How the VA Assigns a Basal Cell Carcinoma VA Rating Under Diagnostic Code 7818

The Department of Veterans Affairs (VA) evaluates a basal cell carcinoma VA rating under Diagnostic Code (DC) 7818 by measuring resulting disfigurement of the head, face, or neck, scar tissue, or impairment of function. Under federal rules, active skin cancer does not receive a 100 percent evaluation unless treatment is comparable to systemic cancer therapy. Local treatments confined to the skin do not qualify for a 100 percent rating.

How Diagnostic Code 7818 Governs a Basal Cell Carcinoma VA Rating

Diagnostic Code 7818 in [38 CFR 4.118](https://www.law.cornell.edu/cfr/text/38/4.118) covers all malignant skin neoplasms other than malignant melanoma. The text of the regulation does not name basal cell carcinoma directly. Because basal cell carcinoma is a non-melanoma skin cancer, rating adjudicators apply DC 7818 strictly by the regulation's title. If your medical diagnosis is melanoma, the VA evaluates your condition under a separate schedule code, which you can review in our guide on [melanoma skin cancer](/va-disability/melanoma-skin-cancer/). Under DC 7818, the rating official directs evaluation to one of three residual categories:

• Disfigurement of the head, face, or neck under DC 7800.
• Scars on any part of the body under DC 7801, DC 7802, DC 7803, DC 7804, or DC 7805.
• Impairment of function of the affected body part.

The rating officer applies whichever of these fits your residuals. You can explore how these rules fit into broader [skin conditions](/va-disability/skin-conditions/) and general [cancer ratings](/explainers/va-disability-rating-cancer/) across the VA disability schedule.

The Evaluation Rule for Systemic Versus Skin-Confined Treatment

A 100 percent disability rating for skin cancer under Diagnostic Code 7818 requires medical therapy comparable to treatment used for systemic malignancies. A specific note in [38 CFR 4.118](https://www.law.cornell.edu/cfr/text/38/4.118) establishes that when a skin malignancy requires therapy comparable to that used for systemic malignancies, a 100 percent evaluation applies from the start of therapy. Treatments confined to the skin do not qualify for this total evaluation. Rating adjudicators evaluate veterans who receive local treatment solely on residual tissue changes.

Treatment Type	Regulatory Category Under DC 7818	Rating Schedule Impact
Therapy comparable to that used for systemic malignancies	Note to DC 7818	A 100 percent evaluation applies from the start of therapy.
Treatment confined to the skin	Note to DC 7818	The 100 percent provision does not apply; the skin cancer is rated on its residuals under DC 7800 to 7805 or on impairment of function.

Rating Basal Cell Carcinoma Residuals After Surgical Removal

A basal cell carcinoma that has been removed and has not returned is evaluated based on physical residuals such as scars or disfigurement. Whether a veteran has a current disability after complete tumor removal is an official decision for the VA. When residuals remain after surgery, adjudicators assess the physical evidence under established residual codes:

• **Disfigurement of the head, face, or neck (DC 7800):** Evaluated based on specific anatomical characteristics documented by a medical examiner, including tissue loss, skin texture changes, indentations, asymmetry, or abnormal pigmentation.
• **Painful or unstable scars (DC 7804):** Evaluated when surgical scar tissue displays persistent tenderness, pain on examination, or repeated ulceration and tissue breakdown.
• **Linear or flat scars (DC 7801, DC 7802, DC 7803, and DC 7805):** Evaluated based on precise physical measurements of total scar area, length, width, and whether the tissue adheres to underlying muscle or bone.
• **Impairment of function:** Evaluated under the rating code for the affected body system if scar tissue restricts the motion of nearby joints.

We do not state specific scar or disfigurement percentages here because those ratings depend entirely on the precise size, location, and anatomical characteristics measured during an in-person physical examination. The medical examiner records these objective measurements, and the VA applies [38 CFR 4.118](https://www.law.cornell.edu/cfr/text/38/4.118) to calculate the evaluation. If your residual scars become increasingly painful or restrict your motion in the future, you can file a [claim for increase](/va-claims/claim-for-increase/) to request a higher evaluation.

Establishing Service Connection for Non-Melanoma Skin Cancer

Establishing service connection for basal cell carcinoma requires three evidentiary components: a current medical diagnosis, evidence of an in-service event or exposure, and a medical link connecting the condition to military service. To obtain service-connected status, your claim must satisfy the fundamental [service connection requirements](/va-claims/service-connection-requirements/) recognized by federal law. A current diagnosis requires an objective pathology report from a laboratory biopsy confirming basal cell carcinoma. The second requirement is proof of an event, injury, or exposure during active duty service. Veterans frequently point to extensive, unprotected sun exposure while performing outdoor duties, deployments to tropical climates, or specific occupational hazards. However, documented sun exposure during military service does not automatically qualify you for service connection. The VA decides how much evidentiary weight each service record carries. The third requirement is a medical link, often called a nexus. This is an official medical opinion written by a qualified healthcare professional explaining the medical link between your service exposure and skin cancer. Treatment records and biopsy results form the core evidence for this assessment. If your official service records do not show active dermatological treatment during service, review our [nexus letter guide](/va-claims/nexus-letter-guide/) to learn how doctors substantiate medical opinions.

Preparing for the Compensation and Pension Examination

The Compensation and Pension (C&P) exam for skin cancer focuses on documenting lesion characteristics, scar dimensions, and any ongoing functional limitations. When you submit a disability claim, the VA schedules an examination with a medical provider who completes a standardized skin conditions questionnaire. During the examination, the clinician conducts a thorough physical assessment to record the following objective data:

• The exact length and width of any surgical scars, recorded in centimeters or inches.
• The presence of visible disfigurement features on the head, face, or neck, such as facial distortion, indentations, or abnormal skin color.
• Whether scar tissue produces pain or tenderness when touched lightly by the clinician.
• Whether scars are unstable, meaning they frequently bleed, crack, or fail to heal completely.
• Any reduction in joint mobility or muscle movement caused by scar tightness or contractures.

The C&P examiner does not decide your final disability percentage or approve your claim. The examiner submits the completed report to the VA regional office, where a rating specialist compares the physical measurements against [38 CFR 4.118](https://www.law.cornell.edu/cfr/text/38/4.118). For practical preparation steps before your medical appointment, review our guide on [C&P exam tips](/va-claims/c-and-p-exam-tips/).

Evidence Checklist for Your Skin Cancer Disability Claim

Gathering complete pathology and military records before filing helps ensure that VA rating adjudicators have the evidence needed to evaluate your claim. Assemble these core documents before submitting your application:

1. **Pathology and biopsy reports:** Laboratory documentation confirming the diagnosis of basal cell carcinoma, detailing the histological type and exact anatomical location of the lesion.
2. **Operative and surgical records:** Detailed notes from dermatologists or surgeons describing the removal procedure, including Mohs excision maps, tissue margins, and reconstruction details.
3. **Military service records:** Documentation showing military occupational specialties that required outdoor labor, naval deck operations, flight line work, or deployments to equatorial regions with high solar radiation.
4. **Service treatment records:** Military medical entries reflecting in-service sunburns, actinic keratosis treatments, skin rashes, or dermatological clinic visits.
5. **Post-operative treatment records:** Current medical notes recording lingering scar pain, skin breakdown, physical restrictions, or ongoing dermatological monitoring.
6. **Medical nexus opinion:** A formal written statement from your physician explaining the medical connection between your service-era sun exposure and your current skin cancer diagnosis.

Who This Skin Cancer Guidance Does Not Serve

This guidance does not apply to veterans seeking disability ratings for malignant melanoma. Melanoma is classified under separate schedule codes with distinct criteria. If your biopsy confirms malignant melanoma, consult our dedicated [melanoma skin cancer](/va-disability/melanoma-skin-cancer/) page instead of DC 7818. This material also does not serve veterans with internal organ malignancies or systemic lymphatic cancers. See our general [cancer ratings](/explainers/va-disability-rating-cancer/) page for those conditions. Furthermore, if your basal cell carcinoma was removed completely through minor outpatient excision and left zero measurable scars, no facial disfigurement, and no physical pain, the VA may find that no compensable physical disability exists under the law.

Circumstances That Change the Disability Evaluation

A change in your clinical presentation or the recurrence of a malignant lesion can alter how the VA evaluates your skin condition. The rules described on this page apply to non-melanoma skin cancers managed with standard clinical procedures. Our analysis would change if any of the following clinical or legal developments take place:

• **Recurrence of malignancy:** If a basal cell carcinoma returns in the same anatomical area or new lesions require ongoing intervention, fresh biopsy records must be submitted to establish active disease.
• **Requirement for systemic therapy:** If treatment becomes comparable to therapy used for systemic malignancies, the 100 percent provision under the DC 7818 note takes effect from the start of therapy.
• **Physical worsening of scars:** If surgical scar tissue becomes unstable, breaks open repeatedly, or causes progressive pain, an evaluation under DC 7801 through DC 7805 can be adjusted upward based on updated medical measurements.
• **Regulatory updates:** Revisions to the disability rating schedule by the Department of Veterans Affairs can modify how scars or disfigurement are categorized. Verify current administrative rules directly on the official [VA disability website](https://www.va.gov/disability/).

Next Steps for Filing Your Disability Claim

Collect your post-operative records and verify all current filing instructions and forms directly on the official [VA disability benefits portal](https://www.va.gov/disability/). Gather your pathology records and file your claim to establish your basal cell carcinoma VA rating through the official VA disability portal. This page provides general information and does not constitute legal or medical advice. Rank and Pay is not a law firm and is not affiliated with the Department of Veterans Affairs or the Department of Defense. Confirm current rules and forms on the official [VA disability benefits website](https://www.va.gov/disability/), and consult a qualified healthcare professional regarding any medical questions or treatment decisions.