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Understanding the Psoriasis VA Rating System

Last updated: March 9, 2024

Living with psoriasis can be both physically challenging and mentally draining. For veterans, the effects of this condition can be even more pronounced, given the unique stresses and challenges they have faced during their service.

The psoriasis VA rating system is a significant component of the support structure provided by the Department of Veterans Affairs (VA). This system aims to ensure that veterans affected by psoriasis and other related skin conditions receive the appropriate recognition, support, and benefits they rightly deserve. Understanding this system can empower veterans to navigate the VA benefits landscape more effectively, ensuring they maximize the support available to them.

Read the guide to learn more!

Overview of VA Ratings for Skin Conditions

The Department of Veterans Affairs (VA) employs a structured rating system that evaluates the severity and extent of disabilities to determine suitable compensation. Skin conditions, which can range from minor irritations to debilitating diseases, are among the vast array of conditions covered by this system.

Criteria for Rating Skin Conditions

To determine the VA rating for skin conditions, multiple facets of the ailment are examined. Here's a breakdown of the criteria:

Percentage of Body Surface Area Affected: The VA utilizes a body surface area chart to ascertain the extent of skin affected. This chart segments the body into different regions, each assigned a percentage to reflect its size relative to the entire body. For instance, the head and neck constitute about 9% of the body surface area, while each arm is equivalent to 4.5%.

Type of Skin Condition: Different skin conditions carry varying levels of severity. Conditions like psoriasis and eczema, for example, can be considerably debilitating. Complications linked to the primary skin ailment also play a role. A veteran suffering from psoriasis-induced severe arthritis might receive a higher rating than another whose psoriasis doesn't manifest in such complications.

Severity of the Skin Condition: A pivotal factor in the rating process is the intensity of the skin condition. Burns and skin cancers can be severely impairing, significantly limiting the veteran's daily functional capacity. Conversely, conditions like acne or vitiligo might not be as hindering, thereby leading to a different VA rating.

Impact on Daily Life: One of the central considerations is how the skin condition affects the veteran's everyday life. To gauge this, the VA evaluates:

  • Work Capacity: The skin condition's effect on the veteran's ability to maintain or seek employment.

  • Daily Activities: The extent to which the ailment impedes basic activities like dressing, eating, and bathing.

  • Social and Recreational Participation: Any limitations the condition places on the veteran's social interactions or hobbies.

  • Pain and Discomfort: An assessment of the level of pain or unease the veteran endures due to the condition.

Service-Connected Disabilities & Psoriatic Arthritis

The recognition of the correlation between military service and the emergence or exacerbation of specific skin conditions, such as psoriatic arthritis, is a critical aspect of veteran healthcare. This connection can significantly influence a veteran’s eligibility for VA disability benefits.

Establishing a Direct Service Connection

To secure benefits for conditions like psoriasis or psoriatic arthritis, veterans must provide clear and convincing evidence of a direct service connection. This entails substantiating that the condition either originated during their military service or was notably aggravated by it. Medical records, service records, and expert testimonials can play pivotal roles in affirming this connection, ensuring that veterans receive the compensation they are entitled to.

Presumptive Service Connection for Certain Skin Conditions

In some instances, the VA acknowledges a presumptive service connection for specific skin conditions. This means that under certain predefined conditions, the VA will automatically presume that the skin condition is connected to military service, thereby alleviating the burden of proof on the veteran. This can be particularly relevant for conditions that are widely recognized as being associated with certain types of service or exposure to specific substances.

Constant or Near-Constant Systemic Therapy Requirement

For some ratings, particularly the higher ones, veterans might be required to demonstrate the necessity for consistent or nearly consistent systemic therapies. These treatments can include a range of medical interventions, from oral medications to biologics. The intention is to establish that the severity of the skin condition necessitates ongoing, intensive treatment, which in turn reflects the level of disability and determines the corresponding VA benefits.

Rating Formula & Disability Benefits

The VA employs a systematic formula to decide on a disability rating, which then becomes the bedrock for determining the subsequent disability benefits a veteran is entitled to receive.

Rating Formula Applied to Psoriatic Arthritis

The VA evaluates psoriatic arthritis by focusing on several key aspects:

  • Severity of the joint involvement

  • Presence of accompanying symptoms, including fatigue, pain, and the manifestation of skin lesions

  • The overall impact of the ailment on a veteran's daily activities and quality of life.

Specifically, the VA's rating system for psoriatic arthritis is categorized as follows:

  • Mild PsA: Involvement of one or two joints with minimal disruption to daily life, meriting a rating of 10% to 30%.

  • Moderate PsA: Involvement of three to five joints with a moderate effect on daily activities, securing a rating of 40% to 60%.

  • Severe PsA: Over six joints were affected with significant disruptions to daily life, which warrants a rating of 70% to 100%.

Common Ratings Associated with Psoriasis and Psoriatic Arthritis Conditions

  • 0%: When less than 5% of the body's surface area shows psoriasis symptoms and only topical therapy is required over a year.

  • 10%: For those affected by psoriasis on 5% to 20% of the body's surface area or if systemic therapy like corticosteroids is required for less than six weeks within a year.

  • 30%: Regular, moderately severe flare-ups requiring continuous treatment.

  • 60%: Persistent, severe flare-ups necessitating regular hospitalization and extensive treatment.

Levels of Disability Based on Ratings

The VA utilizes a clear rating system, which aligns with these levels of disability:

  • 0%: No disability.

  • 10% to 30%: Mild disability.

  • 40% to 60%: Moderate disability.

  • 70% to 90%: Severe disability.

  • 100%: Total disability.

Eligibility for Disability Benefits Based on Ratings and Predominant Disability

The VA designates benefits based on two pivotal criteria: the service connection, implying the disability has roots in or was exacerbated by military service, and the assigned rating. The veteran's "predominant disability" is essentially the disability most affecting their daily life. It’s gauged by considering all the veteran's service-connected disabilities, their individual impacts on daily life, medical records, statements from the veteran, and inputs from healthcare providers and relatives.

Current Skin Condition & Treatment Options

The VA rating system serves as a tool to measure the extent and impact of a veteran's disability, ensuring they receive appropriate compensation. However, aside from financial reparation, it's paramount for veterans to stay updated on the current state of skin conditions, particularly psoriasis and associated ailments, and the advances in their treatments. The more informed veterans are, the better they can advocate for their health and improve their quality of life.

Modern Understanding of Psoriasis

Psoriasis, a chronic autoimmune condition, manifests itself in the form of inflamed, scaly skin patches. These patches, often red with silver-white scales, can be itchy or painful. Over recent years, research has deepened the understanding of psoriasis, connecting it not just to skin manifestations but also linking it with other conditions like psoriatic arthritis, cardiovascular diseases, and metabolic syndrome.

Current Treatment Landscape for Psoriasis

The therapeutic world has witnessed significant strides in the treatment of psoriasis, offering a range of solutions to help manage the condition:

  • Topical treatments: These remain the first line of treatment for mild psoriasis. They include corticosteroids, vitamin D analogs, and coal tar preparations.

  • Phototherapy: This treatment uses ultraviolet (UV) light to reduce skin inflammation and is effective for moderate to severe psoriasis.

  • Systemic medications: These are prescription drugs that affect the entire body and are used for those with moderate to severe psoriasis. They include oral treatments like methotrexate or cyclosporine and biologic drugs, which are administered through injection or infusion.

  • Biologic treatments: These are a subset of systemic medications but target specific parts of the immune system. They've transformed the treatment landscape for many psoriasis patients, offering higher rates of skin clearance and better quality of life. Examples include etanercept (Enbrel), adalimumab (Humira), and ustekinumab (Stelara).

  • Lifestyle changes: Beyond medical treatments, adopting a healthy lifestyle can also impact the management of psoriasis. This includes maintaining a balanced diet, avoiding smoking and excessive alcohol, managing stress, and using moisturizers to prevent skin dryness.

Treatment Options for Psoriatic Arthritis

For those suffering from psoriatic arthritis, the joint pain and swelling accompanying the skin condition require specialized attention. Nonsteroidal anti-inflammatory drugs (NSAIDs) often serve as a starting point. However, for more severe cases, disease-modifying antirheumatic drugs (DMARDs) or biologics that target specific immune responses might be prescribed.

Navigating the Path Forward

Comprehending the intricacies of the psoriasis VA rating system is pivotal for veterans battling skin conditions. Armed with this insight and the appropriate tools, they can confidently secure the rightful compensation for their service-induced ailments.

Find ways to secure income while waiting for disability benefits in this guide. Take action now and secure the financial stability you need!

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Chloe Powers
Chloe works with policymakers on behalf of Disability Help to support their work at a strategic level, ensuring the conditions are in place for creative individuals and organizations to grow, reach their potential and effect relevant, sustainable change.
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