Your claim hinges on proving the scar is now painful and unstable, which requires a different evaluation than the initial measurement-based exam. Under 38 CFR § 4.118, Diagnostic Code (DC) 7801, scars are rated based on size, instability, and symptoms like pain. Since your scar has developed painful fibrosis, you must be evaluated under the criteria for "painful or unstable scars," which can yield a rating from 10% to 30% based on characteristics like adherence, texture, and frequency of pain, irrespective of size. The examiner's failure to assess pain and instability was inadequate, as established in *DeLuca v. Brown*, which holds that VA must consider the "functional impairment" of a disability over time. Your next actionable step is to file a Supplemental Claim with new and relevant evidence, specifically a detailed statement from your private provider linking the fibrosis to pain and instability, using language from the DBQ like "painful to touch," "adherent," or "intermittent itching." Explicitly cite the inadequate exam and request a new C&P, referencing DC 7801 and 38 CFR § 4.118 to ensure the rater applies the correct criteria. Consider also filing for secondary service connection for any mental health impact under DC 9421, as painful scars can contribute to anxiety or depression per 38 CFR § 4.130.
*Disclaimer: This information is for educational purposes regarding VA claims processes and is not intended as legal or medical advice. For guidance on your specific claim, consult an accredited VA attorney or claims agent.*
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