**§3.340 Total and permanent total ratings and unemployability.**

\(a\) *Total disability ratings*:

\(1\) *General.* Total disability will be considered to exist when there
is present any impairment of mind or body which is sufficient to render
it impossible for the average person to follow a substantially gainful
occupation. Total disability may or may not be permanent. Total ratings
will not be assigned, generally, for temporary exacerbations or acute
infectious diseases except where specifically prescribed by the
schedule.

\(2\) *Schedule for rating disabilities.* Total ratings are authorized
for any disability or combination of disabilities for which the Schedule
for Rating Disabilities prescribes a 100 percent evaluation or, with
less disability, where the requirements of paragraph 16, page 5 of the
rating schedule are present or where, in pension cases, the requirements
of paragraph 17, page 5 of the schedule are met.

\(3\) *Ratings of total disability on history.* In the case of
disabilities which have undergone some recent improvement, a rating of
total disability may be made, provided:

\(i\) That the disability must in the past have been of sufficient
severity to warrant a total disability rating;

\(ii\) That it must have required extended, continuous, or intermittent
hospitalization, or have produced total industrial incapacity for at
least 1 year, or be subject to recurring, severe, frequent, or prolonged
exacerbations; and

\(iii\) That it must be the opinion of the rating agency that despite
the recent improvement of the physical condition, the veteran will be
unable to effect an adjustment into a substantially gainful occupation.
Due consideration will be given to the frequency and duration of totally
incapacitating exacerbations since incurrence of the original disease or
injury, and to periods of hospitalization for treatment in determining
whether the average person could have reestablished himself or herself
in a substantially gainful occupation.

\(b\) *Permanent total disability.* Permanence of total disability will
be taken to exist when such impairment is reasonably certain to continue
throughout the life of the disabled person. The permanent loss or loss
of use of both hands, or of both feet, or of one hand and one foot, or
of the sight of both eyes, or becoming permanently helpless or bedridden
constitutes permanent total disability. Diseases and injuries of long
standing which are actually totally incapacitating will be regarded as
permanently and totally disabling when the probability of permanent
improvement under treatment is remote. Permanent total disability
ratings may not be granted as a result of any incapacity from acute
infectious disease, accident, or injury, unless there is present one of
the recognized combinations or permanent loss of use of extremities or
sight, or the person is in the strict sense permanently helpless or
bedridden, or when it is reasonably certain that a subsidence of the
acute or temporary symptoms will be followed by irreducible totality of
disability by way of residuals. The age of the disabled person may be
considered in determining permanence.

\(c\) *Insurance ratings. A* rating of permanent and total disability
for insurance purposes will have no effect on ratings for compensation
or pension.

\[26 FR 1585, Feb. 24 1961, as amended at 46 FR 47541, Sept. 29, 1981\]