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. 38

Covering period of *Federal Register* issues

through December 19, 2005

Copyright © 2004 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. 38**

December 24, 2004

Covering the period of Federal Register issues

through December 19, 2005

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. 38**

**December 24, 2004**

*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**

None C-8a to C-8b\* Supp. Filing Record

> \****Note***: Please insert this new sheet between pages C-8 and C-9.
> You will need to use the first line on new page C-8a to verify filing
> this Supplement No. 38.

**4.114-9 to 4.114-10 4.114-9 to 4.114-10 §4.114**

**Be sure to complete the**

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

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

> **HIGHLIGHTS**

**Book C, Supplement No. 38**

**December 24, 2004**

***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\. A technical correction was made to the citation for §4.114, revising
the entry for June 22, 2004.

2\. Additional pages for the *Supplement Filing Record* are being
provided.

\-

Supplement Date Name of Through

# Number Filed Person Filing Fed. Reg.dated

38

39

40

41

42

43

44

45

46

47

48

49

50

51

52

53

54

55

56

57

58

Supplement Date Name of Through

# Number Filed Person Filing Fed. Reg.dated

59

60

61

62

63

64

65

66

67

68

69

70

71

72

73

74

75

76

77

78

79

80

regurgitation, accompanied by substernal or arm or shoulder pain,

productive of considerable impairment of health 30

With two or more of the symptoms for the 30 percent evaluation of

less severity 10

**7347** Pancreatitis:

With frequently recurrent disabling attacks of abdominal pain with few

pain free intermissions and with steatorrhea, malabsorption, diarrhea

and severe malnutrition 100

With frequent attacks of abdominal pain, loss of normal body weight

and other findings showing continuing pancreatic insufficiency

between acute attacks 60

Moderately severe; with at least 4-7 typical attacks of abdominal pain

per year with good remission between attacks 30

With at least one recurring attack of typical severe abdominal pain

in the past year 10

**Note 1**: Abdominal pain in this condition must be confirmed as
resulting from pancreatitis by appropriate laboratory and clinical
studies.

**Note 2**: Following total or partial pancreatectomy, rate under above,
symptoms, minimum rating 30 percent.

**7348** Vagotomy with pyloroplasty or gastroenterostomy:

Followed by demonstrably confirmative postoperative complications

of stricture or continuing gastric retention 40

With symptoms and confirmed diagnosis of alkaline gastritis, or of

confirmed persisting diarrhea 30

Recurrent ulcer with incomplete vagotomy 20

**Note**: Rate recurrent ulcer following complete vagotomy under
diagnostic code 7305, minimum rating 20 percent; and rate dumping
syndrome under diagnostic code 7308.

**7351** Liver transplant:

For an indefinite period from the date of hospital admission for

transplant surgery 100

Minimum 30

**Note**: A rating of 100 percent shall be assigned as of the date of
hospital admission for transplant surgery and shall continue. 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.

**7354** Hepatitis C (or non-A, non-B hepatitis):

With serologic evidence of hepatitis C infection and the following

signs and symptoms due to hepatitis C infection:

Near-constant debilitating symptoms (such as fatigue, malaise,

nausea, vomiting, anorexia, arthralgia, and right upper quadrant

pain) 100

Daily fatigue, malaise, and anorexia, with substantial weight loss (or

other indication of malnutrition), and hepatomegaly, or;

incapacitating episodes (with symptoms such as fatigue,

malaise, nausea, vomiting, anorexia, arthralgia, and right upper

quadrant pain) having a total duration of at least six weeks

during the past 12-month period, but not occurring constantly 60

Daily fatigue, malaise, and anorexia, with minor weight loss and

hepatomegaly, or; incapacitating episodes (with symptoms such as

fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right

upper quadrant pain) having a total duration of at least four weeks,

but less than six weeks, during the past 12-month period 40

Daily fatigue, malaise, and anorexia (without weight loss or

hepatomegaly), requiring dietary restriction or continuous

medication, or; incapacitating episodes (with symptoms such as

fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right

upper quadrant pain) having a total duration of at least two weeks,

but less than four weeks, during the past 12-month period 20

Intermittent fatigue, malaise, and anorexia, or; incapacitating episodes

(with symptoms such as fatigue, malaise, nausea, vomiting, anorexia,

arthralgia, and right upper quadrant pain) having a total duration of

at least one week, but less than two weeks, during the past

12-month period 10

Nonsymptomatic\...\...\...\...\...\...\...\...\...\...\...\...\...\... 0

**Note (1)**: Evaluate sequelae, such as cirrhosis or malignancy of the
liver, under an appropriate diagnostic code, but do not use the same
signs and symptoms as the basis for evaluation under DC 7354 and under a
diagnostic code for sequelae. (See §4.14.).

**Note (2)**: For purposes of evaluating conditions under diagnostic
code 7354, "incapacitating episode" means a period of acute signs and
symptoms severe enough to require bed rest and treatment by a physician.

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

\[29 FR 6718, May 22, 1964, as amended at 34 FR 5063, Mar. 11, 1969; 40
FR 42540, Sept. 15, 1975; 41 FR 11301, Mar. 18, 1976; 66 FR 29488, May
31, 2001; 69 FR 34585, June 22, 2004\]