Lupus VA Rating: Systemic (DC 6350) and Discoid (DC 7809) Criteria

Systemic and discoid lupus VA rating table (DC 6350 and DC 7809)

The table below lists every rating percentage and criterion for systemic lupus under 38 CFR 4.88b (DC 6350) and discoid lupus under 38 CFR 4.118 (DC 7809).

Under the veteran-alone compensation schedule effective 2025-12-01, 10% pays $180.42 per month, 30% pays $552.47, 60% pays $1,435.02, and 100% pays $3,938.58 per month.

How the VA evaluates systemic lupus flare-ups under Diagnostic Code 6350

Under Diagnostic Code 6350 in 38 CFR 4.88b, the rating percentage turns on the frequency, duration, and severity of exacerbations (acute flare-ups):

• 10% rating: Assigned for exacerbations once or twice a year, or being symptomatic during the past 2 years. Even with zero acute flares in the past year, any lupus-attributable symptoms (joint aching, fatigue, oral ulcers, or low-grade inflammation) within the past two years satisfy the 10% criteria, as do one or two flares per year lasting under a week.
• 60% rating: Assigned for exacerbations lasting a week or more, 2 or 3 times per year. DC 6350 jumps directly from 10% to 60% with no 20%–50% tiers. Qualifying for 60% requires medical records documenting both frequency (2 or 3 exacerbations per year) and duration (each lasting 7 consecutive days or longer).
• 100% rating: Assigned when systemic lupus is acute, with frequent exacerbations, producing severe impairment of health (such as >3 flares per year, hospitalization, life-threatening organ involvement, or inability to sustain self-care or work).
• 0% rating (38 CFR 4.31): Assigned when service-connected systemic lupus is in remission with no flares or symptoms over the past two years.

Because the jump from 10% ($180.42/month for a veteran alone) to 60% ($1,435.02/month for a veteran alone), per VA rates effective 2025-12-01, hinges on whether 2 or 3 annual flares last a week or more, documenting flare start and end dates in rheumatology notes, urgent care records, or steroid tapers is essential.

The Note to DC 6350: rating by combined organ residuals when higher

Many veterans with systemic lupus take daily maintenance medications—such as hydroxychloroquine, mycophenolate mofetil, azathioprine, methotrexate, or belimumab—that keep week-long flares below two per year, yet they suffer chronic organ or joint damage. The Note to Diagnostic Code 6350 in 38 CFR 4.88b mandates a two-way comparison:

“Note: Evaluate this condition either by combining the evaluations for residuals under the appropriate system, or by evaluating DC 6350, whichever method results in a higher evaluation.”

Under this Note, the VA compares the standalone DC 6350 flare rating (10%, 60%, or 100%) against separate organ-system residual ratings combined under 38 CFR 4.25, awarding whichever is higher:

• Renal (Lupus nephritis) — 38 CFR 4.115a & 4.115b (DC 7502): Rated under Renal Dysfunction by eGFR for at least 3 consecutive months in the past year: 0% (eGFR 60–89 with casts, glomerular abnormalities, or albumin/creatinine ratio ≥30 mg/g), 30% (eGFR 45–59), 60% (eGFR 30–44), 80% (eGFR 15–29), or 100% (eGFR <15, dialysis, or transplant). Renal hypertension rates under DC 7101 (10%–60%).
• Musculoskeletal (Lupus arthritis) — 38 CFR 4.71a (DC 5002 / DC 5003): Multi-joint arthritis in the hands, wrists, knees, ankles, or shoulders rates under DC 5002 (20%–100%) or by limitation of motion / painful motion (38 CFR 4.59) under DC 5003, with the 10% bilateral factor (38 CFR 4.26) for paired extremities.
• Cardiopulmonary — 38 CFR 4.97 (DC 6845) & 4.104 (DCs 7000–7002, 7006): Pleurisy or shrinking lung syndrome rates under DC 6845 at 10%, 30%, 60%, or 100% by FEV-1, FEV-1/FVC, or DLCO(SB) (100% for pulmonary hypertension, cor pulmonale, or oxygen therapy). Pericarditis (DC 7002), Libman-Sacks endocarditis (DC 7001), valvular disease (DC 7000), or myocarditis (DC 7006) rates at 10%, 30%, 60%, or 100% by METs, ejection fraction, or continuous medication (10%).
• Hematologic, neurologic, and vascular — 38 CFR 4.117, 4.124a, & 4.130: Immune thrombocytopenia (DC 7705) rates at 0%, 10%, 30%, 70% (immunosuppressive therapy), or 100% (platelets ≤30,000 despite treatment or chemotherapy). Seizures, peripheral neuropathy, lupus depression or anxiety, thrombosis (DC 7121), or Raynaud’s (DC 7117, 10%–100%) rate under their respective schedules.

For example, if a veteran has one week-long flare per year (10% under DC 6350) but has Stage 3a lupus nephritis with eGFR 50 (30%), painful arthritis in both wrists and knees (40% with the bilateral factor), and chronic pleurisy with DLCO at 62% (30%), combining 40% + 30% + 30% under 38 CFR 4.25 yields 70%, which the VA must award under the Note to DC 6350.

Discoid lupus erythematosus (DC 7809) and cutaneous lupus under 38 CFR 4.118

When lupus affects the skin—either as discoid lupus erythematosus (DLE) or subacute cutaneous lupus erythematosus (SCLE)—the VA rates it under 38 CFR 4.118, Diagnostic Code 7809, using the General Rating Formula for the Skin at 0%, 10%, 30%, or 60% based on whichever of two measurements is higher:

1. Characteristic lesions by body surface area or exposed areas: Examiners estimate the percentage of your entire body and exposed areas (face, neck, and hands) covered by characteristic lupus lesions (discoid plaques, scaling, atrophy, or malar butterfly rash): <5% with topical therapy only (0%), 5% to <20% (10%), 20% to 40% (30%), or >40% (60%).
2. Duration of systemic therapy over the past 12 months: Under 38 CFR 4.118(a), systemic therapy means treatment administered through any route (orally, injection, suppository, intranasally) other than the skin, while topical therapy is applied to the skin. Requiring oral or injectable corticosteroids, systemic immunosuppressives, biologics, oral retinoids, or phototherapy/PUVA over the past 12 months warrants 10% (<6 weeks), 30% (6 weeks or more, but not constantly), or 60% (constant or near-constant systemic therapy).

If permanent skin damage is predominant, 38 CFR 4.118 rates discoid lupus under DC 7800 (head, face, or neck disfigurement at 10%, 30%, 50%, or 80%—see our scars VA rating guide), DC 7804 (unstable or painful scars at 10%–30%, plus 10% if both), or DC 7830 (scarring alopecia at 0% for <20% of scalp, 10% for 20 to 40 percent, or 20% for more than 40 percent). While 38 CFR 4.88b and 38 CFR 4.118 bar combining DC 6350 with DC 7809 (38 CFR 4.14), if systemic lupus is rated by combining residuals instead of under DC 6350, your skin rating combines with your internal organ and joint ratings under 38 CFR 4.25.

Service connection, the SLE DBQ exam, and secondary conditions

Veterans establish service connection for lupus through three pathways:

1. One-year chronic disease presumption (38 CFR 3.307(a)(3) & 38 CFR 3.309(a)): Systemic lupus erythematosus is listed as a chronic disease in 38 CFR 3.309(a) (“Lupus erythematosus, systemic”). If a veteran with 90+ days of continuous active service manifests systemic lupus to 10% or more within 1 year of separation, service connection is presumed. Under 38 CFR 3.303(b), documented chronic lupus symptoms in service or within the 1-year window continuing until diagnosis also establish service connection.
2. Direct service connection (38 CFR 3.303(a)): Requires a current diagnosis, in-service symptoms (sun-triggered rashes, joint swelling, pleurisy, leukopenia, or positive ANA tests) or occupational exposures, and a medical nexus opinion.
3. Secondary service connection (38 CFR 3.310): Drug-induced lupus from medications for a service-connected disability, or lupus permanently aggravated beyond its natural progression (38 CFR 3.310(b)) by a service-connected condition, may be service connected with a medical nexus.

At a C&P exam, the clinician completes the Systemic Lupus Erythematosus (SLE) and Other Autoimmune Diseases DBQ (and the Skin Diseases DBQ for discoid lupus or scars):

• Sections I–III: Confirms SLE, discoid, or subacute cutaneous lupus (1A–1B); logs 12-month duration (<6 weeks, 6 weeks or more, but not constant, or Constant/near-constant) of oral/topical steroids, immunosuppressives, and retinoids (2B); checks annual flare frequency (0, 1, 2, 3, More than 3), duration (<1 week vs. 1 week or more), and severe impairment of health (2D–2E); and records malar/discoid lesions across Total Body Area, Exposed Body Area (face, neck, and hands), and scarring alopecia (3A–3G).
• Sections IV–VII: Records non-cutaneous symptoms in the past 2 years (4B), screens 10 organ systems requiring specialist DBQs (4C–4L: arthritis, oral ulcers, hematologic, pulmonary, cardiac, neurologic, renal, obstetric, gastrointestinal, and vascular thrombosis), and records labs (ANA titer, anti-dsDNA, anti-Smith, anti-Ro, antiphospholipid, C3/C4, ESR/CRP, CBC/platelets, BUN/creatinine/eGFR, and urinalysis for proteinuria, casts, and hematuria).

Under 38 CFR 3.310(a), long-term lupus therapy—especially oral corticosteroids—may cause or aggravate secondary diabetes (DC 7913), hypertension (DC 7101), osteoporosis or avascular necrosis of the hip or knee, cataracts or hydroxychloroquine retinopathy (38 CFR 4.79), GERD (DC 7206), or secondary depression and anxiety (38 CFR 4.130) with a medical nexus.

Combined ratings (38 CFR 4.25), TDIU (38 CFR 4.16), and accredited help

The VA combines lupus ratings using 38 CFR 4.25, which you can model with our VA combined rating calculator, while our VA back pay calculator estimates retroactive pay. A 60% rating under DC 6350 or DC 7809 (or combined common-etiology lupus residual ratings reaching 60% or 70% under 38 CFR 4.16(a)) meets the schedular threshold for Total Disability based on Individual Unemployability (TDIU), paying at the 100% rate ($3,938.58 per month alone) if lupus prevents substantially gainful employment.

For free claims assistance, contact a Veterans Service Organization (VSO) (DAV, VFW, or American Legion), or consult a VA-accredited claims agent or attorney for appeals. No representative can promise an outcome; verify credentials via the VA Office of General Counsel Accreditation Search.