Daniel Prokowich, who served as a fire protection technician in the Air Force, positions a hose during an exercise in 2013 at Spangdahlem Air Base, Germany. Prokowich, who served from 2012 to 2021, said the VA should not deny disability compensation for painful scars that are internal and not easily diagnosed in an office exam. (Gustavo Castillo/U.S. Air Force)
WASHINGTON — Veterans with painful scars from wounds connected to military service may have a tougher time obtaining disability compensation under a rule change proposed by the Department of Veterans Affairs.
An estimated 1 million veterans have painful scars that qualify them for disability benefits, according to the VA. Scars can become sore from nerve damage, wound infections and inflammation during healing. Painful scars are among the most common disability ratings sought by veterans.
The proposed rule, titled “Objective Evidence of Pain for Painful Scars” and published in the Federal Register, would require an in-person medical exam to confirm the pain.
But Daniel Prokowich, an Air Force veteran who is training to be a nurse practitioner, questioned how the VA will apply the standard to internal scars.
An estimated 65,000 veterans, for example, suffer from burn injuries in their lungs.
“I’ve seen firsthand how pain does not always show itself on the outside. Many veterans, especially those with burns, blast injuries, or surgical scars, live with intense nerve-related pain that is very real, yet invisible,” said Prokowich, who served from 2012 to 2021.
Prokowich said in a written statement that VA “should not create a system that denies veterans support simply because their pain doesn’t produce a measurable physical sign during an exam.”
The public comment period for the rule change ended Nov. 28.
Peter Kasperowicz, VA press secretary, said the proposed change only seeks to clarify what has been “long-standing policy” at the VA for awarding compensation.
Scars can be the result of injuries in combat and training or from surgeries for conditions related to military service.
Kirt Love, a Gulf War veteran, said he has multiple scars — called keloids — from surgeries on tumors he developed after military service.
Keloids are a type of raised scar that is lumpy and may extend beyond the original injury.
“The keloids are big enough that they catch on things. If they rub or bang against a piece of furniture, they will hurt for days,” said Love, 61, of Texas. “They are raised and get inflamed.”
Love said he has scars from operations that removed the nonmalignant tumors from his feet, limbs and back. He also has growths on internal organs, including his lungs, kidneys and liver, that VA doctors are monitoring.
Love said he developed the tumors after he was deployed near burning oil wells in the Middle East. His job involved operating large diesel-powered generators that produced a lot of smoke and soot. “It was filthy work,” he said.
But Love, who served from 1988 to 1992, has not tried to seek disability compensation for the scarring.
Disabled American Veterans is advising members not to minimize painful scars and the effect on their daily lives.
Veterans will need an in-person medical exam, in addition to providing medical records that contain firsthand reports about their pain symptoms.
“This means that a veteran’s statement would not be enough on its own — the pain would need to be confirmed during an exam or through an observable sign such as tenderness when the scar is touched,” Disabled American Veterans said in a message to members.
The organization said former service members are a population “trained to push through their pain.”
Disability ratings are based on the size of the scar, location, pain and effect on their daily functions, such as restriction of movement.
Nathan Welch, an Army veteran, urged the VA to strengthen and clarify the rule change to ensure that the pain can be both visible on the skin and from internal injuries.
Veterans must “have a fair path to recognition and care,” he said.
Love described the disability compensation process for painful scarring as a gray area without clear direction.
“My scars healed but they didn’t heal,” Love said. “I just don’t complain and learned to live with them.”
