Inside the exam room
1. You will be asked how each scar happened, whether it hurts, and whether the skin repeatedly breaks down. Point out painful scars and identify dated photos or records of breakdown.
2. The examiner measures each scar and checks its location, skin and tissue changes, and appearance. Head, face, or neck scars may require photos. Tell them if touching the scar hurts.
3. You will be asked whether a scar limits movement or daily tasks. Identify the scar and explain clothing irritation or tasks it restricts.
How VA rates scars and disfigurement
Point out which scars hurt, repeatedly lose their skin covering, or restrict movement. The examiner records their size, location, and any damage under the skin. VA rates head/face/neck disfigurement under 38 CFR § 4.118, DC 7800; scars with damage to tissue under the skin by area under DC 7801; superficial scars by area under DC 7802; scars that hurt or repeatedly lose their skin covering (unstable scars) under DC 7804; and other disabling effects under DC 7805.
What each rating percentage means
Match the whole description with your exam and records. A single symptom or illustration does not decide your rating.
| Rating | What the rule requires |
|---|---|
| 10–80% | DC 7800: changes in the appearance of the head, face, or neck, based on missing tissue, uneven features, and other changes listed in the rule |
| 10–40% | DC 7801: non-head/face/neck scars with damage to tissue under the skin, based on area |
| 10% | DC 7802: qualifying area of scars without damage to deeper tissue totaling at least 144 square inches |
| 10/20/30% | DC 7804: one or two, three or four, or five or more scars that hurt or repeatedly lose their skin covering (unstable scars) |
Check these details in your records
The examiner uses a condition form called a Disability Benefits Questionnaire (DBQ). Compare these items with your own records and explain what actually happens in daily life.
- One or two scars that hurt or repeatedly lose their skin covering (unstable scars)10%DC 7804
- Three or four scars that hurt or repeatedly lose their skin covering (unstable scars)20%DC 7804
- Five or more scars that hurt or repeatedly lose their skin covering (unstable scars)30%DC 7804
- Head, face, or neck scar with one characteristic of disfigurement10%DC 7800
What may happen in the exam room
- Measure length, width, and total area
- The examiner feels the scar’s shape and checks whether it sticks to tissue underneath
- They check whether skin breaks down, hurts, changes color or texture, or has lost tissue
- They may photograph changes in the appearance of scars on the head, face, or neck
- They check whether the scar makes movement or other activities harder
What the measurements tell you
- Centimeters and square centimeters
- Where the scar is and whether tissue under the skin is damaged
- How many scars hurt or repeatedly lose their skin covering
- Each change in appearance listed in the scar rating rule
- Separate effects on daily life
Questions the examiner may cover
- Is the scar painful?
- Does skin covering break down repeatedly?
- Does it stick to tissue underneath, or is tissue missing?
- Does it limit motion or other function?
Questions to expect
Which scars hurt or repeatedly lose their skin covering?
Explain: Identify each location, pain and breakdown pattern separately. Bring dated photographs or treatment records if available.
Rating connection: DC 7804 considers the count of painful or unstable scars, with an additional rule when scars are both painful and unstable.
What size, tissue changes or movement limits are present?
Explain: Describe restrictions and identify each affected scar. The examiner measures area and checks underlying tissue; head, face and neck findings require different assessment.
Rating connection: Area, depth, disfigurement and other functional effects use different criteria, not just a scar count.
Your answer outline
The scar at [location] feels [actual sensation] during [contact or movement]. This occurs [frequency]. I have noticed [actual skin changes, or none]. It affects [activity] by [specific effect].
Mark approximate dates and counts as estimates.
My notes: ________________________
Service connection records
1. How is this connected to your service?
For a direct claim, identify your current disability, what happened in service, and evidence linking them. Being on active duty or orders alone does not prove that link.
- Write the 5 Ws and how: who was there; what happened; when; where; why you were there; how the problem began. Add duty status, treatment, witnesses, and records. Mark uncertain dates as estimates.
- Guard or Reserve: find your orders, dates, duty type, and any line-of-duty records. Active duty, training, and drills have different rules.
- Secondary condition: it may start after service. Identify the service-connected condition and evidence that it caused or worsened this problem. A medical opinion may help explain the link.
- Started before service? Record what changed during service. Presumptive condition? Check the required diagnosis and service history; qualifying claims do not require separate proof of a link.
- Already service connected and seeking an increase? Focus on what has worsened and the records showing it.
If you do not know the cause, say so. Do not guess a medical connection.
Explain what changes in daily life
Describe both what you can do and what becomes difficult. Include how often it happens and how long it lasts.
- Point out each scar that hurts or repeatedly loses its skin covering.
- Describe pulling, sensitivity, breakdown, or motion restriction.
- Explain changes over time and during flare-ups.
Common mistakes to avoid
- Counting scars without describing pain or instability
- Not measuring area
- Combining dermatitis with a separate scar evaluation
Records to get ready before the exam
- Scars/Disfigurement DBQ
- Dated photographs
- Surgery and wound-care records
- Measurements from treatment notes
Preparation notes
- Point out every scar being claimed.
- Explain what the scar makes harder to do, as well as how it looks.
Important context
Additional scar rules: Under DC 7804, if at least one scar is both unstable and painful, 10% is added to the evaluation based on the total number of unstable or painful scars. The example selector does not calculate this addition or combine body zones, disfigurement, area-based ratings, and distinct effects on daily life. Those findings require individual review.
Official rating rule and code numbers
Use this source to check the full rule and its medical terms: 38 CFR 4.118, DCs 7800-7805. Source review recorded 2026-09-04.
Could one health problem have caused another?
A condition VA has already linked to your service may cause another health problem or make it worse. VA calls this secondary service connection. Having both conditions does not prove the link. Your records need to show a current diagnosis and explain how the first condition or its treatment affected the second.
- Start with your records. Find the current diagnosis, the condition VA already linked to service, and evidence from someone qualified to explain the connection.
- Ask about cause and worsening. Did the first condition or its treatment cause the new disability, or make an existing disability worse? These are different questions. The rules call them causation under 38 CFR § 3.310(a) and aggravation under § 3.310(b). If both are raised by your records, the medical opinion should address both; answering only the cause question may not be enough (El-Amin).
- If treatment may be involved, collect the dates. List the medicine or surgery prescribed for the condition VA linked to service, the side effect, and the new diagnosis. Bring pharmacy records and dates when treatment started or stopped. A provider must explain the connection in your case; taking a medicine alone does not prove it.
- If weight gain may be involved, ask how it fits. Weight gain or obesity can be a step between the first condition and another diagnosed disability under VAOPGCPREC 1-2017. Obesity itself does not receive a VA disability rating.
- You do not need absolute certainty. VA uses the “at least as likely as not” standard and the reasonable-doubt rule under 38 CFR § 3.102. Ask a VA-accredited representative how the evidence applies to your claim.
- The same symptom cannot be counted twice. This is the rule against pyramiding in 38 CFR § 4.14. Mental-health diagnoses generally share one § 4.130 rating when they affect the same work and social abilities. Trouble sleeping may be a symptom rather than a separate disability.
- Check whether VA already assumes a link to service. Some conditions qualify based on where or when you served. These are called presumptive conditions. Examples can include chronic rhinitis, chronic sinusitis, hypertension after qualifying herbicide exposure, and type 2 diabetes. Sleep apnea (OSA) is not a PACT Act presumptive. Check eligibility before seeking a medical opinion about the link.
- An exam form and a medical opinion do different jobs. A Disability Benefits Questionnaire (DBQ) records the diagnosis and how severe it is. It may not explain why it is linked to service, often called a nexus. A VA-accredited veterans service organization (VSO) can help you file at no charge.
If another prescribed treatment may have caused a problem, ask your health care provider to record what happened and explain the connection in your case.
Sources: 38 CFR § 3.310 · 38 CFR § 4.14 · VA-accredited representatives
Other health problems to ask about
Use these notes to ask your provider about problems you already have. Your records must explain the connection. VA decides whether the condition is linked to service.
If a scar pulls tight and limits movement, show the examiner which movement is affected. Ask them to measure it and explain whether the scar causes the limit. VA can assess effects not already covered by the scar rating; the same limit cannot be counted twice.
Sources: VA scar exam form · NIH: scars that restrict movement
Bring records of any diagnosed nerve or muscle damage near the scar. Ask the examiner what the injury or treatment damaged and which effects are separate from the scar itself. The body part and diagnosis determine which guide applies.
Sources: VA scar exam form · VA scar rating rules
Choose the related health problems you want to discuss. Your preparation packet will include the notes you select and the full condition guides available for them.