Entitlement to an initial compensable evaluation for service-connected scars secondary to laceration of chin and right cheek status post motor vehicle accident (claimed as scars, head, face or neck and head trauma) is…

Citation Nr: A26069995 Decision Date: 07/30/26 Archive Date: 07/30/26 DOCKET NO. 251020-600073 DATE: July 30, 2026 ORDER Entitlement to an initial compensable evaluation for service-connected scars secondary to laceration of chin and right cheek status post motor vehicle accident (claimed as scars, head, face or neck and head trauma) is denied. REMANDED Entitlement to service connection for a back disability is remanded. FINDING OF FACT The Veteran's service-connected facial scars manifested in a combined total area of 1 centimeter squared with hypo or hyperpigmented areas and are not painful or unstable. CONCLUSION OF LAW The criteria for entitlement to an initial compensable evaluation for service-connected scars secondary to laceration of chin and right cheek status post motor vehicle accident (claimed as scars, head, face or neck and head trauma) have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1-4.7, 4.118, Diagnostic Code 7800-5325. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1994 to January 1997. This matter comes before the Board of Veterans' Appeals (Board) from a July 2025 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) adjudicated under the Appeals Modernization Act (AMA). In the October 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the July 2025 agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 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. However, because the Board is remanding the claim of entitlement to service connection for a back disability, any evidence the Board could not consider will be considered by the AOJ in the adjudication of that claim. 38 C.F.R. § 3.103(c)(2)(ii). 1. Entitlement to an initial compensable evaluation for service-connected scars secondary to laceration of chin and right cheek status post motor vehicle accident (claimed as scars, head, face or neck and head trauma) The Veteran is seeking an initial compensable evaluation for his service-connected scars secondary to laceration of chin and right cheek status post motor vehicle accident (claimed as scars, head, face or neck and head trauma), referred to herein as service-connected facial scars. Disability ratings are determined by the application of a schedule of ratings, which is based on average impairment of earning capacity caused by the given disability. Separate diagnostic codes identify various disabilities. 38 U.S.C. § 1155; 38 C.F.R. Part 4. Where service connection has already been established and an increase in the disability rating is at issue, it is the present level of disability that is of primary concern. Francisco v. Brown, 7 Vet. App. 55 (1994). The relevant temporal focus for adjudicating the level of disability of an increased rating claim begins one year before the claim was filed. 38 C.F.R. § 3.400(o)(2). If it is factually ascertainable that an increase in disability occurred within the one-year period prior to the date of claim, the effective date can be the date the increase was shown. Gaston v. Shinseki, 605 F.3d 979, 980-981 (Fed. Cir. 2010). When a question arises as to which of two ratings applies under a particular Code, the higher rating is assigned if the disability more clearly approximates the criteria for the higher rating. 38 C.F.R. § 4.7. After careful consideration of the evidence, any reasonable doubt remaining, including degree of disability, is to be resolved in favor of the Veteran. 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 4.3. If the evidence is not in approximate balance or nearly equal, the claim is to be denied. See Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021); Ortiz v. Principi, 271 F.3d 1361, 1364 (Fed. Cir. 2001). The diagnostic criteria for disorders of the skin are found at 38 C.F.R. § 4.118, Diagnostic Codes 7800 to 7805. The General Rating Formula for the Skin was revised effective August 13, 2018. See 38 C.F.R. § 4.118. Scars (including burn scars) and other disfigurements of the head, face or neck are currently rated under the Schedule of Ratings for Skin, DC 7800. A ten percent rating is warranted if there is one characteristic of disfigurement. A 30 percent rating is warranted for visible or palpable tissue loss and other gross distortion or asymmetry of one feature or paired set of features (nose, chin, forehead, eyes (including eyelids), ears (auricles), cheeks, lips), or; with two or three characteristics of disfigurement. A 50 percent rating is warranted with visible or palpable tissue loss and other gross distortion or asymmetry of two features or paired sets of features (nose, chin, forehead, eyes (including eyelids), ears (auricles), cheeks, lips), or; with four or five characteristics of disfigurement. An 80 percent rating is warranted with visible or palpable tissue loss and either gross distortion or symmetry 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. See 38 C.F.R. § 4.118, DC 7800. The eight characteristics of disfigurement for purposes of evaluation under 38 C.F.R. § 4.118 are: scar 5 or more inches (13 or more cm.) in length; scar at least one-quarter inch (0.6 cm.) wide at widest part; surface contour of scar elevated or depressed on population; scar adherent to underlying tissue; skin hypo-or hyperpigmented 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.); and skin indurated and inflexible in an area exceeding six square inches (00 sq. cm.). The Veteran received a VA examination regarding the nature and severity of his service-connected chin and right cheek scars in May 2025. The examiner noted that the scars were asymptomatic, not painful or unstable. The examiner found three scars. The right cheek scar was found to measure 5 x 0.1 cm. The upper lip scar measured at 1 x 0.1 cm. The chin scar measured 4 x 0.1 cm. The approximate total area of head, face and neck with hypo- or hyperpigmented areas measured 1cm2. No gross distortion or asymmetry of facial features or visible or palpable tissue loss was noted. Although hypopigmentation is considered a characteristic of disfigurement for the purposes of DC 7800, the area of hypopigmentation must exceed 6 square inches (or 39 square centimeters). Here, the Veteran's hypopigmentation, while noted, does not meet the measurement criteria to qualify as a characteristic of disfigurement. Moreover, the Veteran does not have any other characteristics of disfigurement for the purposes of DC 7800. The evidence of record does not indicate any visible or palpable tissue loss and other gross distortion or asymmetry of a facial feature. The Veteran's scars are not 5 or more inches (13 or more cm.) in length or at least one-quarter inch (0.6 cm.) wide at widest part. The Veteran does not have any limitation of function (to include limitation of motion) caused by his facial scar. There are no skin texture abnormalities or indurated and inflexible skin. Thus, the Veteran is not entitled to a compensable rating for his facial scars based on no characteristics of disfigurement as described in DC 7800. The Board has also considered the other Diagnostic Codes pertaining to scars. However, none of the Veteran's service-connected scars have been found to be unstable or painful, therefore DC 7804 is inapplicable. The evidence of record did not demonstrate any other disabling effect(s) not considered in a rating provided under Diagnostic Codes 7800-04 as contemplated under Diagnostic Code 7805. Finally, the Board finds that DC 5325 is inapplicable because the evidence of record does not indicate that Veteran has any facial muscle injuries associated with his facial scars. The Board also finds that a 10 percent evaluation is not warranted based on interference with mastication because none is indicated in the evidence of record for the appeal period. After weighing all of the factors above, the Board finds that a compensable rating is not warranted for the Veteran's facial scars. Accordingly, entitlement to a compensable evaluation for service-connected scars secondary to laceration of chin and right cheek status post motor vehicle accident is denied. REASONS FOR REMAND 1. Entitlement to service connection for a back disability is remanded. The Veteran is seeking service connection for a back disability, which he contends is etiologically related to active service. The Board notes that under the AMA, remands are generally only permissible to correct pre-decisional duty to assist errors and "for correction of any other error by the AOJ in satisfying a regulatory duty, if correction of the error would have a reasonable possibility of aiding in substantiating the appellant's claim." 38 C.F.R. § 20.802. The Veteran received a VA examination regarding the nature and etiology of his claimed back disability in June 2025. The examiner diagnosed the Veteran with degenerative arthritis and intervertebral disc syndrome. The examiner noted that the Veteran reported "back pain which started with injuries related to motor vehicle accident when he was ejected from a vehicle as a driver in Germany and worsened with regular everyday activities per their military duties." The examiner ultimately opined that the diagnosed back disabilities are less likely than not (likelihood is less than approximately balanced or nearly equal) incurred in or caused by the claimed in-service injury, event, or illness. By way of rationale, the examiner merely stated "[t]he opinion was formulated, because no objective evidence was found to correlate this condition to being a result in veteran's military service." No explanation was provided. The examiner did not provide an explanation in support of the conclusion nor did the examiner address the Veteran's lay testimony or assertion that the present back disabilities are etiologically related to his in-service motor vehicle accident. As such, the Board finds the opinion to be conclusory and, therefore, inadequate for adjudication purposes. See Stefl v. Nicholson, 21 Vet. App. 120 (2007); Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). The Board finds the failure to obtain an adequate VA examination constitutes a pre-decisional duty to assist error and that remand is necessary to obtain a new examination. The matter is REMANDED for the following action: Afford the Veteran an examination by an examiner of appropriate expertise to determine the nature and etiology of the Veteran's claimed back disability. All pertinent evidence of record must be made available to and reviewed by the examiner(s). Any indicated studies should be performed. Following a review of the relevant records and lay statements, the examiner should state an opinion with respect to whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that any diagnosed back disability began in or is otherwise etiologically related to active duty service, to include as related to the Veteran's in-service motor vehicle accident. T. REYNOLDS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Gorum, Associate Counsel The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.