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. 24

Covering period of *Federal Register* issues

from June 23, 1998, through July 22, 1998

Copyright © 1998 Jonathan Publishing

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Copyright © 1998 Jonathan Publishing

> **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. 24**

# 25 July 1998

Covering the period of Federal Register issues

from June 23, 1998, through July 22, 1998

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. 24**

**July 25, 1998**

*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**

4.104-15 to 4.104-16 4.104-15 to 4.104-16 §4.104

**Be sure to complete the**

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

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

> **HIGHLIGHTS**

**Book C, Supplement No. 24**

**July 25, 1998**

***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 July 1998, the VA published a final rule, effective 13 August
1998, to amend the *Schedule for Rating Disabilities* by revising
provisions governing evaluations for cold injury residuals in order to
provide evaluation criteria based on current medical knowledge about the
long-term effects of cold injury that can be applied to any part of the
body affected by cold injury. Change:

• In §4.104, revised diagnostic code 7122 (*see* page 4.104-15).

**7122** Cold injury residuals:

With the following in affected parts:

Arthralgia or other pain, numbness, or cold sensitivity plus two

or more of the following: tissue loss, nail abnormalities, color

changes, locally impaired sensation, hyperhidrosis, X-ray

abnormalities (osteoporosis, subarticular punched out lesions,

or osteoarthritis) 30

Arthralgia or other pain, numbness, or cold sensitivity plus tissue

loss, nail abnormalities, color changes, locally impaired sensation,

hyperhidrosis, or X-ray abnormalities (osteoporosis, subarticular

punched out lesions, or osteoarthritis) 20

Arthralgia or other pain, numbness, or cold sensitivity 10

**Note 1**: Separately evaluate amputations of fingers or toes, and
complications such as squamous cell carcinoma at the site of a cold
injury scar or peripheral neuropathy, under other diagnostic codes.
Separately evaluate other disabilities that have been diagnosed as the
residual effects of cold injury, such as Raynaud's phenomenon, muscle
atrophy, etc., unless they are used to support an evaluation under
diagnostic code 7122.

**Note 2**: Evaluate each affected part (e.g., hand, foot, ear, nose)
separately and combine the ratings in accordance with §§4.25 and 4.26.

**7123** Soft tissue sarcoma (of vascular origin) 100

**Note**: A rating of 100 percent shall continue beyond the cessation of
any surgical, X-ray, 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 upon 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.

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

\[29 FR 6718, May 22, 1964, as amended at 40 FR 42539, Sept. 15, 1975;
41 FR 11300, Mar. 18, 1976; 43 FR 45361, Oct. 2, 1978; 56 FR 51653, Oct.
15, 1991; 62 FR 65219, Dec. 11, 1997; 63 FR 37779, July 14, 1998\]

**Supplement *Highlights* references**: 22(1), 24(1).

*Next Section is §4.110*

Reserved