Scars are described as fibrous tissue areas that replace normal skin after destruction of some of the dermis. A scar becomes painful when a nerve is involved during the healing.

A scar is caused by lacerations, healing of a wound, surgical operations, burns or, less commonly, diseases including skin diseases.

At first, a scar is red or purple, and then becomes glistening and white. Pain is present when a superficial nerve is involved and the end of the nerve becomes bulbous.

Physical examination and patient complaint are sufficient to diagnose a painful scar.

Treatment generally includes peripheral neurectomy.

If peripheral neurectomy is performed, the patient may experience a complete loss of sensation, recurrence of pain, or possible paralysis.

None.

• An unstable scar is one where, for any reason, there is frequent loss of covering skin over the scar.

• If one or more scars are both unstable and painful, add 10 percent to the evaluation that is based on the total number of scars.

• Scars evaluated under Diagnostic Codes 7800, 7801, 7802, or 7805 may also receive an evaluation under this diagnostic code when applicable.

• A separate disability evaluation for a painful scar under 38 CFR 4.118, DC 7804 may be assigned when the evidence demonstrates functional impairment that is distinct and separate from the functional impairment addressed by another DC and is not duplicative of or overlapping with the symptomatology addressed under another DC. 

• Do not establish a compensable evaluation for a painful scar unless there is some objective indication supporting subjective reports of pain or tenderness. The physical examination section (for the trunk/extremities or the head/face/ neck as applicable) of the Scars/Disfigurement Disability Benefits Questionnaire (DBQ) asks the examiner if scars are tender to palpation and, if yes, to check the box.  If the examiner checks that a scar is tender to palpation, consider pain to be objectively demonstrated. 

• If a painful or unstable scar is noted on VA examination or in other evidence of record but has not been expressly claimed, whether to put it at issue and decide it as part of the claim depends on whether the scar is considered within scope of the pending claim. 38 CFR 3.155(d)(2)