THIGH IMPAIRMENT OF

Summary

The veteran, who served from October 2012 to February 2013 and January 2014 to September 2018, appeals the denial of increased ratings for right hip girdle dysfunction and for right hip anterior and lateral scars. The veteran sought higher ratings for limitation of extension, limitation of flexion, right hip instability, and scars associated with the right hip. The Board reviewed the evidence, including treatment notes and a February 2025 VA examination. The examination documented limitations in range of motion, but these did not meet the criteria for higher ratings under the applicable diagnostic codes (DCs 5251, 5252, 5253). Specifically, the veteran's flexion was limited to 100 degrees, extension to 25 degrees, and abduction to 40 degrees, with no further loss of function after repetitive use. The Board found that while pain was present, it did not meet the threshold for higher ratings, and the existing 10 percent rating for limitation of extension was appropriate. For the scars, the VA examination found them to be superficial, not painful or unstable, and measuring a total of 3 square centimeters, which did not meet the 929 square centimeter threshold for a compensable rating under DC 7802. The Board found the medical evidence more probative than the veteran's subjective complaints. Therefore, the Board denied entitlement to increased ratings for the hip conditions and denied a compensable rating for the scars.

Rationale

Veteran's extension limited to 25 degrees.; Criteria for rating in excess of 10 percent not met.; Painful motion considered but did not warrant higher rating.

Full Decision Text

Citation Nr: A26037944
Decision Date: 04/22/26	Archive Date: 04/22/26

DOCKET NO. 250903-611241
DATE: April 22, 2026

ORDER

Entitlement to a rating in excess of 10 percent for right hip girdle dysfunction (limitation of right hip extension) is denied.

Entitlement to a compensable rating for right hip girdle dysfunction (limitation of flexion) is denied.

Entitlement to a compensable rating for right hip girdle dysfunction (right hip instability) is denied.

Entitlement to an initial compensable rating for right hip anterior and lateral scars is denied.

FINDINGS OF FACT

1. The Veteran's right hip girdle dysfunction is manifested by pain with extension of the right hip, at worst, 25 degrees, even with consideration of her pain and repeated use over time. 

2. The Veteran's right hip girdle dysfunction is manifested with flexion of the right hip, at worst, 100 degrees, even with consideration of her pain and repeated use over time. 

3. The Veteran's right hip girdle dysfunction is manifested with painful internal rotation but does not result in inability to cross the legs or limitation of less than 10 degrees, even with repeated use over time. 

4. The Veteran's service-connected linear right hip anterior and lateral scars not painful or unstable, not associated with underlying tissue damage, and does not measure to a total area of 929 square centimeters.

CONCLUSIONS OF LAW

1. The criteria for entitlement to a rating in excess of 10 percent for right hip girdle dysfunction (limitation of right hip extension) have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.3, 4.7, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code (DC) 5251.

2. The criteria for entitlement to a compensable rating for right hip girdle dysfunction (limitation of flexion) have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.3, 4.7, 4.40, 4.45, 4.59, 4.71a, DC 5252.

3. The criteria for entitlement to a compensable rating for right hip girdle dysfunction (right hip instability) have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§, 4.3, 4.7, 4.14, 4.21, 4.40, 4.45, 4.59, 4.71a, DC 5253.

4. The criteria for an initial compensable rating for right hip anterior and lateral scars have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.3, 4.7, 4.40, 4.45, 4.59, 4.71a, DC 7802.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from October 2012 to February 2013 and January 2014 through September 2018. 

This matter is on appeal from a March 2025 Appeals Modernization Act (AMA) rating decision. The Veteran timely appealed this March 2025 rating decision by submitting a September 2025 VA Form 10182, Decision Review Request: Board Appeal. 

In the September 2025 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the agency of original jurisdiction (AOJ) decision on appeal. 38?C.F.R. § 20.301. 

Increased Ratings

A disability rating is determined by the application of VA's Schedule for Rating Disabilities (Rating Schedule). 38 C.F.R. Part 4. The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and their residual conditions in civil occupations. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Generally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or the illnesses proportionate to the severity of the several grades of disability. 38 C.F
. 

Increased Ratings

A disability rating is determined by the application of VA's Schedule for Rating Disabilities (Rating Schedule). 38 C.F.R. Part 4. The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and their residual conditions in civil occupations. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Generally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or the illnesses proportionate to the severity of the several grades of disability. 38 C.F.R. § 4.1.

VA has a duty to acknowledge and consider all regulations that are potentially applicable through the assertions and issues raised in the record and to explain the reasons and bases for its conclusions. Schafrath v. Derwinski, 1 Vet. App. 589, 592-593 (1991).

Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria 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. 38 C.F.R. § 4.3.

The evaluation of the same disability under various diagnoses, known as pyramiding, is generally to be avoided. 38 C.F.R. § 4.14. The critical element in permitting the assignment of several ratings under various diagnostic codes is that none of the symptomatology for any one of the disabilities is duplicative or overlapping with the symptomatology of the other disability. See Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994).

The Board will consider whether separate ratings may be assigned for separate periods of time based on facts found, a practice known as "staged ratings."  Fenderson v. West, 12 Vet. App. 119, 126-27 (1999); Hart v. Mansfield, 21 Vet. App. 505, 509 (2007).

In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable rating are not met. 38 C.F.R. §4.31.

When evaluating musculoskeletal disabilities based on limitation of motion, 38 C.F.R. § 4.40 requires consideration of functional loss caused by pain or other factors listed in that section that could occur during flareups or after repeated use and, therefore, not be reflected on range-of-motion testing. 38 C.F.R. § 4.45 requires consideration also be given to less movement than normal, more movement than is normal, weakened movement, excess fatigability, incoordination, and pain on movement.  See DeLuca v. Brown, 8 Vet. App. 202, 204 (1995); see also Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011). Nonetheless, even when the background factors listed in § 4.40 or 4.45 are relevant when evaluating a disability, the rating is assigned based on the extent to which motion is limited, pursuant to 38 C.F.R. § 4.71a; a separate or higher rating under § 4.40 or 4.45 itself is not appropriate. See Thompson v. McDonald, 815 F.3d 781, 785 (Fed. Cir. 2016) (" [I]t is clear that the guidance of § 4.40 is intended to be used in understanding the nature of the veteran's disability, after which a rating is determined based on the § 4.71a criteria.").

Under 38 C.F.R. § 4.59, painful motion is a factor to be considered with any form of arthritis; however, 38 C.F.R. § 4.59 is not limited to disabilities involving arthritis. See Burton v. Shinseki, 25 Vet. App. 1, 5 (2011).

In the case of Correia v. McDonald, 28 Vet. App. 158, 168 (2016), the Court held that the final sentence of 38 C.F.R. § 4.59 requires that the examiner record the results of range of motion testing "for pain on both active and passive motion [and] in weightbearing and nonweight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint."  

In Sharp v.
 be considered with any form of arthritis; however, 38 C.F.R. § 4.59 is not limited to disabilities involving arthritis. See Burton v. Shinseki, 25 Vet. App. 1, 5 (2011).

In the case of Correia v. McDonald, 28 Vet. App. 158, 168 (2016), the Court held that the final sentence of 38 C.F.R. § 4.59 requires that the examiner record the results of range of motion testing "for pain on both active and passive motion [and] in weightbearing and nonweight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint."  

In Sharp v. Shulkin, 29 Vet. App. 26, 31 (2017), the Court held that VA examiners must obtain information about the severity, frequency, duration, precipitating and alleviating factors, and extent of functional impairment of flares from the veterans themselves, when a flare-up is not observable at the time of examination.

1. Entitlement to a rating in excess of 10 percent for right hip girdle dysfunction (limitation of right hip extension) is denied.

2. Entitlement to a compensable rating for right hip girdle dysfunction (limitation of flexion) is denied.

3. Entitlement to a compensable rating for right hip girdle dysfunction (right hip instability) is denied.

The Veteran is currently assigned a 10 percent rating for right hip dysfunction (limitation of right hip extension). She is also assigned noncompensable ratings for limitation of flexion and right hip instability. She disagrees with the ratings assigned.

The Veteran's right hip girdle dysfunction (limitation of right hip extension) is currently rated under 38 C.F.R. § 4.71a, DC 5251, for limitation of extension of the thigh. Under DC 5251, a maximum 10 percent rating is warranted for extension of the thigh limited to 5 degrees.  

The Veteran's right hip girdle dysfunction (limitation of flexion) is rated under 38 C.F.R. § 4.71a, DC 5252, for limitation of flexion of the thigh. Under DC 5252, a 10 percent rating is warranted for flexion limited to 45 degrees. A 20 percent rating is warranted for flexion limited to 30 degrees. A 30 percent rating is warranted for flexion limited to 20 degrees. A maximum 40 percent rating is warranted for flexion limited to 10 degrees. 38 C.F.R. § 4.71a, DC 5252.  

Lastly, the Veteran's right hip girdle dysfunction is rated at noncompensable under 38 C.F.R. § 4.71a, DC 5253, for impairment of the thigh. Under DC 5253, a 10 percent rating is warranted for limitation of rotation of affected leg, cannot toe out more than 15 degrees. A 10 percent rating is also warranted for limitation of adduction, cannot cross legs. A maximum 20 percent rating is warranted for limitation of abduction, motion lost beyond 10 degrees. 38 C.F.R. § 4.71a, DC 5253.  

Turning to the evidence of record, the Veteran's treatment notes in March 2024 documented a right hip examination during routine treatment for pain. Upon examination, the Veteran's gait was normal with flexion to 100 degrees, internal rotation to 30 degrees, external rotation to 35 degrees, and abduction to 20 degrees. In April 2024, she described constant burning and throbbing pain in the anterior and lateral hip. She also endorsed right hip locking. 

The Veteran underwent a February 2025 VA examination, and per the report, the Veteran had abnormal initial range of motion, with flexion endpoint to 110 degrees, extension endpoint to 25 degrees, abduction endpoint to 40 degrees, adduction endpoint to 20 degrees, external rotation endpoint to 50 degrees, and internal rotation endpoint to 35 degrees. The VA examiner indicated that limitation in adduction does not prevent the Veteran from crossing her legs. Passive range of motion was the same as with active and was noted as not preventing the Veteran from being able to cross her legs. The Veteran was able to perform repetitive-use testing with at least three repetitions, but with no additional loss of function or range of motion. The Veteran was examined after repeated use over time, and had no further reductions in range of motion with repeated use over time. The Veteran denied flareups. There was no evidence of femur of flail joint impairment. Lastly, the VA examiner did not find that the Veteran suffers from ankylosis, favorable or unfavorable, of the right hip.


 rotation endpoint to 35 degrees. The VA examiner indicated that limitation in adduction does not prevent the Veteran from crossing her legs. Passive range of motion was the same as with active and was noted as not preventing the Veteran from being able to cross her legs. The Veteran was able to perform repetitive-use testing with at least three repetitions, but with no additional loss of function or range of motion. The Veteran was examined after repeated use over time, and had no further reductions in range of motion with repeated use over time. The Veteran denied flareups. There was no evidence of femur of flail joint impairment. Lastly, the VA examiner did not find that the Veteran suffers from ankylosis, favorable or unfavorable, of the right hip.

Based on the aforementioned, the Board finds that the evidence of record persuasively weighs against a rating in excess of 10 percent for limitation of extension of the right hip, as well as against compensable ratings for limitation of flexion and for impairment of the thigh. To point, at worst, the Veteran's right hip was manifested by limitation of flexion to 100 degrees, limitation of extension to 25 degrees, adduction limited to 20 degrees, abduction limited to 40 degrees, internal rotation limited to 35 degrees, and external rotation limited to 50 degrees. Thus, while limited range of motion was shown in treatment notes and within the February 2025 VA examination, the required findings for higher ratings were not.

The Board notes that the Veteran was awarded a minimum 10 percent disability rating pursuant to 38 C.F.R. § 4.59 for painful motion of the right hip (limitation of extension). See October 2018 Rating Decision. The Veteran cannot receive multiple 10 percent ratings for painful motion of the same joint under the provisions of 38 C.F.R. §§ 4.40, 4.45, 4.59 in this case as it would be impermissible pyramiding. See 38 C.F.R. § 4.14; Esteban v. Brown, 6 Vet. App. 259, 262 (1994). 

The Board acknowledges the Veteran's lay reports of symptoms and the request for increased ratings asserted in the representative's March 2026 Appellate Brief. While the record does demonstrate that there was functional loss due to intermittent right hip pain, even considering the Veteran's lay reports of symptoms and noted functional loss, the degree of additional limitation reflected by the statements would not result in symptoms more nearly approximating flexion limited to 30 degrees, extension limited to 5 degrees, limitation of rotation cannot toe-out more than 15 degrees for the right leg, limitation of adduction cannot cross legs, or limitation of adduction motion lost beyond 10 degrees.

The Board has also considered the other Diagnostic Codes pertaining to the hip and thigh. Other disability ratings may be assigned only if the symptomatology for a disability is not duplicative or overlapping with the symptomatology of any other disability. See Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994); see also Lyles v. Shulkin, 29 Vet. App. 107 (2017) (holding that 38 C.F.R. § 4.14 prohibits paying compensation twice for the same symptoms or functional impairment). The February 2025 VA examination report does not reveal that the Veteran suffers from ankylosis, or the functional equivalent, flail hip joint, or impairment of the femur. Thus, the Board also does not find the Veteran entitled to separate ratings for the right hip based on the most probative evidence assessing her disability for the period on appeal.

In conclusion, the Board finds that the evidence of record persuasively weighs against the Veteran's appeal for a rating in excess of 10 percent for the right hip girdle dysfunction (limitation of extension), as well as against compensable rating for limitation of flexion and impairment of thigh. As the evidence of record persuasively weighs against a rating increased and compensable ratings for the right hip girdle dysfunction under the respective diagnostic criteria, the benefit-of-the-doubt rule does not apply, and the claims must be denied.  38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

4. Entitlement to an initial compensable rating for right hip anterior and lateral scars is denied.

The Veteran is currently assigned a noncompensable rating for right hip anterior and lateral scars, under 38 C.F.R. § 4.118, DC 7802. 

DC 7801 indicates that for burn scar(s) or scar(s) due to other causes, not of
-of-the-doubt rule does not apply, and the claims must be denied.  38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

4. Entitlement to an initial compensable rating for right hip anterior and lateral scars is denied.

The Veteran is currently assigned a noncompensable rating for right hip anterior and lateral scars, under 38 C.F.R. § 4.118, DC 7802. 

DC 7801 indicates that for burn scar(s) or scar(s) due to other causes, not of the head, face, or neck, that are deep and nonlinear in an area or areas of at least 6 square inches (39 sq. cm.) but less than 12 square inches (77 sq. cm.), a 10 percent rating is warranted. 38 C.F.R. § 4.118, DC 7801. Note (1) provides that a deep scar is one associated with underlying soft tissue damage.

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.

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. Note (1). 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. Note (2). Scars evaluated under DCs 7800, 7801, 7802, or 7805 may also receive an additional rating under DC 7804, when applicable. Note (3).

Under DC 7805, other scars (including linear scars) and other effects of scars evaluated under DCs 7800, 7801, 7802, and 7804 require the evaluation of any disabling effect(s) not considered in a rating provided under DCs 7800-04 under an appropriate diagnostic code.

The Veteran's February 2025 VA examination documents two scars lateral and anterior scars. These scars were not painful or unstable and did not have a total area equal to 929 square centimeters or greater. Rather, the examiner documented that the Veteran had two scars on her right lower extremity which measurements of 1x1 centimeters and 2x1 centimeters. She had an affected total area of 3 centimeters. There was no underlying tissue damage. Treatment notes dated within the period on appeal showed no greater effects or limitations from the Veteran's right hip anterior and lateral scars.

Based on the aforementioned, the Board finds that a compensable disability rating is not warranted for the Veteran's right hip anterior and lateral scars. See 38 C.F.R. § 4.118, DC 7802. DC 7802 provides for a compensable rating only where the scarred area is 144 square inches (929 sq. cm.) or greater. The evidence shows the Veteran's right hip anterior and lateral scars, do not meet that threshold, and a compensable rating is not warranted.

The Board has also considered the applicability of other potentially applicable diagnostic criteria for rating the Veteran's scars but finds that no higher rating is assignable under any other diagnostic code. To that end, DC 7800 contemplates scars of the head, face, or neck. 38 C.F.R. § 4.118. As the Veteran does not have scars of the head, face or neck, this is not applicable.

In addition, the evidence does not show that the scars were greater than 39 square centimeters with associated underlying soft tissue damage; thus, a rating under DC 7801 is not appropriate. There is no indication that the scars are painful or unstable, thus, the Veteran is not entitled to a compensable rating under DC 7804. With regard to DC 7805, the evidence of record does not indicate, and the Veteran does not contend, that there are any disabling effects resulting from her right hip anterior and lateral scars.

Although the Veteran contends that her right hip anterior and lateral scars warrant a higher rating, she is competent to report symptoms because this requires only personal knowledge as it
 head, face or neck, this is not applicable.

In addition, the evidence does not show that the scars were greater than 39 square centimeters with associated underlying soft tissue damage; thus, a rating under DC 7801 is not appropriate. There is no indication that the scars are painful or unstable, thus, the Veteran is not entitled to a compensable rating under DC 7804. With regard to DC 7805, the evidence of record does not indicate, and the Veteran does not contend, that there are any disabling effects resulting from her right hip anterior and lateral scars.

Although the Veteran contends that her right hip anterior and lateral scars warrant a higher rating, she is competent to report symptoms because this requires only personal knowledge as it comes to her through her senses. Layno v. Brown, 6 Vet. App. 465 (1994). She is not, however, competent to identify a specific level of disability of this disorder according to the appropriate diagnostic codes. Such competent evidence concerning the nature and extent of the Veteran's disabilities has been provided by the medical personnel who have examined her during the current appeal and who have rendered pertinent opinions in conjunction with the evaluations. The medical findings (as provided in the examination reports and the clinical records) directly address the criteria under which her disability is evaluated. As such, the Board finds these records to be more probative than the Veteran's subjective complaints of increased symptomatology. Moreover, the Board has considered arguments within the March 2026 Appellate Brief that generally points to the Veteran's lay statements for a request for higher ratings. However, after considering the totality of the evidence, including lay statements and arguments, the weight of the evidence does not demonstrate that higher ratings are warranted.

Accordingly, the right hip anterior and lateral scars are appropriately rated as noncompensable under DC 7802, and the claim is denied.

 

 

J. NICHOLS

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	N.B. Mmeje, 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.