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**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. 41

Covering period of *Federal Register* issues

through September 24, 2006

Copyright © 2006 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. 41**

25 September 2006

Covering the period of Federal Register issues

through September 24, 2006

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. 41**

**September 25, 2006**

*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**

**C-13 to C-14 C-13 to C-14 Contents of Book C**

[index]{.smallcaps}-5 to [index]{.smallcaps} --6 [index]{.smallcaps}-5
to [index]{.smallcaps} --6 Index to Book C

[index]{.smallcaps}-13 to [index]{.smallcaps} --16
[index]{.smallcaps}-13 to [index]{.smallcaps} --16 Index to Book C

**4.96-1 to 4.96-2 4.96-1 to 4.96-2 §4.96**

**4.100-1 to 4.104-16 4.100-1 to 4.104-16 §§4.100 & 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. 41**

**September 25, 2006**

***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 6 September 2006, the VA published a final rule, effective 6
October 2006, to amend the Schedule for Rating Disabilities by adding
guidelines for the evaluation of certain respiratory and cardiovascular
conditions and by explaining that hypertension will be evaluated
separately from hypertensive and other types of heart diseases. Changes:

In §4.96, added a new paragraph (d);

Added a new §4.100; and

In §4.104, added a new Note 3 to diagnostic code 7101.

#  The Respiratory System

4.96 Special provisions regarding evaluation of respiratory conditions
4.96-1

4.97 Schedule of ratings---respiratory system 4.97-1

**The Cardiovascular System**

4.100 Application of the evaluation criteria for diagnostic codes
7000--7007,

7011, and 7015--7020 4.100-1

4.101 Rheumatic heart disease 4.101-1

4.102 Varicose veins and phlebitis 4.102-1

4.103 \[Reserved\]

4.104 Schedule of ratings---cardiovascular 4.104-1

**The Digestive System**

4.110 Ulcers 4.110-1

4.111 Postgastrectomy syndromes 4.111-1

4.112 Weight loss 4.112-1

4.113 Coexisting abdominal conditions 4.113-1

4.114 Schedule of ratings---digestive system 4.114-1

**The Genitourinary System**

4.115 Nephritis 4.115-1

4.115a Ratings of the genitourinary system---dysfunction 4.115a-1

4.115b Ratings of the genitourinary system---diagnoses 4.115b-1

**Gynecological Conditions and Disorders of the Breast**

4.116 Schedule of ratings---gynecological conditions and

disorders of the breast 4.116-1

**The Hemic and Lymphatic Systems**

4.117 Schedule of ratings---hemic and lymphatic systems 4.117-1

**The Skin**

4.118 Schedule of ratings---skin 4.118-1

**The Endocrine System**

4.119 Schedule of ratings---endocrine system 4.119-1

**Neurological Conditions and Convulsive Disorders**

4.120 Evaluations by comparison 4.120-1

4.121 Identification of epilepsy 4.121-1

4.122 Psychomotor epilepsy 4.122-1

4.123 Neuritis, cranial or peripheral 4.123-1

4.124 Neuralgia, cranial or peripheral 4.124-1

4.124a Schedule of ratings---neurological conditions and

convulsive disorders 4.124a-1

**Mental Disorders**

4.125 Diagnosis of mental disorders 4.125-1

4.126 Evaluation of disability from mental disorders 4.126-1

4.127 Mental retardation and personality disorders 4.127-1

4.128 Convalescence ratings following extended hospitalization 4.128-1

4.129 Mental disorders due to traumatic stress 4.129-1

4.130 Schedule of ratings---mental disorders 4.130-1

**Dental and Oral Conditions**

4.149 \[Reserved\]

4.150 Schedule of ratings---dental and oral conditions 4.150-1

End of Section Number Index

Buerger's disease (thrombo-angiitis obliterans) 7115 4.104

Bulbar palsy 8005 4.124a

Bulimia nervosa 9521 4.130

Bullous disorders 7815 4.118

Bursitis 5019 4.71a

Bypass, coronary artery 7017 4.104

**C**

C-cell hyperplasia of the thyroid 7919 4.119

Cardiac pacemakers, implantable 7018 4.104

Cardiac transplantation 7019 4.104

Cardiomyopathy 7020 4.104

Cardiovascular system---application of evaluation criteria for
diagnostic codes

7000--7007, 7011, and 7015--7020 4.100

**[cardiovascular system---schedule of ratings:]{.smallcaps}**

**Arteries and veins, diseases of**

Aneurysm, aortic 7110 4.104

Angioneurotic edema 7118 4.104

Arteriosclerosis obliterans 7114 4.104

Arteriovenous fistula, traumatic 7113 4.104

Artery, any large, aneurysm of 7111 4.104

Artery, any small, aneurysm of 7112 4.104

Cold injury residuals 7122 4.104

Erythromelalgia 7119 4.104

Hypertensive vascular disease 7101 4.104 Post-phlebitic syndrome of any
etiology 7121 4.104

Raynaud's syndrome 7117 4.104

Soft-tissue sarcoma (of vascular origin) 7123 4.104

Thrombo-angiitis obliterans (Buerger's disease) 7115 4.104

Varicose veins 7120 4.104

**Heart, diseases of**

Adhesions, pericardial 7003 4.104

Arteriosclerotic heart disease 7005 4.104

Atrioventricular block 7015 4.104

Cardiac transplantation 7019 4.104

Cardiomyopathy 7020 4.104

Coronary artery bypass 7017 4.104

Coronary artery disease 7005 4.104

Endocarditis 7001 4.104

Heart valve replacement (prosthesis) 7016 4.104

Hypertensive heart disease 7007 4.104

Hyperthyroid heart disease 7008 4.104

Implantable cardiac pacemakers 7018 4.104

Myocardial infarction 7006 4.104

Pericardial adhesions 7003 4.104

Pericarditis 7002 4.104

Rheumatic heart disease 7000 4.104

Syphilitic heart disease 7004 4.104

Valvular heart disease 7000 4.104

Ventricular arrhythmias (sustained) 7011 4.104

Diabetes insipidus 7909 4.119

Diabetes mellitus 7913 4.119

Hyperaldosteronism (benign or malignant) 7917 4.119

Hyperparathyroidism 7904 4.119

Hyperpituitarism (prolactin secreting

pituitary dysfunction) 7916 4.119

Hyperthyroidism 7900 4.119

Hypoparathyroidism 7905 4.119

Hypothyroidism 7903 4.119

Neoplasm, benign, any specified part of the

endocrine system 7915 4.119

Neoplasm, malignant, any specified part of the

endocrine system 7914 4.119

Pheochromocytoma (benign or malignant) 7918 4.119

Pluriglandular syndrome 7912 4.119

Thyroid gland, nontoxic adenoma of 7902 4.119

Thyroid gland, toxic adenoma of 7901 4.119

Endolymphatic hydrops 6205 4.87

Endometriosis 7629 4.116

Enteritis, chronic 7325 4.114

Enterocolitis, chronic 7326 4.114

Entropion 6021 4.84a

Eosinophilic granuloma of lung 6828 4.97

Epididymo-orchitis, chronic only 7525 4.115b

Epilepsies, the (*see* Neurological System and Convulsive Disorders---

Schedule of Ratings)

Epilepsy:

Diencephalic 8913 4.124a

Grand mal 8910 4.124a

Identification of 4.121

Jacksonian and focal motor or sensory 8912 4.124a

Mental disorders in Note 4.124a

Petit mal 8911 4.124a

Psychomotor 4.122

Psychomotor 8914 4.124a

Unemployability and Note 4.124a

Epiphora 6025 4.84a

Erythema multiforme 7827 4.118

Erythromelalgia 7119 4.104

Esophagus:

Diverticulum of, acquired 7205 4.114

Spasm of (cardiospasm) 7204 4.114

Stricture of 7203 4.114

Essentials of evaluative rating 4.1

Etiology, misconduct 4.17a

Evaluation criteria for diagnostic codes 7000--7007, 7011, and
7015--7020 4.100

Evaluation of evidence 4.6

Evaluations, higher of two 4.7

Evaluative rating, essentials of 4.1

Evidence, evaluation of 4.6

Examination of (*see* specific topic)

Examination reports, interpretation of 4.2

Exceptional patterns of hearing impairment 4.86

Exfoliative dermatitis (erythroderma) 7817 4.118

Eye (*see also* Visual Acuity and Visual Field):

Diplopia 6090 4.84a

Diplopia, due to limited muscle function 6092 4.84a

Impairment of central visual acuity 6061--6079 4.84a

Impairment of field of vision 6080 4.84a

Injury of, unhealed 6009 4.84a

Loss, anatomical, both eyes 6061 4.84a

Loss, anatomical, one eye 6063--6066 4.84a

Loss of use of one, having only light perception 4.79

Rating of one 4.80

Ratings as scheduled steps and distances 4.83

Scotoma, pathological, unilateral 6081 4.84a

Symblepharon 6091 4.84a

Tuberculosis of, active or inactive 6010 4.84a

**[Eye---Schedule of Ratings]{.smallcaps}**

**Diseases of the Eye**

Accommodation, paralysis of 6030 4.84a

Aphakia 6029 4.84a

Cataract, senile, and others 6028 4.84a

Cataract, traumatic 6027 4.84a

Choroiditis 6005 4.84a

Conjunctivitis, other, chronic 6018 4.84a

Conjunctivitis, trachomatous, chronic 6017 4.84a

Cyclitis 6004 4.84a

Dacryocystitis 6031 4.84a

Ectropion 6020 4.84a

Entropion 6021 4.84a

Epiphora 6025 4.84a

Eye, injury of, unhealed 6009 4.84a

Eye, tuberculosis of, active or inactive 6010 4.84a

Eyebrows, loss of, complete 6023 4.84a

Eyelashes, loss of, complete 6024 4.84a

Eyelids, loss of portion of 6032 4.84a

Glaucoma, congestive or inflammatory 6012 4.84a

Glaucoma, simple, primary,

noncongestive 6013 4.84a

Hemorrhage, intra-ocular, recent 6007 4.84a

Iritis 6003 4.84a

Keratitis 6001 4.84a

Keratoconus 6035 4.84a

Lagophthalmos 6022 4.84a

Lens, crystalline, dislocation of 6033 4.84a

Neuritis, optic 6026 4.84a

New growths, benign 6015 4.84a

New growths, malignant (eyeball only) 6014 4.84a

Nystagmus, central 6016 4.84a

Pterygium 6034 4.84a

Ptosis, unilateral or bilateral 6019 4.84a

Retina, detachment of 6008 4.84a

Retina, localized scars, atrophy,

or irregularities of 6011 4.84a

Retinitis 6006 4.84a

Scleritis 6002 4.84a

Uveitis 6000 4.84a

**Impairment of Central Visual Acuity**

Anatomical loss, both eyes 6061 4.84a

Anatomical loss of one eye 6063--6066 4.84a

Blindness in both eyes, having only

light perception 6062 4.84a

Blindness in one eye, having only

light perception 6067--6070 4.84a

Ratings Table V 4.84a

Vision in one eye, 5/200 (1.5/60) 6071--6074 4.84a

Vision in one eye, 10/200 (3/60) 6075--6077 4.84a

Vision in one eye, 15/200 (4.5/60) 6075--6077 4.84a

Vision in one eye, 20/100 (6/30) 6078--6079 4.84a

Vision in one eye, 20/200 (6/60) 6075-6077 4.84a

Vision in one eye, 20/50 (6/15) 6078--6079 4.84a

Vision in one eye, 20/70 (6/21) 6078--6079 4.84a

**Impairment of Field of Vision**

Field of vision, impairment of 6080 4.84a

Scotoma, pathological, unilateral 6081 4.84a

**Impairment of Muscle Function**

Diplopia 6090 4.84a

Diplopia, due to limited muscle function 6092 4.84a

Symblepharon 6091 4.84a

Eyebrows, loss of, complete 6023 4.84a

Eyelashes, loss of, complete 6024 4.84a

Eyelids, loss of portion of 6032 4.84a

**F**

Facial muscles, injury 5325 4.73

Fallopian tube---disease, injury, or

adhesions of 7614 4.116

Fanconi's syndrome 7532 4.115b

Femur, impairment of 5255 4.71a

Fever, relapsing 6308 4.88b

Fibromyalgia 5025 4.71a

Fibrosis:

Diffuse interstitial 6825 4.97

Drug-induced 6829 4.97

Field of vision, impairment of 6080 4.84a

Field vision, examination of 4.76

**Figures:**

Goldmann perimeter chart Figure 2 4.77

Visual field, chart Figure 1 4.76

Finger, amputations (*see* Musculoskeletal System---Schedule of

Ratings---Amputations, Upper Extremity)

Fingers, individual:

Ankylosis of:

Index finger 5225 4.71a

Long finger 5226 4.71a

Ring or little finger 5227 4.71a

Thumb 5224 4.71a

Fingers, limitation of motion of individual digits:

Index or long finger 5229 4.71a

Ring or little finger 5230 4.71a

Thumb 5228 4.71a

Fingers, multiple:

Favorable Ankylosis

Five digits of one hand 5220 4.71a

Four digits of one hand 5221 4.71a

Three digits of one hand 5222 4.71a

Two digits of one hand 5223 4.71a

Unfavorable ankylosis:

Five digits of one hand 5216 4.71a

Four digits of one hand 5217 4.71a

Three digits of one hand 5218 4.71a

Two digits of one hand 5219 4.71a

Fistula:

Rectovaginal 7624 4.116

Urethrovaginal 7625 4.116

Foot:

Anatomical loss of both feet 5107 4.71a

Anatomical loss of one foot and

loss of use of one hand 5105 4.71a

**The Respiratory System**

4.96 Special provisions regarding evaluation of respiratory conditions
4.96-1

4.97 Schedule of ratings---respiratory system 4.97-1

**§4.96 Special provisions regarding evaluation of respiratory
conditions.**

\(a\) *Rating coexisting respiratory conditions*. Ratings under
diagnostic codes 6600 through 6817 and 6822 through 6847 will not be
combined with each other. Where there is lung or pleural involvement,
ratings under diagnostic codes 6819 and 6820 will not be combined with
each other or with diagnostic codes 6600 through 6817 or 6822 through
6847. A single rating will be assigned under the diagnostic code which
reflects the predominant disability with elevation to the next higher
evaluation where the severity of the overall disability warrants such
elevation. However, in cases protected by the provisions of Pub. L.
90-493, the graduated ratings of 50 and 30 percent for inactive
tuberculosis will not be elevated.

\(b\) *Rating "protected" tuberculosis cases.* Public Law 90-493
repealed section 1156 of title 38, United States Code which had provided
graduated ratings for inactive tuberculosis. The repealed section,
however, still applies to the case of any veteran who on August 19,
1968, was receiving or entitled to receive compensation for
tuberculosis. The use of the protective provisions of Pub. L. 90-493
should be mentioned in the discussion portion of all ratings in which
these provisions are applied. For application in rating cases in which
the protective provisions of Pub. L. 90-493 apply the former evaluations
pertaining to pulmonary tuberculosis are retained in §4.97.

\(c\) *Special monthly compensation*. When evaluating any claim
involving complete organic aphonia, refer to §3.350 of this chapter to
determine whether the veteran may be entitled to special monthly
compensation. Footnotes in the schedule indicate conditions which
potentially establish entitlement to special monthly compensation;
however, there are other conditions in this section which under certain
circumstances also establish entitlement to special monthly
compensation. (Authority: 38 U.S.C. 1155)

\(d\) *Special provisions for the application of evaluation criteria for
diagnostic codes 6600, 6603, 6604, 6825--6833, and 6840--6845*.

\(1\) Pulmonary function tests (PFT's) are required to evaluate these
conditions except:

(i) When the results of a maximum exercise capacity test are of record
    and are 20 ml/kg/min or less. If a maximum exercise capacity test is
    not of record, evaluate based on alternative criteria.

(ii) \(ii\) When pulmonary hypertension (documented by an echocardiogram
     or cardiac catheterization), cor pulmonale, or right ventricular
     hypertrophy has been diagnosed.

> \(iii\) When there have been one or more episodes of acute respiratory
> failure.
>
> \(iv\) When outpatient oxygen therapy is required.

\(2\) If the DLCO (SB) (Diffusion Capacity of the Lung for Carbon
Monoxide by the Single Breath Method) test is not of record, evaluate
based on alternative criteria as long as the examiner states why the
test would not be useful or valid in a particular case.

\(3\) When the PFT's are not consistent with clinical findings, evaluate
based on the PFT's unless the examiner states why they are not a valid
indication of respiratory functional impairment in a particular case.

\(4\) Post-bronchodilator studies are required when PFT's are done for
disability evaluation purposes except when the results of
pre-bronchodilator pulmonary function tests are normal or when the
examiner determines that post-bronchodilator studies should not be done
and states why.

\(5\) When evaluating based on PFT's, use post-bronchodilator results in
applying the evaluation criteria in the rating schedule unless the
post-bronchodilator results were poorer than the pre-bronchodilator
results. In those cases, use the pre-bronchodilator values for rating
purposes.

\(6\) When there is a disparity between the results of different PFT's
(FEV-1 (Forced Expiratory Volume in one second), FVC (Forced Vital
Capacity), etc.), so that the level of evaluation would differ depending
on which test result is used, use the test result that the examiner
states most accurately reflects the level of disability.

\(7\) If the FEV-1 and the FVC are both greater than 100 percent, do not
assign a compensable evaluation based on a decreased FEV-1/FVC ratio.

\[34 FR 5062, Mar. 11, 1969, as amended at 61 FR 46727, Sept. 5, 1996;
71 FR 52459, Sept. 6, 2006\]

**Supplement *Highlights* references**: 18(1), 41(1).

**The Cardiovascular System**

4.100 Application of the evaluation criteria for diagnostic codes
7000--7007,

7011, and 7015--7020 4.100-1

4.101 \[Reserved\]

4.102 \[Reserved\]

4.103 \[Reserved\]

4.104 Schedule of ratings---cardiovascular system 4.104-1

**§4.100 Application of the evaluation criteria for diagnostic codes
7000--7007, 7011,**

> **and 7015--7020.**

\(a\) Whether or not cardiac hypertrophy or dilatation (documented by
electrocardiogram, echocardiogram, or X-ray) is present and whether or
not there is a need for continuous medication must be ascertained in all
cases.

\(b\) Even if the requirement for a 10% (based on the need for
continuous medication) or 30% (based on the presence of cardiac
hypertrophy or dilatation) evaluation is met, METs testing is required
in all cases except:

> \(1\) When there is a medical contraindication.
>
> \(2\) When the left ventricular ejection fraction has been measured
> and is 50% or less.
>
> \(3\) When chronic congestive heart failure is present or there has
> been more than one episode of congestive heart failure within the past
> year.
>
> \(4\) When a 100% evaluation can be assigned on another basis.

\(c\) If left ventricular ejection fraction (LVEF) testing is not of
record, evaluate based on the alternative criteria unless the examiner
states that the LVEF test is needed in a particular case because the
available medical information does not sufficiently reflect the severity
of the veteran's cardiovascular disability.

\[71 FR 52460, Sept. 6, 2006\]

**Supplement *Highlights* reference**: 41(1)

**§4.101 \[Reserved\]**

**§4.102 \[Reserved\]**

**§4.103 \[Reserved\]**

**§4.104 Schedule of ratings---cardiovascular system.**

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

Rating

**Note 1**: Evaluate cor pulmonale, which is a form of secondary heart
disease, as part of the pulmonary condition that causes it.

**Note 2**: One MET (metabolic equivalent) is the energy cost of
standing quietly at rest and represents an oxygen uptake of 3.5
milliliters per kilogram of body weight per minute. When the level of
METs at which dyspnea, fatigue, angina, dizziness, or syncope develops
is required for evaluation, and a laboratory determination of METs by
exercise testing cannot be done for medical reasons, an estimation by a
medical examiner of the level of activity (expressed in METs and
supported by specific examples, such as slow stair climbing or shoveling
snow) that results in dyspnea, fatigue, angina, dizziness, or syncope
may be used.

**7000** Valvular heart disease (including rheumatic heart disease):

During active infection with valvular heart damage and for three

months following cessation of therapy for the active infection 100

Thereafter, with valvular heart disease (documented by findings on

physical examination and either echocardiogram, Doppler

echocardiogram, or cardiac catheterization) resulting in:

Chronic congestive heart failure, or; workload of 3 METs or less

results in dyspnea, fatigue, angina, dizziness, or syncope,

or; left ventricular dysfunction with an ejection fraction of

less than 30 percent 100

More than one episode of acute congestive heart failure in the past

year, or; workload of greater than 3 METs but not greater than

5 METs results in dyspnea, fatigue, angina, dizziness, or syncope,

or; left ventricular dysfunction with an ejection fraction of

30 to 50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electro-cardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous

medication required 10

**7001** Endocarditis:

For three months following cessation of therapy for active infection

with cardiac involvement 100

Thereafter, with endocarditis (documented by findings on physical

examination and either echocardiogram, Doppler echocardiogram,

or cardiac catheterization) resulting in:

Chronic congestive heart failure, or; workload of 3 METs or less

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of less than

30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of 30 to

50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electrocardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

continuous medication required 10

**7002** Pericarditis:

For three months following cessation of therapy for active infection

with cardiac involvement 100

Thereafter, with documented pericarditis resulting in:

Chronic congestive heart failure, or; workload of 3 METs or less

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of less

than 30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of 30 to

50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electro-cardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous

medication required 10

**7003** Pericardial adhesions:

Chronic congestive heart failure, or; workload of 3 METs or less results

in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular

dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past

year, or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or; left

ventricular dysfunction with an ejection fraction of 30 to 50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electro-cardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous

medication required 10

**7004** Syphilitic heart disease:

Chronic congestive heart failure, or; workload of 3 METs or less

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of less

than 30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of 30 to

50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electrocardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous

medication required 10

**Note**: Evaluate syphilitic aortic aneurysms under DC 7110 (aortic
aneurysm).

**7005** Arteriosclerotic heart disease (Coronary artery disease):

With documented coronary artery disease resulting in:

Chronic congestive heart failure, or; workload of 3 METs or less results

in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular

dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or; left

ventricular dysfunction with an ejection fraction of 30 to 50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electrocardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous

medication required 10

**Note**: If nonservice-connected arteriosclerotic heart disease is
superimposed on service-connected valvular or other non-arteriosclerotic
heart disease, request a medical opinion as to which condition is
causing the current signs and symptoms.

**7006** Myocardial infarction:

During and for three months following myocardial infarction,

documented by laboratory tests 100

Thereafter:

With history of documented myocardial infarction, resulting in:

Chronic congestive heart failure, or; workload of 3 METs or less

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of less

than 30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of 30 to

50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electrocardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

continuous medication required 10

**7007** Hypertensive heart disease:

Chronic congestive heart failure, or; workload of 3 METs or less

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of less

than 30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of 30 to

50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electrocardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous

medication required 10

**7008** Hyperthyroid heart disease:

Include as part of the overall evaluation for hyperthyroidism under

DC 7900. However, when atrial fibrillation is present, hyperthyroidism

may be evaluated either under DC 7900 or under DC 7010

(supraventricular arrhythmia), whichever results in a higher evaluation.

**7010** Supraventricular arrhythmias:

Paroxysmal atrial fibrillation or other supraventricular tachycardia,
with

more than four episodes per year documented by ECG or Holter

monitor 30

Permanent atrial fibrillation (lone atrial fibrillation), or; one to
four

episodes per year of paroxysmal atrial fibrillation or other

supraventricular tachycardia documented by ECG or

Holter monitor 10

**7011** Ventricular arrhythmias (sustained):

For indefinite period from date of hospital admission for initial
evaluation

and medical therapy for a sustained ventricular arrhythmia, or; for

indefinite period from date of hospital admission for ventricular

aneurysmectomy, or; with an automatic implantable Cardioverter-

Defibrillator (AICD) in place 100

Chronic congestive heart failure, or; workload of 3 METs or less results

in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular

dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or; left

ventricular dysfunction with an ejection fraction of 30 to 50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results in

dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electrocardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or;

continuous medication required 10

**Note**: A rating of 100 percent shall be assigned from the date of
hospital admission for initial evaluation and medical therapy for a
sustained ventricular arrhythmia or for ventricular aneurysmectomy. Six
months following discharge, 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.

**7015** Atrioventricular block:

Chronic congestive heart failure, or; workload of 3 METs or less results

in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular

dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of 30 to

50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electrocardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous

medication or a pacemaker required 10

**Note**: Unusual cases of arrhythmia such as atrioventricular block
associated with a supraventricular arrhythmia or pathological
bradycardia should be submitted to the Director, Compensation and
Pension Service. Simple delayed P-R conduction time, in the absence of
other evidence of cardiac disease, is not a disability.

**7016** Heart valve replacement (prosthesis):

For indefinite period following date of hospital admission for valve

replacement 100

Thereafter:

Chronic congestive heart failure, or; workload of 3 METs or less results

in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular

dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of 30 to

50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electrocardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous

medication required 10

**Note**: A rating of 100 percent shall be assigned as of the date of
hospital admission for valve replacement. Six months following
discharge, 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.

**7017** Coronary bypass surgery:

For three months following hospital admission for surgery 100

Thereafter:

Chronic congestive heart failure, or; workload of 3 METs or less results

in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular

dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or; left

ventricular dysfunction with an ejection fraction of 30 to 50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electrocardiogram,

echocardiogram, or X-ray 30

Workload greater than 7 METs but not greater than 10 METs results in

dyspnea, fatigue, angina, dizziness, or syncope, or; continuous

medication required 10

**7018** Implantable cardiac pacemakers:

For two months following hospital admission for implantation or

reimplantation 100

Thereafter:

Evaluate as supraventricular arrhythmias (DC 7010), ventricular

arrhythmias (DC 7011), or atrioventricular block (DC 7015).

Minimum 10

**Note**: Evaluate implantable Cardioverter-Defibrillators (AICD's)
under DC 7011.

**7019** Cardiac transplantation:

For an indefinite period from date of hospital admission for cardiac

transplantation 100

Thereafter:

Chronic congestive heart failure, or; workload of 3 METs or less results

in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular

dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of 30 to

50 percent 60

Minimum 30

**Note**: A rating of 100 percent shall be assigned as of the date of
hospital admission for cardiac transplantation. One year following
discharge, 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.

**7020** Cardiomyopathy:

Chronic congestive heart failure, or; workload of 3 METs or less results

in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular

dysfunction with an ejection fraction of less than 30 percent 100

More than one episode of acute congestive heart failure in the past
year,

or; workload of greater than 3 METs but not greater than 5 METs

results in dyspnea, fatigue, angina, dizziness, or syncope, or;

left ventricular dysfunction with an ejection fraction of 30 to

50 percent 60

Workload of greater than 5 METs but not greater than 7 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of

cardiac hypertrophy or dilatation on electrocardiogram,

echocardiogram, or X-ray 30

Workload of greater than 7 METs but not greater than 10 METs results

in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous

medication required 10

**[Diseases of the Arteries and Veins]{.smallcaps}**

**7101** Hypertensive vascular disease (hypertension and isolated
systolic

hypertension):

Diastolic pressure predominantly 130 or more 60

Diastolic pressure predominantly 120 or more 40

Diastolic pressure predominantly 110 or more, or; systolic pressure

predominantly 200 or more 20

Diastolic pressure predominantly 100 or more, or; systolic pressure

predominantly 160 or more, or; minimum evaluation for an

individual with a history of diastolic pressure predominantly 100

or more who requires continuous medication for control 10

**Note 1**: Hypertension or isolated systolic hypertension must be
confirmed by readings taken two or more times on at least three
different days. For purposes of this section, the term hypertension
means that the diastolic blood pressure is predominantly 90mm. or
greater, and isolated systolic hypertension means that the systolic
blood pressure is predominantly 160mm. or greater with a diastolic blood
pressure of less than 90mm.

**Note 2**: Evaluate hypertension due to aortic insufficiency or
hyperthyroidism, which is usually the isolated systolic type, as part of
the condition causing it rather than by a separate evaluation.

**Note 3**: Evaluate hypertension separately from hypertensive heart
disease and other types of heart disease.

**7110** Aortic aneurysm:

If five centimeters or larger in diameter, or; if symptomatic, or; for

indefinite period from date of hospital admission for surgical

correction (including any type of graft insertion) 100

Precluding exertion 60

Evaluate residuals of surgical correction according to organ systems
affected.

**Note**: A rating of 100 percent shall be assigned as of the date of
admission for surgical correction. Six months following discharge, 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.

**7111** Aneurysm, any large artery:

If symptomatic, or; for indefinite period from date of hospital
admission

for surgical correction 100

Following surgery:

Ischemic limb pain at rest, and; either deep ischemic ulcers or ankle/

brachial index of 0.4 or less 100

Claudication on walking less than 25 yards on a level grade at 2 miles
per

hour, and; persistent coldness of the extremity, one or more deep

ischemic ulcers, or ankle/brachial index of 0.5 or less 60

Claudication on walking between 25 and 100 yards on a level grade at

2 miles per hour, and; trophic changes (thin skin, absence of hair,

dystrophic nails) or ankle/brachial index of 0.7 or less 40

Claudication on walking more than 100 yards, and; diminished peripheral

pulses or ankle/brachial index of 0.9 or less 20

**Note 1**: The ankle/brachial index is the ratio of the systolic blood
pressure at the ankle (determined by Doppler study) divided by the
simultaneous brachial artery systolic blood pressure. The normal index
is 1.0 or greater.

**Note 2**: These evaluations are for involvement of a single extremity.
If more than one extremity is affected, evaluate each extremity
separately and combine (under §4.25), using the bilateral factor, if
applicable.

**Note 3**: A rating of 100 percent shall be assigned as of the date of
hospital admission for surgical correction. Six months following
discharge, 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.

**7112** Aneurysm, any small artery:

Asymptomatic 0

**Note**: If symptomatic, evaluate according to body system affected.
Following surgery, evaluate residuals under the body system affected.

**7113** Arteriovenous fistula, traumatic:

With high output heart failure 100

Without heart failure but with enlarged heart, wide pulse pressure,

and tachycardia 60

Without cardiac involvement but with edema, stasis dermatitis, and
either ulceration or cellulitis:

Lower extremity 50

Upper extremity 40

With edema or stasis dermatitis:

Lower extremity 30

Upper extremity 20

**7114** Arteriosclerosis obliterans:

Ischemic limb pain at rest, and; either deep ischemic ulcers or ankle/

brachial index of 0.4 or less 100

Claudication on walking less than 25 yards on a level grade at 2 miles

per hour, and; either persistent coldness of the extremity or ankle/

brachial index of 0.5 or less 60

Claudication on walking between 25 and 100 yards on a level grade at

2 miles per hour, and; trophic changes (thin skin, absence of hair,

dystrophic nails) or ankle/brachial index of 0.7 or less 40

Claudication on walking more than 100 yards, and; diminished peripheral

pulses or ankle/brachial index of 0.9 or less 20

**Note 1**: The ankle/brachial index is the ratio of the systolic blood
pressure at the ankle (determined by Doppler study) divided by the
simultaneous brachial artery systolic blood pressure. The normal index
is 1.0 or greater.

**Note 2**: Evaluate residuals of aortic and large arterial bypass
surgery or arterial graft as arteriosclerosis obliterans.

**Note 3**: These evaluations are for involvement of a single extremity.
If more than one extremity is affected, evaluate each extremity
separately and combine (under §4.25), using the bilateral factor
(§4.26), if applicable.

**7115** Thrombo-angiitis obliterans (Buerger's Disease):

Ischemic limb pain at rest, and; either deep ischemic ulcers or ankle/

brachial index of 0.4 or less 100

Claudication on walking less than 25 yards on a level grade at 2 miles

per hour, and; either persistent coldness of the extremity or ankle/

brachial index of 0.5 or less 60

Claudication on walking between 25 and 100 yards on a level grade at

2 miles per hour, and; trophic changes (thin skin, absence of hair,

dystrophic nails) or ankle/brachial index of 0.7 or less 40

Claudication on walking more than 100 yards, and; diminished peripheral

pulses or ankle/brachial index of 0.9 or less 20

**Note 1**: The ankle/brachial index is the ratio of the systolic blood
pressure at the ankle (determined by Doppler study) divided by the
simultaneous brachial artery systolic blood pressure. The normal index
is 1.0 or greater.

**Note 2**: These evaluations are for involvement of a single extremity.
If more than one extremity is affected, evaluate each extremity
separately and combine (under §4.25), using the bilateral factor
(§4.26), if applicable.

**7117** Raynaud's syndrome:

With two or more digital ulcers plus autoamputation of one or more

digits and history of characteristic attacks 100

With two or more digital ulcers and history of characteristic attacks 60

Characteristic attacks occurring at least daily 40

Characteristic attacks occurring four to six times a week 20

Characteristic attacks occurring one to three times a week 10

**Note**: For purposes of this section, characteristic attacks consist
of sequential color changes of the digits of one or more extremities
lasting minutes to hours, sometimes with pain and paresthesias, and
precipitated by exposure to cold or by emotional upsets. These
evaluations are for the disease as a whole, regardless of the number of
extremities involved or whether the nose and ears are involved.

**7118** Angioneurotic edema:

Attacks without laryngeal involvement lasting one to seven days or

longer and occurring more than eight times a year, or; attacks with

laryngeal involvement of any duration occurring more than twice

a year 40

Attacks without laryngeal involvement lasting one to seven days and

occurring five to eight times a year, or; attacks with laryngeal

involvement of any duration occurring once or twice a year 20

Attacks without laryngeal involvement lasting one to seven days and

occurring two to four times a year 10

**7119** Erythromelalgia:

Characteristic attacks that occur more than once a day, last an average

of more than two hours each, respond poorly to treatment, and that

restrict most routine daily activities 100

Characteristic attacks that occur more than once a day, last an average
of

more than two hours each, and respond poorly to treatment, but that

do not restrict most routine daily activities 60

Characteristic attacks that occur daily or more often but that respond
to

treatment 30

Characteristic attacks that occur less than daily but at least three
times

a week and that respond to treatment 10

**Note**: For purposes of this section, a characteristic attack of
erythromelalgia consists of burning pain in the hands, feet, or both,
usually bilateral and symmetrical, with increased skin temperature and
redness, occurring at warm ambient temperatures. These evaluations are
for the disease as a whole, regardless of the number of extremities
involved.

**7120** Varicose veins:

With the following findings attributed to the effects of varicose veins:

Massive board-like edema with constant pain at rest 100

Persistent edema or subcutaneous induration, stasis pigmentation or

eczema, and persistent ulceration 60

Persistent edema and stasis pigmentation or eczema, with or without

intermittent ulceration 40

Persistent edema, incompletely relieved by elevation of extremity,

with or without beginning stasis pigmentation or eczema 20

Intermittent edema of extremity or aching and fatigue in leg after

prolonged standing or walking, with symptoms relieved by elevation of

extremity or compression hosiery 10

Asymptomatic palpable or visible varicose veins 0

**Note**: These evaluations are for involvement of a single extremity.
If more than one extremity is involved, evaluate each extremity
separately and combine (under §4.25), using the bilateral factor
(§4.26), if applicable.

**7121** Post-phlebitic syndrome of any etiology:

With the following findings attributed to venous disease:

Massive board-like edema with constant pain at rest 100

Persistent edema or subcutaneous induration, stasis pigmentation or

eczema, and persistent ulceration 60

Persistent edema and stasis pigmentation or eczema, with or without

intermittent ulceration 40

Persistent edema, incompletely relieved by elevation of extremity,

with or without beginning stasis pigmentation or eczema 20

Intermittent edema of extremity or aching and fatigue in leg after
prolonged standing or walking, with symptoms relieved by

elevation of extremity or compression hosiery 10

Asymptomatic palpable or visible varicose veins 0

**Note**: These evaluations are for involvement of a single extremity.
If more than one extremity is involved, evaluate each extremity
separately and combine (under §4.25), using the bilateral factor
(§4.26), if applicable.

**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)

\[29 FR 6718, May 22, 1964, as amended at 40 FR 42539, Sept. 15, 1975;
41 FR 11300, Mar. 18, 1976; 43 FR 45361, Oct. 2, 1978; 56 FR 51653, Oct.
15, 1991; 62 FR 65219, Dec. 11, 1997; 63 FR 37779, July 14, 1998; 71 FR
52460, Sept. 6, 2006\]

**Supplement *Highlights* references**: 22(1), 24(1), 41(1).

*Next Section is §4.110*

Reserved