An incorrectly low rating from a good-skin exam day can mean $400 to $800 per month less in compensation, indefinitely. The C&P examination for a skin condition is one appointment, one examiner, one snapshot of your skin's appearance that may define your rating for years. If that snapshot doesn't reflect your typical disease burden, your rating won't either. Systematic photo documentation is the most practical tool you have to counter this structural disadvantage, and it costs nothing.
VA adjudicators are not dermatologists. They work from written records: C&P reports, treatment notes, nexus letters. When those records describe your skin condition as "mild" or "well-controlled" because that was the state at the last examination, the rater has no basis to deviate from that characterization.
A dated, well-organized photographic record creates a parallel evidentiary track. Photos submitted with your claim file:
Veterans have successfully used photograph evidence to challenge C&P exam findings that described minimal disease when the true flare burden was substantially more severe.
Photograph during active flares, not on good days. Your goal is to document the worst-case and typical-case presentation, not the best case. During a flare, photograph:
Scars don't flare and remit. Photograph them:
See Skin condition VA rating criteria explained for how scar size and character translate into rating percentages.
Photographs taken before starting treatment and after partial improvement document the treatment responsiveness and imply that the untreated or under-treated state is the baseline.
Photos that serve as VA evidence need to meet basic standards to be credible:
Include photos in a folder of additional evidence submitted with your VA Form 21-526EZ. Label them clearly with your name, claim number (if known), and a brief description.
Submit photos as "new and relevant evidence" under 38 CFR 19.5 (for Legacy appeals) or under the supplemental claim lane (AMA appeals). A personal statement referencing the photos and explaining their significance should accompany the submission.
Bring printed photographs to your C&P examination. Give the examiner a copy and ask that they be included in the examination report. Many examiners will accept and note the photographs; some will decline to include them but you can still submit them separately to your claims file.
You can submit additional evidence directly to your regional office at any time during a pending claim using VA Form 21-4142 (authorization for release) or simply with a cover letter referencing your claim number.
Don't start photographing only when you decide to file a claim. Build the record continuously:
A continuous photographic record going back months or years carries more evidentiary weight than a set of photos taken immediately before filing because it can't be argued that the photos were staged.
Photos are most powerful when they corroborate other evidence in your file. They should align with:
Consistency across evidence types makes it very difficult for a rater or examiner to minimize the true disease burden.
For guidance on how this photographic evidence feeds into the overall claim, see Skin C&P exam: what examiners look for and Anatomy of a strong skin condition nexus letter.
If you're preparing a VA skin condition claim and want to understand whether your current documentation, including your nexus letter, is strong enough to support your rating, the free nexus letter grader at flatratenexus.com/nexus-letter-grade.html gives you a structured evaluation before you submit. Flat Rate Nexus also provides physician-signed independent medical opinions for veterans at every stage of the claims process.
Thinking about your own claim? Every nexus letter we write goes through a full physician record review, cites peer-reviewed research, and is built around the actual evidence in your case.
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