Citation Nr: 21025229 Decision Date: 04/27/21 Archive Date: 04/27/21 DOCKET NO. 10-08 666 DATE: April 27, 2021 ORDER Entitlement to a compensable disability rating for shrapnel wound scar of the right wrist is denied. REMANDED Entitlement to a total disability rating based on individual unemployability (TDIU) due to service-connected disabilities is remanded. FINDING OF FACT The Veteran’s shrapnel wound scar of the right wrist is not manifest by any disabling effects not considered under Diagnostic Codes 7800-04. CONCLUSION OF LAW The criteria for a compensable disability rating for shrapnel wound scar of the right wrist have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.118, Diagnostic Code 7805. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from July 1966 to June 1969, to include combat service in the Republic of Vietnam. The Veteran was awarded the Purple Heart Meal. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2008 rating decision from the Department of Veterans Affairs (VA) Regional Office (RO) in Cleveland, Ohio. The Veteran presented sworn testimony at a hearing before the undersigned in October 2017. The Board remanded this matter in April 2017 for additional development. The Board finds that there has been substantial compliance with its remand directives. See, Stegall v. West, 11 Vet. App. 268 (1998). The Board notes that at the October 2017 Board hearing, the Veteran’s representative confirmed that entitlement to a total disability rating based on individual unemployability (TDIU) has not been raised by the record. See October 2017 Hr’g Tr. at 5. Subsequently, the Veteran was granted service connection for numerous right wrist disabilities, giving him a combined disability rating of 80 percent since July 2007, and which the March 2019 VA muscle injuries examiner stated was interfering with his ability to work. Thus, the Board takes jurisdiction of the issue of entitlement to a TDIU because it is part and parcel to the increased rating claim on appeal. Rice v. Shinseki, 22 Vet. App. 447, 453-54 (2009). 1. Entitlement to a compensable disability rating for shrapnel wound scar of the right wrist. The Veteran does not assert that the scar itself is tender. Instead, he contends that he is entitled to a higher rating for his right wrist shrapnel wound scar due to claimed residuals of nerve damage from the scar. The Veteran’s right wrist shrapnel wound scar is rated under Diagnostic Code 7805 for other scars (including linear scars) and other effects of scars evaluated under Diagnostic Codes 7800, 7801, 7802, and 7804. The Board notes that VA amended the criteria for rating skin disabilities effective from August 13, 2018. However, Diagnostic Code 7805 was not changed by the August 13, 2018, amendments. Diagnostic Code 7805 instructs that any disabling effect(s) not considered in a rating provided under Diagnostic Codes 7800-04 under an appropriate Diagnostic Code. The Veteran was afforded a VA examination in July 2008. A scar on the right forearm of about an inch above the right wrist that shows a superficial transverse wound that is depressed was noted. The scar measured 1.5 inches by 3 millimeters and was characterized as hypopigmented, stable and not attached to the underlying tissue. In his December 2008 Notice of Disagreement (NOD), the Veteran asserted that his right wrist scar warranted a 10 percent evaluation due to it being painful on examination. In a February 2010 Informal Hearing Presentation (IHP), the Veteran's representative argued that the Veteran's right wrist scar warranted a 20 percent evaluation due to incomplete paralysis of hand movements. The Veteran testified at the Board hearing that “there's no pain at the scar itself.” The Veteran’s representative stated that the Veteran had undergone an EMG and was told that he had nerve damage. The Veteran was afforded a VA scars examination in March 2019. A right wrist scar status post shrapnel wound was noted. The scar was not noted as painful or unstable. Two scars on the right forearm were identified, one measuring 1.25 by 1.5 centimeters and the other measuring 4.5 by .5 centimeters. One scar covered approximately 2.5 square centimeters with no underlying tissue damage, and the other covered approximately 3.75 square centimeters with underlying tissue damage. Limitation of function due to the scar on the right wrist causing a strain in the wrist and hand, weakness in the hand and ulnar nerve neuropathy was noted. It was then noted that the scars interfere with the Veteran's gripping, driving, overuse and using tools. The Board finds that the preponderance of the evidence is against the assignment of a compensable rating for the Veteran’s right wrist shrapnel wound scar under Diagnostic Code 7805 as there are no other disabling effects not considered in a rating provided under Diagnostic Codes 7800-04. Further, the Board notes that in a November 2019 rating decision, the RO granted service connection for painful/limited motion of multiple fingers due to right hand osteoarthritis, due to retained shrapnel is granted with an evaluation of 10 percent effective July 5, 2007, service connection for right hand osteoarthritis is granted with an evaluation of 10 percent effective July 5, 2007, service connection for right wrist shrapnel wound flexor (muscle group VII) is granted with an evaluation of 10 percent effective July 5, 2007, service connection for neuropathy (Ulnar Nerve) is granted with an evaluation of 10 percent effective July 5, 2007, and service connection for right wrist strain is granted with an evaluation of 10 percent effective July 5, 2007. The Board has also considered the other Diagnostic Codes pertaining to scars. However, the Veteran’s right wrist shrapnel wound scar is not of the head, face, or neck, is not deep and nonlinear, and is not associated with underlying soft tissue damage. Although it is superficial and not associated with underlying soft tissue damage, it does not cover an area or areas of 144 square inches or greater. Moreover, the Veteran’s right wrist shrapnel wound scar is not unstable or painful. Therefore, Diagnostic Codes 7800, 7801, 7802, and 7804, both prior to and from August 13, 2018, are inapplicable. The Board acknowledges that the Veteran believes that the disability on appeal has been more severe than the assigned disability rating reflects. Moreover, the Veteran is competent to report observable symptoms, to include orthopedic problems, and his reports are credible. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). However, he does not assert, and medical records do not show, that the Veteran’s right wrist shrapnel wound scar is manifest by any disabling effects not considered in a rating provided under Diagnostic Codes 7800-04 or for which have not been granted separate ratings under applicable Diagnostic Codes. In conclusion, the Board finds that the preponderance of the evidence is against the Veteran’s claim for a compensable rating for right wrist shrapnel wound scar. In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. REASONS FOR REMAND 1. Entitlement to TDIU. As noted above, in light of the March 2019 VA examination report, the Board has found that TDIU has been raised by the record. As the RO has not adjudicated this matter, after giving the Veteran an opportunity to file a formal claim for a TDIU, the RO should address this matter, in the first instance. The matters are REMANDED for the following action: Reach out to the Veteran and his representative and give the Veteran an opportunity to clarify his work history and submit a VA Form 21-8940 (Application for Increased Compensation Based on Unemployability) in addition to any additional evidence that is relevant with regard to his claim for a TDIU. STEVEN D. REISS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Brian P. Keeley 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.