If you’re a veteran with scars, it’s important to fully understand how the VA calculates disability rates.
At first, you might think VA disability rates for scars are pretty straightforward. In reality, there is a small mountain of math and paperwork required to calculate your exact rate.
Fortunately, you don’t have to go into this process blind. We’ve assembled all the key info you need to know to understand VA compensation for scars.
In This Article About VA Ratings for Scars and Scar Pain:
- Multiple Rating Systems
- First Rating for Scar Disability
- The Second Rating System for Scars
- The 8 Characteristics of Disfigurement for VA Scar Ratings:
- The Math Behind It
- Adding Up All of Your Scars
- Understanding Body Scars
- The Painful/Unstable Scars Factor
- Competing Exams
- Ties in Your Favor
- The Need for Accurate Records
- The Hospitality/Convalescent Factors
- Professional Representation
- VA Disability Rates: Time to Take Control
Multiple Rating Systems
The first reason that the VA disability calculator for scars is confusing is because of the rating systems used. That’s because there are two different rating systems, and it’s important for you to understand the specifics of each system. One system measures specific medical conditions while the other assesses different characteristics of disfigurement.
On top of this, you need to understand that different ratings are used for very specific injuries. There is not a single rating for the loss of an eye, for example. Instead, there are separate ratings for the loss of a single eye and the loss of both eyes.
Additionally, the scarring that accompanies the loss of an eye (or both eyes) further affects the rating used.
With that being said, let’s dive a bit deeper into the two ways your scars will be assessed by the VA, ultimately determining your monthly compensation.
First Rating for Scar Disability
The first rating is arguably the simplest. It involves examining the condition of your scarring and assigning one of three ratings: 80%, 50%, or 30%.
You are assigned the 80% rating if there is major tissue loss and distortion to at least three areas. These areas include eyes/eyelids, nose, ears, mouth, forehead, chin, and cheeks.
If there is major tissue loss and distortion to two of those areas, you are rated at 50%. If you have tissue loss and distortion in one of those areas, you are rated at 30%.
The Second Rating System for Scars
The second rating system focuses on the specific characteristics of your disfigurement. If you meet at least six of these characteristics, you are rated at 80%. If you meet 4-5 of the characteristics, you are rated at 30%.
If you meet one of these characteristics, you are rated at 10%.
The characteristics include scar length and width, as well as whether a scar rises or sinks when you touch it. They also include whether the skin is hard and unmoveable, whether soft tissue is attached or missing, and whether the texture and/or color is irregular.
The 8 Characteristics of Disfigurement for VA Scar Ratings:
|Scar 5 or more inches (13 or more cm.) in length.|
|Scar at least one-quarter inch (0.6 cm.) wide at the widest part.|
|Surface contour of scar elevated or depressed on palpation.|
|Scar adherent to underlying tissue.|
|Skin hypo-or hyper-pigmented in an area exceeding six square inches (39 sq. cm.).|
|Skin texture abnormal (irregular, atrophic, shiny, scaly, etc.) in an area exceeding six square inches (39 sq. cm.).|
|Underlying soft tissue missing in an area exceeding six square inches (39 sq. cm.).|
|Skin indurated and inflexible in an area exceeding six square inches (39 sq. cm.).|
When calculating everything (more on this in a bit), you are allowed to “count” multiple scars. Some of your scars may meet criteria that the others don’t meet, allowing you to qualify for a higher disability rate.
One important thing to keep in mind is the total area of a scar. This is why scar length and width are so important. A scar cannot contribute towards some of these characteristics unless it is at least 6 square inches.
However, factors such as the skin being unmoveable and whether the scar rises or falls when touched do not have a minimum area requirement. Therefore, some scars are able to contribute towards some characteristics but not others.
The Math Behind It
You may be looking at these numbers and thinking that the calculations shouldn’t be too hard. However, a lot of the math behind these calculations is more complex than you think.
For example, you may be looking at multiple scars spread across your head, neck, and face and think you’re practically guaranteed the 80% rate. However, for VA purposes, all of those places only count towards one area. Multiple scars in these areas do not count as more scars for the purposes of calculation.
However, multiple scars spread across the head, neck, and face can count towards the total area of scars. So, you may have two smaller scars on your neck and head that, individually, are not that large. But you can add these up to calculate a much larger combined scar area.
When you’re calculating the area, the scar needs to have a width of 1/4 of an inch to qualify. If you’re calculating a combined scar area, you cannot add width when determining the total area.
You can also get into some special scenarios where one scar can contribute to multiple characteristics and another scar cannot. For example, scars that are at least 6 square inches may meet multiple characteristics. But a smaller scar may be limited only to characteristics that do not require a minimum area.
As you can see, the math behind all of this is very complex, and there are many special scenarios that can affect the VA calculation. By understanding what they are looking for and measuring, you can make sure that those calculations are accurate.
Adding Up All of Your Scars
Regardless of the complex calculations behind the scenes, the final calculations for each rating method are pretty straightforward. Once you know how many characteristics are present, you can find out what your rating is.
As we said, the first rating system results in ratings of 80%, 50%, and 30%. Respectively, these ratings correspond to whether you have three (or more), two, or one area with extreme tissue loss and distortion.
The second rating system is more precise, ranging from as low as 10% (with one characteristic present) to 80% (with 6 or more characteristics present). Two or three characteristics equal 30% while four or five equals 50%.
Specifics about which scars count towards which characteristics can sometimes be very contentious. Make sure to retain any paperwork you get regarding the VA calculations so that you can understand the final rating and voice any potential questions (or complaints) about the math.
Understanding Body Scars
Another way to understand the VA calculations is to understand how scars are classified. Generally speaking, the VA has three different codes that they apply to scars.
Code 7801 refers to “deep scars.” How do they determine if a scar is deep or not? The primary deciding factor is whether the soft tissue beneath the scar has been affected. They will use this form as they examine you, so you can download it and get an advanced look at the kinds of questions they will ask.
Individual scars are rated on their own based on the area. It is rated at 40% if the scar of a single body area is more than 144 square inches. It is rated 30% if the area is between 72 and 144 square inches.
Finally, it’s 20% if the scar is between 12 and 72 square inches, and 10% if it’s between 6 and 12 square inches.
Code 7802 refers to “superficial scars.” Those are scars where only the skin is affected and not the deeper soft tissues. Superficial scars are rated at 10% if they cover more than 144 inches squared.
Finally, code 7805 refers to all other scars. The “7805” denotes a linear scar that does not fit into other categories, and it will be followed by another four-digit number that rates the scar. This allows the VA to rate complicated scars or scar effects that might not be otherwise included in the other codes.
Keloid scars may fall under any of these or under other 7800 diagnostic codes depending on their other characteristics. You’ll have to show the size of a keloid scar just like a ‘deep’ or ‘superficial’ scar when trying to get the best VA rating. It can get a rating on appearance only, but the higher va ratings come when they affect your ability to move or work.
The Painful/Unstable Scars Factor
Code 7804 refers to painful or unstable scars. “Unstable” refers to scars re-opening and re-healing. You are likelier to have such scars over joints, especially if the scar is large and/or deep. A scar under this code receives its own rating. However, it may also be rated again if it meets one of the other scar codes.
You receive a 40% rating if you have 5 or more scars that are considered either unstable or painful and at least one of those scars meets both criteria. Meanwhile, if you have 5 or more unstable or painful scars and none of them meet both criteria, you are rated at 30%.
If you have 3-4 unstable or painful scars, and one meets both criteria, you are rated at 30%. But if you have 3-4 unstable or painful scars and none meet both criteria, you are rated at 20%.
Finally, if you have 1-2 unstable or painful scars and one meets both criteria, you are rated at 20%. And if you have 1-2 unstable or painful scars and none meet both criteria, you are rated at 10%.
Get the most out of your C&P Exam by following tips from a VA disability lawyer that looks over these cases every day.
It’s not uncommon for you to deal with competing exams. This occurs when you have had multiple examinations and their findings disagree with how your scarring should be recorded.
Which exam carries the most weight? This generally comes down to the quality of both the exam and the physician.
Your final rating is decided by the examination with the most thorough data and the most qualified physician. For example, if one exam was conducted by a specialist who is likelier to have a better understanding of scars, his exam would yield your final scar rating.
There are times when deciding which exam and physician to trust are difficult. Fortunately, there is a system in place for that eventuality that works in your favor.
Ties in Your Favor
Obviously, no system is perfect. You may eventually end up in a scenario where two exams yield different ratings and it is difficult to determine as both exams and physicians are equally qualified. How, then, is the final rating determined?
In that case, such “ties” are always in your favor. Whichever exam would give you the highest rating is the one the VA goes with.
This philosophy also extends to scars that could be rated differently under different codes. Ultimately, the VA will go with whichever code offers you the highest rating.
Generally, all such decisions will always be decided in favor of the veteran.
The Need for Accurate Records
You’ve probably picked up on this by now, but all of this is a highly numbers-driven process. It’s important that doctors accurately measure each scar, and equally important that you understand how they are calculating this.
As we noted, you may end up seeing multiple doctors and receiving multiple examinations. Even if your number of doctors and physicians is kept to a minimum, you’re going to have a lot of paperwork.
Make sure that you hold onto all of your paperwork. At best, doing so will simplify your future dealings with the VA. We will work with you to keep it organized and backed up. We do the filing and follow-up with the VA to make sure nothing gets lost in the shuffle.
Think of this as a major potential time saver. Why scramble to track these records down after the fact when you can safely store each bit of paperwork as you receive it? We’ll also deal with the various VA offices to request you C-File and other past copies of your other files. We’ll put it all together in a complete package for the best chance at getting your VA application approved.
The Hospitality/Convalescent Factors
Scars can have a number of unexpected effects. One of the best examples of this is that you may have to spend time in a VA-approved hospital or at-home convalescent care.
If this occurs, then your rating will be 100% during the time of your treatment. No matter how long the hospital or convalescent care lasts, you will have the 100% rating for the entirety of that time.
After you have completed care, you will retain that 100% rating for a period of 3 months (or longer if your conditions warrant such an extension). If you feel that you need more time to recover than you’re given, then you may want to consider seeking professional representation. You don’t have to go anywhere or appear before anyone when you work with us. All of our correspondence is handled over the phone or by email. Gone are the days of needing a VA lawyer nearby. Now all applications are filed so electronically that we can help veterans no matter where they are.
Do I need a VA Lawyer Near Me? One of our attorneys explains why you don’t in this video:
You might not think you need to hire an attorney to help with your VA benefits. However, doing so can help you out in a number of surprising ways.
For example, maybe you disagree with the rating that you received and feel that the rating should be higher. On your own, it may be difficult to navigate the complex world of VA paperwork and make a successful appeal. But with an experienced attorney by your side, your odds are greatly increased.
You may also want an attorney’s help when it comes to filing for a rating increase if your conditions worsen in any way. Doing so maximizes your odds of getting the highest rating possible. And the best attorneys don’t charge anything unless you win your claim, so you don’t have anything to worry about when you hire a representative.
VA Disability Rates: Time to Take Control
Now you know more about VA disability rates for scar pain. But do you know who can help you when you apply for benefits, or if you wish to appeal?
We specialize in helping veterans just like yourself get the most from their benefits. After your sacrifices, you deserve nothing less than the best. Contact us today and we can get started right away on reviewing your case.
Yes you can. You can apply for benefits and if you can prove that the scars were service-connected, whether they were from combat or fighting doesn’t matter, you could have a claim.
No, it’s not too late. Just because the scars didn’t cause you pain until recently if they are service-connected, you should already have records to support your claim.