**§4.29 Ratings for service-connected disabilities requiring hospital
treatment or observation.**

A total disability rating (100 percent) will be assigned without regard
to other provisions of the rating schedule when it is established that a
service-connected disability has required hospital treatment in a
Department of Veterans Affairs or an approved hospital for a period in
excess of 21 days or *hospital observation at Department of Veterans
Affairs expense* for a service-connected disability for a period in
excess of 21 days.

\(a\) Subject to the provisions of paragraphs (d), (e), and (f) of this
section this increased rating will be effective the first day of
continuous hospitalization and will be terminated effective the last day
of the month of hospital discharge (regular discharge or release to
non-bed care) or effective the last day of the month of termination of
treatment or observation for the service-connected disability. A
temporary release which is approved by an attending Department of
Veterans Affairs physician as part of the treatment plan will not be
considered an absence.

\(1\) An authorized absence in excess of 4 days which begins during the
first 21 days of hospitalization will be regarded as the equivalent of
hospital discharge effective the first day of such authorized absence.
An authorized absence of 4 days or less which results in a total of more
than 8 days of authorized absence during the first 21 days of
hospitalization will be regarded as the equivalent of hospital discharge
effective the ninth day of authorized absence.

\(2\) Following a period of hospitalization in excess of 21 days, an
authorized absence in excess of 14 days or a third consecutive
authorized absence of 14 days will be regarded as the equivalent of
hospital discharge and will interrupt hospitalization effective on the
last day of the month in which either the authorized absence in excess
of 14 days or the third 14 day period begins, except where there is a
finding that convalescence is required as provided by paragraph (e) or
(f) of this section. The termination of these total ratings will not be
subject to §3.105(e) of this chapter.

\(b\) Notwithstanding that hospital admission was for disability not
connected with service, if during such hospitalization, hospital
treatment for a service-connected disability is instituted and continued
for a period in excess of 21 days, the increase to a total rating will
be granted from the first day of such treatment. If service connection
for the disability under treatment is granted after hospital admission,
the rating will be from the first day of hospitalization if otherwise in
order.

\(c\) The assignment of a total disability rating on the basis of
hospital treatment or observation will not preclude the assignment of a
total disability rating otherwise in order under other provisions of the
rating schedule, and consideration will be given to the propriety of
such a rating in all instances and to the propriety of its continuance
after discharge. Particular attention, with a view to proper rating
under the rating schedule, is to be given to the claims of veterans
discharged from hospital, regardless of length of hospitalization, with
indications on the final summary of expected confinement to bed or
house, or to inability to work with requirement of frequent care of
physician or nurse at home.

\(d\) On these total ratings Department of Veterans Affairs regulations
governing effective dates for increased benefits will control.

\(e\) The total hospital rating if convalescence is required may be
continued for periods of 1, 2, or 3 months in addition to the period
provided in paragraph (a) of this section.

\(f\) Extension of periods of 1, 2, or 3 months beyond the initial 3
months may be made upon approval of the Veterans Service Center Manager.

\(g\) Meritorious claims of veterans who are discharged from the
hospital with less than the required number of days but need
post-hospital care and a prolonged period of convalescence will be
referred to the Director, Compensation and Pension Service, under
§3.321(b)(1) of this chapter.

\[29 FR 6718, May 22, 1964, as amended at 41 FR 11294, Mar. 18, 1976; 41
FR 34256, Aug. 13, 1976; 54 FR 4281, Jan. 30, 1989; 54 FR 34981, Aug.
23, 1989; 71 FR 28586, May 17, 2006\]