Scars are one of the most common sources of veteran disability claims with the U.S. Department of Veterans Affairs (the VA). Depending on the severity of the scarring, you can receive a VA disability rating of up to 80%.
In this post, we cover how the VA assigns disability ratings for scars and the multiple factors it uses to evaluate your VA disability claim, how to apply for VA disability benefits based on scar injuries, and what you can do if the VA denies your initial benefits claim.
If you need help obtaining a VA rating for scars, please call Stone Rose Law at (480) 498-8998 or use our contact form to get in touch with a VA disability attorney for a free consultation.
Under the Schedule for Rating Disabilities, the VA uses diagnostic codes 7800 to 7805 for skin conditions to assign a VA rating for scars.
Under this diagnostic code, the VA considers tissue loss, distortion or asymmetry of features, and characteristics of disfigurement.
Nonlinear scars located on different areas of your body, like on one extremity, or two separate extremities, or on the front or back of your torso, will receive separate ratings with each rating being based on the area of qualifying scars.
For example, if you have one qualifying scar on your right arm, and another qualifying scar on your left leg, then you will receive separate ratings for each scar.
The ratings for nonlinear, deep scars are as follows:
Superficial scars are not permanent and affect only the skin and not the underlying soft tissue. These scars are rated separately for each area of your body that is affected.
An unstable scar is one in which there is frequent loss of covering of skin over the scar.
If more than one scar is considered unstable, an additional 10% may be added to the rating.
Scars rated under diagnostic codes 7800, 7801, 7802, or 7805 can also receive an evaluation under 7804:
Disability ratings for these scars depend on the disabling effects of the scar.
For example, if you have a linear scar running along your elbow that prevents flexion, then you will receive a rating based on the elbow’s limitation of motion.
Scar conditions not listed in the schedule of rating disabilities are rated to the extent that they are analogous to diagnostic codes 7800 to 7805.
Based on certain combinations, you could qualify for additional VA disability compensation for scarring.
Multiple scars can be the basis for separate ratings for each in a combined disability rating. This depends in part on where the scars are located on your body.
For example, if you have a significant scar on your left leg that qualifies you for a 20% disability rating, and another scar on your right arm that also separately qualifies for a 20% disability rating, these can contribute to a combined VA rating.
Although the maximum VA scar rating you can receive is 80%, if your scar disability contributes to you being unable to keep substantially gainful employment, then it can become the basis for a total disability claim based on TDIU.
If you qualify for TDIU, then you receive 100% disability benefits.
Most veterans who qualify for TDIU do so based on what the VA calls schedular TDIU benefits. This means that in addition to not being able to be substantially gainfully employed, you must also have either:
In some cases, you may still qualify for VA disability benefits under TDIU even if you do not qualify for them on a schedular basis.
To apply for extraschedular TDIU, you must provide evidence that your service-connected disability or disabilities are so severe that they cannot be adequately reflected by the standard rating schedule. In this case, the VA will refer your claim to the Director of Compensation Service for review. This process involves submitting detailed information about your disabilities, employment history, and other relevant factors.
The VA recognizes several types of scars for disability benefit purposes.
A hypertrophic scar is the result of increased collagen production around deep tissue wounds. It is thick, raised, and inflexible.
A keloid scar is a lumpy, ridged scar that rises over the skin after an injury.
An atrophic scar occurs when your skin cannot properly repair itself after an injury. Atrophic scars are indented because of the lack of collagen in the scar.
A contracture scar follows damage to a large area of skin. As the wound heals, the skin tightens, which can restrict joint movement.
To qualify for disability compensation, you must have at least one scar that is unstable, painful, or both.
The VA rates scars using two ratings systems in determining your disability rating. The first system looks at the condition of the scar itself, including:
The second rating system is based on eight characteristics of disfigurement:
You file a disability claim and supporting documentary evidence for scarring using VA Form 21-526EZ. You can file your claim online, or mail it to the VA, or take your claim to your regional VA office.
Unlike some conditions, scars are not a presumptive VA disability. You must establish a service connection between your current diagnosis for scarring symptoms and your active military service to qualify for benefits.
To establish a service connection for scarring, you will need to demonstrate the following to the satisfaction of the VA:
You will need to support your benefits claim with relevant documentation. Examples of supporting documents include:
A Disability Benefits Questionnaire (DBQ) for scars can help the VA evaluate your claim. Your treating doctor will often prepare this for you. If you undergo a compensation and pension (C&P) exam, the VA examiner will also likely use a DBQ in conducting your exam.
After you submit your benefits claim, often the VA will schedule you to attend a compensation and pension exam. The purpose of this exam is to give the VA the opportunity to gather information it will use to decide whether to approve your claim and, if it does, what disability rating to assign to you.
C&P exams are not optional. If the VA schedules you for one, it is important that you show up. If you miss your exam without a good reason, then the VA may deny your claim for that reason alone.
During the C&P exam, the VA examiner will review your medical records and ask you questions about your scarring condition and its effects on your ability to work and to engage in daily life activities.
The last part of a C&P exam will often be a physical exam, which may include some tests.
The VA examiner will prepare a report for the VA based on the results of your C&P exam. You are entitled to receive a copy of this report. Your VA disability attorney can help you prepare for your C&P exam, and request a copy of the VA examiner’s report on your behalf.
Sometimes the VA will not approve an initial claim for scarring. This can occur because of an incomplete claim, a lack of sufficient supporting evidence, or in some cases, the VA itself can make an error in processing your claim.
If the VA does not approve your initial claim, you have three options to revive it.
The purpose of a supplemental claim is to give the VA new and relevant evidence to bolster your initial claim to overcome a denial based on lack of sufficient evidence or an incomplete claim.
If you believe that the VA has mistakenly denied your claim, a higher-level review can give a senior VA examiner the opportunity to go over your claim again.
If you have tried a supplemental claim or requested a higher-level review and the VA is still denying your claim, then you can make an appeal to the VA Board of Veterans Appeals. In this formal appeal, you will have a hearing before a VA law judge who will review your claim and any new supporting evidence you present.
Although it is possible to prepare and submit your VA benefits claim by yourself, having an experienced VA benefits lawyer to assist with its preparation can help you in meaningful ways:
At Stone Rose Law, we are board-certified VA claims lawyers who help veterans receive VA disability benefits nationwide. Our VA-accredited attorneys give you affordable, high-quality veterans appeals legal assistance.
A Stone Rose Law VA disability lawyer can help you prepare your disability claim, monitor your claim status, and consult with you before disability examinations at no cost to you.
If the VA denies your original claim, our VA benefits law firm will help you respond effectively, up to making a formal request for a hearing with the Board of Appeals if necessary.
For more information about how one of our VA disability lawyers can help you with your VA disability compensation claim or appeal, request a free assistance consultation at (480) 498-8998 or use our contact form.
