Citation Nr: A19001543 Decision Date: 09/26/19 Archive Date: 09/25/19 DOCKET NO. 190228-3054 DATE: September 26, 2019 ORDER The reduction of the rating for an abdominal scar from 10 percent to 0 percent, effective February 1, 2018, was improper. The 10 percent rating is restored, effective February 1, 2018. FINDING OF FACT 1. In a February 1, 2018 rating decision, the Regional Office (RO) reduced the rating for the Veteran’s abdominal scar from 10 percent to 0 percent. The 10 percent rating had been in effect for over five years. 2. The objective and lay evidence of record does not demonstrate sustained improvement of the Veteran’s abdominal scar which reflects an improvement in the Veteran’s ability to function under the ordinary conditions of life and work. CONCLUSION OF LAW The criteria for reduction of a 10 percent rating to noncompensable for scar of the left abdomen have not been met; restoration is warranted effective February 1, 2018. 38 U.S.C. § 1155 (2012); 38 C.F.R. §§ 3.105 (e), 3.344, 4.3, 4.7, 4.40, 4.45, 4.59, 4.104, Diagnostic Code 7804. REASONS AND BASES FOR FINDING AND CONCLUSION The Board notes that the rating decision on appeal was issued in November 2017. In March 2018 the Veteran elected the modernized review system. 84 Fed. Reg. 138, 177 (Jan. 18, 2019) (to be codified at 38 C.F.R. § 19.2(d)). The Veteran served on active duty in the United States Navy from May 1990 to May 1994 and from June 1996 to June 2000. The Veteran selected the Higher-Level Review lane when she opted in to the Appeals Modernization Act (AMA) review system by submitting a Rapid Appeals Modernization Program (RAMP) election form. Accordingly, the March 2018 AMA rating decision considered the evidence of record as of the date VA received the RAMP election form. The Veteran timely appealed this rating decision to the Board and requested direct review of the evidence considered by the Agency of Original Jurisdiction (AOJ). The propriety of the rating reduction for an abdominal surgical scar from 10 percent to 0 percent Legal Criteria A rating reduction is proper if the evidence reflects an actual change in the disability. The examination reports reflecting such change must be based upon thorough examinations. Brown, 5 Vet. App. at 421. The evidence must reflect an actual change in the veteran’s condition and not merely a difference in the thoroughness of the examination or in the use of descriptive terms. 38 C.F.R. § 4.13. If a rating has been in effect for five years or more, it must be reasonably certain that the improvement will be maintained under the conditions of ordinary life even if material improvement in the physical or mental condition is clearly reflected. 38 C.F.R. §§ 3.344 (a) and (b). If doubt remains, after according due consideration to all the evidence, VA will continue the rating in effect. 38 C.F.R. § 3.344 (b). Factual Background In a February 2001 rating decision, the Veteran was granted a 10 percent rating for an abdominal scar following a hysterectomy. In a March 2016 rating decision proposed to reduce the 10 percent rating to 0 percent following the results of a March 2016 Disability Benefits Questionnaire (DBQ) which noted that the scar was not unstable or painful. In a December 2017 notice of disagreement (NOD) the Veteran stated that her abdominal scar was still painful to the touch, that she experienced a “pulling sensation” across the left side of her scar and that her condition had not improved. She explained that the scar impacts her clothing choices, self-image and ability to be intimate with her partner. Analysis The Board finds that the weight of the evidence does not establish sustained improvement in the Veteran’s service-connected abdominal scar. Importantly, the March 2016 DBQ is the only evidence the VARO relied on to support finding that the reduction was warranted. The DBQ noted that the Veteran’s scar was not painful but also noted that the Veteran experiences a “pulling sensation” on the left side of the scar. As stated, the evidence must reflect an actual change in the veteran’s condition and not merely a difference in the thoroughness of the examination or in the use of descriptive terms. 38 C.F.R. § 4.13. Parsing the difference between the sensations of discomfort and pain with respect to the Veteran’s scar is not by itself an adequate basis to substantiate a reduction in this instance. Moreover, the Veteran is competent (medically qualified) to report observable symptoms such as pain. The Veteran’s report of her scar being painful to the touch in the November 2017 NOD establishes that there has been no sustained improvement in the Veteran’s service-connected abdominal scar. The incongruence between the March 2016 DBQ and the Veteran’s credible lay statements about whether her scar is painful casts doubt over the thoroughness of the examination. Brown, 5 Vet. App. at 420-421 (reductions must be based on thorough VA examinations). Accordingly, the Board finds that the preponderance of the evidence does not reflect an actual change in the Veteran’s disability such that the Board can be “reasonably certain that the improvements will be maintained under the ordinary conditions of life.” Id. at 419 (citing 38 C.F.R. § 3.344(a); Dofflemyer, 2 Vet. App. at 280; Schafrath v. Derwinski, 1 Vet. App. 589, 594–95 (1991)). Therefore, the November 2017 reduction of the rating for an abdominal scar was improper and a 10 percent rating will be restored, effective February 1, 2018. VICTORIA MOSHIASHWILI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. McKone, Attorney for the Board The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.