SCAR(S) UNSTABLE OR PAINFUL

MARIAH N. SIM · 2026 · Case ID: A26039745

DENIED

Summary

The Veteran, who served in the U.S. Marine Corps from August 1974 to August 1976 and the Army from July 1980 to May 1986, appeals the denial of an increased rating for painful scars of the left axilla cyst removal and left fifth finger. The Veteran contended that his symptoms were more severe than contemplated by the current 10% rating. The Board reviewed the evidence, including a July 2019 VA treatment record noting left axillary scar pain and an August 2020 VA scars examination. The examination found three painful scars, with the left axilla scar measuring 6 cm by 1.5 cm and the left fifth finger scar measuring 1.1 cm by 0.15 cm. The examiner noted tenderness and underlying soft tissue damage for both, and worsening pain with numbness for the finger scar. However, the scars were not found to be unstable, and the total area of the left upper extremity scars was 9.8 square centimeters. The Board found that to warrant a higher rating, the scars would need to be unstable, or three to four scars would need to be painful, or the area would need to be at least 12 square centimeters. The Board concluded that the evidence persuasively weighed against a rating higher than 10%, noting the lack of instability and insufficient area for a higher evaluation under Diagnostic Code 7801 or 7804. The Board also considered staged ratings and found the Veteran's symptomatology stable. The Veteran's lay testimony regarding pain was considered competent but given less weight than the competent medical evidence. The Board denied the increased rating.

Rationale

Scars not found to be unstable.; Total area of left upper extremity scars (9.8 sq. cm.) did not meet criteria for higher rating.; Symptomatology found to be stable, precluding staged ratings.

Service Branch

MARINE CORPS

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210903-183017

Full Decision Text

Citation Nr: A26039745
Decision Date: 04/28/26 Archive Date: 04/28/26

DOCKET NO. 210903-183017
DATE: April 28, 2026

ORDER

Entitlement to a rating in excess of 10 percent for painful scars of left axilla cyst removal and left fifth finger is denied.

FINDING OF FACT

Throughout the period on appeal, the Veteran's scars of the left axilla cyst removal and left fifth finger are not manifested by an area or areas of at least 12 square inches (77 square centimeters) but less than 72 square inches (465 square centimeters) or three or four scars that are unstable or painful.

CONCLUSION OF LAW

The criteria for entitlement to a rating in excess of 10 percent for painful scars of left axilla cyst removal and left fifth finger have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1-4.14, 4.118, Diagnostic Codes (DCs) 7801, 7804.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty in the United States Marine Corps from August 1974 to August 1976 and in the Army from July 1980 to May 1986.

The rating decision on appeal was issued in November 2020 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.

In the September 3, 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. An April 2025 notification advised the Veteran that a hearing was scheduled for July 9, 2025. In July 2025, the Veteran filed a motion to postpone the hearing. In a July 2025 letter, the Board found good cause to postpone the hearing. A July 2025 notification advised the Veteran that a hearing was rescheduled for July 22, 2025. In the July 17, 2025 VA Form 20-101208 Document/Evidence Submission, the Veteran waived the request for a Board hearing.

Therefore, the Board may only consider the evidence of record at the time of the November 2020 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or representative within 90 days following receipt of the withdrawal of the hearing request. 38 C.F.R. § 20.302(b). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to receipt of the withdrawal, or (2) more than 90 days following receipt of the withdrawal, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(b), 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, 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 RATING - SCARS

The Veteran asserts that the left axilla cyst removal scar and left fifth finger scar warrant a higher rating because his symptoms are more severe than contemplated by the currently assigned rating.

Disability evaluations are determined by evaluating the extent to which a veteran's service-connected disability adversely affects his or her ability to function under the ordinary conditions of daily life, including employment, by comparing his or her symptomatology with the criteria set forth in the Schedule for Rating Disabilities (Rating Schedule). 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1, 4.2, 4.10.

Where there is a question as to which of two evaluations shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that evaluation. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Reasonable doubt as to the degree of disability will be resolved in the veteran's favor. 38 C.F.R. § 4.3. It is permissible to switch diagnostic codes to reflect more accurately a claimant's current symptoms. See Read v. Shinseki, 651 F. 3d 1296, 1302 (Fed. Cir.
. §§ 4.1, 4.2, 4.10.

Where entitlement to compensation has already been established and an increase in the disability rating is at issue, the present level of disability is of primary concern. Although a rating specialist is directed to review the recorded history of a disability in order to make a more accurate evaluation, see 38 C.F.R. § 4.2, the regulations do not give past medical reports precedence over current findings. Francisco v. Brown, 7 Vet. App. 55 (1994).

Pertinent regulations do not require that all cases show all findings specified by the Rating Schedule, but that findings sufficiently characteristic to identify the disease and the resulting disability and above all, coordination of rating with impairment of function will be expected in all cases. 38 C.F.R. § 4.21. Therefore, the Board has considered the potential application of various other provisions of the regulations governing VA benefits, whether or not they were raised by the veteran, as well as the entire history of the veteran's disability in reaching its decision. Schafrath v. Derwinski, 1 Vet. App. 589, 595 (1991).

Separate ratings can be assigned for separate periods based on the facts found - a practice known as "staged" ratings. Francisco v. Brown, 7 Vet. App. 55, 58 (1994); Hart v. Mansfield, 21 Vet. App. 505 (2007). Staged ratings are appropriate whenever the factual findings show distinct periods where the service-connected disability exhibits symptoms that would warrant different ratings. Id.

In general, all disabilities, including those arising from a single disease entity, are rated separately, and all disability ratings are then combined in accordance with 38 C.F.R. § 4.25. Pyramiding, the evaluation 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 disability. 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, however, 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 conditions is duplicative or overlapping with the symptomatology of the other condition. See Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994).

The basis of disability evaluation is the ability of the body as a whole, or of the psyche, or of a system or organ of the body to function under the ordinary conditions of daily life including employment. 38 C.F.R. § 4.10.

The veteran is competent to report symptoms and experiences observable by his senses. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); 38 C.F.R. § 3.159(a).

Although the Board has an obligation to provide reasons and bases supporting its decision, there is no obligation to discuss, in detail, the extensive evidence of record. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) (holding that the Board must review the entire record but does not have to discuss each piece of evidence). Therefore, the Board will summarize the relevant evidence where appropriate, and the Board's analysis will focus specifically on what the evidence shows, or fails to show, as it relates to the Veteran's claim.

When there is an approximate balance of positive and negative evidence as to any issue material to the determination of a matter, VA will resolve reasonable doubt in favor of the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

Throughout the period on appeal, the Veteran's painful scars of the left axilla cyst removal and left fifth finger were rated at 10
the Board will summarize the relevant evidence where appropriate, and the Board's analysis will focus specifically on what the evidence shows, or fails to show, as it relates to the Veteran's claim.

Throughout the period on appeal, the Veteran's painful scars of the left axilla cyst removal and left fifth finger were rated at 10 percent disabling under 38 C.F.R. § 4.118, Diagnostic Code 7804.

Under Diagnostic Code 7801, burn scar(s) or scar(s) due to other causes, not of the head, face or neck, that are associated with underlying soft tissue damage, are assigned a 10 percent rating with area or areas of at least 6 square inches (39 sq. cm.) but less than 12 square inches (77 sq. cm.). A 20 percent rating is warranted with area or areas of at least 12 square inches (77 square centimeters (sq. cm.)) but less than 72 square inches (465 sq. cm.). A 30 percent rating is warranted with area or areas of at least 72 square inches (465 sq. cm.) but less than 144 square inches (929 sq. cm.). And a maximum rating of 40 percent is warranted with area or areas of 144 square inches (929 sq. cm.) or greater.

Note (1) to Diagnostic Code 7801: For the purposes of DCs 7801 and 7802, the six (6) zones of the body are defined as each extremity, anterior trunk, and posterior trunk. The midaxillary line divides the anterior trunk from the posterior trunk

Note (2) to Diagnostic Code 7801: A separate evaluation may be assigned for each affected zone of the body under this diagnostic code if there are multiple scars, or a single scar, affecting multiple zones of the body. Combine the separate evaluations under § 4.25. Alternatively, if a higher evaluation would result from adding the areas affected from multiple zones of the body, a single evaluation may also be assigned under this diagnostic code.

Under Diagnostic Code 7804, one or two scars that are unstable or painful scars warrants a 10 percent rating. Three or four scars that are unstable or painful scars 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 Diagnostic Code 7804: An unstable scar is one where, for any reason, there is frequent loss of covering of skin over the scar.

Note (2) to Diagnostic Code 7804: If one or more scars are both unstable and painful, add 10 percent to the evaluation that is based on the total number of unstable or painful scars.

Note (3) to Diagnostic Code 7804: Scars evaluated under diagnostic codes 7800 7801, 7802, or 7805 may also receive an evaluation under this diagnostic code, when applicable.

Turning to the evidence, a July 2019 VA treatment record, the medical provider found the Veteran to have left axillary scar pain.

On the August 2020 VA scars examination, the examiner indicated the Veteran has diagnoses of scars of the left fifth finger, left axillary cyst removal, and right knee scar. The Veteran reported that he experiences pain in the finger, armpit and knee scars. He stated that he also has numbness with the finger scar. The examiner indicated that the Veteran has three painful scars. The examiner did not find the scars to be unstable with frequent loss of covering of the skin over the scar. On examination, the examiner measured the left arm pit scar to be 6 cm. by 1.5 cm. The left fifth finger scar was observed to be 1.1 cm. by 0.15 cm.. The examiner noted the left arm pit scar and left fifth finger scar are tender to palpation and have underlying soft tissue damage. The examiner found the right knee scar to be 5 cm. by 0.2 cm. and indicated that the scar is tender on palpation. The examiner calculated the total area of the right lower extremity scar to be 1 square centimeter and the left upper extremity scars are 9.8 square centimeters. The examiner remarked that the Veteran's fifth finger scar and axilla scar are worsening with increasing pain. The examiner stated that the finger also has numbness. The examiner stated that the Veteran reports
fifth finger scar was observed to be 1.1 cm. by 0.15 cm.. The examiner noted the left arm pit scar and left fifth finger scar are tender to palpation and have underlying soft tissue damage. The examiner found the right knee scar to be 5 cm. by 0.2 cm. and indicated that the scar is tender on palpation. The examiner calculated the total area of the right lower extremity scar to be 1 square centimeter and the left upper extremity scars are 9.8 square centimeters. The examiner remarked that the Veteran's fifth finger scar and axilla scar are worsening with increasing pain. The examiner stated that the finger also has numbness. The examiner stated that the Veteran reports a knee scar during the examination which is unrelated to the service-connected scars.

Further review of the record shows that the Veteran receives VA treatment providers for various disabilities. However, there is no indication from the treatment notes of record that the Veteran has reported scar symptoms that are worse than those noted above.

Upon review of the record, the Board finds that a rating in excess of 10 percent for the left axilla cyst removal scar and left fifth finger scar is not warranted. To warrant a higher rating, it is necessary to show three or four scars that are unstable or painful or that the scars are associated with underlying soft tissue damage and have an area or areas of at least 12 square inches (77 sq. cm.) but less than 72 square inches (465 sq. cm.). Here, the August 2020 VA examination indicated that there are two scars of the left upper extremity and that the total areas of the left upper extremity scars are 9.8 square centimeters. Further, as noted in Note (2) to Diagnostic Code 7804, if one or more scars are both unstable and painful, add 10 percent to the evaluation that is based on the total number of unstable or painful scars. Although the August 2020 VA examiner observed the scars to be painful and to be associated with the underlying soft tissue damage, there is no finding that the left axilla cyst removal scar or the left fifth finger scar are unstable. Therefore, a rating in excess of 10 percent is not warranted for the Veteran's left axilla cyst removal scar and left fifth finger scar.

The Board has considered whether staged ratings under Hart v. Mansfield, supra is appropriate; however, the Board finds that his symptomatology was been stable throughout the period on appeal. Therefore, assigning staged ratings is not warranted. The Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record in regard to the increased rating claim adjudicated herein. Doucette v. Shulkin, 28 Vet. App. 366 (2017).

Additionally, the Board has considered whether an inferred claim for a TDIU has been raised pursuant to Rice v. Shinseki, 22 Vet. App. 447 (2009). The Veteran's current employment status is unknown. The Veteran has also not alleged, and the record does not suggest, that he is unable to obtain and maintain employment due solely to his service connected scars. As such, a Rice claim is not raised.

In so finding the above, the Board acknowledges the Veteran's contentions that his scars are more severe than contemplated by the current rating assigned. The Veteran is competent to report symptoms such as pain because this requires only personal knowledge, not medical expertise, as it comes to him through his senses. See Layno v. Brown, 6 Vet. App. 465, 469 (1994). Lay testimony is competent to establish the presence of observable symptomatology, where the determination is not medical in nature and is capable of lay observation. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). However, he is not considered competent to medically attribute or assess the severity of his scars as required in the Diagnostic Code. See Woehlaert v. Nicholson, 21 Vet. App. 456 (2007). Therefore, his statements do not constitute competent evidence and, the Board assigns more probative weight to the competent medical evidence of record.

The Board concludes that that the evidence persuasively weighs against finding that a rating in excess of 10 percent for left axilla cyst removal scar and left fifth finger scar is warranted. The Board has considered the benefit-of-the-doubt doctrine; however, as the evidence persuasively weighs against the claim, the benefit-of-the-doubt rule is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 4.3; Lynch v. McDonough, 21 F.4th 776 (2021).

Mariah N. Sim

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney

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