Evaluation of Scars

1
Evaluation of Scars

• 38 CFR 4.118
• (Revised)
• Final Rule Published September 23, 2008
• Effective October 23, 2008

2
Summary of Changes

• Added introductory paragraph for 38 CFR 4.118
• Revised the heading to DC 7800 and added new
  notes (4) and (5)
• Revised DC 7801, 7802, 7804 and 7805
• Removed DC 7803

3
38 CFR 4.118
Introductory Paragraph

• Veteran previously rated under DC 7800 through
  7805 before October 23, 2008 can request review
  under revised criteria irrespective of whether
  disability has increased since last review.

4
Effective Date (38 CFR 3.114)

• If review requested, what will be the effective
  date of any increase if
• A) Filed with 1 year of October 23, 2008?
• Date of change of law.
• B) Filed after October 23, 2009?
• 1 year earlier than date of claim.
• Note In both cases, the evidence must show that
  the claimant met all eligibility criteria for the
  liberalized benefit on the effective date of the
  liberalizing law.

5
DC 7800

• Heading changed from
• (Old) Disfigurement of the head, face or neck
• To
• (New) Burn scar (s) of the head, face, or neck
  scar (s) of the head, face, or neck due to other
  causes or other disfigurement of the head, face
  or neck

6
DC 7800 cont.

• The rating criteria and notes (1), (2), and (3)
  remain in effect and unchanged.
• Note (1) The 8 characteristics of
  disfigurement.
• Note (2) Pertains to the eyes
• Note (3) Requirement to take into consideration
  color photos.

7
DC 7800 cont.

• Note (4) New
• Separately evaluate disabling effects other that
  disfigurement such as pain, instability, and
  residuals of associated muscle or nerve injury,
  under the appropriated DC and apply 4.25 to
  combine the evaluation (s) with the evaluation
  under this DC

8
DC 7800 cont.

• Note (5) New
• The characteristic (s) of disfigurement may be
  caused by one scar or by multiple scars the
  characteristic (s) required to assign a
  particular evaluation need not be caused by a
  single scar in order to assign that evaluation.

9
DC 7801

• Revised heading
• Old Scars, other than head, face or neck, that
  are deep or that cause limited motion
• New Burn scar (s) or scar (s) due to other
  causes, not of the head, face, or neck, that are
  deep and nonlinear.

10
DC 7801 cont.

• Rating criteria remains in effect and unchanged.
• The old Note (2) is now the new Note (1)
• Note (1) New A deep scar is one associated
  with underlying soft tissue damage.

11
DC 7801 cont.

• The old Note (1) has been replaced by the new
  Note (2) which provides additional clarification
  not previously contained in the old Note (1).
• Note (2) New Summarization

12
DC 7801 cont.

• A separate evaluation will be assigned for each
  qualifying scar or multiple scars affecting each
  of the four extremities or the posterior or
  anterior portions of the trunk.
• If a scar affects more than one extremity or
  portion of the trunk, separately evaluate each
  extremity using that portion of the scar that is
  on that extremity.

13
DC 7801 cont.

• Combine separate evaluations under 4.25
• Qualifying scars are nonlinear, deep, and are not
  located on the head, face, or neck.

14
DC 7802

• Revised heading
• Old Scars, other than head, face, or neck, that
  are superficial and that do not cause limited
  motion.
• New Burn scar (s) or scar (s) due to other
  causes, not of the head, face, or neck, that are
  superficial and nonlinear.

15
DC 7802 cont.

• Old rating criteria remains in effect and
  unchanged.
• Like DC 7801, DC 7802 old Note (2) is now new
  Note (1).
• Note (1) New A superficial scar is one not
  associated with underlying soft tissue damage.

16
DC 7802 cont

• New Note (2) under DC 7802 is the same as the new
  Note (2) under DC 7801 except that qualifying
  scars are defined as scars that are nonlinear,
  superficial, and are not located on the head,
  face, or neck.

17
DC 7803

• The old DC 7803 has been removed and incorporated
  into the new DC 7804.

18
DC 7804

• Revised header
• Old Scars, superficial, painful on examination
  .. 10
• New Scar (s), unstable or painful
• Five or more that are unstable or painful 30
• Three or four .. 20
• One or two ..10

19
DC 7804 cont

• Old Notes (1) and (2) removed.
• Note (1) New An unstable scar is one where,
  for any reason, there is frequent loss of
  covering of skin over the scar.
• Note (2) New 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.

20
DC 7804 cont

• Note (3) New Scars evaluated under DCs 7800,
  7801, 7802, or 7805 may also receive an
  evaluation under this DC, when applicable.

21
DC 7805

• Old Scars, other rate on limitation of
  function of affected part.
• New Scars, other (including linear scars) and
  other effects of scars evaluated under DCs 7800,
  7801, 7802, and 7804
• Evaluate any disabling effect (s) not
  considered in a rating provided under DCs
  7800-04 under an appropriate DC.

22
Practical Application

• EXERCISE

23
(No Transcript)