SCARS DISFIGURING

ANN K. MINAMI · 2025 · Case ID: A25092673

MIXED

Summary

The veteran, who served from August 1987 to June 1992, appealed the reduction of disability ratings for skin condition scars. The Board of Veterans' Appeals reviewed the RO's decision to reduce ratings for scars on the face/head (from 50% to 0%), anterior trunk (from 10% to 0%), and right upper extremity (RUE) (from 40% to 0%), as well as the denial of initial ratings for scars on the right lower extremity (RLE), left upper extremity (LUE), and left lower extremity (LLE). The Board found that the RO's reductions for the face/head, anterior trunk, and RUE scars were improper because the July 2024 VA examinations did not demonstrate actual sustained improvement in the Veteran's ability to function under ordinary conditions. The examinations noted the conditions had "stayed the same" and indicated pain associated with the scars, with no discernable difference from prior examinations. Consequently, the Board granted restoration of the 50%, 10%, and 40% ratings for these scars. However, for the RLE, LUE, and LLE scars, the Board denied initial compensable ratings, finding that the July 2024 examinations did not meet the criteria for higher ratings under applicable diagnostic codes, particularly DC 7802 and DC 7804, as the scars were superficial, not unstable, and the Veteran's lay contentions were outweighed by objective findings.

Rationale

Reduction to 0% improper as no sustained improvement shown; July 2024 exam noted condition "stayed the same"; Pain associated with scars noted in both Feb 2022 and July 2024 exams

Special Benefit

NO SPECIAL BENEFIT

Diagnostic Code

7800

Docket No.

241023-490264

Full Decision Text

Citation Nr: A25092673
Decision Date: 10/27/25 Archive Date: 10/27/25

DOCKET NO. 241023-490264
DATE: October 27, 2025

ORDER

The reduction of the rating for hidradenitis suppurativa (skin condition) scars throughout face and head from 50 percent to noncompensable (0 percent) effective July 18, 2024, was not proper; restoration of the 50 percent rating is granted.

The reduction of the rating for hidradenitis suppurativa (skin condition) anterior trunk scar from 10 percent to noncompensable (0 percent) effective July 18, 2024, was not proper; restoration of the 10 percent rating is granted.

The reduction of the rating for hidradenitis suppurativa (skin condition) right upper extremity (RUE) scar, from 40 percent to noncompensable (0 percent) effective July 18, 2024, was not proper; restoration of the 40 percent rating is granted.

Entitlement to an initial compensable rating for hidradenitis suppurativa (skin condition) right lower extremity (RLE) scar is denied.

Entitlement to an initial compensable rating for hidradenitis suppurativa (skin condition) left upper extremity (LUE) scar is denied.

Entitlement to an initial compensable rating for hidradenitis suppurativa (skin condition) left lower extremity (LLE) scar is denied.

FINDINGS OF FACT

1. At the time of the October 2024 rating decision that reduced the Veteran's skin condition scars (face and head) rating from 50 percent to 0 percent, effective July 18, 2024, actual sustained improvement in his scars in terms of his ability to function under the ordinary conditions of work and life was not demonstrated by the evidence of record.

2. At the time of the October 2024 rating decision that reduced the Veteran's skin condition scars (anterior trunk) rating from 10 percent to 0 percent, effective July 18, 2024, actual sustained improvement in his scars in terms of his ability to function under the ordinary conditions of work and life was not demonstrated by the evidence of record.

3. At the time of the October 2024 rating decision that reduced the Veteran's skin condition scars (RUE) rating from 40 percent to 0 percent, effective July 18, 2024, actual sustained improvement in his scars in terms of his ability to function under the ordinary conditions of work and life was not demonstrated by the evidence of record.

4. The Veteran's RLE skin condition scar does not measure an area of 144 square inches (929 sq. cm).

5. The Veteran's LUE skin condition scar does not measure an area of 144 square inches (929 sq. cm).

6. The Veteran's LLE skin condition scar does not measure an area of 144 square inches (929 sq. cm).

CONCLUSIONS OF LAW

1. Reduction of the rating for face and head skin condition scars from 50 percent to 0 percent effective July 18, 2024, was not proper. 38 U.S.C. § 1155, 5107, 5112; 38 C.F.R. § 3.105 (e), 3.344, § 4.118, Diagnostic Code (DC) 7800.

2. Reduction of the rating for anterior trunk skin condition scars from 10 percent to 0 percent effective July 18, 2024, was not proper. 38 U.S.C. § 1155, 5107, 5112; 38 C.F.R. § 3.105 (e), 3.344, § 4.118, Diagnostic Code (DC) 7802.

3. Reduction of the rating for RUE skin condition scars from 40 percent to 0 percent effective July 18, 2024, was not proper. 38 U.S.C. § 1155, 5107, 5112; 38 C.F.R. § 3.105 (e), 3.344, § 4.118, Diagnostic Code (DC) 7802, 7804.

4. The criteria for an initial compensable rating for RLE skin condition scars have not been met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10, 4.21, 4.118, Diagnostic Code (
2024, was not proper. 38 U.S.C. § 1155, 5107, 5112; 38 C.F.R. § 3.105 (e), 3.344, § 4.118, Diagnostic Code (DC) 7802, 7804.

5. The criteria for an initial compensable rating for LUE skin condition scars have not been met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10, 4.21, 4.118, Diagnostic Code (DC) 7802.

6. The criteria for an initial compensable rating for LLE skin condition scars have not been met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10, 4.21, 4.118, Diagnostic Code (DC) 7802.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from August 1987 to June 1992. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an October 2024 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran selected the direct review docket in his October 2024 notice of disagreement (NOD) to the Board; as such, evidence up until the date of the rating decision on appeal will be considered.

1. Whether the reduction of the rating from 50 percent to 0 percent, effective July 18, 2024, for face and head skin condition scars was proper.

2. Whether the reduction of the rating from 10 percent to 0 percent, effective July 18, 2024, for anterior trunk skin condition scars was proper.

3. Whether the reduction of the rating from 40 percent to 0 percent, effective July 18, 2024, for RUE skin condition scars was proper.

The provisions of 38 C.F.R. § 3.105(e) allow for the reduction in rating of a service-connected disability when warranted by the evidence, but only after VA has met certain procedural and substantive requirements. Where a disability rating is reduced, but the amount of compensation is not reduced, however, 38 C.F.R. § 3.105(e) does not apply. See Stelzel v. Mansfield, 508 F.3d 1345, 1349 (Fed. Cir. 2007) (holding that VA was not obligated to provide a Veteran with sixty days' notice before making a disability ratings decision effective if the decision did not reduce the overall compensation paid to the Veteran); see also VAOPGCPREC 71-91 (Nov. 7, 1991) (where the evaluation of a specific disability is reduced, but the amount of compensation is not reduced because of a simultaneous increase in the evaluation of one or more other disabilities, section 3.105(e) does not apply).

In this case, as the Veteran has been rated at 100 percent since December 2010, the rating reduction for his skin condition scars, effective July 18, 2024, did not impact his overall compensation, relieving VA of the notice requirements under 38 C.F.R. § 3.105(e).

Substantively, the criteria governing rating reductions for service-connected disabilities is found in 38 C.F.R. § 3.344. The provisions of 38 C.F.R. § 3.344(a) and (b) apply to ratings that have been continued for five years or more. Here, the ratings had not been in effect for five or more years and the provisions of 38 C.F.R. § 3.344(a) and (b) do not apply.

Turning to the propriety of that action, a Veteran's disability rating shall not be reduced unless an improvement in the disability is shown to have occurred. 38 C.F.R. § 3.344.

Prior to reducing a Veteran's disability rating, VA is required to comply with
service-connected disabilities is found in 38 C.F.R. § 3.344. The provisions of 38 C.F.R. § 3.344(a) and (b) apply to ratings that have been continued for five years or more. Here, the ratings had not been in effect for five or more years and the provisions of 38 C.F.R. § 3.344(a) and (b) do not apply.

Turning to the propriety of that action, a Veteran's disability rating shall not be reduced unless an improvement in the disability is shown to have occurred. 38 C.F.R. § 3.344.

Prior to reducing a Veteran's disability rating, VA is required to comply with several regulations applicable to all rating-reduction cases, regardless of the rating level or the length of time that the rating has been in effect. See 38 C.F.R. §§ 4.1, 4.2, 4.10, 4.13; see Brown v. Brown, 5 Vet. App. 413, 420 (1993). These provisions impose a clear requirement that VA rating reductions be based upon review of the entire history of a Veteran's disability. See Schafrath v. Derwinski, 1 Vet. App. 589, 594 (1991). Such review requires VA to ascertain, based upon review of the entire recorded history of the condition, whether the evidence reflects an actual change in the disability and whether the examination reports reflecting such change are based upon thorough examinations. Thus, in any rating-reduction case, not only must it be determined that an improvement in a disability has actually occurred but also that that improvement actually reflects an improvement in the Veteran's ability to function under the ordinary conditions of life and work. See Faust v. West, 13 Vet. App. 342, 350 (2000).

In considering the propriety of a reduction, the Board must focus on the evidence available to the RO at the time the reduction was effectuated. Dofflemyer v. Derwinski, 2 Vet. App. 277, 281-82 (1992). The Veteran need not demonstrate that he is entitled to retain the higher rating; rather, it must be shown by a preponderance of the evidence that the RO's reduction was warranted. See Kitchens v. Brown, 7 Vet. App. 320 (1995); Brown v. Brown, 5 Vet. App. 413, 419 (1993).

Regarding the Veteran's rating reduction from 50 percent to 0 percent for his face and head skin condition scars and turning to the question of whether actual improvement was shown, the Board notes that the 50 percent rating was based on a February 2022 VA examination that showed four or five characteristics of disfigurement. See 38 C.F.R. § 4.118, DC 7800. The Veteran's rating was reduced to 0 percent based on the July 2024 VA examination. The Board finds that the July 2024 findings do not demonstrate actual sustained improvement in his scars in terms of his ability to function under the ordinary conditions of work and life. The examiner noted that his condition had "stayed the same" and not improved; the examiner also specifically noted that the Veteran's scars on his face and head "stayed the same". In addition, the July 2024 examination and the prior February 2022 examination both note the Veteran's scars "throughout face and head" as well as pain associated with the scars. The Board cannot find any discernable difference in the examinations that would demonstrate the Veteran's condition has improved. Therefore, the reduction of the Veteran's 50 percent rating to a 0 percent effective July 18, 2024, was not proper and restoration of the Veteran's 50 percent rating is granted.

Regarding the Veteran's rating reduction from 10 percent to 0 percent for his anterior trunk skin condition scars and turning to the question of whether actual improvement was shown, the Board notes that the 10 percent rating was based on a February 2022 VA examination that showed measurements of areas 144 square inches (929 sq. cm) of all the Veteran's scars. See 38 C.F.R. § 4.118, DC 7802. The Veteran's rating was reduced to 0 percent based on the July 2024 VA examination. The Board finds that the July 2024 findings do not demonstrate actual improvement in his scars in terms of his ability to function under the ordinary conditions of work and life. As noted above, the July 2024 examination noted the Veteran's condition "stayed the same" and it further indicated the Veteran had scars that were too many to
Board notes that the 10 percent rating was based on a February 2022 VA examination that showed measurements of areas 144 square inches (929 sq. cm) of all the Veteran's scars. See 38 C.F.R. § 4.118, DC 7802. The Veteran's rating was reduced to 0 percent based on the July 2024 VA examination. The Board finds that the July 2024 findings do not demonstrate actual improvement in his scars in terms of his ability to function under the ordinary conditions of work and life. As noted above, the July 2024 examination noted the Veteran's condition "stayed the same" and it further indicated the Veteran had scars that were too many to count scattered throughout his anterior trunk, posterior trunk and bilateral upper and lower extremities. Therefore, the reduction of the Veteran's 10 percent rating to a 0 percent effective July 18, 2024, was not proper and restoration of the Veteran's 10 percent rating is granted.

Regarding the Veteran's rating reduction from 40 percent to 0 percent for his RUE skin condition scars and turning to the question of whether actual improvement was shown, the Board notes that the 40 percent rating was based on a February 2022 VA examination that showed five or more painful scars and at least one scar that was both unstable and painful. See 38 C.F.R. § 4.118, DC 7804. The Veteran's rating was reduced to 0 percent based on the July 2024 VA examination. The Board finds that the July 2024 findings do not demonstrate actual improvement in his scars in terms of his ability to function under the ordinary conditions of work and life. The July 2024 examination noted the Veteran had five or more painful scars; in addition, the examination did not show any discernable improvement in the Veteran's scars and explicitly stated that all the Veteran's scars throughout his entire body have a "burning pain." As noted above, the examiner marked that the Veteran's condition "stayed the same" as opposed to "improved". Therefore, the reduction of the Veteran's 40 percent rating to a 0 percent effective July 18, 2024, was not proper and restoration of the Veteran's 40 percent rating is granted.

4. Entitlement to an initial compensable rating for hidradenitis suppurativa (skin condition) right lower extremity (RLE) scar.

5. Entitlement to an initial compensable rating for hidradenitis suppurativa (skin condition) left upper extremity (LUE) scar.

6. Entitlement to an initial compensable rating for hidradenitis suppurativa (skin condition) left lower extremity (LLE) scar.

Disability ratings are assigned in accordance with VA's Schedule for Rating Disabilities and are intended to represent the average impairment of earning capacity resulting from disability. See 38 U.S.C. § 1155; 38 C.F.R. §§ 3.321(a), 4.1. Separate diagnostic codes (DCs) identify the various disabilities. See generally 38 C.F.R. Part 4. If two disability evaluations are potentially applicable, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7.

In order to evaluate the level of disability and any changes in condition, it is necessary to consider the complete medical history of the Veteran's condition. Schafrath v. Derwinski, 1 Vet. App. 589, 594 (1991). Consistent with the facts found, the rating may be higher or lower for segments of the time under review on appeal, which is known as "staged" ratings. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). Reasonable doubt regarding the degree of disability will be resolved in favor of the claimant. 38 C.F.R. § 4.3.

In this case, the Veteran appeals the assignment of initial noncompensable ratings for scars related to his skin condition in his RLE, LUE, LLE.

Generally, scars are evaluated pursuant to Diagnostic Codes (DCs) 7800, 7801, 7802, 7804, and 7805. 38 C.F.R. § 4.118. Under revisions that took effect August 13, 2018, DCs 7801 and 7802 were amended to characterize multiple scars by six body zones, which are defined as each extremity, anterior trunk, and posterior trunk. There were no changes to Diagnostic Codes 7800, 7804, or 7805. 83 Fed. Reg. 32,592 (July 13, 2018). Because the Veteran's claim was filed in January 2022, only the revised versions of DC 7801 and DC 7802 are applicable. In this case, the Veteran's RLE, LUE, LLE scars have been rated under DC 7802.

Under DC 7802, burn scar(s) or scar(s) due to other causes, not of the head, face, or neck, that are superficial and nonlinear in an area or areas of 144 square inches (929 sq. cm.) or greater warrant a 10 percent evaluation. Note (1) provides that a superficial scar is one not associated with underlying soft tissue damage. 38 C.F.R. § 4.118, DC 7802.

Pursuant to DC 7804, a 10 percent rating is warranted for one or two scars that are unstable or painful. A 20 percent rating is warranted for three to four scars that are unstable or painful, and a 30 percent rating is warranted for five or more scars that are unstable or painful. An unstable scar is one where, for any reason, there is frequent loss of covering of skin over the scar. If one or more scars are both unstable and painful, 10 percent is to be added to the evaluation that is based on the total number of unstable or painful scars. Scars evaluated under DCs 7800, 7801, 7802, or 7805 may also receive an additional rating under DC 7804, when applicable.

The July 2024 VA scars examination notes the Veteran's RLE scars measured about 10 centimeters. The scar was not tender or unstable, and there was no underlying soft tissue damage. The Veteran's LUE and LLE scars measured about 10 centimeters each as well. The scars were not tender or unstable, and there was no underlying soft tissue damage. The examination noted his RLE, LUE, and LLE scars are painful, and the Board notes the Veteran is already rated under DC 7804 for painful scars.

Based on a review of the record and rating criteria, the Board determines that the evidence persuasively weighs against finding entitlement to a compensable rating for the Veteran's RLE, LUE, and LLE scars. In addition, no higher rating is assignable under other potentially applicable diagnostic codes. DC 7800 relates only to scars of the head, face, or neck. DC 7801 requires that a scar have underlying, soft tissue damage. A higher rating pursuant to DC 7805 is also not possible, because there are no disabling effects that were not considered in the rating assigned under DC 7802. 38 C.F.R. § 4.118. As noted, the evidence does not reflect that a higher rating would be warranted or applicable under a different scar DC. In addition, the Veteran's scars were not associated with underlying soft tissue damage and were not unstable; as such, only DC 7802 is applicable. See 38 C.F.R. § 4.118.

The Board recognizes the Veteran's contentions that he is entitled to a higher rating for his RLE, LUE and LLE scars; however, the Board finds the lay contentions are outweighed by the objective findings of record. See Buchanan v. Nicholson, 451 F.3d 1331, 1335 (Fed. Cir. 2006).

Based on the foregoing, compensable ratings are not warranted for the Veteran's RLE, LUE and LLE scars, and the claims are denied.

Ann K. Minami

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Ariasaif, Mary

The Board's decision in this case is binding only with respect to the instant matter decided.
he is entitled to a higher rating for his RLE, LUE and LLE scars; however, the Board finds the lay contentions are outweighed by the objective findings of record. See Buchanan v. Nicholson, 451 F.3d 1331, 1335 (Fed. Cir. 2006).

Based on the foregoing, compensable ratings are not warranted for the Veteran's RLE, LUE and LLE scars, and the claims are denied.

Ann K. Minami

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Ariasaif, Mary

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.

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