Skin claims are decided on paper. The examiner's report matters, but so does everything you put in the file before it, and skin is a category where the veteran's own documentation genuinely changes outcomes because the disease is not visible on demand.
This is the checklist.
1. The diagnosis, in writing
A named diagnosis from a qualified provider is the foundation. Rash is not a diagnosis. Atopic dermatitis, psoriasis vulgaris, seborrheic dermatitis, chronic idiopathic urticaria, hidradenitis suppurativa, chloracne - those are. Where a biopsy was done, include the pathology report.
2. Dated flare photographs
This is the single highest-value item unique to skin claims. Photograph flares in natural light, capture the full affected area and a close-up, include something for scale, and preserve the file dates. A dozen photographs across a year showing the same condition at its worst does more than any description of it.
Label each photograph with the date and body location so the reviewer does not have to guess.
3. Complete treatment and prescription history
Because the rating criteria turn on treatment, the pharmacy record is rating evidence, not background. Request the full prescription history including refill dates, and separate the topical medications from the systemic ones. Total up the weeks of systemic therapy in each 12-month period.
Include infusion records for biologic therapy, phototherapy records, and any dermatology procedure notes. Our guide to medical evidence in VA disability claims covers which records carry the most weight.
4. Service records and exposure documentation
Pull the service treatment records for any sick call visit involving skin, no matter how minor it looked at the time. Add personnel records and duty descriptions establishing the physical environment, and where the claim involves exposure, the deployment records, registry enrollment, or unit histories that establish it. Our chloracne and exposure guide covers what exposure evidence looks like.
Where veterans start
Every case is different, and there is no obligation at any step. When veterans want to understand what their records actually support, these are the two most common starting points:
- Medical records review
A licensed physician reviews your records for a $250 flat fee and identifies which conditions the available evidence may support. The fee is refunded in full if nothing supportable is identified.
- Nexus letter
When the records support one, a licensed provider writes the medical opinion that addresses the link between your condition and your service or an already service-connected disability.
5. Lay statements
Statements from a spouse, family member, coworker, or someone who served with you are competent evidence of what they observed: visible rash, constant scratching, shirts marked with blood, avoiding short sleeves, sleep disrupted by itching. They cannot diagnose, and they should not try. Specific, dated, first-hand observation is what carries weight.
One well-written statement from someone who knew you before and after service is worth more than five general ones.
6. A statement in support of your claim
Your own account matters. Describe when the condition started, what you did about it at the time, how often it flares, what triggers it, what treatment you have tried, and how it affects work and daily life. Keep it factual and chronological. If your service records are silent, explain plainly why you did not go to sick call - that explanation is evidence.
7. The medical opinion
When the file has a diagnosis and a credible in-service history but nothing connecting them, the opinion is the missing element. A sound opinion states the conclusion clearly, explains the medical reasoning, addresses the alternatives the VA will consider, cites the records reviewed, and is signed by a qualified provider.
Our guide to what a nexus letter is covers the format, and why VA claims get denied helps identify which element a prior decision actually found missing before you spend money on anything.
Where to go next
Read the rating guide for your diagnosis - eczema and dermatitis, psoriasis, or scars - and the skin C&P exam guide before your exam is scheduled. Free accredited help with filing is available to every veteran; our guide on free help from a Veterans Service Officer explains where to find it.