Painful or Unstable Scars — VA Disability Rating (DC 7804)
Diagnostic Code 7804 · 38 CFR §4.118
What Is It?
DC 7804 is the most useful code in the entire scar family and the one veterans most often leave on the table. It rates scars by count, not by size — one or two painful or unstable scars earn 10 percent, three or four earn 20 percent, and five or more earn 30 percent. A scar the size of a fingernail counts the same as a scar the length of a forearm, provided it is painful or unstable. The regulation defines an unstable scar as one where, for any reason, there is frequent loss of covering of skin over the scar — a scar that repeatedly breaks down, weeps, cracks, or ulcerates. Painful means painful on examination; the examiner presses on the scar and you report tenderness. The other feature that makes this code powerful is Note (3): scars already evaluated under DC 7800, 7801, 7802, or 7805 may ALSO receive an evaluation under DC 7804 when applicable. Size and pain are separate disabling characteristics, so rating both is not pyramiding. Any scar can qualify — combat wounds, burns, and equally the surgical incisions from any operation to treat a service-connected condition.
Rating Criteria
| Rating | Criteria |
|---|---|
| 30% | Five or more scars that are unstable or painful. Note (2): 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. Note (1): an unstable scar is one where, for any reason, there is frequent loss of covering of skin over the scar. |
| 20% | Three or four scars that are unstable or painful. |
| 10% | One or two scars that are unstable or painful. |
Evidence Needed
This claim is won on the count and on the characteristics, so the record needs to name each scar individually. Treatment notes that say "tender to palpation" or "scar breaks down periodically" for a specific scar are worth more than a general statement about scar pain. Photographs taken while a scar is open or ulcerated are strong proof of instability, which is otherwise hard to document because the exam may catch the scar during an intact period. A pain log — which scars hurt, how often, what triggers it, what you take for it — fills the gap between appointments. Prescriptions for topical anesthetics, pain medication, or protective dressings support both characteristics. Buddy statements and lay statements from a spouse describing what you avoid because of scar pain carry real weight; scar pain is exactly the kind of symptom a claimant is competent to describe.
C&P Exam Tips
Bring a written list of every scar you want examined, numbered, with its location. Examiners work from the DBQ and will assess what they are pointed at; an unlisted scar is an uncounted scar, and the count is the rating. When the examiner palpates each scar, answer honestly and specifically — tenderness on examination is the finding that matters. If a scar breaks down periodically but happens to be intact that day, say so and produce photographs from an open period, because instability is defined by frequency, not by what is visible at the moment. Flag any scar that is BOTH painful and unstable, because Note (2) adds 10 percent to the evaluation when at least one scar has both characteristics. Finally, remind the examiner that surgical scars from operations for service-connected conditions belong on the DBQ too.
How to File
File on VA Form 21-526EZ and claim "painful and/or unstable scars" explicitly, listing each scar by location and stating for each whether it is painful, unstable, or both. Attach photographs, a pain log, and treatment records. Claim DC 7804 alongside — not instead of — any area-based scar rating under DC 7800, 7801, or 7802, citing Note (3), which expressly permits both. If a scar arose from surgery to treat a service-connected condition, file it as a secondary claim and name the primary condition and the procedure.
Common Mistakes
The most expensive error in this code is misreading Note (2). The added 10 percent is a single flat addition to the evaluation based on the total number of unstable or painful scars — it is not 10 percent per scar that has both characteristics. A veteran with five painful scars, three of which are also unstable, receives 30 percent plus 10 percent, not 30 plus 30. The second mistake is undercounting: veterans list the scars that bother them most and forget the rest, when the difference between two scars and three scars is the difference between 10 percent and 20 percent. The third is treating DC 7804 as an alternative to the area codes rather than an addition to them; Note (3) is explicit, and raters do sometimes miss it. The fourth is never claiming surgical scars from service-connected treatment at all — knee replacements, hardware removals, hernia repairs, and cancer excisions all leave scars that are frequently tender and routinely go unclaimed.
Frequently Asked Questions
How many painful scars do I need for a 30% rating?
Five or more scars that are unstable or painful. Three or four earn 20 percent and one or two earn 10 percent. If at least one of those scars is both unstable and painful, Note (2) adds 10 percent to whichever tier your count reaches — so five painful scars with one that also breaks down produces 30 percent plus 10 percent.
Does the size of a painful scar matter under DC 7804?
No. DC 7804 is purely a count. A one-inch surgical scar that is tender on examination counts exactly the same as a ten-inch scar. Size only matters under DC 7801 and DC 7802, which rate area, and under DC 7800, which rates the characteristics of disfigurement on the head, face, or neck.
What makes a scar "unstable" for VA purposes?
Note (1) defines it: a scar where, for any reason, there is frequent loss of covering of skin over the scar. In practice that means a scar that repeatedly opens, weeps, ulcerates, cracks, or sheds its surface — and then heals, and then does it again. It does not need to be open on the day of the exam; it needs to break down frequently, which is why dated photographs from an open period are such useful evidence.
Can I be rated under DC 7804 and DC 7801 for the same scar?
Yes. Note (3) under DC 7804 states that scars evaluated under DC 7800, 7801, 7802, or 7805 may also receive an evaluation under DC 7804 when applicable. Area and pain are different disabling characteristics of the same scar, so compensating both is not pyramiding under 38 CFR §4.14. This stacking is the single largest missed opportunity in scar claims.
Do scars from surgery for a service-connected condition count?
Yes, on a secondary basis. If the VA has service-connected your knee, the incision from your knee replacement is service-connected too, and if it is tender on examination it is compensable under DC 7804. The same applies to hernia repairs, spinal fusions, hardware removals, and skin-cancer excisions. Name the primary condition and the procedure when you file.
Is there a limit on how many scars I can claim?
No, but the schedular ceiling under DC 7804 is 30 percent (plus the 10 percent Note (2) addition), and it is reached at five scars. Beyond that point, additional compensation comes from the other codes — area under DC 7801 or 7802, disfigurement under DC 7800, and any limitation of function routed through DC 7805 to the appropriate musculoskeletal, muscle, or neurological code.