## Facts

- Leonardo Esteban, a veteran who served from July 1946 to April 1949, suffered a January 1949 motor-vehicle accident that injured the right side of his face.
- Residuals included four prominent right-sided facial scars, facial muscle injury, and pain.
- A 1977 VA examination led to service connection and a 10% rating under Diagnostic Code (DC) 7800 for disfiguring scars of the head, face, or neck.
- Esteban later sought an increased rating, presenting evidence of additional manifestations including facial paralysis/sensory impairment, painful scarring, and difficulty with mastication (chewing).
- The Board of Veterans’ Appeals acknowledged potentially applicable DCs: DC 7800 (cosmetic disfigurement), DC 7804 (tender/painful scars), and DC 5325 (facial muscle injury with functional impairment).
- The Board denied separate ratings, reasoning that 38 C.F.R. § 4.14 (anti-pyramiding) required a single rating for the facial injury residuals.

## Issues

1. Whether 38 C.F.R. § 4.14 prohibits separate ratings under DC 7800, DC 7804, and DC 5325 when the veteran’s facial injury produces distinct manifestations (disfigurement, painful scarring, and functional impairment in mastication).
2. Whether symptom-based analysis (overlap/duplication) rather than common etiology controls when determining impermissible pyramiding.

## Decision

- The Court reversed the Board’s denial of separate evaluations.
- The Court held that separate ratings under DC 7800, DC 7804, and DC 5325 were permissible because each code compensated different manifestations of the injury.
- The case was remanded for assignment of separate ratings consistent with the distinct symptomatology.

## Legal Principles

- 38 C.F.R. § 4.14 bars compensation of the same manifestation under multiple diagnoses; it does not bar separate ratings for separate and distinct manifestations arising from a single injury.
- The controlling question is whether the symptomatology for the different diagnostic codes is duplicative or overlapping; if not, separate ratings are allowed.
- DC 7800 addresses cosmetic disfigurement from facial scarring; DC 7804 addresses pain/tenderness of scars; DC 5325 addresses functional impairment from facial muscle injury, including interference with mastication.
- When none of the symptomatology for any one condition is duplicative of or overlapping with the symptomatology of the others, separate ratings are required to avoid undercompensation.

## Conclusion

The Court held that anti-pyramiding prohibits only double compensation for the same manifestations and required separate ratings where a facial injury produced distinct cosmetic, painful, and functional impairments under different diagnostic codes.


Esteban v. Brown, 6 Vet. App. 259 (1994)