DC 7801 · 38 CFR 4.118
Scars (Burn / Disfigurement / Painful) C&P Exam Prep
To document the number, location, dimensions, characteristics, and functional impact of all service-connected scars for accurate VA disability rating under 38 CFR 4.118. The examiner will assess whether scars are painful, unstable, have skin loss, involve disfigurement of the head/face/neck, or limit function.
- Format:
- Interview + Physical
- Typical duration:
- 15-30 minutes
- DBQ form:
- scars (scars)
- Examiner:
- Dermatologist or appropriate clinician
What the examiner evaluates
- Location of each scar (body region, laterality, specific anatomical site)
- Scar type: burn, surgical, traumatic, linear, or superficial non-linear
- Scar dimensions: length and width in centimeters at widest point
- Total surface area in square centimeters for all scars per body region
- Whether scars are painful on direct pressure or examination
- Whether scars are unstable (break down repeatedly without trauma)
- Skin loss over or around the scar
- Surface contour: elevated (hypertrophic/keloid) or depressed on palpation
- Abnormal texture: irregular, atrophic, firm, indurated, or inflexible
- Pigmentation changes: hyperpigmentation or hypopigmentation
- Adherence of scar to underlying tissue
- Underlying soft tissue missing
- Disfigurement of head, face, or neck features: nose, chin, forehead, eyes (including eyelids), ears (auricles), cheeks, lips
- Tissue loss or distortion of eyes, eyelids, ears (auricles)
- Anatomical loss of eye or complete loss of auricle
- Impact of scars on occupational functioning and daily activities
- History of scar including cause, origin, and course of treatment
The examiner will visually inspect and physically palpate each scar. Measurements will be taken with a ruler or tape measure in centimeters. Photographs may be taken. If scars are on the head, face, or neck, close attention will be paid to facial feature involvement. Be prepared to remove clothing to expose all affected areas. Bring a list of all scars with their locations to ensure none are overlooked.
Measurements and tests
Scar Dimension Measurement
What it measures: Length and width at the widest point of each individual scar, reported in centimeters (cm). Total surface area is calculated per body region and overall.
What to expect: The examiner will use a ruler or flexible measuring tape to measure each scar in two dimensions. They may press on the scar to assess pain, texture, and adherence. They will record measurements for up to five or more scars individually.
Critical thresholds
- Greater than 39 sq cm (e.g., approximately 6.3 cm x 6.3 cm) per scar or combined area Superficial non-linear scars exceeding 39 sq cm on head/face/neck or 144 sq cm on trunk/extremities trigger higher rating consideration under DC 7802/7804
- Painful scar of any size Painful scars are rated at minimum 10% regardless of size under DC 7804; ensure pain is documented at the exam
- Unstable scar (breaks down with or without trauma) Unstable scars are rated at minimum 10% under DC 7802; document frequency of breakdown episodes
- Head/face/neck scar with 1 disfigured feature or 2-3 characteristics 10% rating under DC 7800
- Head/face/neck scar with 2 disfigured features or 4-5 characteristics 50% rating under DC 7800
- Head/face/neck scar with 3+ disfigured features or 6+ characteristics 80% rating under DC 7800
Tips
- Measure your own scars before the exam and write down the dimensions so you can confirm the examiner measures them accurately
- If you have multiple scars in the same body region, ensure all are measured - do not allow the examiner to stop after measuring only the largest one
- Scars that are hidden under hair, clothing folds, or in skin creases are still ratable - point them out proactively
- For scars on the head/face/neck, specifically tell the examiner which facial features are affected (nose, chin, forehead, eyes/eyelids, ears/auricles, cheeks, lips)
- Total area calculations matter for trunk and extremity scars - make sure all scars in the same region are included in the combined total
Pain considerations: Pain on direct pressure during palpation is a critical rating factor under DC 7804. Tell the examiner immediately and clearly if pressing on the scar causes pain. Do not minimize pain out of politeness. Describe the character of pain (burning, sharp, aching, shooting) and whether it is constant or triggered by touch, clothing friction, temperature changes, or activity. Report your pain on your worst typical day, not on the day of the exam if that day happens to be better than usual.
Scar Characteristic Assessment
What it measures: Physical characteristics of each scar that contribute to disfigurement ratings under DC 7800, including surface contour, texture, pigmentation, adherence, and tissue loss.
What to expect: The examiner will visually inspect and palpate each scar for the following characteristics: (1) surface contour elevated on palpation (hypertrophic or keloid), (2) surface contour depressed on palpation (atrophic), (3) abnormal texture (irregular, atrophic, firm, indurated, inflexible), (4) hyperpigmentation, (5) hypopigmentation, (6) scar adherent to underlying tissue, (7) underlying soft tissue missing.
Critical thresholds
- 2-3 characteristics of disfigurement present 10% rating under DC 7800 (head/face/neck)
- 4-5 characteristics of disfigurement present 50% rating under DC 7800 (head/face/neck)
- 6+ characteristics of disfigurement present 80% rating under DC 7800 (head/face/neck)
Tips
- Multiple scars can collectively contribute to the count of disfigurement characteristics - all scars on the head/face/neck count together
- Bring photographs of your scars taken on days when they appear most prominent (e.g., after physical activity, in direct lighting) to supplement in-person examination
- Tell the examiner about induration and inflexibility - areas where the scar feels hard, tight, or restricts movement of the overlying skin
- Hypopigmentation (lighter patches) and hyperpigmentation (darker patches) both count as separate characteristics of disfigurement
- If your scar has both an elevated area and a depressed area, both contour characteristics may apply
Pain considerations: Scar induration and inflexibility can cause pain and functional limitation that extends beyond the visible scar. Describe any tightness, pulling sensation, restriction of movement, or increased sensitivity to temperature or touch. These functional impacts support a higher rating and should be communicated even if the examiner does not specifically ask.
Rating criteria by percentage
80%
Burn scar(s) or other 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 or paired sets of features (nose, chin, forehead, eyes/eyelids, ears/auricles, cheeks, lips); OR with SIX OR MORE characteristics of disfigurement.
Key symptoms
- Visible or palpable tissue loss on head, face, or neck
- Gross distortion or asymmetry affecting 3 or more facial features
- Six or more of the following characteristics: surface contour elevated, surface contour depressed, abnormal texture, hyperpigmentation, hypopigmentation, scar adherent to underlying tissue, underlying soft tissue missing, other
- Involvement of nose AND chin AND forehead (or other 3+ feature combinations)
- Multiple facial features disfigured simultaneously
From 38 CFR: 38 CFR 4.118, DC 7800: 'With visible or palpable tissue loss and either gross distortion or asymmetry of three or more features or paired sets of features (nose, chin, forehead, eyes (including eyelids), ears (auricles), cheeks, lips), or; with six or more characteristics of disfigurement - 80'
50%
Burn scar(s) or other 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 2 facial features or paired sets
- Four or five characteristics of disfigurement present
- Deformity of auricle with loss of one-third or more of the auricle
- Tissue loss/distortion involving 2 facial structures
From 38 CFR: 38 CFR 4.118, DC 7800: '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 - 50'
30%
Burn scar(s) or other 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. Also applicable to superficial non-linear scars of the trunk or extremities covering 144 sq cm or more under DC 7804.
Key symptoms
- Visible or palpable tissue loss on head, face, or neck
- Gross distortion or asymmetry of one facial feature
- Two or three characteristics of disfigurement present
- Deformity of auricle with loss of less than one-third of auricle
- Large superficial non-linear scar on trunk or extremity (144+ sq cm)
From 38 CFR: 38 CFR 4.118, DC 7800: '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 - 10' (Note: 30% is the threshold for DC 7804 superficial non-linear scars covering 144+ sq cm on trunk/extremities)
10%
Burn scar(s) or other scar(s) of the head, face, or neck with one or two characteristics of disfigurement. Also applicable to: (DC 7802) unstable or painful scars of any size and location; (DC 7804) superficial non-linear scars of the trunk/extremities exceeding 39 sq cm but less than 144 sq cm. Note: Painful scars rated under DC 7804 receive a minimum 10% regardless of size.
Key symptoms
- One or two characteristics of disfigurement on head/face/neck
- Any scar that is painful on examination or pressure
- Any scar that is unstable (recurrently breaks down)
- Superficial non-linear scar on trunk or extremity 40-143 sq cm
- Loss of skin covering over scar area
- Scar causing itching, burning, or sensitivity with clothing contact
From 38 CFR: 38 CFR 4.118, DC 7800: 'With one or two characteristics of disfigurement - 10'. DC 7802: 'Unstable or painful scar(s) - 10 minimum'. DC 7804: 'Superficial non-linear scar(s), other than head, face, or neck, exceeding 39 sq cm - 10'.
Describing your symptoms accurately
Pain from Scars
How to describe it: Describe pain in specific, concrete terms: location, character (burning, sharp, aching, throbbing, shooting), intensity on a 0-10 scale, duration (constant vs. intermittent), and triggers (touch, clothing friction, temperature changes, pressure, activity). Specify whether pain prevents you from wearing certain clothing, engaging in physical activity, or sleeping comfortably.
Example: On my worst days, the burn scar on my left forearm feels like it is on fire even without touching it. Just the friction of my shirt sleeve against it causes a 7 out of 10 burning pain that lasts for hours. I have to wear loose-fitting clothing and avoid direct sunlight on that area because any heat makes it significantly worse.
Examiner listens for: The examiner needs to document whether the scar is 'painful on examination' for DC 7804/7802 eligibility. They are listening for clear confirmation that pressing on or touching the scar causes pain. They also note whether the pain is spontaneous or only elicited by pressure.
Avoid: Do not say 'it bothers me sometimes' or 'it is a little sensitive.' Instead, say 'it is painful when pressed' or 'it hurts when my clothing rubs against it.' Avoid minimizing language. The DBQ has a specific checkbox for painful scars - you want that box checked.
Unstable Scar Characteristics
How to describe it: Describe how often the scar breaks down, bleeds, forms open sores, or weeps fluid. Note whether this happens spontaneously or with minimal trauma such as light scratching, bending, or stretching. Describe how long healing takes, whether it requires wound care or bandaging, and whether it has required medical treatment.
Example: At least two or three times a month, the scar on my right thigh opens up on its own - I wake up to find it bleeding or wet. It takes 10 to 14 days to fully close each time, and during that period I have to keep it bandaged and limit my physical activity to prevent further breakdown.
Examiner listens for: Frequency of breakdown episodes, whether the scar requires treatment when it breaks down, and whether the instability has been documented in medical records. Examiners are looking for evidence that this is a chronic, recurrent problem rather than a one-time event.
Avoid: Do not say 'it heals on its own' without also mentioning how often it breaks down and how long healing takes. Do not omit the frequency of breakdown - this is critical for the unstable scar diagnosis under DC 7802.
Disfigurement of Head, Face, or Neck
How to describe it: Identify each specific facial feature affected (nose, chin, forehead, eyes including eyelids, ears including auricles, cheeks, lips) and describe exactly how the scar has altered the appearance or function of that feature. Describe visible tissue loss, asymmetry, or distortion that others notice or that affects your self-image and social interactions.
Example: The burn scar on my right cheek has pulled my lower eyelid downward on that side, causing it to look asymmetrical compared to my left eye. The scar on my chin has caused a noticeable indentation where tissue is missing. When I meet new people, they frequently stare at or ask about my face, and I have withdrawn from social activities because of how my appearance has changed.
Examiner listens for: Specific facial features affected, presence of tissue loss, degree of asymmetry or distortion, and the psychosocial impact of disfigurement. The examiner must document which features from the statutory list (nose, chin, forehead, eyes/eyelids, ears/auricles, cheeks, lips) are affected and to what degree.
Avoid: Do not simply say 'my face looks different.' Instead, specifically name each feature affected and describe the visible change. Do not omit effects on eyelids (which count separately from eyes) or auricles (outer ear structures). Characteristics from multiple scars count together toward the disfigurement rating - mention all scars in the head/face/neck region.
Functional Impact and Daily Life Limitations
How to describe it: Describe how your scars limit specific daily activities, occupational tasks, recreational activities, and personal care. Include limitations caused by pain, tightness, itching, sensitivity, disfigurement-related psychological distress, or physical restriction of movement. Quantify limitations where possible (e.g., 'I can only stand for 20 minutes before the scar on my leg becomes too painful').
Example: The scar contracture on my neck limits how far I can turn my head - I cannot look left more than about 45 degrees without sharp pulling pain. This prevents me from driving safely and has required me to request a workplace accommodation. On my worst days, the itching and tightness are so severe that I cannot concentrate on work and have to leave early.
Examiner listens for: Specific occupational and functional limitations, whether the veteran has sought workplace accommodations, whether daily activities of personal care (bathing, dressing, grooming) are affected, and the overall burden of the scar on quality of life. The DBQ has a dedicated section for describing the impact of scars on the veteran's functioning.
Avoid: Do not say 'I manage okay' if you have adapted your lifestyle to work around scar limitations. The adaptations themselves are evidence of functional impairment. Describe what you can no longer do, or can only do with difficulty, that you could do before the injury.
Skin Loss and Surface Characteristics
How to describe it: Describe any areas where the normal outer layer of skin is absent, thin, fragile, or regularly breaks down over the scar. Note the presence of tight, inflexible, or hardened scar tissue (induration) that limits skin movement. Describe any color changes compared to surrounding skin - areas that are lighter (hypopigmentation) or darker (hyperpigmentation).
Example: The skin over my burn scar on the upper back is so thin and fragile that any pressure from a backpack or tight clothing causes it to tear. The scar tissue itself is extremely hard and does not flex normally - I can feel it pulling when I reach forward or raise my arms. The scar is noticeably much lighter than my surrounding skin and has never regained any color.
Examiner listens for: The examiner is specifically checking each of the seven recognized characteristics of disfigurement: elevated contour, depressed contour, abnormal texture, hyperpigmentation, hypopigmentation, adherence to underlying tissue, and missing soft tissue. The more characteristics that are clearly documented, the higher the potential rating.
Avoid: Do not assume the examiner will notice subtle pigmentation changes or texture differences without your input. Point out every visible characteristic. If part of the scar is elevated and another part is depressed, both may be documented. Do not minimize induration by calling it just 'stiff' - describe it as 'hard, inflexible tissue that does not move normally.'
Common mistakes to avoid
Failing to disclose all scars during the exam
Why: Veterans often only mention their most prominent scar, not realizing that multiple smaller scars in the same body region are counted together for total area calculations, and that characteristics from multiple scars on the head/face/neck can combine toward a higher disfigurement rating.
Do this instead: Before your exam, make a complete written inventory of every scar on your body that is related to your service. Include location, approximate size, and characteristics for each one. Bring this list to the exam and review it with the examiner at the start. Explicitly ask that each scar be measured and documented.
Impact: All rating levels - can mean the difference between 10% and 50%+ if facial scars are undercounted
Minimizing or not reporting pain during palpation
Why: Many veterans endure the examiner pressing on their scars without stating that it hurts, either out of habit, stoicism, or not wanting to appear dramatic. If pain is not documented, a painful scar cannot be rated under DC 7804.
Do this instead: When the examiner touches or presses on your scar, immediately and clearly state if it is painful. Say 'Yes, that is painful - that hurts when you press on it.' You may also verbally confirm: 'I want to make sure it is documented that this scar is painful on direct pressure.'
Impact: 10% minimum for painful scars under DC 7804 - could mean the difference between 0% and 10%
Describing symptoms only on the day of the exam rather than on typical worst days
Why: Scar pain, skin breakdown, and disfigurement characteristics can vary. If your symptoms happen to be mild on exam day, or if you dressed to minimize discomfort, the examiner may document a condition that appears less severe than it typically is. VA rating is supposed to reflect your average condition, including your worst days.
Do this instead: Explicitly tell the examiner: 'Today is not a typical day for me - on my worst days, [describe symptoms]. I want to make sure you document how my condition typically presents, not just today's presentation.' Bring photographs of your scars on days when they appear more severe, inflamed, or broken down.
Impact: All rating levels - worst-day reporting is a legal standard per M21-1 adjudication procedures
Not mentioning the psychosocial impact of facial disfigurement
Why: The DBQ has a specific section asking about the impact of scars on the veteran's functioning, including social and occupational effects. Veterans who do not discuss the psychological and social toll of disfigurement may receive ratings that do not fully capture their disability.
Do this instead: Describe specific examples of how your facial scars have affected your social life, employment, relationships, and self-confidence. Mention if you have avoided public situations, declined promotions that require public-facing work, or sought mental health treatment related to your appearance. These impacts support both the scar rating and potential secondary mental health claims.
Impact: DC 7800 ratings at 10%, 50%, and 80% - functional impact documentation supports higher ratings and secondary claims
Confusing scar types and allowing misclassification
Why: Burn scars, surgical scars, and traumatic scars are all rated under different diagnostic codes and may have different rating thresholds. If a burn scar on the head/face/neck is classified only as a superficial non-linear scar, it may receive a lower rating than warranted under DC 7800.
Do this instead: Know the origin of each scar before your exam. Be specific with the examiner about how each scar was caused (burn, blast, shrapnel, surgical incision following combat injury, etc.). Bring your service medical records documenting the original injury if possible. The history section of the DBQ is critical - ensure the cause is documented accurately.
Impact: Head/face/neck scars - difference between DC 7800 (up to 80%) and DC 7802/7804 (up to 10%)
Not requesting that skin loss over the scar be documented
Why: Loss of skin covering over a scar is a separately ratable characteristic that many examiners overlook during a brief exam. Veterans may not think to mention fragile, thin, or absent skin over scar tissue because they have adapted to it.
Do this instead: Specifically tell the examiner: 'The skin over this scar is very thin and fragile - it breaks down easily with minimal friction or pressure.' Ask the examiner to document skin loss as part of the scar assessment. Point to any areas where the surface skin is visibly absent, ulcerated, or chronically broken down.
Impact: DC 7802 (unstable scars) at 10% minimum - also contributes to disfigurement characteristic count under DC 7800
Failing to account for scar contractures that limit range of motion
Why: When scars cross joints or restrict skin movement, they can limit range of motion and function. This limitation is separately ratable as a musculoskeletal limitation under DC 7805 ('other effects of scars') and should not be overlooked.
Do this instead: If any scar causes tightness that limits your ability to bend a joint, turn your head, open your mouth fully, or perform other movements, describe this explicitly. Ask the examiner to document the functional limitation. Note that DC 7805 allows for additional ratings for disabling effects not captured in the primary scar rating, evaluated under the appropriate musculoskeletal diagnostic code.
Impact: DC 7805 additional rating - can add 10-30%+ for joint range of motion limitation caused by scar contracture
Prep checklist
- critical
Create a complete scar inventory with measurements
Using a soft tape measure, document every service-connected scar: body region, specific anatomical location (e.g., 'anterior left forearm, 3 inches below elbow crease'), approximate dimensions in centimeters, and whether each scar is painful, elevated, depressed, discolored, or has fragile/missing skin. Bring this written list to the exam.
before exam
- critical
Photograph all scars in good lighting before the exam
Take clear, well-lit photographs of every scar, including close-up photos that show texture, color changes, and contour variations. Also photograph on days when scars appear most prominent (e.g., after activity, in natural light). Label each photo with the date and scar location. Bring printed copies or have them available on your phone. M21-1 states that photographs may be considered in rating decisions.
before exam
- critical
Gather all relevant medical documentation
Collect service treatment records documenting the original injury (burn, blast, shrapnel, surgical report), emergency room records, dermatology or wound care notes, and any records of scar treatment (steroid injections, laser therapy, surgical revision, wound care). These documents establish the service connection and history of the scar.
before exam
- critical
Write a detailed personal statement about your worst-day symptoms
Write a 1-2 page personal statement describing how your scars affect your daily life on your worst days. Include: pain levels, functional limitations, occupational impact, social impact, hygiene/dressing challenges, sleep disturbance, and psychological effects of disfigurement. Submit this as a lay statement (VA Form 21-4138) before or at the exam.
before exam
- recommended
Research the rating criteria for your specific scar types and locations
Review 38 CFR 4.118 diagnostic codes 7800 (head/face/neck), 7801 (burn scars trunk/extremities), 7802 (unstable scars), 7804 (painful/non-linear superficial scars), and 7805 (other effects). Understand what characteristics and measurements apply to your specific scars so you can ensure the examiner captures all relevant data.
before exam
- recommended
Check your state's law on C&P exam recording rights
Many states allow veterans to record their C&P examination. Check your state's law before the exam. If permitted, bring a recording device or use your smartphone. Inform the examiner at the start that you intend to record. A recording can be invaluable if the exam report is later found to be inadequate or inaccurate.
before exam
- recommended
Do not treat or cover scars in ways that mask their appearance on exam day
Do not apply heavy bandaging, compression garments, or cosmetic cover-up products to your scars on the day of the exam unless medically necessary. The examiner needs to see the scars in their natural state. If you normally use compression garments due to scar management, mention this to the examiner and explain what the scar looks like without them.
before exam
- critical
Wear clothing that allows easy access to all scar locations
Wear loose-fitting, easy-to-remove clothing that allows the examiner to access all scar areas without significant undressing difficulty. For scars on the trunk, back, or extremities, wear clothing that can be easily pulled up or removed. For head/face/neck scars, avoid heavy makeup or hair products that could obscure scar boundaries.
day of
- critical
Bring your scar inventory list and photographs
Have your written scar inventory and photographs physically in hand at the start of the exam. Present them to the examiner at the beginning and ask that each item on your list be addressed. This ensures nothing is missed in a brief 15-30 minute exam.
day of
- recommended
Arrive early and review your symptom notes
Arrive 15-20 minutes early to review your scar inventory, personal statement, and key points you want to communicate. Being mentally prepared helps you avoid forgetting important symptoms during the exam.
day of
- critical
Verbally confirm pain when the examiner palpates each scar
When the examiner touches, presses, or palpates any scar, immediately state whether it is painful: 'Yes, that is painful when you press on it - I would rate that as a [X]/10 pain.' Do not wait to be asked. Clear verbal confirmation of pain during examination is required for the painful scar rating under DC 7804.
during exam
- critical
Ensure every scar on your list is examined and measured
After the examiner has examined what they believe to be all scars, refer to your inventory list and confirm: 'I also have scars at [location] - have those been measured and documented?' Do not let the exam end until all documented scars have been assessed.
during exam
- critical
Explicitly describe your worst-day presentation if today is a better day
If your scars look better than usual on exam day, tell the examiner directly: 'I want to note that today is not typical - on my worst days, this scar appears more inflamed/raised/open than it does right now. I have photographs showing how it looks on worse days.' Hand over your photographs.
during exam
- critical
Describe all seven disfigurement characteristics for head/face/neck scars
For each scar on the head, face, or neck, describe all applicable characteristics: (1) elevated contour, (2) depressed contour, (3) abnormal texture, (4) hyperpigmentation, (5) hypopigmentation, (6) adherence to underlying tissue, (7) underlying soft tissue missing. Point out each characteristic you have identified and ask the examiner to document it.
during exam
- recommended
Describe functional limitations caused by scar contracture
If any scar causes tightness that limits movement, describe it: 'This scar on my neck prevents me from turning my head fully to the left - I lose about [X] degrees of rotation and it causes a sharp pulling pain at end range.' This supports a DC 7805 additional rating.
during exam
- recommended
Describe the psychosocial impact of facial disfigurement
When asked about the impact of your scars, describe specific social and occupational effects: withdrawal from activities, difficulty with employment, impact on relationships, psychological distress, avoidance behaviors, and any mental health treatment sought because of your appearance. The DBQ has a dedicated field for this information.
during exam
- critical
Document what was and was not covered in the exam
Immediately after the exam, write down everything that was discussed, which scars were measured, what the examiner's noted observations were, and anything that was missed. Note the examiner's name, credentials, and the date. This contemporaneous record is valuable if you need to challenge an inadequate exam report.
after exam
- critical
Request a copy of the DBQ/examination report
Submit a request to obtain a copy of the completed DBQ once it is in your VA file. Review it carefully to ensure all your scars are documented, measurements are accurate, pain is noted, and no characteristics of disfigurement were omitted. If significant information is missing, you may have grounds to request a new examination.
after exam
- optional
Consider submitting a nexus letter from a private dermatologist
If your C&P exam was brief or you felt the examiner did not thoroughly document your scars, consider having a private dermatologist conduct a thorough evaluation and write a detailed nexus/medical opinion letter documenting all scar characteristics, measurements, and their relationship to your service injury. This can supplement or rebut a deficient C&P report.
after exam
Your rights during a C&P exam
- You have the right to record your C&P examination in most states - check your state law before the appointment and notify the examiner at the start if you choose to record.
- You have the right to request a new C&P examination if you believe the original exam was inadequate, the examiner was not qualified, or the report did not accurately reflect your condition.
- You have the right to submit private medical opinions, buddy statements, and lay statements as evidence to supplement or rebut the C&P examiner's findings.
- You have the right to submit photographs of your scars as supporting evidence - VA M21-1 adjudication procedures explicitly recognize photographs as relevant evidence for skin and scar claims.
- You have the right to have all scars measured and documented individually, not just the most prominent scar - ensure the examiner examines every service-connected scar.
- You have the right to a rating based on your worst-day presentation, not only how you appeared on the day of the exam - verbally communicate your typical worst-day symptoms.
- You have the right to a rating that accounts for all characteristics of disfigurement from multiple scars combined - per 38 CFR 4.118 Note 5, characteristics from multiple scars are counted together.
- You have the right to an additional separate rating under DC 7805 for any disabling effects of your scars (such as joint limitation from contracture) not captured in your primary scar rating.
- You have the right to be evaluated in person for a skin/scar condition unless a records-based review is clearly appropriate and you agree to it.
- You have the right to request that your claim file (C-file) be reviewed by the examiner before the exam to ensure they have full knowledge of your service history and treatment records.
Related conditions
- Burn Scars of the Head, Face, or Neck DC 7800 governs burn scars and other scars of the head, face, or neck. If your scars are on the head, face, or neck, they should be rated under DC 7800 rather than DC 7801, potentially yielding a much higher rating (up to 80%) based on facial feature involvement and disfigurement characteristics.
- Unstable Scars DC 7802 provides a minimum 10% rating for any scar that is unstable - meaning it recurrently breaks down spontaneously or with minimal trauma. If your scar is both painful and unstable, you may be entitled to ratings under both DC 7802 and DC 7804, which are evaluated separately.
- Superficial Non-Linear Scars (Trunk/Extremities) DC 7804 governs superficial, non-linear (non-straight-line) scars on areas other than the head, face, and neck. Ratings range from 10% (39-144 sq cm) to 30% (144+ sq cm). Painful scars of any size receive a minimum 10% under this code.
- Scars, Other Effects (DC 7805) DC 7805 allows for additional ratings for disabling effects of scars not captured under DC 7800-7804. Most commonly used when a scar contracture causes joint range of motion limitation, which is then rated under the appropriate musculoskeletal diagnostic code. Veterans should request evaluation of all functional limitations caused by their scars.
- PTSD / Adjustment Disorder Secondary to Disfigurement Veterans with significant facial or visible disfigurement from scars frequently develop secondary psychiatric conditions including PTSD, depression, social anxiety, or adjustment disorder related to the psychological impact of their changed appearance. These conditions may be ratable as secondary to the scar condition and should be addressed with a mental health provider.
- Range of Motion Limitation Secondary to Scar Contracture Scar contractures crossing joints (neck, shoulder, elbow, knee, ankle) can restrict range of motion and are separately ratable as musculoskeletal limitations under the applicable joint diagnostic code via DC 7805. This is a common source of additional compensation that veterans frequently overlook.
- Peripheral Neuropathy Secondary to Burn Scars Deep burn scars can cause nerve damage resulting in numbness, tingling, hypersensitivity, or chronic neuropathic pain in the affected area. If you experience these symptoms in or around a burn scar, mention them to the examiner and your VA provider - peripheral neuropathy may be separately ratable as secondary to the burn injury.
Get a personalized prep packet
This guide covers what to expect for any veteran with this condition. If you have already uploaded your medical records, sign in to generate a packet that maps your specific symptoms to the DBQ fields your examiner will fill out.
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.