When it comes to applying for a VA disability rating for scars, understanding the specific criteria and processes is crucial. This comprehensive article will delve deeply into the VA’s rating system, shedding light on the evaluation criteria, the required documentation for a VA disability claim, and even the minimum size requirement for a scar to qualify for VA disability.
Furthermore, we will provide valuable insights into the appeals process, outlining the necessary steps for appealing a VA disability claim. Upon reading this article, you will understand how the VA rates scars, know what documentation is needed to support your claim, the size requirements for eligibility, and gain valuable insights into appealing a scar-related disability claim that has been denied or unfairly awarded at a lower rating than you deserve.
1. How does the VA Define Scars?
It was reported in the VA’s Annual Benefits Report for 2021 that almost 1 million veterans are affected by scars, making it the seventh most common disability. The VA defines an unstable scar as any scar frequently losing skin covering. Scars are evaluated based on eight main attributes that the VA considers:
- Length: Scars that are 5 inches (13 cm) or longer.
- Width: Scars with a width of at least one-quarter (¼) inch (0.6 cm).
- Surface: Scars that elevate or depress when pressed upon.
- Adherence: Scars that are adherent to soft tissue below.
- Pigmentation: Scars with hyperpigmentation or hypopigmentation, with the change in pigmentation occurring within an area of 6 square inches or greater.
- Texture: Scars with abnormal skin texture in an area greater than 6 square inches. Abnormal texture can be scaly, tight, shiny, irregular, atrophic, or other types.
- Soft tissue: Scars that affect underlying soft tissue in an area of 6 square inches or larger.
- Immobile skin: Scars that cause immobile or hard skin over an area of 6 square inches or greater
2. What is The VA Disability Rating for Scars?
The VA disability rating system for scars can be complex and bewildering for many veterans. It encompasses two distinct rating systems that intertwine and interact with each other.
To qualify for VA disability compensation for scars, the scar must demonstrate instability, pain, or both. The VA rates scars based on two primary systems:
- Medical conditions concentrate on assessing the actual condition of the scar itself. This involves evaluating the scar’s size, shape, color, texture, and overall appearance. The severity and extent of the physical changes caused by the scar are considered during this evaluation.
- Characteristics of disfigurement focus on the impact of the scarring on an individual’s appearance and function. It considers how the scars affect the veteran’s overall physical appearance, the social stigma associated with the scarring, and any functional limitations caused by the scars. Functional limitations could include restrictions on motion, flexibility, or dexterity directly attributable to the scar tissue.
It’s important to note that scars may also contribute to the development of other related conditions, which could potentially qualify for additional VA disability compensation. For instance, if scarring affects your vision, such as losing both eyes due to scarring-related complications, you may be eligible for a combined rating that considers both the scarring and the vision loss. There is a general VA disability rating formula and various diagnostic codes that correspond with specific eye diseases for service connection. The VA uses 38 CFR § 4.79 as the schedule for rating disabilities of the eye.
The VA’s rating formula for eye conditions is as follows:
- 10%: With clearly documented incapacitating episodes requiring you to complete at least one but less than three treatment visits for an eye condition during the past 12 months
- 20%: With clearly documented incapacitating episodes requiring you to complete at least three but less than five treatment visits for an eye condition during the past 12 months
- 40%: With clearly documented incapacitating episodes requiring you to complete at least five but less than seven treatment visits for an eye condition during the past 12 months
- 60%: With documented incapacitating episodes requiring seven or more treatment visits for an eye condition during the past 12 months
Scars are evaluated using five different diagnostic codes, which consider various factors such as the number and location of scars, their permanence, and whether they cause pain or instability. The official diagnostic code for the VA’s scar rating is under 38 CFR §4.118, diagnostic codes 7800, 7801, 7802, 7804, and 7805.
| Area of the Body where the scar is located | The VA Diagnostic Code | Underlying soft tissue damage? | Painful or unstable? | Rating Level |
| Head, face, or neck | 7800 | – | – | 10%, 30%, 50%, or 80% |
| Any area other than the head, face, or neck | 7801 | Yes | – | 10%, 20%, 30%, or 40% |
| Any area other than the head, face, or neck | 7802 | No | – | 10% |
| Any area of the body | 7804 | – | Yes | 10%, 20%, 30%, or 40% |
| Any area of the body with a disabling effect not considered | 7805 | No | No | It depends on the disabling effect |
Eligibility for a VA rating for shrapnel wounds:
- The specific VA diagnostic code for shrapnel wounds is “7110.” Disability ratings for shrapnel wounds assigned by the VA range from 10% to 100% in increments of 10%. The specific rating depends on the severity of the disability resulting from the shrapnel wounds. Veterans with minor muscle disabilities typically receive the lowest rating of 10%, while those with severe disabilities may be eligible for benefits up to the maximum rating of 100%.
3. What is the Process for Filing a Claim for VA Disability Rating for Scars?
Filing a claim for a VA disability rating for surgical scars involves several essential steps. Here is a breakdown of the process:
- Obtain relevant medical records: Gather your service medical records or service treatment records (STRs) that document the existence or treatment of your scars during your time in the military.
- Seek medical opinions: Consult with medical professionals, particularly those with expertise in scar evaluation, to obtain their opinions and assessments regarding the relationship between your scars and your military service.
- Provide supporting evidence: Submit any relevant documents or records, such as photographs, personal statements, or buddy statements from fellow service members, which can help establish the connection between your scars and your military service.
- Complete a Disability Benefits Questionnaire (DBQ): If available, fill out a DBQ specific to scars or disfigurement. This form, completed by a medical professional during an examination, provides detailed information about the nature and impact of your scars, further supporting your claim for service connection.
- Establish the nexus: Clearly articulate and provide evidence of the link between your scars and your military service.
- Seek professional assistance: Consider consulting with a Veterans’ Service Officer (VSO) or an accredited attorney or claims agent specializing in VA disability claims.
The DBQ is a form your doctor and typically your C&P examiner will complete to help the VA evaluate your claim. Reviewing the form before your C&P exam can help you understand the examiner’s questions. You must include the following mandatory information on your DBQ form:
- Diagnosis, location, and history of your scars.
- Pain, skin covering loss, and burn scars details.
- Extremity assessment, color, and texture differences.
- Calculation of total scar area and functional limitations caused by scars.
- Muscle or nerve damage, impact on your ability to work, and doctor’s remarks.
4. How Do I Prove VA Service Connection for Scars?
To submit a VA claim for your scars, evidence must be provided for these three elements:
- You possess scars that satisfy the prescribed criteria regarding their location and severity.
- Your scars resulted from an event, injury, or illness during military service.
- You have a medical nexus, also known as a service connection, establishing a link between your scars and the event that caused them.
5. What Are The Challenges When Filing A VA Claim for Scars?
While proving VA service connection for scars, veterans may encounter several challenges that can impact their claim. These challenges include:
- Lack of documentation: Veterans may have difficulty obtaining or locating relevant medical records, especially if their military service was several years ago. In some cases, records may have been lost, damaged, or not adequately documented.
- Delayed diagnosis or treatment: Some veterans may have yet to seek immediate medical attention for their scars while in service, leading to delays in diagnosing and documenting the condition.
- Inadequate medical opinions: Obtaining accurate and persuasive medical opinions that establish the nexus between the scars and military service can be crucial. However, finding medical professionals with expertise in scar evaluation and a thorough understanding of VA disability requirements may be challenging.
- Subjective nature of disfigurement assessment: Assessing the disfiguring effects of scars is inherently subjective, as it involves evaluating the impact on a person’s physical appearance and psychological well-being. Different examiners or decision-makers may have varying opinions regarding the severity of disfigurement, leading to potential inconsistencies in ratings.
- Lack of understanding of the VA claims process: Navigating the VA claims process is often complex and overwhelming, particularly for veterans unfamiliar with the procedures and requirements.
6. What Happens After I File My Claim?
After you file your claim, the VA reviews and decides its validity. Here’s an overview of what veterans can expect during this phase:
- Claim receipt and acknowledgment: Once the VA receives your claim, you will receive an acknowledgment letter confirming that your claim has been received and is being processed.
- Development of evidence: The VA will develop evidence for your claim. This may involve gathering relevant medical records, scheduling medical examinations or assessments, and obtaining additional information to evaluate the extent and impact of your scars.
- Rating decision: After reviewing all the evidence, the VAs decision will be communicated to you in writing and outline the assigned disability rating, effective date, and associated benefits.
- Notification and award letter: Once the rating decision is made, the VA will send you a notification letter detailing the outcome of your claim.
Filing a VA disability claim for scars requires understanding the VA code for scars, providing appropriate documentation, establishing the severity and functional impact, and proving service connection. The VA evaluates scars based on their characteristics and disfigurement, considering length, width, surface, adherence, pigmentation, texture, soft tissue involvement, and immobile skin. Seeking guidance from a VA accredited law group like VetsForever or a Veterans Service Officer (VSO) may clarify the process and potential outcomes for obtaining compensation.
After filing a claim, veterans can expect their claim to go through a review and decision process, leading to a rating decision and notification of the outcome. If necessary, veterans can appeal a disability claim for scars. Understanding the process, gathering appropriate evidence, and seeking professional guidance can improve the chances of a successful claim for VA disability for scars.
FAQs
How does the VA rate scars for disability compensation?
The VA rates scars for disability compensation using the VASRD, considering severity and function and assigning a percentage rating (0% to 100%). Size, location, appearance, and limitations influence the rating determined by the diagnostic code.
What kind of documentation is required to support a VA Disability claim for scars?
To support a VA disability claim for scars, relevant medical documentation, including service and private medical records, treatment records, scar photographs, and statements from medical professionals is required.
How big does a scar have to be to get a VA disability?
The size of the scar doesn’t solely determine VA disability eligibility. The VA considers impact, functional limitations, severity, and location when determining eligibility and disability rating.
What is the VA rating for corneal scars?
The VA assigns a specific diagnostic code for corneal scars, which fall under eye disabilities. The exact diagnostic code for corneal scars may vary depending on the particular characteristics and effects of the scar.
What is the average disability rating for scars?
The average disability rating for scars varies depending on several factors, including the severity and functional limitations caused by the scars. There is no fixed average disability rating, and it is determined individually, considering the specific circumstances and impact of the scars.
How do I appeal a VA disability claim for scars?
To appeal a VA disability claim for scars, you can follow the VA’s established appeals process. This typically involves filing a Notice of Disagreement (NOD) within the specified timeframe, expressing your disagreement with the rating decision. Additional evidence or arguments may be required to support your appeal.