FINGER IMPAIRMENT OF

YVETTE R. WHITE · 2026 · Case ID: A26030411

DENIED

Summary

The veteran, who served in the U.S. Army from July 2010 to February 2013, appeals the denial of increased ratings for his service-connected right hand 5th finger proximal phalangeal fracture, swan neck deformity of the right 4th finger, and linear scars on the right 3rd and 4th fingers. The veteran sought ratings higher than the 0% currently assigned for the finger fracture and swan neck deformity, and a compensable rating for the scars. The Board reviewed the evidence of record at the time of the prior AOJ decision, as the veteran did not appear for a scheduled hearing. For the 5th finger fracture and swan neck deformity, rated under Diagnostic Code 5230, the Board found the veteran was already receiving the maximum available rating for limitation of motion, and that the cited diagnostic code does not provide a compensable rating for painful motion alone, citing Sowers v. McDonald. For the linear scars, the Board noted that service connection was previously granted for painful surgical scars on the right hand, for which the veteran was already rated 20% under Diagnostic Code 7804. The Board found no evidence of a scar on the right 3rd finger during the appeal period, and that the scars on the right 4th finger, while painful, were not unstable and were already compensated under DC 7804. The evidence persuasively weighed against a higher or compensable rating for any of the claimed conditions, thus denying the appeal.

Rationale

Already receiving maximum rating under DC 5230; DC 5230 does not provide compensable rating for painful motion alone; No alternative diagnostic codes applicable for higher rating

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Diagnostic Code

5230

Docket No.

200716-98416

Full Decision Text

Citation Nr: A26030411
Decision Date: 04/02/26 Archive Date: 04/02/26

DOCKET NO. 200716-98416
DATE: April 2, 2026

ORDER

Entitlement to a compensable rating for right (dominant) hand 5th finger proximal phalangeal fracture is denied.

Entitlement to a compensable rating for swan neck deformity right (dominant) 4th finger is denied.

Entitlement to a compensable rating for linear scars, right 3rd and 4th finger is denied.

FINDINGS OF FACT

1. The Veteran is in receipt of the maximum schedular rating for his service-connected right (dominant) hand 5th finger proximal phalangeal fracture.

2. The Veteran is in receipt of the maximum schedular rating for his service-connected swan neck deformity right (dominant) 4th finger.

3. There is no evidence of a scar on the right 3rd finger (let alone one that is shown to be painful or unstable) during the appeal period. While there is evidence of painful scars on the right 4th finger, the Veteran is already being compensated for those scars.

CONCLUSIONS OF LAW

1. The criteria for a compensable rating for right (dominant) hand 5th finger proximal phalangeal fracture have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. 4.59, § 4.71a, Diagnostic Code 5230.

2. The criteria for a compensable rating for swan neck deformity right (dominant) 4th finger have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. 4.59, § 4.71a, Diagnostic Code 5230.

3. The criteria for a compensable rating for linear scars, right 3rd and 4th finger have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.14, 4.118, Diagnostic Code 7805.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Army from July 2010 to February 2013.

The rating decision on appeal was issued in September 2019 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.

In July 2019, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), and requested review of an April 2019 decision. In September 2019, the agency of original jurisdiction (AOJ) issued the HLR decision on appeal, which considered the evidence of record at the time of the prior April 2019 decision.

In the July 2020 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A January 25, 2024 notification advised the Veteran that a hearing was scheduled for June 17, 2024. The Veteran did not appear for the scheduled Board hearing.

Therefore, the Board may only consider the evidence of record at the time of the April 2019 AOJ decision, which was subsequently subject to higher-level review, as well as any evidence submitted by the Veteran or his representative within 90 days following the date of the scheduled hearing. 38 C.F.R. § 20.302(c). If evidence was submitted either (1) during the period after the AOJ issued the decision, which was subsequently subject to higher-level review, and prior to the date of the scheduled Board hearing, or (2) more than 90 days following the date of the scheduled hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(c), 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim(s), considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

Increased Ratings

Disability ratings are assigned in accordance with VA's Schedule for Rating Disabilities and are intended to represent
.R. §§ 20.300, 20.302(c), 20.801.

Increased Ratings

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 a disability. See 38 U.S.C. § 1155; 38 C.F.R. §§ 3.321(a), 4.1, 4.2, 4.10. Separate diagnostic codes identify the various disabilities. If two ratings are potentially applicable, the higher rating 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. Any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran. See 38 C.F.R. § 4.3.

Pyramiding, the rating of the same disability, or the same manifestation of a disability, under different diagnostic codes, is to be avoided when rating a veteran's service-connected disabilities. 38 C.F.R. § 4.14. It is possible for a veteran to have separate and distinct manifestations from the same injury which would permit rating under several diagnostic codes. The critical element in doing so is that none of the symptomatology is duplicative or overlapping with the symptomatology of the other condition. Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994).

VA is responsible for determining whether the evidence supports the claim or is in approximate balance, with a claimant prevailing in either event. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. The claimant is entitled to the benefit of the doubt when there is an "approximate" (meaning nearly equal) balance of positive and negative evidence regarding any material determination. See Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). If the evidence persuasively weighs against a claim, the claim is denied.

1. Entitlement to a compensable rating for right (dominant) hand 5th finger proximal phalangeal fracture is denied.

The Veteran is seeking a rating in excess of 0 percent for his service-connected right (dominant) hand 5th finger proximal phalangeal fracture, rated under Diagnostic Code 5230, 38?C.F.R. §?4.71a. The relevant temporal focus is one year prior to the date of receipt of the increased rating claim on February 22, 2019, thus from February 22, 2018. 38 C.F.R. § 3.400.

The Board notes that the Veteran is already rated 20 percent for his service connected painful surgical scars, right hand, under Diagnostic Code 7804 and 10 percent for his service-connected swan neck deformity right (dominant) 3rd finger under Diagnostic Code 5229. The Veteran has not appealed those ratings.

In response to the Veteran's increased rating claim in February 2019, the AOJ continued the noncompensable rating under Diagnostic Code 5230 for the Veteran's right (dominant) hand 5th finger proximal phalangeal fracture. See April 2019 Rating Decision; see also September 2019 HLR Rating Decision.

Diagnostic Code 5230 refers to limitation of motion of the ring or little finger. A 0 percent rating is assigned for any limitation of motion. 38 C.F.R. § 4.71a, DC 5230.

The rating criteria for evaluating musculoskeletal disabilities under 38 C.F.R. §4.71a were amended effective February 7, 2021. 85 Fed. Reg. 76,453 (Nov. 30, 2020). These amendments revised select diagnostic codes "to ensure that this portion of the rating schedule uses current medical terminology and provides detailed and updated criteria for the evaluation of musculoskeletal disabilities." Id. However, the diagnostic code in use here (DC 5230) was not changed.

In connection with his increased rating claim, the
percent rating is assigned for any limitation of motion. 38 C.F.R. § 4.71a, DC 5230.

In connection with his increased rating claim, the Veteran was afforded a VA examination in April 2019. See April 2019 VA Hand and Finger Conditions DBQ. During the examination, the Veteran reported that "he had fracture of the right 5th finger in 2012 during physical training when he was running upstairs, [and] he fell and hurt the right fifth finger." He also reported that he "had to give up his manufacturing and the corrections officers job because he could not make a good grip. He now works with manufacturing company that makes the computer boards." In addition, he reported that he still had swelling of the fingers and had very little grip with his right hand.

The examiner indicated that the initial range of motion of the right hand was "abnormal or outside of normal range." She noted pain on examination that caused functional loss with finger flexion. In addition, she indicated that there was no gap between the pad of the thumb and the fingers and no gap between the finger and proximal transverse crease of the hand on maximal finger flexion. The examiner found normal hand grip strength on muscle strength testing and no muscle atrophy. The examiner also found no ankylosis of any thumb or finger joint.

With respect to other pertinent physical findings, complications, conditions, signs or symptoms, the examiner noted "surgery scars." As for objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue, she indicated that "while gripping the scars of the finger are hypersensitive." As noted above, the Veteran is already rated 20 percent for his service connected painful surgical scars, right hand, under Diagnostic Code 7804, and has not appealed that rating.

While the Board acknowledges the Veteran's right 5th finger symptoms and the effect they have on him, he is already receiving the maximum rating available for little finger limitation of motion. No higher rating is legally available under his currently assigned diagnostic code. Moreover, as he has not been diagnosed with ankylosis of any thumb or finger joint or amputation of the little finger, and there is no gap between the pad of the thumb and the fingers or between the finger and proximal transverse crease of the hand on maximal finger flexion, there are no alternative diagnostic codes providing a higher schedular rating that are applicable.

The Board also acknowledges the Veteran's reported painful motion of the right little finger. However, a compensable rating is not warranted under 38 C.F.R. § 4.59 because Diagnostic Code 5230 does not contain a compensable rating. Indeed, the Court of Appeals for Veterans Claims (Court) has clarified this point explicitly: "Reading § 4.59 in conjunction with DC 5230, [a veteran] is not entitled to a compensable rating under this DC. Section 4.59 intends to recognize actually painful joints and provide at least the minimum compensable rating for the joint. There is no minimum compensable rating available under DC 5230, that is, any level of disability warrants a 0% rating. DC 5230's specific finding that there is no impairment in earning capacity from any limitation of motion of the ring finger trumps the general intent in § 4.59 to compensate painful motion with at least the minimum compensable rating." Sowers v. McDonald, 27 Vet. App. 472, 480 (2016) (citing Beverly v. Nicholson, 19 Vet. App. 394, 402 (2005) (acknowledging that general "cannon of interpretation that the more specific trumps the general").

For the foregoing reasons, the evidence is neither evenly balanced nor approximately so with regard to whether the Veteran's right (dominant) hand 5th finger proximal phalangeal fracture more nearly approximates a rating higher than 0 percent at any point during the appeal period. Rather, the evidence persuasively weighs against a compensable rating, and the benefit of the doubt doctrine is therefore not for application in this regard. Lynch v. McDonough, 21 F.4th
480 (2016) (citing Beverly v. Nicholson, 19 Vet. App. 394, 402 (2005) (acknowledging that general "cannon of interpretation that the more specific trumps the general").

For the foregoing reasons, the evidence is neither evenly balanced nor approximately so with regard to whether the Veteran's right (dominant) hand 5th finger proximal phalangeal fracture more nearly approximates a rating higher than 0 percent at any point during the appeal period. Rather, the evidence persuasively weighs against a compensable rating, and the benefit of the doubt doctrine is therefore not for application in this regard. Lynch v. McDonough, 21 F.4th 776, 781-82 (Fed. Cir. 2021) (only when the evidence persuasively favors one side or the other is the benefit of the doubt doctrine not for application). Accordingly, the claim must be denied.

2. Entitlement to a compensable rating for swan neck deformity right (dominant) 4th finger is denied.

The Veteran is seeking a rating in excess of 0 percent for his service-connected swan neck deformity right (dominant) 4th finger, rated under Diagnostic Code 5230, 38?C.F.R. §?4.71a. The relevant temporal focus is one year prior to the date of receipt of the increased rating claim on February 22, 2019, thus from February 22, 2018. 38 C.F.R. § 3.400.

With respect to the instant appeal, in response to the Veteran's increased rating claim, the AOJ continued the noncompensable rating under Diagnostic Code 5230 for the Veteran's swan neck deformity right (dominant) 4th finger. See April 2019 Rating Decision; see also September 2019 HLR Rating Decision.

As noted above, Diagnostic Code 5230 refers to limitation of motion of the ring or little finger. A 0 percent rating is assigned for any limitation of motion. 38 C.F.R. § 4.71a, DC 5230.

As also noted above, while the rating criteria for evaluating musculoskeletal disabilities under 38 C.F.R. §4.71a were amended effective February 7, 2021, the diagnostic code in use here (DC 5230) was not changed.

In connection with the increased rating claim, the Veteran was afforded a VA examination in April 2019. See April 2019 VA Hand and Finger Conditions DBQ. During the examination, the Veteran reported that during service he was kicked in the right hand while he was crawling on the ground and sustained the swan neck deformity of the right 4th and 5th fingers. He also reported that he had had two surgeries to fix the swan neck deformities.

With respect to other pertinent physical findings, complications, conditions, signs or symptoms, the examiner noted "surgery scars." As for objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue, she noted that "while gripping the scars of the finger are hypersensitive." As noted above, the Veteran is already rated 20 percent for his service connected painful surgical scars, right hand, under Diagnostic Code 7804, and has not appealed that rating.

While the Board acknowledges the Veteran's right 4th finger symptoms and the effect they have on him, he is already receiving the maximum rating available for ring finger limitation of motion. No higher rating is legally available under his currently assigned diagnostic code. Moreover, as he has not been diagnosed with ankylosis of any thumb or finger joint or amputation of the ring finger, and there is no gap between the pad of the thumb and the fingers or between the finger and proximal transverse crease of the hand on maximal finger flexion, there are no alternative diagnostic codes providing a higher schedular rating that are applicable.

The Board also acknowledges the Veteran's reported painful motion of the right ring finger. However, as discussed above, a compensable rating is not warranted under 38 C.F.R. § 4.59 because Diagnostic Code 523
the maximum rating available for ring finger limitation of motion. No higher rating is legally available under his currently assigned diagnostic code. Moreover, as he has not been diagnosed with ankylosis of any thumb or finger joint or amputation of the ring finger, and there is no gap between the pad of the thumb and the fingers or between the finger and proximal transverse crease of the hand on maximal finger flexion, there are no alternative diagnostic codes providing a higher schedular rating that are applicable.

For the foregoing reasons, the evidence is neither evenly balanced nor approximately so with regard to whether the Veteran's swan neck deformity right (dominant) 4th finger more nearly approximates a rating higher than 0 percent at any point during the appeal period. Rather, the evidence persuasively weighs against a compensable rating, and the benefit of the doubt doctrine is therefore not for application in this regard. Lynch v. McDonough, supra. Accordingly, the claim must be denied.

3. Entitlement to a compensable rating for linear scars, right 3rd and 4th finger is denied.

The Veteran is seeking a rating in excess of 0 percent for his service-connected linear scars, right 3rd and 4th finger, rated under Diagnostic Code 7805, 38 C.F.R. § 4.118. The relevant temporal focus is one year prior to the date of receipt of the increased rating claim on February 22, 2019, thus from February 22, 2018. 38 C.F.R. § 3.400.

By way of history, in May 2013, the AOJ granted service connection for linear scars, right 3rd and 4th finger with a noncompensable rating effective February 19, 2013. See May 2013 Rating Decision (noting that the surgical scars were superficial and linear, located on the right hand medial aspect 3rd finger and right hand 4th medial finger, respectively, and that the scars were neither painful nor unstable).

In February 2019, the Veteran filed an increased rating claim. See February 2019 VA Form 21-526EZ (seeking "increase on s/c right hand").

In April 2019, the AOJ continued the noncompensable rating under Diagnostic Code 7805 for the Veteran's linear scars, right 3rd and 4th finger. See April 2019 Rating Decision; see also September 2019 HLR Rating Decision. In addition, the AOJ granted service connection for painful surgical scars, right hand with an evaluation of 20 percent effective February 22, 2019. See April 2019 Rating Decision (assigning a 20 percent evaluation under Diagnostic Code 7804 "for painful surgical scars, right hand based on: Three or four scars that are unstable or painful").

Scars in general are evaluated in accordance with the criteria set forth in 38 C.F.R. § 4.118, DCs 7800-7805. The Board notes that certain of the rating criteria for scars were amended on August 13, 2018. Generally, in a claim for an increased rating, the Board considers both the former and current criteria where the rating criteria are amended during the course of an appeal. However, because this appeal arises from a claim filed on February 22, 2019, the Board will consider the Veteran's scar under the criteria in effect from August 2018.

Diagnostic Code 7800 deals with scars and disfigurement of the head, face, or neck. Therefore, discussion of the Veteran's right finger scars under DC 7800 is not necessary in this case.

Diagnostic Code 7801 evaluates burn scars or scars due to other causes, not of the head, face, or neck, that are associated with underlying soft tissue damage. Under these criteria, a scar with an area or areas of at least 6 square inches (39 sq. cm.) but less than 12 square inches (77 sq. cm.) warrants a 10 percent rating. A scar with an area or areas of at least 12 square inches (77 sq. cm.) but less than 72 square inches (465 sq. cm.) warrants a 20 percent rating. Higher ratings are available if larger areas are affected.

Diagnostic Code 7802 evaluates burn scars or scars due to other causes, not of the head, face, or neck, that
scars or scars due to other causes, not of the head, face, or neck, that are associated with underlying soft tissue damage. Under these criteria, a scar with an area or areas of at least 6 square inches (39 sq. cm.) but less than 12 square inches (77 sq. cm.) warrants a 10 percent rating. A scar with an area or areas of at least 12 square inches (77 sq. cm.) but less than 72 square inches (465 sq. cm.) warrants a 20 percent rating. Higher ratings are available if larger areas are affected.

Diagnostic Code 7802 evaluates burn scars or scars due to other causes, not of the head, face, or neck, that are not associated with underlying soft tissue damage. Under these criteria, a scar with an area or areas of 144 square inches (929 sq. cm.) or greater warrants a 10 percent rating. 38 C.F.R. § 4.118. No higher ratings are available under this code.

Under Diagnostic Code 7804, one or two scars that are unstable or painful warrants a 10 percent rating. Three or four scars that are unstable or painful warrants a 20 percent rating. Five or more scars that are unstable or painful warrants a 30 percent rating. 38 C.F.R. § 4.118. Note 1 to DC 7804 instructs that an unstable scar is one where, for any reason, there is frequent loss of covering of skin over the scar. Note 2 instructs that if one or more scars are both unstable and painful, 10 percent is added to the evaluation based on the total number of unstable and painful scars. Id.

Diagnostic Code 7805 applies to other scars and other effects of scars evaluated under Diagnostic Codes 7800, 7801, 7802, and 7804. Under DC 7805, a rating is to be assigned on the basis of any disabling effect(s) not considered in a rating provided under Diagnostic Codes 7800-04 under another appropriate diagnostic code.

The Veteran was afforded a VA scars examination in April 2019, in which the examiner indicated a diagnosis of "right hand surgery scars." See April 2019 VA Scars/Disfigurement DBQ. The examiner noted that two of the scars were painful and stated that "scars of the right fifth and fourth finger swan neck deformity repair are hypersensitive when touched and painful." She further noted that there were 4 scars on the Veteran's right fourth and fifth finger and that they measured as follows: "Scar #1: 7 x 0.2 cm; Scar #2: 6 x 0.2 cm; Scar #3: 5 x 0.2 cm; and Scar #4: 4 x 0.4 cm." With respect to limitation of function, the examiner noted that there was limitation of the fingertips due to the hypersensitivity of the scars and pain. The examiner indicated that none of the scars were unstable, with frequent loss of covering of skin over the scar, and that none of the scars were due to burns.

Based on the foregoing, the Board finds that the evidence persuasively weighs against the grant of a compensable rating for the service-connected linear scars, right 3rd and 4th finger.

As a preliminary matter, there is no evidence of a scar on the right 3rd finger during the appeal period. See April 2019 VA Scars/Disfigurement DBQ (documenting the presence of scars on the right fourth and fifth fingers but not the third). In addition, there is no evidence showing that the Veteran's right finger scars are associated with underlying soft tissue damage and cover an area of at least 6 square inches (39 sq. cm.) but less than 12 square inches (77 sq. cm.) to warrant a 10 percent rating under DC 7801. There is also no evidence showing that the Veteran's right finger scars cover an area or areas of 144 square inches (929 sq. cm.) or greater to warrant a 10 percent rating under DC 7802.

With respect to Diagnostic Code 7804, there is only evidence of (at most) four scars on the right fourth and fifth fingers, which are painful but not unstable. As noted above, the Veteran has already been granted a 20 percent evaluation for painful surgical scars, right hand, based on "three or four scars that are unstable or painful." See April 2019 Rating Decision. Thus, the Veteran has already been compensated under DC 7804 for any painful scars on his right fourth finger. Again, as noted above, there is currently no evidence of a scar on the right 3rd
square inches (929 sq. cm.) or greater to warrant a 10 percent rating under DC 7802.

With respect to Diagnostic Code 7804, there is only evidence of (at most) four scars on the right fourth and fifth fingers, which are painful but not unstable. As noted above, the Veteran has already been granted a 20 percent evaluation for painful surgical scars, right hand, based on "three or four scars that are unstable or painful." See April 2019 Rating Decision. Thus, the Veteran has already been compensated under DC 7804 for any painful scars on his right fourth finger. Again, as noted above, there is currently no evidence of a scar on the right 3rd finger, let alone one that is painful or unstable.

Finally, as noted above, Diagnostic Code 7805 (under which the AOJ continued the noncompensable rating) allows for an evaluation of any disabling effects associated with a scar under an appropriate diagnostic code. However, with respect to the service-connected linear scar, right 3rd finger, the evidence does not show that there are any disabling effects of said scar. Indeed, as noted above, there is currently no evidence of a scar on the Veteran's right 3rd finger during the appeal period.

With respect to the service-connected linear scar, right 4th finger, as explained above, Diagnostic Code 5230 provides for only a noncompensable rating for the ring or little finger. Thus, any limitation of motion (or painful motion) of the Veteran's right 4th finger under DC 5230 is non-compensable. See 4.71a, DC 5230. See also Sowers v. McDonald, supra.

For the foregoing reasons, the evidence is neither evenly balanced nor approximately so with regard to whether the Veteran is entitled to a compensable rating for linear scars, right 3rd and 4th finger. Rather, the evidence persuasively weighs against a compensable rating, and the benefit of the doubt doctrine is therefore not for application in this regard. Lynch v. McDonough, 21 F.4th 776, 781-82 (Fed. Cir. 2021) (only when the evidence persuasively favors one side or the other is the benefit of the doubt doctrine not for application). Accordingly, the claim must be denied.

YVETTE R. WHITE

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board C.D., Associate Counsel

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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