Scar ratings tend to surprise people. A scar you’d rather not look at can come back noncompensable, and a set of small ones you’d forgotten about can be worth more than the one you filed for. The schedule measures scars on terms that have very little to do with how they look to you, which is where most of the confusion starts.
Scars are rated under 38 CFR 4.118, and the code that applies to yours depends on where the scar sits on your body, how much surface it covers, and whether it's painful or unstable.
Separate scars in separate areas of skin can produce separate ratings that combine, so the count matters as much as the criteria.
Which diagnostic code sets your scars VA rating
Scars fall under five diagnostic codes, and which one applies to yours comes down to where it is on your body and whether it’s painful or breaks open.
| Code | Where the scar is | What the code measures | What triggers a rating |
|---|---|---|---|
| 7800 | Head, face, or neck | Tissue loss, feature distortion, characteristics of disfigurement | At least one characteristic of disfigurement |
| 7801 | Anywhere else, with underlying soft tissue damage | Area covered, by body zone | At least 6 square inches (39 sq. cm.) |
| 7802 | Anywhere else, without underlying soft tissue damage | Area covered, by body zone | 144 square inches (929 sq. cm.) or greater |
| 7804 | Anywhere | Number of scars that are unstable or painful | One or two unstable or painful scars |
| 7805 | Anywhere | Disabling effects not covered by 7800 through 7804 | Any such effect, rated under another code |
Notice how the codes aren’t defined by how you got your scar. They only account for where it’s located, how much surface it covers, and whether it hurts or reopens. The cause only matters for service connection.
How does the VA rate scars of the head, face, or neck
DC 7800 rates head, face, and neck scars at 10, 30, 50, or 80 percent. What percentage you reach depends on either the number of facial features distorted by visible or palpable tissue loss, or the number of characteristics of disfigurement present.
| Level | Tissue loss and feature distortion | Or, characteristics of disfigurement |
|---|---|---|
| 80% | Visible or palpable tissue loss with gross distortion or asymmetry of three or more features or paired sets | Six or more |
| 50% | Visible or palpable tissue loss with gross distortion or asymmetry of two features or paired sets | Four or five |
| 30% | Visible or palpable tissue loss with gross distortion or asymmetry of one feature or paired set | Two or three |
| 10% | Not applicable | One |
The features the regulation counts under DC 7800 are the nose, chin, forehead, eyes including eyelids, ears, cheeks, and lips.
The characteristics don’t have to come from one scar. Three separate scars on your face, each contributing one characteristic, reach the same 30 percent as one scar contributing three.
What counts as a characteristic of disfigurement
Six of the eight are thresholds you could measure yourself with a tape measure:
- Scar 5 or more inches (13 or more cm.) in length
- Scar at least one-quarter inch (0.6 cm.) wide at its widest part
- Surface contour of the scar elevated or depressed on palpation
- Scar adherent to underlying tissue
- Skin hypo- or hyper-pigmented in an area exceeding six square inches (39 sq. cm.)
- Skin texture abnormal, meaning irregular, atrophic, shiny, or scaly, in an area exceeding six square inches (39 sq. cm.)
- Underlying soft tissue missing in an area exceeding six square inches (39 sq. cm.)
- Skin indurated and inflexible in an area exceeding six square inches (39 sq. cm.)
A rater works from what’s in the report. So, if nobody measured the length, the width, or the area of skin that changed color or texture, those characteristics won’t count toward your rating.
How does the VA rate painful or unstable scars
DC 7804 is the code for scars that are painful or unstable, and it works differently from the ones above. There’s no measurement involved, just a count of how many of your scars are painful or unstable. Five or more is 30 percent, three or four is 20 percent, and one or two is 10 percent.
If one or more scars are both unstable and painful, add 10 percent to the evaluation based on the total number of unstable or painful scars.
This code also stacks. A scar already rated under 7800, 7801, or 7802 can carry a 7804 evaluation on top of it when it’s painful or unstable.
What makes a scar unstable
An unstable scar is one where, for any reason, there’s frequent loss of covering of skin over the scar. The definition turns on the skin breaking down repeatedly, not on the cause, so a scar that opens from friction, from dryness, or from no identified reason meets the same standard.
Worked example: You have four scars on your forearm and thigh. All four are painful on examination. One of the four also breaks open every few weeks. Four painful or unstable scars puts you at 20 percent under DC 7804. Because one of them is both unstable and painful, that adds 10 percent, for 30 percent under this code.
When do scars get separate ratings instead of one
Separate areas of skin are what allow separate ratings. A scar on your face and a scar on your leg are rated under different codes and combine under § 4.25, because they involve different skin. If two conditions affect the same patch of skin, only the higher evaluation is used.
Pain and instability are the exception to that. As we mentioned before, a scar rated under 7800, 7801, 7802, or 7805 can carry a 7804 evaluation on top of it, even though both ratings cover the same piece of skin. For head, face, and neck scars, the same applies to residuals of muscle or nerve injury.
Now, there’s a limit on how many codes one scar can be rated under to avoid “pyramiding”. The regulation tells raters not to rate the same disability under different diagnoses, or the same symptom under more than one code. So two codes can apply to one scar as long as each one covers a different effect.
How is a scar rated when it limits motion or function
DC 7805 handles the effects the other codes leave out: things like limits on motion or function. Say a scar on your shoulder tightened as it healed and now stops your arm short. The lost motion gets its own evaluation under the code that covers shoulder movement, and that combines with the rating on the scar.
Bear in mind, the loss of motion due to the scar has to be measured and written into your record as its own finding. A note saying the scar feels tight or pulls when you reach doesn’t give a rater any range-of-motion figures to work with.
What do the C&P exam and the record need to show
There’s no evidence checklist tied to each rating level for scars. What the regulation asks of any exam in your file is that it be accurate and fully descriptive, and that it record what the condition keeps you from doing. The criteria themselves tell you what has to be in there, whether that’s length and width, the area in square inches, or the number of painful scars.
An exam that records a scar on your cheek as "well-healed, non-tender" leaves a rater with nothing to count.
The same scar written up as "14 cm in length, elevated on palpation, tender" gives the rater two characteristics of disfigurement and a painful scar.
For head, face, and neck scars, the regulation also directs that unretouched color photographs be taken into consideration under DC 7800.
Why is a service-connected scar sometimes rated at zero
Service connection and a compensable rating are two separate findings, and you can have the first without the second. None of the scar codes list a zero percent level, so when your scar doesn’t meet the minimum for the lowest level, § 4.31 fills that gap with a zero.
A scar can be plainly connected to your service, plainly visible, and still sit under every minimum in the schedule:
- DC 7800 needs at least one characteristic of disfigurement
- DC 7801 needs at least 6 square inches
- DC 7802 needs a full 144 square inches
- DC 7804 needs at least one scar that’s painful or unstable
A zero percent scars VA rating keeps the condition on your record as service connected, which matters if the scar changes later. If you want to look at how your file would be evaluated before deciding anything, you can book a free strategy call.
Go Deeper:
FAQs about scars VA ratings
How does the VA rate surgical scars?
There’s no code for surgical scars, and the regulation never uses the word. A scar from surgery routes like any other, on location, area, and whether it’s painful or unstable.
How does the VA rate burn scars?
The same way as scars from any other cause. Burns are named in the headings of 7800, 7801, and 7802, but they share those headings with scars from other causes and get measured against identical criteria.
Are keloid or hypertrophic scars listed in the rating schedule?
They aren’t. Neither term appears in 38 CFR 4.118, and no code or note addresses them. A keloid or hypertrophic scar gets rated under the same criteria as any other scar when it meets them, and raised scars often do, since surface contour elevated or depressed on palpation is one of the characteristics of disfigurement. Where the criteria don’t fit, § 4.20 covers unlisted conditions.
Can the VA rate a scar and the underlying condition it came from separately?
Yes, when each rating covers a different effect. The scar itself gets rated on its appearance, area, or pain, and anything else the injury left behind gets rated under whichever code covers that. What blocks a second rating is § 4.14, which tells raters not to evaluate the same symptom under two codes.
How does the VA rate a scar that is not listed in the rating schedule?
By analogy. When a condition isn’t listed, it can be rated under a closely related disease or injury where the functions affected, the anatomical location, and the symptoms are closely analogous, and conjectural analogies are avoided. The code number gets built up, with the first two digits from the part of the schedule that most closely identifies the body part involved and the last two digits being 99. A code ending in 99 on your decision tells you the rater used this route.
What happens if a scar looks different on exam day than it usually does?
The regulation sets no rule for scars examined outside their usual state. What it does say is that each disability has to be viewed in relation to its history, in the examination and in the evaluation. Treatment records showing the scar in its typical condition are what give a rater something to weigh against a single exam that caught it on a good day.