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C&P Exam Prep: Scars (Burn / Disfigurement / Painful)
DBQ Overview
Interview + Physical- Form Name
- scars
- Form Code
- scars
- Page Count
- 12
- Examiner Type
- Dermatologist or appropriate clinician
- Estimated Duration
- 15-30 minutes
- Exam Format
- Interview + Physical
What to Expect During Your Exam
Exam Overview
To document the nature, location, dimensions, characteristics, and functional impact of all service-connected scars, burn scars, and disfigurement for rating purposes under 38 CFR 4.118.
What the examiner evaluates:
- Location of each scar (body region, laterality)
- Scar type: linear, superficial non-linear, burn, keloid, or hypertrophic
- Dimensions: length and width at widest part in centimeters
- Total area in square centimeters
- Surface contour: elevated (raised/hypertrophic) or depressed on palpation
- Pigmentation changes: hyperpigmentation or hypopigmentation
- Abnormal texture (irregular, atrophic, etc.)
- Induration and inflexibility
- Whether scar is adherent to underlying tissue
- Presence of pain on palpation or otherwise
- Loss of skin covering over the scar (skin breakdown, unstable scar)
- Head, face, or neck involvement and specific features affected (forehead, nose, cheeks, lips, chin, eyes/eyelids, ears/auricles)
- Whether scars are associated with underlying soft tissue damage
- Disfigurement characteristics: tissue loss, distortion, asymmetry of facial features
- Impact of scars on occupational and daily functioning
- History including cause, origin, and course of each scar
You will be asked to expose the areas where scars are located. The examiner will visually inspect and palpate each scar, and may measure them with a ruler. Ensure all scar locations are accessible for inspection. The exam covers both interview (history, symptoms) and physical examination (visual and tactile inspection, measurement).
Typical duration: 15-30 minutes
Scar Area Measurement
The total surface area of each scar and the combined total area of all scars, measured in square centimeters (cm-). For non-head/face/neck scars, area determines whether the 10% threshold (929 cm- or greater) is met under DC 7802.
What to expect:
The examiner will use a ruler or measuring tool to record the length and width of each scar at its widest point. Multiple scars may be measured individually and summed. You may be asked to stand, sit, or change position to allow access to all affected areas.
Key thresholds:
- 929 cm- (144 sq. inches) or greater - combined area of non-head/face/neck scars without underlying soft tissue damage — 10% under DC 7802
- Less than 929 cm- - non-head/face/neck scars without underlying soft tissue damage, not painful, not unstable — 0% under DC 7802 (may be rated under other DCs if painful or associated with soft tissue damage)
- DC 7800 - head, face, or neck: 6+ characteristics of disfigurement, OR tissue loss with gross distortion/asymmetry of 3+ features — 80%
- DC 7800 - head, face, or neck: 4-5 characteristics of disfigurement, OR tissue loss with gross distortion/asymmetry of 2 features — 50%
- DC 7800 - head, face, or neck: 2-3 characteristics of disfigurement, OR tissue loss with gross distortion/asymmetry of 1 feature — 30%
- DC 7800 - head, face, or neck: 1 characteristic of disfigurement — 10%
Tips:
- Before your exam, measure your own scars as best you can with a tape measure and write down the dimensions so you can confirm accuracy.
- If a scar has irregular borders, make sure the examiner captures the widest points in both length and width.
- If you have multiple scars across different body regions, list each one separately with its approximate location and size.
- Do not allow the examiner to only measure the most visible scar - all service-connected scars should be documented.
- Scars on hair-covered areas may be harder to visualize; remind the examiner if you have hidden scars under hair or clothing.
Pain considerations: If any scar is painful on palpation or at rest, communicate this clearly during measurement. Painful scars may qualify for separate rating under DC 7804 regardless of size.
Disfigurement Feature Assessment (Head, Face, Neck - DC 7800)
The number and nature of disfigurement characteristics present on the head, face, or neck, including tissue loss, distortion, or asymmetry of specific facial features (forehead, nose, cheeks, lips, chin, eyes/eyelids, ears/auricles).
What to expect:
The examiner will visually assess your face, head, and neck for visible abnormalities. They will check each anatomical feature individually and count how many characteristics of disfigurement are present. They may ask you to look straight ahead, tilt your head, or open/close your eyes and mouth.
Key thresholds:
- 6 or more disfigurement characteristics — 80% (DC 7800)
- 4-5 disfigurement characteristics — 50% (DC 7800)
- 2-3 disfigurement characteristics — 30% (DC 7800)
- 1 disfigurement characteristic — 10% (DC 7800)
Tips:
- Multiple scars can contribute collectively to disfigurement characteristics - each characteristic does NOT need to come from a single scar.
- Characteristics of disfigurement include: scar adherent to underlying tissue, hyperpigmentation, hypopigmentation, elevated surface contour, depressed surface contour, abnormal texture, induration and inflexibility, missing underlying soft tissue.
- Be sure to point out all visible and palpable changes, even subtle ones like slight color differences or firmness.
- If scarring affects your ear(s), specifically note whether there is deformity of the auricle (less than one-third vs. one-third or more of substance lost, or complete loss).
- If scarring affects your eye(s) or eyelid(s), make sure to report any tissue loss, distortion, or functional impact.
Pain considerations: Pain or tenderness on palpation of facial scars should be reported; it constitutes an additional characteristic of disfigurement and may support a higher rating level.
Pain Characterization and Palpation Assessment
Whether any scar is painful (at rest, on contact/palpation, or both) and the nature and severity of that pain. Painful scars are rated separately under DC 7804.
What to expect:
The examiner will press on each scar and ask whether it is tender or painful. You will be asked to describe the character of the pain (burning, stabbing, aching), when it occurs (constant, with touch, with movement, with temperature changes), and how severe it is.
Key thresholds:
- Painful scar confirmed on examination — 10% under DC 7804 (in addition to any area-based rating)
- No pain elicited on palpation — 0% under DC 7804
Tips:
- Report pain accurately - if a scar is painful only sometimes (e.g., with clothing friction, temperature changes, or pressure), say so and describe when it hurts.
- Do not feel pressure to say 'not painful' if it is only mildly painful; accurately report your typical and worst-case pain experience.
- If pain affects your sleep, concentration, or ability to wear certain clothing or equipment, tell the examiner.
- Report pain during the exam itself if palpation hurts - do not stay silent.
- If you have multiple painful scars, ensure each one is assessed individually and documented as painful.
Pain considerations: Even a scar that is only occasionally painful should be reported as painful. Per M21-1 guidance, accurately describe your worst-day experience. If pain varies, explain the range: 'On bad days, the scar burns constantly; on average days, it hurts when touched or rubbed by clothing.'
Rating Criteria Breakdown
| Rating % | Criteria | Key Symptoms |
|---|---|---|
| 80% | DC 7800: Burn scar(s) or scar(s) of the head, face, or neck with visible or palpable tissue loss AND either gross distortion or asymmetry of three or more features/paired sets of features (nose, chin, forehead, eyes including eyelids, ears/auricles, cheeks, lips), OR with six or more characteristics of disfigurement. |
CFR: Example: Burn scars of the face with visible tissue loss causing asymmetry of both eyes (eyelids), nose, and cheeks (3 paired/individual features) - OR - scars exhibiting hyperpigmentation, hypopigmentation, depressed contour, elevated contour, induration, and missing soft tissue simultaneously (6 characteristics). Under Note (5), these characteristics can be contributed by multiple scars combined. |
| 50% | DC 7800: Burn scar(s) or scar(s) of the head, face, or neck with visible or palpable tissue loss AND either gross distortion or asymmetry of two features or paired sets of features, OR with four or five characteristics of disfigurement. |
CFR: Example: Burn scars affecting the forehead and nose (2 features) with palpable tissue loss - OR - scars exhibiting four characteristics such as adherence to underlying tissue, hypopigmentation, depressed surface contour, and induration. Multiple scars may collectively contribute the required characteristics. |
| 30% | DC 7800: Burn scar(s) or scar(s) of the head, face, or neck with visible or palpable tissue loss AND either gross distortion or asymmetry of one feature or paired set of features, OR with two or three characteristics of disfigurement. |
CFR: Example: Scar on the cheek with palpable tissue loss causing asymmetry of that cheek (1 feature) - OR - a scar exhibiting hyperpigmentation and induration (2 characteristics). Characteristics may be contributed by multiple scars collectively. |
| 10% | DC 7800: Head, face, or neck scars with one characteristic of disfigurement. DC 7802: Burn scar(s) or scar(s) due to other causes, NOT of the head, face, or neck, NOT associated with underlying soft tissue damage, with total area of 929 cm- (144 sq. inches) or greater. |
CFR: DC 7802 Example: Burn scars covering the anterior trunk and right upper extremity totaling 150+ square inches (approximately 968+ cm-) with no associated underlying soft tissue damage. DC 7800 Example: A scar on the forehead exhibiting only hyperpigmentation as its one disfigurement characteristic. |
| 10% | DC 7804 (Painful or unstable scars): Any scar that is painful on examination, regardless of location or size. Can be assigned in addition to ratings under DC 7800 or 7802. |
CFR: Example: A scar on the left lower extremity that is painful when touched during examination. This 10% rating is separate from any DC 7802 rating and both can be assigned simultaneously if criteria for each are met independently. |
80% DC 7800: Burn scar(s) or scar(s) of the head, face, or neck ...
DC 7800: Burn scar(s) or scar(s) of the head, face, or neck with visible or palpable tissue loss AND either gross distortion or asymmetry of three or more features/paired sets of features (nose, chin, forehead, eyes including eyelids, ears/auricles, cheeks, lips), OR with six or more characteristics of disfigurement.
Key Symptoms
- Visible tissue loss on head, face, or neck
- Gross distortion or asymmetry of three or more facial features
- Six or more disfigurement characteristics present
- Severe facial asymmetry affecting appearance and function
- Extensive scarring across multiple facial zones
CFR: Example: Burn scars of the face with visible tissue loss causing asymmetry of both eyes (eyelids), nose, and cheeks (3 paired/individual features) - OR - scars exhibiting hyperpigmentation, hypopigmentation, depressed contour, elevated contour, induration, and missing soft tissue simultaneously (6 characteristics). Under Note (5), these characteristics can be contributed by multiple scars combined.
50% DC 7800: Burn scar(s) or scar(s) of the head, face, or neck ...
DC 7800: Burn scar(s) or scar(s) of the head, face, or neck with visible or palpable tissue loss AND either gross distortion or asymmetry of two features or paired sets of features, OR with four or five characteristics of disfigurement.
Key Symptoms
- Visible or palpable tissue loss on head, face, or neck
- Gross distortion or asymmetry of two facial features
- Four or five disfigurement characteristics present
- Noticeable facial asymmetry affecting at least two anatomical zones
- Moderate-to-severe disfigurement impacting appearance
CFR: Example: Burn scars affecting the forehead and nose (2 features) with palpable tissue loss - OR - scars exhibiting four characteristics such as adherence to underlying tissue, hypopigmentation, depressed surface contour, and induration. Multiple scars may collectively contribute the required characteristics.
30% DC 7800: Burn scar(s) or scar(s) of the head, face, or neck ...
DC 7800: Burn scar(s) or scar(s) of the head, face, or neck with visible or palpable tissue loss AND either gross distortion or asymmetry of one feature or paired set of features, OR with two or three characteristics of disfigurement.
Key Symptoms
- Visible or palpable tissue loss on head, face, or neck
- Gross distortion or asymmetry of one facial feature
- Two or three disfigurement characteristics present
- Single area of significant facial abnormality
- Noticeable but more limited head/face/neck scarring
CFR: Example: Scar on the cheek with palpable tissue loss causing asymmetry of that cheek (1 feature) - OR - a scar exhibiting hyperpigmentation and induration (2 characteristics). Characteristics may be contributed by multiple scars collectively.
10% DC 7800: Head, face, or neck scars with one characteristic o ...
DC 7800: Head, face, or neck scars with one characteristic of disfigurement. DC 7802: Burn scar(s) or scar(s) due to other causes, NOT of the head, face, or neck, NOT associated with underlying soft tissue damage, with total area of 929 cm- (144 sq. inches) or greater.
Key Symptoms
- One disfigurement characteristic on head, face, or neck (DC 7800)
- Non-head/face/neck scars totaling 929 cm- or more in area (DC 7802)
- Large body surface area covered by scars on trunk or extremities
- Minimal but documentable facial/neck disfigurement
- Extensive scarring of the trunk or limbs without underlying soft tissue damage
CFR: DC 7802 Example: Burn scars covering the anterior trunk and right upper extremity totaling 150+ square inches (approximately 968+ cm-) with no associated underlying soft tissue damage. DC 7800 Example: A scar on the forehead exhibiting only hyperpigmentation as its one disfigurement characteristic.
10% DC 7804 (Painful or unstable scars): Any scar that is painfu ...
DC 7804 (Painful or unstable scars): Any scar that is painful on examination, regardless of location or size. Can be assigned in addition to ratings under DC 7800 or 7802.
Key Symptoms
- Scar painful to palpation
- Scar painful at rest or with minimal contact
- Tenderness elicited during physical examination
- Pain with clothing contact, temperature changes, or friction
- Burning, stabbing, or aching sensation from scar site
CFR: Example: A scar on the left lower extremity that is painful when touched during examination. This 10% rating is separate from any DC 7802 rating and both can be assigned simultaneously if criteria for each are met independently.
How to Describe Your Symptoms
Pain from Scars
How to describe:
Describe the type of pain (burning, sharp, aching, throbbing), when it occurs (constant, with touch, with clothing friction, with temperature changes, with activity), its severity on a 0-10 scale on both typical and worst days, and what relieves or worsens it. Clearly state if any scar is painful when touched or pressed.
Worst-day example:
“On my worst days, the scar on my left forearm burns constantly, like a hot iron is pressed against it. Even a light breeze or the sleeve of my shirt touching it sends sharp pain through my arm. I cannot sleep on that side. The pain level reaches 8 out of 10 and nothing fully relieves it.”
What the examiner listens for:
The examiner needs to determine whether pain can be elicited on palpation during the exam (required for DC 7804). They also want to understand the frequency, character, and functional impact of pain to document it accurately in the DBQ.
Understatements to avoid:
Do not say 'it only hurts a little' or minimize pain to seem stoic. If your scar is painful, even mildly and occasionally, say so clearly. Saying 'it doesn't really bother me' when it does can result in a 0% rating for a potentially ratable painful scar.
Appearance and Disfigurement (Head, Face, Neck)
How to describe:
Describe specifically which facial or neck features are visibly altered: Are they asymmetrical? Is there tissue missing or sunken? Is there a visible color difference (darker or lighter patches)? Is the skin texture abnormal (rough, waxy, tight)? Are specific features like your nose, ears, eyelids, or lips visibly distorted or changed in shape?
Worst-day example:
“My right cheek is visibly sunken where tissue was lost in the burn. My right eyelid is pulled downward and does not close fully, causing my eye to appear asymmetric compared to my left. The skin on my forehead is tight, waxy, and a deep red-brown color compared to surrounding skin. Three separate features are clearly distorted.”
What the examiner listens for:
The examiner is counting characteristics of disfigurement and identifying which specific anatomical features (from the regulatory list: nose, chin, forehead, eyes/eyelids, ears/auricles, cheeks, lips) are affected, and whether tissue loss accompanies those changes.
Understatements to avoid:
Do not leave it to the examiner to notice subtle changes. Point out every area of color change, contour difference, or asymmetry. Do not assume the examiner will count a barely-visible feature change as a 'characteristic' - describe it explicitly and in detail.
Scar Size and Location (Trunk/Extremities - DC 7802)
How to describe:
Accurately describe all scars by location (right upper arm, left anterior thigh, posterior trunk, etc.), approximate size, and whether they cover a broad surface area. If you have many scars, describe them collectively and emphasize their combined area. State whether any burn scars involve large regions of your body.
Worst-day example:
“I have burn scars covering most of my upper back, both shoulders, and my right upper arm from a service-connected fire. The combined area is roughly 200 square inches. The skin is tight, discolored, and abnormal in texture across the entire region.”
What the examiner listens for:
The examiner needs to document whether the combined area equals or exceeds 929 cm- (144 sq. in.) for the 10% threshold under DC 7802, and to confirm there is no associated underlying soft tissue damage (which would route the claim to a different DC).
Understatements to avoid:
Do not forget to mention all scars across all body regions - not just the most visible or symptomatic one. Failing to identify a large posterior trunk scar could mean the total area falls below the 929 cm- threshold and results in a 0% rating.
Functional and Daily Life Impact
How to describe:
Describe how scars affect your ability to work, dress, exercise, sleep, maintain relationships, and engage in social or recreational activities. Note if tight or adherent scars limit range of motion of underlying joints. Note if scar appearance causes psychological distress, avoidance of social situations, or affects your ability to perform your job.
Worst-day example:
“Because the scar on my neck is so visible and disfiguring, I avoid social events and have been passed over for customer-facing roles at work. On days when the scar tightens due to cold weather, I cannot fully turn my head, which makes driving painful and difficult.”
What the examiner listens for:
The examiner looks for functional impairment to document in the DBQ's functional impact sections. This information, while not directly rated under DC 7802, supports the overall picture and may influence nexus opinions or secondary claims for other body systems.
Understatements to avoid:
Do not say 'I manage fine' if scars genuinely affect your daily activities. The VA rates based on the impact of the condition, and understating functional limitations can result in lower ratings or denial of secondary conditions.
Scar History and Service Connection
How to describe:
Clearly and concisely explain when, where, and how each scar occurred during or as a result of military service. Name the specific event, injury, or condition that caused the scar, if known. Describe how the scar has changed over time - has it grown, become more painful, contracted, or developed new characteristics?
Worst-day example:
“This burn scar resulted from a vehicle fire in Iraq in 2006. I was treated at Landstuhl for second and third degree burns. Since returning home, the scar on my right arm has tightened, become more elevated, and is increasingly painful. It was flat for the first two years but has progressively hardened and become keloid.”
What the examiner listens for:
The examiner documents scar history in the DBQ (fields for cause, origin, and course). This information anchors service connection and helps the rater understand whether the scar is a residual of a service wound.
Understatements to avoid:
Do not be vague about the cause. Saying 'I got hurt in the military' is less effective than 'I sustained second-degree burns during a vehicle fire in Fallujah in 2005 and was treated at the combat support hospital.' Specificity strengthens service connection.
Common Mistakes to Avoid
Failing to expose all scar locations during the exam
If the examiner cannot see or measure a scar, it will not be documented in the DBQ. Undocumented scars cannot be rated, and their area will not count toward thresholds.
Instead: Wear clothing that allows easy access to all scar locations. Bring a list of every scar with approximate location and size. Verbally remind the examiner of each one: 'I also have a scar on my posterior right thigh - I'd like you to document that as well.'
Impact: Any - especially critical for DC 7802 area threshold
Not mentioning pain during the examination
Under DC 7804, painful scars earn an additional 10% rating. If you do not report pain - or the examiner does not palpate the scar and ask - pain will not be recorded and the additional rating will be missed.
Instead: Proactively state which scars are painful before the examiner begins palpation. When the examiner touches a scar, accurately report whether it hurts. Say: 'That scar is painful when you press on it, and it also hurts when my shirt rubs against it throughout the day.'
Impact: 10% (DC 7804)
Describing only your 'average day' rather than your worst-day experience
VA rating is based on the full spectrum of your condition. Per M21-1 guidance, examiners should document the worst-day presentation. If you only describe mild symptoms, the rating will not reflect the severity of your condition.
Instead: Explicitly describe both your typical experience AND your worst days. Say: 'On an average day the pain is a 4/10, but on bad days - which happen 2-3 times per week - it reaches 8/10 and I cannot focus on work or sleep through the night.'
Impact: All rating levels
Assuming the examiner will count disfigurement characteristics without prompting
The examiner may focus on the most obvious features and miss subtle characteristics like mild hypopigmentation, slight induration, or marginal surface contour changes. Each missed characteristic can mean the difference between a 10%, 30%, 50%, or 80% rating.
Instead: Review the eight official disfigurement characteristics beforehand (adherence to underlying tissue, hyperpigmentation, hypopigmentation, elevated contour, depressed contour, abnormal texture, induration/inflexibility, missing underlying soft tissue) and point out each one you believe applies to your scars.
Impact: 10%, 30%, 50%, 80% (DC 7800)
Not accounting for multiple scars collectively contributing to disfigurement
Under CFR Note (5), disfigurement characteristics do NOT all need to come from a single scar. Veterans with multiple smaller scars may collectively have enough characteristics for a higher rating but miss out because they present scars in isolation.
Instead: When asked about disfigurement, say: 'Looking at all my scars together - the scar on my left cheek contributes hyperpigmentation, the scar near my eye contributes an elevated contour, and the scar on my forehead shows induration - together that's three characteristics.' Encourage the examiner to assess them collectively.
Impact: 30%, 50%, 80% (DC 7800)
Failing to differentiate head/face/neck scars from body scars
Head, face, and neck scars are rated under DC 7800 (up to 80%), while non-head/face/neck burn scars without soft tissue damage are rated under DC 7802 (10% maximum). Mixing them up or failing to identify head/face/neck involvement leaves significant rating potential on the table.
Instead: Clearly identify which scars are on your head, face, or neck (DC 7800 - potentially 10-80%) and which are on your trunk or extremities (DC 7802 - 10% if 929+ cm-). If you have scars in both areas, ensure both sets are fully documented under the appropriate sections of the DBQ.
Impact: 10% vs. up to 80%
Not reporting underlying soft tissue damage for trunk/extremity scars
DC 7802 covers scars NOT associated with underlying soft tissue damage. If underlying soft tissue IS affected (missing subcutaneous fat, adherent to bone, etc.), the correct DC is 7801 or 7803, which may carry higher ratings. Failing to report this routes the claim to a lower-rated DC.
Instead: If your scar feels 'stuck down' to deeper tissue, has a pit or crater indicating missing fat or muscle, or causes functional limitation beyond skin level, tell the examiner: 'This scar feels like it is attached to the tissue underneath - it doesn't move freely when I try to lift it.' This triggers evaluation under a different DC.
Impact: Potentially all levels - affects which DC applies
Forgetting to bring documentation of scar treatment history
The examiner reviews evidence including service treatment records, private records, and VA treatment notes. If scar treatments (skin grafts, steroid injections, excision, physical therapy for contracture) are in private records not yet in your VA file, they may not be considered.
Instead: Bring copies of any private medical records documenting scar treatment, surgeries, or photographs. Hand them to the examiner and note: 'These records document my burn treatment and scar management that may not be in my VA file.' Request that they be included in the examination report.
Impact: All rating levels - affects service connection and severity documentation
Prep Checklist
Before Your Exam
Day Of
During the Exam
After the Exam
Your Rights During a C&P Exam
- You have the right to a thorough, in-person examination by a qualified clinician - a records-only review is generally insufficient for scar claims requiring physical measurement and palpation.
- You have the right to request that ALL service-connected scars be examined and documented, not just those listed in the exam request - bring your full scar inventory.
- In most states, you have the right to record your C&P examination - check your state's one-party or two-party consent recording laws before the appointment.
- You have the right to receive a copy of the completed DBQ and examination report - request it through MyHealtheVet or your VSO.
- You have the right to submit a rebuttal if the examination report is inaccurate, incomplete, or if the examiner failed to physically examine you - document discrepancies in writing immediately after the exam.
- You have the right to request a new examination if the original is inadequate - for example, if scars were not measured, pain was not assessed by palpation, or if the examiner lacked appropriate qualifications.
- You have the right to submit independent medical evidence (private physician reports, photographs, buddy statements) to supplement or challenge the C&P examination findings.
- Under the PACT Act and related laws, burn pit and toxic exposure-related scars may be subject to presumptive service connection - ask your VSO whether your scar origin qualifies.
- You have the right to have disfigurement characteristics assessed collectively across multiple scars - the law (CFR Note 5) explicitly states that characteristics need not all come from a single scar.
- You have the right to be examined for painful scars separately from size-based ratings - DC 7804 provides an additional 10% for confirmed painful scars, and this rating can stack with DC 7802 or 7800.
- You have the right to benefit of the doubt - if there is an approximate balance of evidence for and against service connection for your scars, the VA must resolve that doubt in your favor.
Related Conditions
- Scars with Underlying Soft Tissue Damage (non-head/face/neck) DC 7801 applies when scars outside the head/face/neck ARE associated with underlying soft tissue damage potentially higher rating than DC 7802. If your scar feels adherent to deeper tissue or involves missing subcutaneous fat or muscle, this DC may apply instead of or in addition to 7802.
- Unstable or Superficial Scars DC 7803 (superficial, non linear scars of 144+ sq. in.) and DC 7804 (unstable or painful scars) provide separate and stackable ratings. If your scars are painful or break down repeatedly, DC 7804 provides an additional 10% rating on top of any area based rating.
- Joint Contracture from Burn Scars Burn scars that limit range of motion of an underlying joint (e.g., elbow, knee, shoulder) may be separately rated for the joint limitation under the appropriate musculoskeletal DC. The VA must consider whether the scar's restriction of joint motion warrants a separate or higher combined rating.
- PTSD / Depression Related to Disfigurement Veterans with visible disfigurement (especially facial scarring) frequently develop PTSD, depression, or anxiety as secondary conditions. These mental health conditions can be rated separately and secondarily service connected to the primary scar condition.
- Peripheral Neuropathy (Burn Scar Related) Burn scars can damage underlying nerves, resulting in peripheral neuropathy with numbness, tingling, or loss of sensation in the affected region. This may be a separately ratable condition secondary to the service connected burn scar under 38 CFR 4.120.
- Chronic Pain Syndrome Persistent pain from scars particularly painful, adherent, or keloid scars can develop into chronic pain syndrome. This may be separately ratable as a secondary condition when it exceeds what is captured by the scar rating itself.
- Skin Cancer (Squamous Cell or Basal Cell) at Scar Site Chronic burn scars (Marjolin's ulcer) carry an elevated risk of squamous cell carcinoma. If skin cancer develops at the site of a service connected scar, it may be ratable as secondary to the scar. Veterans with burn scars should report any new skin changes at scar sites promptly.
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This C&P exam preparation guide is for educational purposes only and does not constitute legal, medical, or claims advice. Always consult with a qualified Veterans Service Organization (VSO) representative or VA-accredited attorney for guidance specific to your claim. Never exaggerate, minimize, or fabricate symptoms during a C&P examination.