Custom Federal Regulations Service™

**This is supplemental material**

**for Book C of your set of**

**Federal Regulations**

Title 38, Part 4

*Schedule for Rating Disabilities*

**Veterans Benefits Administration**

Supplement No. 32

Covering period of *Federal Register* issues

through May 26, 2003

Copyright © 2003 Jonathan Publishing

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> **GENERAL INSTRUCTIONS**

Custom Federal Regulations Service™

**Supplemental Materials for *Book C***

**Code of Federal Regulations**

**Title 38, Part 4**

***Schedule for Rating Disabilities***

**Veterans Benefits Administration**

**Supplement No. 32**

25 May 2003

Covering the period of Federal Register issues

through May 26, 2003

When **Book C** was originally prepared, it was current through final
regulations published in the *Federal Register* of 24 March 1992. These
supple­mental materials are designed to keep your regulations up to date.
You should file the attached pages immediately, and record the fact that
you did so on the *Supplement Filing Record* which is at page C-8 of
Book C, *Schedule for Rating Disabilities*.

> **To ensure accuracy and timeliness of your materials,**
>
> **it is important that you follow these simple procedures:**

1\. Always file your supplemental materials immediately upon receipt.

2\. Before filing, always check the Supplement Filing Record (page C-8)
to be sure that all prior supplements have been filed. If you are
missing any supple­ments, contact the Veterans Benefits Administration at
the address listed on page C-2.

3\. After filing, enter the relevant information on the Supplement
Filing Record sheet (page C-8)---the date filed, name/initials of filer,
and date through which the *Federal Register* is covered.

4\. If as a result of a failure to file, or an undelivered supplement,
you have more than one supplement to file at a time, be certain to file
them in chronological order, lower number first.

5\. Always retain the filing instructions (simply insert them at the
back of the book) as a backup record of filing and for reference in case
of a filing error.

6\. Be certain that you *permanently discard* any pages indicated for
removal in the filing instructions in order to avoid confusion later.

To execute the filing instructions, simply remove *and throw away* the
pages listed under *Remove These Old Pages,* and replace them in each
case with the corres­pond­ing pages from this supplement listed under *Add
These New Pages*. Occasionally new pages will be added without removal
of any old material (reflecting new regulations), and occasionally old
pages will be removed with­out addition of any new material (reflecting
rescinded regulations)---in these cases the word *None* will appear in
the appropriate column.

> **FILING INSTRUCTIONS**

**Book C, Supplement No. 32**

**May 25, 2003**

*Remove these Add these Section(s)*

*[old pages]{.underline} [new pages]{.underline} [Affected]{.underline}*

**Do not file this supplement until you confirm that**

**all prior supplements have been filed**

4.87-1 to 4.87-2 4.87-1 to 4.87-2 §4.87

**4.118-9 to 4.118-10 4.118-9 to 4.118-10 Tech. corr.**

**Be sure to complete the**

***Supplement Filing Record* (page C-8)**

**when you have finished filing this material.**

> **HIGHLIGHTS**

**Book C, Supplement No. 32**

**May 25, 2003**

***Supplement* Highlights *references***: Where substantive changes are
made in the text of regulations, the paragraphs of *Highlights* sections
are cited at the end of the relevant section of text. Thus, if you are
reading §3.263, you will see a note at the end of that section which
reads: "Supplement *Highlights* references---6(2)." This means that
paragraph 2 of the *Highlights* section in Supplement No. 6 contains
information about the changes made in §3.263. By keeping and filing the
*Highlights* sections, you will have a reference source explaining all
substantive changes in the text of the regulations.

***Supplement frequency***: This Book C (*Schedule for Rating
Disabilities*) was originally supplemented four times a year, in
February, May, August, and November. Beginning 1 August 1995,
supplements will be issued *every month* during which a final rule
addition or modification is made to the parts of Title 38 covered by
this book. Supplements will be numbered consecutively as issued.

**Modifications in this supplement include the following:**

1\. On 14 May 2003, the VA published a final rule, effective 13 June
2003, to amend the Schedule for Rating Disabilities to state more
explicitly the method of evaluation of tinnitus under diagnostic code
6260 in the portion of the rating schedule that addresses evaluation of
disabilities of the ear; and to codify current standard VA practice by
stating that recurrent tinnitus will be assigned only a single
10-percent evaluation whether it is perceived in one ear, both ears, or
somewhere in the head. Change:

• Revised §4.87.

**§4.87 Schedule of ratings---ear.**

**[Diseases of the Ear]{.smallcaps}**

Rating

**6200** Chronic suppurative otitis media, mastoiditis, or cholesteatoma

(or any combination):

During suppuration, or with aural polyps 10

> Note: Evaluate hearing impairment, and complications such as
> labyrinthitis, tinnitus, facial nerve paralysis, or bone loss of
> skull, separately.

**6201** Chronic nonsuppurative otitis media with effusion (serous
otitis media):

Rate hearing impairment

**6202** Otosclerosis:

Rate hearing impairment

**6204** Peripheral vestibular disorders:

Dizziness and occasional staggering 30

Occasional dizziness 10

Note: Objective findings supporting the diagnosis of vestibular
disequilibrium are required before a compensable evaluation can be
assigned under this code. Hearing impairment or suppuration shall be
separately rated and combined.

**6205** Meniere's syndrome (endolymphatic hydrops):

Hearing impairment with attacks of vertigo and cerebellar gait

occurring more than once weekly, with or without tinnitus 100

Hearing impairment with attacks of vertigo and cerebellar gait

occurring from one to four times a month, with or without tinnitus 60

Hearing impairment with vertigo less than once a month, with or

without tinnitus 30

> Note: Evaluate Meniere's syndrome either under these criteria or by
> separately evaluating vertigo (as a peripheral vestibular disorder),
> hearing impairment, and tinnitus, whichever method results in a higher
> overall evaluation. But do not combine an evaluation for hearing
> impairment, tinnitus, or vertigo with an evaluation under diagnostic
> code 6205.

**6207** Loss of auricle:

Complete loss of both 50

Complete loss of one 30

Deformity of one, with loss of one-third or more of the substance 10

**6208** Malignant neoplasm of the ear (other than skin only) 100

Note: A rating of 100 percent shall continue beyond the cessation of any
surgical, radiation treatment, antineoplastic chemotherapy or other
therapeutic procedure. Six months after discontinuance of such
treatment, the appropriate disability rating shall be determined by
mandatory VA examination. Any change in evaluation based on that or any
subsequent examination shall be subject to the provisions of §3.105(e)
of this chapter. If there has been no local recurrence or metastasis,
rate on residuals.

**6209** Benign neoplasms of the ear (other than skin only):

Rate on impairment of function.

**6210** Chronic otitis externa:

Swelling, dry and scaly or serous discharge, and itching

requiring frequent and prolonged treatment 10

**6211** Tympanic membrane, perforation of 0

**6260** Tinnitus, recurrent 10

**Note (1):** A separate evaluation for tinnitus may be combined with an
evaluation under diagnostic codes 6100, 6200, 6204, or other diagnostic
code, except when tinnitus supports an evaluation under one of those
diagnostic codes.

**Note (2):** Assign only a single evaluation for recurrent tinnitus,
whether the sound is perceived in one ear, both ears, or in the head.

**Note (3):** Do not evaluate objective tinnitus (in which the sound is
audible to other people and has a definable cause that may or may not be
pathologic) under this diagnostic code, but evaluate it as part of any
underlying condition causing it.

(Authority: 38 U.S.C. 1155).

\[29 FR 6718, May 22, 1964, as amended at 64 FR 25209, May 11, 1999; 68
FR 25823, May 14, 2003\]

**Supplement *Highlights* references**: 25(1), 32(1).

*Next Section is §4.87a*

Recurrent episodes occurring during the past 12-month period that

respond to treatment with antihistamines or sympathomimetics, or;

one to three episodes occurring during the past 12-month period

requiring intermittent systemic immunosuppressive therapy 10

Or rate as disfigurement of the head, face, or neck (DC 7800) or scars
(DC's

7801, 7802, 7803, 7804, or 7805), depending upon the predominant
disability.

**7828** Acne:

Deep acne (deep inflamed nodules and pus-filled cysts) affecting 40

percent or more of the face and neck 30

Deep acne (deep inflamed nodules and pus-filled cysts) affecting less

than 40 percent of the face and neck, or; deep acne other than on the

face and neck 10

Superficial acne (comedones, papules, pustules, superficial cysts) of

any extent 0

Or rate as disfigurement of the head, face, or neck (DC 7800) or scars
(DC's

7801, 7802, 7803, 7804, or 7805), depending upon the predominant
disability.

**7829** Chloracne:

Deep acne (deep inflamed nodules and pus-filled cysts) affecting 40

percent or more of the face and neck 30

Deep acne (deep inflamed nodules and pus-filled cysts) affecting less

than 40 percent of the face and neck, or; deep acne other than on the

face and neck 10

Superficial acne (comedones, papules, pustules, superficial cysts) of

any extent 0

Or rate as disfigurement of the head, face, or neck (DC 7800) or scars
(DC's

7801, 7802, 7803, 7804, or 7805), depending upon the predominant
disability.

**7830** Scarring alopecia:

Affecting more than 40 percent of the scalp 20

Affecting 20 to 40 percent of the scalp 10

Affecting less than 20 percent of the scalp 0

**7831** Alopecia areata:

With loss of all body hair 10

With loss of hair limited to scalp and face 0

**7832** Hyperhidrosis:

Unable to handle paper or tools because of moisture, and

unresponsive to therapy 30

Able to handle paper or tools after therapy 0

**7833** Malignant melanoma:

Rate as scars (DC's 7801, 7802, 7803, 7804, or 7805), disfigurement of
the head, face,

or neck (DC 7800), or impairment of function (under the appropriate body
system).

**Note**: If a skin malignancy requires therapy that is comparable to
that used for

systemic malignancies, i.e., systemic chemotherapy, X-ray therapy more

extensive than to the skin, or surgery more extensive than wide local
excision,

a 100-percent evaluation will be assigned from the date of onset of
treatment,

and will continue, with a mandatory VA examination six months following

the completion of such antineoplastic treatment, and any change in
evaluation

based upon that or any subsequent examination will be subject to the

provisions of §3.105(e). If there has been no local recurrence or
metastasis,

evaluation will then be made on residuals. If treatment is confined to
the

skin, the provisions for a 100-percent evaluation do not apply.

(Authority: 38 U.S.C. 1155)

\[29 FR 6718, May 22, 1964, as amended at 34 FR 5063, Mar. 11, 1969; 40
FR 42540, Sept. 15, 1975; 43 FR 45262, Oct. 2, 1978; 67 FR 49596, July
31, 2002; 67 FR 58448, Sept. 16, 2002; 68 FR 62889, Oct. 9, 2002\]

**Supplement *Highlights* references**: 30(2), 31(2).