Citation Nr: 18152340 Decision Date: 11/21/18 Archive Date: 11/21/18 DOCKET NO. 16-52 818 DATE: November 21, 2018 REMANDED Entitlement to an evaluation in excess of 10 percent prior to October 27, 2017, and in excess of 20 percent beginning October 27, 2017, for painful surgical scars, left lower extremity, is remanded. Entitlement to a compensable evaluation for scar, residual of surgery, non-linear, associated with residual, degenerative changes status post fracture left ankle and structural repair, is remanded. Entitlement to a compensable evaluation for scars, residual of surgery, linear, associated with residual, degenerative changes status post fracture left ankle and structural repair, is remanded. REASONS FOR REMAND The Veteran served on active duty from May 2008 to January 2010. In her October 2016 substantive appeal, the Veteran limited the issues on appeal to the issues of convalescence, left ankle surgical scars, scar non-linear, and scar non-linear. See October 2016 VA Form 9. Regarding the claim for convalescence, a February 2015 rating decision granted a temporary 100 percent evaluation, effective March 14, 2014, based on surgical or other treatment necessitating convalescence for residual degenerative changes status post fracture left ankle and surgical repair. Thereafter, the Veteran filed a March 2015 notice of disagreement (NOD) with the grant of convalescence. However, in her substantive appeal, the Veteran conceded that the period of convalescence in March 2014 was accurately reflected, but she would like to request additional periods of convalescence. See October 2016 VA Form-9. The October 2016 request for additional periods of convalescence was separately adjudicated in an unappealed August 2017 rating decision. As such, the Board finds that the February 2015 rating decision granted the benefit in full and the convalescence issue is not before the Board on appeal. In a November 2017 rating decision, the AOJ amended the Veteran’s disability formerly rated as service-connected residual scars, left ankle, to service-connected painful scars, left lower extremity, to more accurate reflect the disability. The AOJ indicated that although the left knee and lower leg are not on appeal, they were considered with the assignment of a higher 20 percent rating for painful scars, left lower extremity, effective October 27, 2017. The issue is reflected below, accordingly. Scars The Board has reviewed the February 2015 and November 2017 VA examination reports of record and finds that clarification is needed. Significantly, the February 2015 VA examination report indicated that the Veteran had eight scars. The Veteran had one superficial, non-linear scar (scar #1), located on the superior/lateral aspect of the left leg, which was nonpainful and measured and measured 1.0 centimeter (cm) by 0.7 cm. The approximate total area was 7.0 square cm. The Veteran had a second linear scar (scar #2), located on the superior, posterior aspect of the left leg, which was nonpainful and measured 7.2 cm. The Veteran had a third linear scar (scar #3), located on the inferior/lateral aspect of the left leg, which was nonpainful and measured 3.0 cm. The Veteran had a fourth linear scar (scar #4), located over the lateral aspect of the left ankle, which was painful and measured 10.0 cm. The Veteran had a fifth linear scar (scar #5), located over the lateral aspect of the left ankle, which was nonpainful and measured 14.0 cm. The Veteran had a sixth linear scar (scar #6), located over the medial aspect of the left ankle, which was nonpainful and measured 11.0 cm. The Veteran had a seventh linear scar (scar #7), located on the left popliteal fossa, which was painful and measured 4.0 cm. The Veteran had an eighth linear scar (scar #8), that was not measured. The November 2017 VA examination report indicated that the Veteran had 10 scars. The Veteran had one superficial non-linear scar (scar #1), located on her posterior knee that was healed and measured 1 cm in length by 1 cm in width. However, the report also described the Veteran’s scar #1 as linear and measuring 18.5 cm in length. The Veteran had a second linear scar (scar #2), located on the left calf that was healed and measured 8.0 cm in length. The Veteran had a third linear scar (scar #3), located on the left calf that was healed and measured 8.0 cm. The Veteran had a fourth linear scar (scar #4), located on the left lateral ankle that was healed. The Veteran had a fifth linear scar (scar #5), located on the left lateral ankle that was healed. The Veteran had a sixth scar (scar #6), located on the left lateral ankle that was healed. The Veteran had a seven scar (scar #7), located on the left lateral ankle that was healed. The Veteran had an eighth scar (scar #8), located on the left lateral lower leg that was healed. The Veteran had a ninth scar (scar #9), located on the left ankle that was healed. The Veteran had a tenth scar (scar #10), located on the left ankle that was healed. However, the measurements for scars numbered 6, 7, 8, 9, and 10 were not included in the November 2017 VA examination report. Further, indication whether these scars were linear, non-linear, painful, and/or unstable was not provided. As such, remand for examination is warranted. The matters are REMANDED for the following action: 1. Obtain all outstanding, pertinent VA treatment records and associate them with the claims file. 2. Then, schedule the Veteran for an appropriate VA examination to ascertain the current severity of the Veteran’s service-connected left lower extremity scars and left ankle scars. The claims file must be made available to the examiner, and the examiner must specify in the examination report that these records have been reviewed. All necessary and appropriate tests must be performed and their results documented. 3. The VA examiner is asked to identify any and all scars related to the Veteran’s service-connected left lower extremity scars and left ankle scars. For each scar identified, the examiner must provide all information required for rating purposes, to include but not limited to, the accurate size of the scars, and whether such scars are painful, unstable, deep, superficial, linear, or non-linear. The examiner is also asked to determine whether there are any disabling effects caused by the Veteran’s scars. A complete rationale for all opinions must be provided. (Continued on the next page)   4. After completing the above action and any other necessary development, the claims must be readjudicated. If a claim remains denied, a Supplemental Statement of the Case must be provided to the Veteran and current representative. After the Veteran has had adequate opportunity to respond, the appeal must be returned to the Board for appellate review. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Schick, Associate Counsel