If systemic treatment, 100% continues through treatment + 6-month tail, then residuals rating.
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.
“Malignant melanoma — PACT Act presumptive cancer for post-9/11 SW Asia / Afghanistan qualifying service per 38 USC § 1120 / 38 CFR § 3.320”
Anchors automatic presumption — no nexus letter required. Qualifying service: deployment to Iraq, Afghanistan, Saudi Arabia, Kuwait, Bahrain, UAE, Oman, Qatar, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen, Uzbekistan after 9/11/2001. DD-214 + service history anchor the presumption.
“Malignant melanoma — radiogenic skin cancer per § 3.309(d) for atomic veterans”
Skin cancers (including melanoma) on the § 3.309(d) radiogenic presumptive list for atomic veterans (participation in atmospheric nuclear testing, Hiroshima/Nagasaki occupation, DOE radiation work). RECA + service records anchor.
“Therapy comparable to that used for internal malignancies — systemic chemotherapy, immunotherapy, targeted therapy, extensive X-ray therapy, or surgery more extensive than wide local excision”
Anchors automatic 100% under DC 7833. ANY ONE of the treatment categories triggers 100%. Modern immunotherapy (pembrolizumab/nivolumab) and targeted therapy (BRAF/MEK inhibitors) ARE systemic — don't accept rating-by-residuals if any modern systemic agent is in the regimen.
“100% from date of onset of treatment, continuing with mandatory VA examination 6 months following completion of antineoplastic treatment”
100% begins at treatment start date, not diagnosis date. Continues through entire treatment course + 6-month post-treatment mandatory re-evaluation. Don't let VA prematurely reduce during the active treatment + 6-month tail.
“If treatment is confined to the skin, the 100% does not apply. Rate as scars (DC 7800-7805), disfigurement of head/face/neck (DC 7800), or impairment of function”
Wide local excision alone = skin-confined treatment, no 100% gate. But residuals stack — surgical scars under DC 7804 (painful) and DC 7805 (functional limitation), disfigurement of head/face/neck under DC 7800 (up to 80% for 6+ characteristics).
Evidence Checklist — Specific to This Condition
Excisional biopsy with pathology report confirming melanoma
CRITICALAnchor diagnosis. Pathology must specify melanoma (not basal cell, squamous cell, or other skin cancer — those rate under DC 7818). Document Breslow depth, Clark level, ulceration status, mitotic rate for staging.
PACT Act service period documentation
CRITICALDD-214 + service history establishing post-9/11 qualifying SW Asia / Afghanistan deployment. Triggers § 3.320 presumption — no nexus letter required.
Oncology treatment records — systemic chemo, immunotherapy, targeted therapy, extensive radiation, lymphadenectomy
CRITICALAny of the systemic treatment categories triggers automatic 100% under DC 7833. Document specific regimens (pembrolizumab, nivolumab, ipilimumab, BRAF inhibitors like dabrafenib, MEK inhibitors like trametinib).
Staging documentation — TNM stage, AJCC stage
CRITICALStage I-IIA (thin melanoma, no lymph nodes) often treated by wide excision only. Stage IIB+ commonly requires sentinel lymph node biopsy, systemic adjuvant therapy.
Atomic veteran radiation exposure documentation (if applicable)
IMPORTANTAtmospheric nuclear testing participation, Hiroshima/Nagasaki occupation, DOE radiation work. RECA + service records. Triggers § 3.309(d) radiogenic presumption.
Sun exposure / occupational documentation (if pursuing direct SC)
IMPORTANTOutdoor MOS (aviation, naval bridge watch, field operations, MP, infantry) supports occupational sun exposure nexus for non-presumptive cases.
Camp Lejeune contaminated water service period (if 1953-1987)
IMPORTANTCamp Lejeune presumptive lane for veterans who served at least 30 days between Aug 1953 and Dec 1987. Multiple cancers on the presumptive list.
Surgical operative reports + scar / disfigurement photographs
IMPORTANTAnchors residuals rating after treatment completion. Document lymphadenectomy if performed (impacts lymphedema secondary). Date all photos.
Recurrence surveillance — dermatology / oncology follow-up + imaging
SUPPORTINGMelanoma carries significant recurrence + metastasis risk. Each recurrence triggers another 100% cycle. Document each new event.
C&P Exam Tips
Bring pathology + service-period documentation (DD-214) — anchor PACT presumption
If post-9/11 qualifying SW Asia / Afghanistan service, the presumption is automatic. No nexus letter needed.
Bring treatment records anchoring 100%-during-treatment trigger
Immunotherapy (pembrolizumab, nivolumab, ipilimumab), targeted therapy (BRAF/MEK inhibitors), systemic chemo, extensive radiation, or lymphadenectomy = automatic 100%.
Document all post-treatment residuals — scars, disfigurement, lymphedema, functional impairment
After 6-month re-evaluation, rate on residuals. Each residual is a separate analog DC.
Document atomic veteran radiation exposure if applicable
§ 3.309(d) radiogenic presumption is automatic for atmospheric nuclear testing, Hiroshima/Nagasaki occupation, DOE radiation work.
Don't accept 0% for melanoma with systemic-level treatment
Immunotherapy IS systemic — anchors 100% during treatment + 6-month tail. Don't let VA skip to residuals-only rating.
Don't file melanoma under DC 7818
DC 7818 explicitly excludes melanoma. Melanoma has its own dedicated DC 7833 with the PACT Act presumption.
Common Mistakes That Cost Veterans Points
Not filing under PACT Act presumption for post-9/11 qualifying service
Melanoma is on the PACT Act presumptive list per 38 USC § 1120 / 38 CFR § 3.320. Post-9/11 SW Asia / Afghanistan deployment automatically establishes nexus — no nexus letter required. Many veterans pursue direct SC nexus when the presumption is the easier path.
Filing melanoma under DC 7818 instead of DC 7833
DC 7818 explicitly EXCLUDES malignant melanoma. Melanoma has its own dedicated DC 7833 with the PACT Act presumption. Match the biopsy histology to the correct code.
Accepting rating-by-residuals when modern systemic treatment was used
DC 7833 grants automatic 100% if treatment requires systemic chemo, immunotherapy (pembrolizumab, nivolumab, ipilimumab), targeted therapy (BRAF/MEK inhibitors), extensive radiation, or more-than-wide-local-excision surgery. Modern melanoma treatment routinely uses immunotherapy. Don't let VA skip to residuals-only rating during the active treatment + 6-month tail.
Missing the atomic veteran radiogenic presumption
Skin cancers (including melanoma) 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 — pre-dates PACT Act.
Not pursuing direct SC for occupational sun exposure
Outdoor military duty (aviation, naval bridge watch, field operations, MP, infantry, special forces) supports occupational sun exposure nexus for non-presumptive cases. Document MOS + unit history + climate / latitude of service.
Not stacking post-treatment residuals aggressively
After 6-month re-evaluation, file each residual separately: scars (DC 7804 painful, DC 7805 functional), disfigurement (DC 7800 head/face/neck — up to 80%), lymphedema (post-lymphadenectomy), functional impairment. Each stacks.
Not filing recurrence as new 100% cycle
Melanoma carries significant recurrence + metastasis risk. Each recurrence triggers another 100%-during-treatment cycle. File the recurrence as a new claim event with new treatment start date.
Tactical Plays
⚡ File under PACT Act presumption for post-9/11 SW Asia / Afghanistan service
Melanoma is on the PACT Act presumptive cancer list per 38 USC § 1120 / 38 CFR § 3.320. Qualifying service: deployment to Iraq, Afghanistan, Saudi Arabia, Kuwait, Bahrain, UAE, Oman, Qatar, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen, Uzbekistan after 9/11/2001. The presumption is AUTOMATIC — no nexus letter required. File explicitly citing § 3.320 PACT Act presumption + cite DC 7833.
⚡ Anchor 100% via modern systemic treatment (immunotherapy, targeted therapy)
Modern melanoma treatment routinely includes immunotherapy (pembrolizumab, nivolumab, ipilimumab) and targeted therapy (BRAF/MEK inhibitors like dabrafenib/trametinib, encorafenib/binimetinib). ALL of these are systemic-level therapy comparable to internal malignancies — anchors automatic 100% during treatment + 6-month tail. Pull oncology records and document the specific regimen. Don't accept rating-by-residuals during active immunotherapy.
⚡ Stack atomic veteran radiogenic presumption for older claims
Pre-PACT Act, melanoma was already on the § 3.309(d) radiogenic presumptive list for atomic veterans. Atmospheric nuclear testing participation, Hiroshima/Nagasaki occupation, DOE radiation work — automatic presumption. Older atomic veterans should pursue this lane; post-9/11 veterans should pursue PACT lane. RECA + service records anchor.
⚡ Build the immunotherapy-related secondary file aggressively
Immune checkpoint inhibitors (pembrolizumab, nivolumab, ipilimumab) commonly cause autoimmune endocrinopathies and other immune-related adverse events. Hypothyroidism (DC 7903) is the most common (~10-15% of patients on PD-1 inhibitors). Type 1 diabetes (DC 7913), adrenal insufficiency, hypophysitis, colitis, hepatitis, pneumonitis all rate as direct secondary. Many oncology survivors miss the secondary stack entirely.
⚡ Stack post-treatment residuals — disfigurement, scars, lymphedema
After the 6-month post-treatment re-evaluation, residuals are the rating path. Head/face/neck melanoma resection often leaves DC 7800 disfigurement (up to 80%). Lymphadenectomy commonly causes lymphedema (DC 7121 analog). Painful scars under DC 7804 (up to 30%). Each rates separately. Build the comprehensive file.
⚡ File recurrence and metastasis as new 100% cycles
Melanoma carries significant recurrence + metastasis risk (especially Stage IIB+). Each new metastatic event (brain, liver, lung, bone) triggers another 100%-during-treatment cycle. Brain metastases also drive late-effects secondaries (cognitive impairment, seizures). File each recurrence as a new claim event with new treatment start date.
Secondary Conditions to File With This One
Disfigurement of head, face, neck (post-surgical)
STRONGDC 7800
Wide local excision of head/face/neck melanoma often leaves visible disfigurement. Rates 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 by the affected function (e.g., joint ROM).
Lymphedema (post-lymphadenectomy)
STRONGSentinel lymph node biopsy or completion lymphadenectomy may cause secondary lymphedema. Common in axillary or inguinal node dissections. Rates under appropriate extremity DC (often DC 7121 for chronic edema).
Immunotherapy-related endocrine dysfunction (hypothyroidism, adrenal insufficiency, hypophysitis, T1DM)
STRONGImmune checkpoint inhibitors (pembrolizumab, nivolumab, ipilimumab) commonly cause autoimmune endocrinopathies. Hypothyroidism (DC 7903) is the most common; type 1 diabetes (DC 7913), adrenal insufficiency, hypophysitis also documented.
Immunotherapy-related colitis / hepatitis / pneumonitis
MODERATEImmune-related adverse events from checkpoint inhibitors. Colitis (analog to DC 7323 ulcerative colitis), hepatitis, pneumonitis all rate under appropriate analog codes if persistent.
Depression secondary to cancer diagnosis + disfigurement
STRONGDC 9434
Cancer survivorship + visible disfigurement (especially head/face/neck) drive depression. Well-documented secondary.
Metastatic melanoma as new 100% cycle
SITUATIONALBrain mets, liver mets, lung mets, bone mets — each new metastatic event triggers another 100%-during-treatment cycle + may anchor late-effects secondaries (cognitive impairment from brain mets, etc.).
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
Melanoma requiring systemic chemo, immunotherapy (pembrolizumab/nivolumab/ipilimumab), targeted therapy (BRAF/MEK inhibitors), extensive radiation, or more-than-wide-local-excision surgery.
100% during treatment → 80% DC 7800 disfigurement + 30% DC 7804 painful scars (post-treatment residuals)
Base rating
$2,362.30
TOTAL
$2,362.30/mo
Head/face/neck melanoma residuals stack post-treatment.
100% during treatment → 30% DC 7903 immunotherapy hypothyroidism + 20% lymphedema + 30% DC 9434 MDD
Base rating
$1,435.02
TOTAL
$1,435.02/mo
Immunotherapy-related secondaries + lymphedema + depression after cancer survivorship.
Wide local excision only — 0% DC 7833 + 10% DC 7804 painful scar (residual)
Base rating
$180.42
TOTAL
$180.42/mo
Skin-confined treatment; rate residuals only.
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 the PACT Act melanoma presumption?
The Honoring our PACT Act of 2022 (38 USC § 1120, codified at 38 CFR § 3.320) added melanoma to the presumptive cancer list for post-9/11 veterans who served in SW Asia / Afghanistan / other qualifying locations. The presumption is automatic — service in any of these locations after 9/11/2001 + melanoma diagnosis = service connection without requiring a nexus letter. Qualifying locations include: Iraq, Afghanistan, Saudi Arabia, Kuwait, Bahrain, UAE, Oman, Qatar, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen, Uzbekistan.
↔️Why does melanoma rate differently from other skin cancers?
Most non-melanoma skin cancers (basal cell carcinoma, squamous cell carcinoma) are treated by wide local excision and rate by residuals. Melanoma is more aggressive — Stage IIB+ commonly requires sentinel lymph node biopsy + completion lymphadenectomy + systemic adjuvant therapy (immunotherapy, targeted therapy). The treatment intensity triggers automatic 100% under DC 7833. Also, melanoma has its own dedicated DC (7833), unlike non-melanoma skin cancers which fall under DC 7818 (which explicitly excludes melanoma).
💊What modern treatments trigger the 100% systemic-treatment gate?
Modern melanoma treatment routinely includes: (1) immune checkpoint inhibitors (pembrolizumab/Keytruda, nivolumab/Opdivo, ipilimumab/Yervoy, the combination nivolumab+ipilimumab), (2) targeted therapy (BRAF inhibitors like dabrafenib/encorafenib + MEK inhibitors like trametinib/binimetinib), (3) traditional systemic chemotherapy (dacarbazine, temozolomide), (4) intralesional therapy (talimogene laherparepvec/Imlygic for advanced cases). ALL of these are systemic-level therapy that anchors automatic 100% under DC 7833.
⏰What is the 6-month post-treatment tail?
After completion of antineoplastic treatment, the 100% rating continues for 6 months, then mandatory VA examination determines whether residuals warrant continued or reduced rating. If no local recurrence or metastasis at the 6-month mark, the rating transitions to residuals (scars, disfigurement, lymphedema, immunotherapy-related endocrinopathies, depression secondary to cancer survivorship). Each residual rates separately under its own DC.
🧬What are immunotherapy-related adverse events?
Immune checkpoint inhibitors (pembrolizumab, nivolumab, ipilimumab) can cause autoimmune reactions affecting any organ. Most common: hypothyroidism (DC 7903 — ~10-15% of PD-1 inhibitor patients), other endocrinopathies (type 1 diabetes per DC 7913, adrenal insufficiency, hypophysitis), colitis (analog DC 7323), hepatitis (analog), pneumonitis, dermatitis (analog DC 7806), arthritis. These are direct secondary to the immunotherapy treatment for SC melanoma and rate under appropriate analog DCs.
How to File Your Claim
Pull biopsy + pathology report — confirm melanoma diagnosis + staging
Match histology to DC 7833 (not DC 7818). Breslow depth, Clark level, ulceration, mitotic rate.
Pull DD-214 + service history — confirm PACT Act qualifying service if applicable
Post-9/11 SW Asia / Afghanistan deployment triggers § 3.320 automatic presumption.
Pull oncology treatment records — anchor 100% systemic-treatment gate
Immunotherapy (pembrolizumab/nivolumab/ipilimumab), targeted therapy (BRAF/MEK inhibitors), systemic chemo, extensive radiation, lymphadenectomy.
File 21-526EZ specifying 'malignant melanoma (DC 7833)' + cite PACT Act presumption / atomic veteran lane / direct SC
Identify the strongest applicable lane. PACT > atomic > Camp Lejeune > direct SC.
Build residuals + immunotherapy secondary file proactively
Disfigurement (DC 7800), scars (DC 7804/7805), lymphedema (DC 7121 analog), immunotherapy hypothyroidism (DC 7903), immunotherapy T1DM (DC 7913), depression (DC 9434). Each stacks.
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
PACT Act presumption — automatic for post-9/11 SW Asia / Afghanistan service
Per 38 USC § 1120 / 38 CFR § 3.320. Melanoma is on the presumptive cancer list. No nexus letter required.
100% gate = systemic treatment intensity (immunotherapy counts)
Pembrolizumab, nivolumab, ipilimumab, BRAF/MEK inhibitors, systemic chemo, extensive radiation, or more-than-wide-local-excision surgery ALL trigger 100%.
Atomic veteran radiogenic presumption pre-dates PACT
§ 3.309(d) — atmospheric nuclear testing, Hiroshima/Nagasaki occupation, DOE radiation work. Pursue if older atomic vet.
Build immunotherapy-related secondary file — hypothyroidism, T1DM, colitis
Immune checkpoint inhibitors cause autoimmune endocrinopathies + other adverse events. Often-missed secondaries.
Each recurrence / metastasis = new 100% cycle
Brain mets, liver mets, lung mets, bone mets — file each as new event with new treatment start date.
Related Tools & Resources
Frequently Asked Questions
Is melanoma a PACT Act presumptive cancer?
Yes — melanoma is on the PACT Act presumptive cancer list per 38 USC § 1120, codified at 38 CFR § 3.320. Post-9/11 veterans who served in qualifying SW Asia / Afghanistan / other listed locations (Iraq, Afghanistan, Saudi Arabia, Kuwait, Bahrain, UAE, Oman, Qatar, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen, Uzbekistan) have automatic service connection — no nexus letter required. File explicitly citing § 3.320 PACT Act presumption + DC 7833.
When does DC 7833 grant automatic 100%?
DC 7833 grants automatic 100% if the melanoma requires therapy comparable to that used for internal malignancies — ANY ONE of: (1) systemic chemotherapy, (2) immunotherapy (pembrolizumab, nivolumab, ipilimumab), (3) targeted therapy (BRAF/MEK inhibitors like dabrafenib/trametinib), (4) X-ray therapy more extensive than to the skin, (5) surgery more extensive than wide local excision (sentinel lymph node biopsy + lymphadenectomy, wide excision with flap reconstruction). The 100% continues through treatment and for 6 months after completion. Then mandatory re-evaluation determines residual rating.
What if my melanoma was just removed by wide local excision — do I get a rating?
Not under the 100% systemic-treatment gate, but residuals can rate. For skin-confined treatment, rate the residuals: scars under DC 7804 (painful — up to 30%) and DC 7805 (functional limitation), disfigurement of head/face/neck under DC 7800 (up to 80%), impairment of function. Stack each rateable residual. DC 7833 itself may yield 0% for thin melanoma treated by wide excision, but the residuals can add meaningful percentage. If post-9/11 qualifying service applies, the PACT Act presumption still grants service connection — the rating then depends on the residuals.
Can immunotherapy side effects rate as secondary?
Yes — immune checkpoint inhibitors (pembrolizumab, nivolumab, ipilimumab) commonly cause autoimmune adverse events that rate as direct secondary to the SC melanoma + immunotherapy regimen. Most common: hypothyroidism (DC 7903 — ~10-15% of PD-1 inhibitor patients), type 1 diabetes (DC 7913), adrenal insufficiency, hypophysitis, colitis (analog DC 7323), hepatitis, pneumonitis, dermatitis (analog DC 7806), inflammatory arthritis. Each rates separately. Many oncology survivors miss the immunotherapy secondary stack entirely.
What presumptive lanes apply to melanoma?
Multiple lanes (use the strongest applicable): (1) PACT Act — post-9/11 SW Asia / Afghanistan qualifying service, § 3.320, automatic presumption. (2) Atomic veteran radiogenic — § 3.309(d), atmospheric nuclear testing, Hiroshima/Nagasaki occupation, DOE radiation work. (3) Camp Lejeune contaminated water — 30+ days at Camp Lejeune between Aug 1953 and Dec 1987 (§ 3.307(a)(7) presumptive cancers include some that overlap). (4) Direct SC for occupational sun exposure (outdoor MOS: aviation, naval bridge watch, field operations, MP, infantry, special forces) or known carcinogen exposure. Pursue the strongest applicable lane.
What happens if my melanoma recurs or metastasizes?
Each recurrence or new metastatic event triggers another 100%-during-treatment cycle under DC 7833. File the recurrence as a new claim event with new treatment start date. Brain metastases drive additional late-effects secondaries (cognitive impairment under DC 8045 by analogy, seizures under DC 8910). Liver / lung / bone metastases also generate site-specific secondaries. Melanoma carries significant recurrence + metastasis risk for Stage IIB+ disease — surveillance + file each event.
Official Regulatory Source
Malignant melanoma rates under 38 CFR § 4.118, DC 7833 — automatic 100% if treatment requires systemic chemo, immunotherapy, targeted therapy, extensive radiation, or more-than-wide-local-excision surgery + 6-month post-treatment tail. PACT Act presumption per 38 CFR § 3.320.
38 CFR § 4.118 — Skin (eCFR) →Scroll to DC 7833. Distinct from DC 7818 (other malignant skin neoplasms — explicitly excludes melanoma). PACT Act presumption per 38 CFR § 3.320 / 38 USC § 1120. Atomic veteran radiogenic per § 3.309(d). Residuals rate under DC 7800-7805.
Next Steps
If your rating decision lists DC 7833, 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 7833 • 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.