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. 30

Covering period of *Federal Register* issues

through August 18, 2002

Copyright © 2002 Jonathan Publishing

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Copyright © 2002 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. 30**

25 August 2002

Covering the period of Federal Register issues

through August 18, 2002

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. 30**

**August 25, 2002**

*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**

[Index]{.smallcaps}-1 to [Index]{.smallcaps}-64 [Index]{.smallcaps}-1 to
[Index]{.smallcaps}-64 Index to Book C

**4.68-1 to 4.71-1 4.68-1 to 4.71-1 §4.71**

**4.71a-5 to 4.71a-8 4.71a-5 to 4.71a-8 §4.71a**

**4.71a-13 to 4.71a-28 4.71a-13 to 4.71a-28 §4.71a**

4.118-1 to 4.118-4 4.118-1 to 4.118-10 §4.118

**Be sure to complete the**

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

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

> **HIGHLIGHTS**

**Book C, Supplement No. 30**

**August 25, 2002**

***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 26 July 2002, the VA published a final rule, effective 26 August
2002, to amend the Schedule for Rating Disabilities by revising the
evaluation criteria for ankylosis and limitation of motion of the
fingers and thumb in order to assure that veterans diagnosed with these
conditions receive consistent evaluations. Changes:

• In §4.71, revised the last sentence;

• In §4.71a, in tables *Multiple Finger Amputations* and *Single Finger
Amputations*, replaced *middle* with *long*; and

• In §4.71a, removed tables *Multiple Fingers: Unfavorable Ankylosis*,
*Multiple Fingers: Favorable Ankylosis*, and *Ankylosis of Individual
Fingers*, and replaced them with a new table *Evaluation of Ankylosis or
Limitation of Motion of Single or Multiple Digits of the Hand*.

2\. On 31 July 2002, the VA published a final rule, effective 30 August
2002, to amend the Schedule for Rating Disabilities in order to update
the portion of the rating schedule that deals with skin to ensure that
it uses current medical terminology and unambiguous criteria, and that
it reflects medical advances that have occurred since the last review.
Changes:

• Revised §4.118.

**Index 2 --- Alphabetical**

***Note***: This index is not part of the *Code of Federal Regulations*.

It was created, and is maintained, by Jonathan Publishing

specifically for this looseleaf service.

**Note to users of this index** --- We want to continually improve this
index as a

search tool in any way that will be useful to you. If you have
suggestions for

additional cross-references, multiple entries, special groupings of
terms, or

any other change, simply fax your ideas to Jonathan Publishing at:

512/328-5365

*Diagnostic Code*

*Term (where applicable) Section*

**A**

Abdominal conditions, coexisting 4.113

Abscess:

Kidney 7501 4.115b

Lung, chronic 6824 4.97

Accommodation, paralysis of (eye) 6030 4.84a

Acne 7828 4.118

Acromegaly 7908 4.119

Actinomycosis 6822 4.97

Addison's disease (adrenal cortical

hypofunction) 7911 4.119

Adenitis, tuberculous, active or inactive 7710 4.117

Adhesions, pericardial 7003 4.104

Adjustment disorder, chronic (*see* Mental Disorders---Schedule of
Ratings)

Adrenal cortical hypofunction 7911 4.119

Age in service-connected claims 4.19

Agoraphobia 9412 4.130

Agranulocytosis, acute 7702 4.117

Alopecia:

Areata 7831 4.118

Scarring 7830 4.118

Alzheimer's type dementia 9312 4.130

Amebiasis 7321 4.114

Aminoacidurias 7532 4.115b

Amnestic disorders (*see* Mental Disorders---Schedule of Ratings)

Amputation, generally (*see* specific item)

Amputations: Upper Extremity (*see* Musculoskeletal System---Schedule

of Ratings---Amputations, Upper Extremity and Lower Extremity)

Amyotrophic lateral sclerosis 8017 4.124a

Analogous ratings 4.20

Anemia, hypochromic-microcytic and

megaloblastic 7700 4.117

Aneurysm, aortic 7110 4.104

Angioneurotic edema 7118 4.104

Anorexia nervosa 9520 4.130

Ankle:

Ankylosis of 5270 4.71a

Astragalectomy 5274 4.71a

Limited motion of 5271 4.71a

Os calcis or astragalus, malunion of 5273 4.71a

Replacement (prosthesis) 5056 4.71a

Subastragalar or tarsal joint, ankylosis of 5272 4.71a

Ankylosis and joint motion, measurement Plates I--II 4.71

Ano, fistula in 7335 4.114

Anxiety disorders (*see* Mental Disorders---Schedule of Ratings)

Aphakia 6029 4.84a

Aphonia, complete organic 6519 4.97

Aplastic anemia 7716 4.117

Application of rating schedule 4.21

Arm, amputation of:

Above insertion of deltoid 5121 4.71a

Below insertion of deltoid 5122 4.71a

Disarticulation 5120 4.71a

Limitation of motion of 5201 4.71a

Arrhythmias:

Supraventricular 7010 4.104

Ventricular (sustained) 7011 4.104

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

Arteriosclerosis:

Cerebral 8046 4.124a

Obliterans 7114 4.104

Arteriosclerotic heart disease 7005 4.104

Arteriovenous fistula, traumatic 7113 4.104

Artery:

Large, any, aneurysm of 7111 4.104

Small, any, aneurysm of 7112 4.104

Arthritis

Degenerative 5003 4.71a

Gonorrheal 5004 4.71a

Other types 5009 4.71a

Pneumococcic 5005 4.71a

Rheumatoid (atrophic) 5002 4.71a

Streptococcic 5008 4.71a

Syphilitic 5007 4.71a

Trauma, due to 5010 4.71a

Typhoid 5006 4.71a

Asbestosis 6833 4.97

Aspergillosis 6838 4.97

Asthma, bronchial 6602 4.97

Atherosclerotic renal disease 7534 4.115b

Athetosis, acquired 8107 4.124a

Attitude of rating officers 4.23

Auditory acuity, impairment of (*see also* Ear, Hearing):

Evaluation of hearing impairment 4.85

Hearing impairment, evaluation of 4.85

Auricle, loss of 6207 4.87

Atrioventricular block 7015 4.104

Avitaminosis 6313 4.88b

Avoidance of pyramiding 4.14

**B**

Bacillary dysentery 7322 4.114

Bartonellosis 6306 4.88b

Bartter's syndrome 7532 4.115b

Beriberi 6314 4.88b

Bilateral factor 4.26

Bipolar disorder 9432 4.130

Bladder:

Calculus in 7513 4.115b

Fistula of 7516 4.115b

Injury of 7517 4.115b

Neurogenic 7542 4.115b

Blastomycosis 6836 4.97

Blindness (*see* Visual acuity)

Bones:

Caisson disease of, 5011 4.71a

New growths of, benign 5015 4.71a

New growths of, malignant 5012 4.71a

Bones and joints, tuberculosis of,

active or inactive 5001 4.71a

Bones of the foot Plate IV 4.71

Bones of the hand Plate III 4.71

Brain:

Abscess of 8020 4.124a

Disease due to trauma 8045 4.124a

New growth of:

Benign 8003 4.124a

Malignant 8002 4.124a

Vessels:

Embolism of 8007 4.124a

Hemorrhage from 8009 4.124a

Thrombosis of 8008 4.124a

Breast:

Surgery of 7626 4.116

Neoplasms of:

Benign 7628 4.116

Malignant 7627 4.116

Bronchi and trachea, diseases of:

Asthma, bronchial 6602 4.97

Bronchiectasis 6601 4.97

Bronchitis, chronic 6600 4.97

Chronic obstructive pulmonary disease 6604 4.97

Emphysema, pulmonary 6603 4.97

Obstructive pulmonary disease, chronic 6604 4.97

Pulmonary disease, obstructive, chronic 6604 4.97

Bronchiectasis 6601 4.97

Bronchitis, chronic 6600 4.97

Brucellosis 6316 4.88b

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---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

Cartilage:

Semilunar, dislocated 5258 4.71a

Semilunar, removal of 5259 4.71a

Cataract:

Senile, and others 6028 4.84a

Traumatic 6027 4.84a

Cerebral arteriosclerosis 8046 4.124a

Cervix, disease of injury of 7612 4.116

Change of diagnosis, effect 4.13

Chest wall defect, traumatic 6843 4.97

Chloracne 7829 4.118

Cholangitis, chronic 7316 4.114

Cholecystitis, chronic 7314 4.114

Cholera, Asiatic 6300 4.88b

Chorea:

Huntington's 8106 4.124a

Sydenham's 8105 4.124a

Choroiditis 6005 4.84a

Chronic adjustment disorder (*see* Mental Disorders---Schedule of
Ratings)

Chronic fatigue syndrome 4.88a

Chronic fatigue syndrome 6354 4.88b

Cirrhosis of liver 7312 4.114

Clavicle or scapula, impairment of 5203 4.71a

Coccidioidomycosis 6835 4.97

Coccyx, removal of 5298 4.71a

Code numbers, diagnostic, use of 4.27

Cognitive disorders (*see* Mental Disorders---Schedule of Ratings)

Cold injury residuals 7122 4.104

Colitis:

Mucous 7319 4.114

Spastic 7319 4.114

Ulcerative 7323 4.114

Combined ratings table Table I 4.25

Condyloid process, loss of, one or both sides 9908 4.150

Congenital or developmental defects 4.9

Conjunctivitis:

Other, chronic 6018 4.84a

Trachomatous, chronic 6017 4.84a

Convalescent ratings 4.30

Convalescence ratings following extended hospitalization 4.128

Conversion disorder 9424 4.130

Convulsive disorders (*see* Neurological Conditions and Convulsive
Disorders)

Coronary artery:

Bypass 7017 4.104

Disease 7005 4.104

Coronoid process, loss of 9909 4.150

Correspondence 4.24

Cranial Nerves, diseases of (*see* Neurological System and Convulsive
Disorders--- Schedule of Ratings)

Cryptococcosis 6837 4.97

Cushing's syndrome 7906 4.119

Cutaneous manifestations of collagen-vascular

disease (not listed elsewhere) 7821 4.118

Cyclitis 6004 4.84a

Cyclothymic disorder 9431 4.130

Cystic diseases of the kidney 7533 4.115b

Cystitis, chronic 7512 4.115b

**D**

Dacryocystitis 6031 4.84a

Degenerative arthritis 5003 4.71a

Delirium (*see* Mental Disorders---Schedule of Ratings)

Dermatitis, exfoliative 7817 4.118

Dermatitis or eczema 7806 4.118

Dementia (*see* Mental Disorders---Schedule of Ratings)

**[Dental and oral conditions---schedule of ratings:]{.smallcaps}**

Condyloid process, loss of, one or both sides 9908 4.150

Coronoid process, loss of 9909 4.150

Hard palate, loss of half or more 9911 4.150

Hard palate, loss of less than half of 9912 4.150

Mandible, loss of approximately one-half 9902 4.150

Mandible, loss of, complete, between angles 9901 4.150

Mandible, malunion of 9904 4.150

Mandible, nonunion of 9903 4.150

Maxilla or mandible, chronic osteomyelitis or

osteoradionecrosis of 9900 4.150

Maxilla, loss of half or less 9915 4.150

Maxilla, loss of more than half 9914 4.150

Maxilla, malunion or nonunion of 9916 4.150

Ramus, loss of less than one-half the substance

of, not involving loss of continuity 9907 4.150

Ramus, loss of whole or part of 9906 4.150

Teeth, loss of, due to loss of substance of body

of maxilla or mandible without loss of

continuity 9913 4.150

Temporomandibular articulation, limited

motion of 9905 4.150

Depersonalization disorder 9417 4.130

Depressive disorder, major 9434 4.130

Dermatophytosis 7813 4.118

Desquamative interstitial pneumonitis 6826 4.97

Developmental or congenital defects 4.9

Diabetes:

Insipidus 7909 4.119

Mellitus 7913 4.119

Diagnosis, change of, effect 4.13

Diagnostic code numbers, use of 4.27

Diaphragm:

Paralysis or paresis 6840 4.97

Rupture of, with herniation 5324 4.73

Diffuse interstitial fibrosis 6825 4.97

Digestive system:

Abdominal conditions, coexisting 4.113

Postgastrectomy syndromes 4.111

Ulcers 4.110

Weight loss 4.112

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

Amebiasis 7321 4.114

Ano, fistula in 7335 4.114

Benign neoplasms of the digestive system 7344 4.114

Cholangitis, chronic 7316 4.114

Cholecystitis, chronic 7314 4.114

Cholelithiasis, chronic 7315 4.114

Colitis, ulcerative 7323 4.114

Distomiasis, intestinal or hepatic 7324 4.114

Diverticulitis 7327 4.114

Dysentery, bacillary 7322 4.114

Enteritis, chronic 7325 4.114

Enterocolitis, chronic 7326 4.114

Esophagus, diverticulum of, acquired 7205 4.114

Esophagus, spasm of (cardiospasm) 7204 4.114

Esophagus, stricture of 7203 4.114

Gall bladder, injury of 7317 4.114

Gall bladder, removal of 7318 4.114

Gastritis, hypertrophic 7307 4.114

Hemochromatosis 7345 4.114

Hemorrhoids, external or internal 7336 4.114

Hepatitis (B & C) 7345, 7354 4.114

Hernia hiatal 7346 4.114

Hernia, femoral 7340 4.114

Hernia, inguinal 7338 4.114

Hernia, ventral, postoperative 7339 4.114

Intestine, fistula of, persistent 7330 4.114

Intestine, large, resection of 7329 4.114

Intestine, small, resection of 7328 4.114

Irritable colon syndrome (spastic colitis,

mucous colitis, etc.) 7319 4.114

Lips, injuries of 7201 4.114

Liver, cirrhosis of 7312 4.114

Liver, injury of 7311 4.114

Liver, transplant 7351 4.114

Malignant neoplasms of the digestive system 7343 4.114

Mouth, injuries of 7200 4.114

Pancreatitis 7347 4.114

Peritoneum, adhesions of 7301 4.114

Peritonitis, tuberculous, active or inactive 7331 4.114

Postgastrectomy syndromes 7308 4.114

Pruritus ani 7337 4.114

Rectum and anus, impairment of sphincter

control 7332 4.114

Rectum, prolapse of 7334 4.114

Rectum and anus, stricture of 7333 4.114

Stomach, injury of 7310 4.114

Stomach, stenosis of 7309 4.114

Tongue, loss of whole or part 7202 4.114

Ulcer, duodenal 7305 4.114

Ulcer, gastric 7304 4.114

Ulcer, marginal 7306 4.114

Vagotomy with pyloroplasty or

gastroenterostomy 7348 4.114

Visceroptosis, symptomatic, marked 7342 4.114

Digits (see Fingers)

Diplopia 6090 4.84a

Diplopia, due to limited muscle function 6092 4.84a

Disabilities:

Aggravated by active service, rating of 4.22

Service-connected, requiring hospital

treatment or observation, ratings for 4.29

Disability:

Ratings, total 4.15

Ratings, total, for compensation based

on unemployability of the individual 4.16

Rating, total, for pension based on

unemployability and age of the individual 4.17

Disfigurement of the head, fact, or neck 7800 4.118

Disseminated intravascular coagulation with

renal cortical necrosis 7540 4.115b

Dissociative disorders (*see* Mental Disorders---Schedule of Ratings)

Distomiasis, intestinal or hepatic 7324 4.114

Diverticulitis 7327 4.114

Drug-induced pulmonary pneumonitis

and fibrosis 6829 4.97

Dysentery, bacillary 7322 4.114

Dysthymic disorder 9433 4.130

**E**

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

Auricle, loss of 6207 4.87

Benign neoplasms of the ear 6209 4.87

Cholesteatoma 6200 4.87

Chronic nonsuppurative otitis media 6201 4.87

Chronic otitis externa 6210 4.87

Chronic suppurative otitis media 6200 4.87

Endolymphatic hydrops 6205 4.87

Malignant neoplasm of the ear 6208 4.87

Mastoiditis 6200 4.87

Meniere's syndrome 6205 4.87

Otosclerosis 6202 4.87

Peripheral vestibular disorders 6204 4.87

Tinnitus, recurrent 6260 4.87

Tympanic membrane, perforation of 6211 4.87

Eating disorders (*see* Mental Disorders---Schedule of Ratings)

Ectropion 6020 4.84a

Effect of change of diagnosis 4.13

Elbow and Forearm:

Elbow, ankylosis of 5205 4.71a

Elbow, other impairment of Flail joint 5209 4.71a

Forearm, flexion limited to 100º

and extension to 45º 5208 4.71a

Forearm, limitation of extension of 5207 4.71a

Forearm, limitation of flexion of 5206 4.71a

Radius and ulna, nonunion of 5210 4.71a

Radius, impairment of 5212 4.71a

Supination and pronation, impairment of 5213 4.71a

Ulna, impairment of 5211 4.71a

Elbow:

Ankylosis of 5205 4.71a

Other impairment of Flail joint 5209 4.71a

Replacement (prosthesis) 5052 4.71a

Emphysema, pulmonary 6603 4.97

Encephalitis, epidemic, chronic 8000 4.124a

Endocarditis 7001 4.104

**[Endocrine system---Schedule of Ratings]{.smallcaps}**

Acromegaly 7908 4.119

Addison's disease (adrenal cortical

hypofunction) 7911 4.119

C-cell hyperplasia of the thyroid 7919 4.119

Cushing's syndrome 7906 4.119

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 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

Anatomical loss of one hand and

loss of use of one foot 5104 4.71a

Anatomical loss of one hand and one foot 5108 4.71a

Bones of the Plate IV 4.71

Claw foot (pes cavus), acquired 5278 4.71a

Flatfoot, acquired 5276 4.71a

Hallux rigidus, unilateral, severe 5281 4.71a

Hallux valgus, unilateral 5280 4.71a

Hammer toe 5282 4.71a

Injuries, other 5284 4.71a

Loss of use of both feet 5110 4.71a

Loss of use of one hand and one foot 5111 4.71a

Metatarsalgia, anterior (Morton's disease) 5279 4.71a

Tarsal, or metatarsal bones, malunion of 5283 4.71a

Tarsal, or metatarsal bones, nonunion of 5283 4.71a

Weak foot, bilateral 5277 4.71a

Foot and Leg---muscle injuries:

Group X 5310 4.73

Group XI 5311 4.73

Group XII 5312 4.73

Forearm:

Amputation of:

Above insertion of pronator teres 5123 4.71a

Below insertion of pronator teres 5124 4.71a

Hand, loss of use of 5125 4.71a

Flexion limited to 100º and extension to 45º 5208 4.71a

Limitation of extension of 5207 4.71a

Limitation of flexion of 5206 4.71a

Forearm and elbow (*see* Elbow and forearm)

Forearm and Hand---Muscle injuries:

Group VII 5307 4.73

Group VIII 5308 4.73

Group IX 5309 4.73

Functional impairment 4.10

**G**

Gall bladder:

Injury of 7317 4.114

Removal of 7318 4.114

Gastritis, hypertrophic 7307 4.114

Genitourinary system:

Neoplasms:

Benign 7529 4.115b

Nephritis:

General 4.115

Chronic 7502 4.115b

**[Genitourinary system: diagnoses---Schedule of Ratings]{.smallcaps}**

Atherosclerotic renal disease 7534 4.115b

Benign neoplasms of the genitourinary system 7529 4.115b

Bladder, calculus in 7513 4.115b

Bladder, fistula of 7516 4.115b

Bladder, injury of 7517 4.115b

Chronic renal disease requiring regular

dialysis 7530 4.115b

Cystic diseases of the kidney 7533 4.115b

Cystitis, chronic 7512 4.115b

Disseminated intravascular coagulation with

renal cortical necrosis 7540 4.115b

Epididymo-orchitis, chronic only 7525 4.115b

Glomerulonephritis 7536 4.115b

Hydronephrosis 7509 4.115b

Interstitial nephritis 7537 4.115b

Kidney transplant 7531 4.115b

Kidney, abscess of 7501 4.115b

Kidney, removal of one 7500 4.115b

Kidney, tuberculosis of 7505 4.115b

Malignant neoplasm of the genitourinary

system 7528 4.115b

Nephritis, chronic 7502 4.115b

Nephrolithiasis 7508 4.115b

Nephrosclerosis, arteriolar 7507 4.115b

Neurogenic bladder 7542 4.115b

Papillary necrosis 7538 4.115b

Penis, deformity, with loss of erectile power 7522 4.115b

Penis, removal of glans 7521 4.115b

Penis, removal of half or more 7520 4.115b

Prostate gland injuries, infections, hypertrophy,

post-operative residuals 7527 4.115b

Pyelonephritis, chronic 7504 4.115b

Renal amyloid disease 7539 4.115b

Renal involvement in diabetes mellitus, sickle

cell anemia, systemic lupus erythematosus,

vasculitis, or other systemic disease

processes 7541 4.115b

Renal tubular disorders 7532 4.115b

Testis, atrophy complete 7523 4.115b

Testis, removal 7524 4.115b

Toxic nephropathy 7535 4.115b

Ureter, stricture of 7511 4.115b

Ureterolithiasis 7510 4.115b

Urethra, fistula of 7519 4.115b

Urethra, stricture of 7518 4.115b

**[Genitourinary system: dysfunctions---Schedule of
Ratings]{.smallcaps}**

Obstructed voiding 4.115a

Renal dysfunction 4.115a

Urinary frequency 4.115a

Urinary tract infection 4.115a

Voiding dysfunction 4.115a

Genu recurvatum 5263 4.71a

Glaucoma:

Congestive or inflammatory 6012 4.84a

Simple, primary, noncongestive 6013 4.84a

Glomerulonephritis 7536 4.115b

Goldmann perimeter chart Figure 2 4.77

Gonorrheal arthritis 5004 4.71a

Gout 5017 4.71a

**[Gynecological conditions and disorders of the
breast---]{.smallcaps}**

**[schedule of ratings]{.smallcaps}**

Benign neoplasms of the gynecological

system or breast 7628 4.116

Breast, surgery of 7626 4.116

Cervix, disease of injury of 7612 4.116

Endometriosis 7629 4.116

Fallopian tube---disease, injury, or

adhesions of 7614 4.116

Fistula, rectovaginal 7624 4.116

Fistula, urethrovaginal 7625 4.116

Malignant neoplasms of gynecological system

or breast 7627 4.116

Ovaries, atrophy of both, complete 7620 4.116

Ovary, disease, injury, or adhesions of 7615 4.116

Ovary, removal of 7619 4.116

Pregnancy, surgical complications of 7623 4.116

Uterus and both ovaries, removal of, complete 7617 4.116

Uterus, disease, injury, or adhesions of 7613 4.116 Uterus, displacement
of 7622 4.116

Uterus, prolapse 7621 4.116

Uterus, removal of, including corpus 7618 4.116

Vagina, disease or injury of 7611 4.116

Vulva, disease or injury of 7610 4.116

Gynecological system:

Neoplasms:

Benign neoplasms of 7628 4.116

Malignant 7627 4.116

**H**

Hand:

Anatomical loss of both hands 5106 4.71a

Anatomical loss of one foot and

loss of use of one hand 5105 4.71a

Anatomical loss of one hand and

loss of use of one foot 5104 4.71a

Anatomical loss of one hand and one foot 5108 4.71a

Bones of the Plate III 4.71

Loss of use of both hands 5109 4.71a

Loss of use of one hand and one foot 5111 4.71a

Hand and Forearm (*see* Forearm and Hand)

Hansen's Disease (leprosy) 6302 4.88b

Hard palate:

Loss of half or more 9911 4.150

Loss of less than half of 9912 4.150

Hearing (*see also* Ear, Auditory Acuity):

Impairment:

Evaluation of 4.85

Exceptional patterns of 4.86

Numeric designation of Tables VI, VIA 4.85

Percentage evaluation for Table VII 4.85

Loss combined with bilateral blindness Table IV 4.84a

Heart, diseases of (see also Cardiovascular system):

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

Heart valve replacement (prosthesis) 7016 4.104

Hematomyelia 8012 4.124a

**[Hemic and Lymphatic systems---schedule of ratings]{.smallcaps}**

Adenitis, tuberculous, active or inactive 7710 4.117

Agranulocytosis, acute 7702 4.117

Anemia, hypochromic-microcytic and

megaloblastic 7700 4.117

Aplastic anemia 7716 4.117

Hodgkin's disease 7709 4.117

Leukemia 7703 4.117

Non-Hodgkin's lymphoma 7715 4.117

Polycythemia vera 7704 4.117

Sickle cell anemia 7714 4.117

Spleen, injury of, healed 7707 4.117

Splenectomy 7706 4.117

Thrombocytopenia, primary, idiopathic

or immune 7705 4.117

Hemochromatosis 7345 4.114

Hemorrhage, intra-ocular, recent 6007 4.84a

Hemorrhoids, external or internal 7336 4.114

Henle's loop, disorders 7532 4.115b

Hepatic distomiasis 7324 4.114

Hepatitis (B and C) 7345, 7354 4.114

Hernia:

Femoral 7340 4.114

Hiatal 7346 4.114

Inguinal 7338 4.114

Muscle, extensive 5326 4.73

Ventral, postoperative 7339 4.114

Hiatal hernia 7346 4.114

Higher of two evaluations 4.7

Hip:

Ankylosis of 5250 4.71a

Flail joint 5254 4.71a

Replacement (prosthesis) 5054 4.71a

Histoplasmosis of lung 6834 4.97

HIV-related illness 6351 4.88b

Hodgkin's disease 7709 4.117

Humerus, other impairment of 5202 4.71a

Hydrarthrosis, intermittent 5018 4.71a

Hydronephrosis 7509 4.115b

Hyperaldosteronism (benign or malignant) 7917 4.119

Hyperhidrosis 7832 4.118

Hyperparathyroidism 7904 4.119

Hyperpituitarism (prolactin secreting

pituitary dysfunction) 7916 4.119

Hypersensitivity pneumonitis (extrinsic

allergic alveolitis) 6831 4.97

Hypertensive heart disease 7007 4.104

Hypertensive vascular disease 7101 4.104

Hyperthyroid heart disease 7008 4.104

Hyperthyroidism 7900 4.119

Hypertrophic gastritis 7307 4.114

Hypochondriasis 9425 4.130

Hypoparathyroidism 7905 4.119

Hypothyroidism 7903 4.119

**I**

Immune disorders (*see* Infectious Diseases, Immune Disorders,

and Nutritional Deficiencies)

Impairment, functional 4.10

Infections of the skin (not listed elsewhere) 7820 4.118

**[Infectious diseases, immune disorders, and]{.smallcaps}**

**[nutritional deficiencies--- schedule of ratings]{.smallcaps}**

Avitaminosis 6313 4.88b

Bartonellosis 6306 4.88b

Beriberi 6314 4.88b

Brucellosis 6316 4.88b

Cholera, Asiatic 6300 4.88b

Chronic fatigue syndrome 6354 4.88b

Hansen's Disease (leprosy) 6302 4.88b

HIV-related illness 6351 4.88b

Leprosy (Hansen's Disease) 6302 4.88b

Lupus erythematosus, systemic 6350 4.88b

Lyme disease 6319 4.88b

Lymphatic filariasis 6305 4.88b

Malaria 6304 4.88b

Melioidosis 6318 4.88b

Parasitic diseases otherwise not specified 6320 4.88b

Pellagra 6315 4.88b

Plague 6307 4.88b

Relapsing fever 6308 4.88b

Rheumatic fever 6309 4.88b

Syphilis, and other treponemal infections 6310 4.88b

Tuberculosis:

Miliary 6311 4.88b

Nonpulmonary, inactive 4.88c, 4.89

Typhus, scrub 6317 4.88b

Visceral leishmaniasis 6301 4.88b

Interpretation of examination reports 4.2

Interstitial nephritis 7537 4.115b

Intestinal distomiasis 7324 4.114

Intestine:

Fistula of, persistent 7330 4.114

Large, resection of 7329 4.114

Small, resection of 7328 4.114

Intra-ocular hemorrhage, recent 6007 4.84a

Intravascular coagulation (disseminated) with

renal cortical necrosis 7540 4.115b

Iritis 6003 4.84a

Iron deficiency anemia 7700 4.117

Irritable colon syndrome (spastic colitis,

mucous colitis, etc.) 7319 4.114

**J**

No entries

**K**

Keratinization, diseases of 7824 4.118

Keratitis 6001 4.84a

Keratoconus 6035 4.84a

Kidney:

Abscess of 7501 4.115b

Cystic diseases of 7533 4.115b

Medullary sponge kidney 7533 4.115b

Polycystic disease 7533 4.115b

Removal of one 7500 4.115b

Transplant 7531 4.115b

Tuberculosis of 7505 4.115b

Uremic medullary cystic disease 7533 4.115b

Knee:

Ankylosis of 5256 4.71a

Other impairment of 5257 4.71a

Replacement (prosthesis) 5055 4.71a

Kyphoscoliosis, pectus excavatum, pectus

carinatum 6842 4.97

**L**

Lagophthalmos 6022 4.84a

Laryngectomy, total 6518 4.97

Laryngitis:

Chronic 6516 4.97

Tuberculous, active or inactive 6515 4.97

Larynx, stenosis of, including residuals 6520 4.97

Leg:

Amputation of:

Amputation not improvable by prosthesis

controlled by natural knee action 5164 4.71a

At a lower level, permitting prosthesis 5165 4.71a

Foot, loss of use of 5167 4.71a

Forefoot 5166 4.71a

Toe, great, amputation of 5171 4.71a

Toes, all, amputation of 5170 4.71a

Toes, other than great, amputation of 5172 4.71a

Toes, three or four, amputation of 5173 4.71a

With defective stump, thigh, amputation

recommended 5163 4.71a

Limitation of extension of 5261 4.71a

Limitation of flexion of 5260 4.71a

Leg and Foot (*see* Foot and Leg)

Leishmaniasis:

American 7807 4.118

Old world 7808 4.118

Lens, crystalline, dislocation of 6033 4.84a

Leprosy (Hansen's Disease) 6302 4.88b

Leukemia 7703 4.117

Lips, injuries of 7201 4.114

Liver:

Cirrhosis of 7312 4.114

Injury of 7311 4.114

Transplant 7351 4.114

Lower Extremity:

Bones of, shortening of 5275 4.71a

Lupus erythematosus:

Discoid 7809 4.118

Systemic 6350 4.88b

Lungs and pleura, diseases of (*see* *also* Tuberculosis):

Bacterial infections of the lung:

Actinomycosis 6822 4.97

Chronic lung abscess 6824 4.97

Lung abscess, chronic 6824 4.97

Nocardiosis 6823 4.97

Interstitial lung disease:

Asbestosis 6833 4.97

Desquamative interstitial pneumonitis 6826 4.97

Diffuse interstitial fibrosis 6825 4.97

Drug-induced pulmonary pneumonitis

and fibrosis 6829 4.97

Eosinophilic granuloma of lung 6828 4.97

Hypersensitivity pneumonitis (extrinsic

allergic alveolitis) 6831 4.97

Pneumoconiosis (silicosis,

anthracosis, etc.) 6832 4.97

Pulmonary alveolar proteinosis 6827 4.97

Radiation-induced pulmonary

pneumonitis and fibrosis 6830 4.97

Neoplasms, malignant, any specified part of

respiratory system exclusive of

skin growths 6819 4.97

Mycotic lung disease:

Aspergillosis 6838 4.97

Blastomycosis 6836 4.97

Coccidioidomycosis 6835 4.97

Cryptococcosis 6837 4.97

Histoplasmosis of lung 6834 4.97

Mucormycosis 6839 4.97

Pulmonary vascular disease 6817 4.97

Restrictive lung disease:

Chronic pleural effusion or fibrosis 6845 4.97

Diaphragm paralysis or paresis 6840 4.97

Kyphoscoliosis, pectus excavatum,

pectus carinatum 6842 4.97

Post-surgical residual (lobectomy,

pneumonectomy, etc.) 6844 4.97

Sarcoidosis 6846 4.97

Sleep apnea syndromes 6847 4.97

Spinal cord injury with respiratory

insufficiency 6841 4.97

Traumatic chest wall defect,

pneumothorax, hernia, etc. 6843 4.97

Lyme disease 6319 4.88b

Lymphatic filariasis 6305 4.88b

Lymphatic System---Schedule of Ratings (*see* Hemic and

Lymphatic Systems---Schedule of Ratings)

Lymphoma, non-Hodgkin's 7715 4.117

**M**

Malaria 6304 4.88b

Mandible:

Chronic osteomyelitis or

osteoradionecrosis of 9900 4.150

Loss of approximately one-half 9902 4.150

Loss of, complete, between angles 9901 4.150

Malunion of 9904 4.150

Nonunion of 9903 4.150

Maxilla:

Chronic osteomyelitis or

osteoradionecrosis of 9900 4.150

Loss of half or less 9915 4.150

Loss of more than half 9914 4.150

Malunion or nonunion of 9916 4.150

Medullary sponge kidney 7533 4.115b

Melanoma, malignant 7833 4.118

Melioidosis 6318 4.88b

Meniere's syndrome 6205 4.87

Meningitis, cerebrospinal, epidemic 8019 4.124a

Mental disorders:

Convalescence ratings following extended hospitalization 4.128

Diagnosis of mental disorders 4.125

Evaluation of disability from mental disorders 4.126

Mental disorders due to traumatic stress 4.129

Mental retardation and personality disorders 4.127

**[mental disorders ---schedule of ratings]{.smallcaps}**

**Anxiety Disorders**

Anxiety disorder, not otherwise specified 9413 4.130

Generalized anxiety disorder 9400 4.130

Obsessive compulsive disorder 9404 4.130

Other and unspecified neurosis 9410 4.130

Panic disorder and/or agoraphobia 9412 4.130

Post-traumatic stress disorder 9411 4.130

Specific (simple) phobia; social phobia 9403 4.130

**Chronic Adjustment Disorder**

Chronic adjustment disorder 9440 4.130

**Delirium, Dementia, and Amnestic and Other Cognitive Disorders**

Delirium 9300 4.130

Dementia due to head trauma 9304 4.130

Dementia due to infection (HIV, syphilis,

or other systemic or intracranial

infections) 9301 4.130

Dementia due to other neurologic or

general medical conditions 9326 4.130

Dementia of the Alzheimer's type 9312 4.130

Dementia of unknown etiology 9310 4.130

Organic mental disorder, other 9327 4.130

Vascular dementia 9305 4.130

**Dissociative Disorders**

Depersonalization disorder 9417 4.130

Dissociative amnesia; dissociative fugue;

dissociative identity disorder 9416 4.130

**Eating Disorders**

Anorexia nervosa 9520 4.130

Bulimia nervosa 9521 4.130

**Mood Disorders**

Bipolar disorder 9432 4.130

Cyclothymic disorder 9431 4.130

Dysthymic disorder 9433 4.130

Major depressive disorder 9434 4.130

Mood disorder, not otherwise specified 9435 4.130

**Schizophrenia and Other Psychotic Disorders**

Psychotic disorder, not otherwise

specified 9210 4.130

Schizoaffective disorder 9211 4.130

Schizophrenia, catatonic type 9202 4.130

Schizophrenia, disorganized type 9201 4.130

Schizophrenia, paranoid type 9203 4.130

Schizophrenia, residual type; other 9205 4.130

Schizophrenia, undifferentiated type 9204 4.130

**Somatoform Disorders**

Conversion disorder 9424 4.130

Hypochondriasis 9425 4.130

Pain disorder 9422 4.130

Somatization disorder 9421 4.130

Undifferentiated somatoform disorder 9423 4.130

Mental retardation and personality disorders 4.127

Migraine 8100 4.124a

Misconduct etiology 4.17a

Mood disorders (*see* Mental Disorders---Schedule of Ratings)

Mouth, injuries of 7200 4.114

Multiple fingers (*see* Fingers, multiple)

Mucormycosis 6839 4.97

Multiple sclerosis 8018 4.124a

Muscle function, examination of 4.77

Muscle hernia, extensive 5326 4.73

**[Muscle injuries---schedule of ratings:]{.smallcaps}**

**Foot and Leg**

Group X 5310 4.73

Group XI 5311 4.73

Group XII 5312 4.73

**Forearm and Hand**

Group VII 5307 4.73

Group VIII 5308 4.73

Group IX 5309 4.73

**Miscellaneous**

Diaphragm, rupture of, with herniation 5324 4.73

Facial muscles 5325 4.73

Muscle hernia, extensive 5326 4.73

Muscle, neoplasm of, benign, postoperative 5328 4.73

Muscle, neoplasm of, malignant 5327 4.73

Sarcoma, soft tissue (of muscle, fat, or

fibrous connective tissue) 5329 4.73

**Pelvic Girdle and Thigh**

Group XIII 5313 4.73

Group XIV 5314 4.73

Group XV 5315 4.73

Group XVI 5316 4.73

Group XVII 5317 4.73

Group XVIII 5318 4.73

**Shoulder Girdle and Arm**

Group I 5301 4.73

Group II 5302 4.73

Group III 5303 4.73

Group IV 5304 4.73

Group V 5305 4.73

Group VI 5306 4.73

**Torso and Neck**

Group XIX 5319 4.73

Group XX 5320 4.73

Group XXI 5321 4.73

Group XXII 5322 4.73

Group XXIII 5323 4.73

Muscle, neoplasm of:

Benign, postoperative 5328 4.73

Malignant 5327 4.73

Muscular atrophy, progressive 8023 4.124a

Musculoskeletal system---generally:

Accurate measurement 4.46

Amputation rule 4.68

Ankylosis and joint motion, measurement of 4.71

Arthritis due to strain 4.58

Bones, pelvic 4.67

Bones, the 4.44

Buttocks, loss of use of both 4.64

Circulatory disturbances 4.62

Combined ratings for muscle injuries, principles of 4.55

Complete medical examination of injury cases 4.42

Deformities, static foot 4.57

Dominant hand 4.69

Examination 4.61

Examination, complete medical of injury cases 4.42

Examinations, inadequate 4.70

Evaluation of muscle disabilities 4.56

Foot deformities, static 4.57

Foot or hand, loss of use of 4.63

Functional loss 4.40

Hand or foot, loss of use of 4.63

Hand, dominant 4.69

History of injury 4.41

Inadequate examinations 4.70

Injury, history of 4.41

Joint motion and ankylosis, measurement of 4.71

Joints, the 4.45

Loss of use of both buttocks 4.64

Loss of use of hand or foot 4.63

Loss, functional 4.40

Dominant hand 4.69

Measurement of ankylosis and joint motion 4.71

Measurement, accurate 4.46

Motion, painful 4.59

Osteomyelitis 4.43

Painful motion 4.59

Pelvic bones 4.67

Plates I--IV 4.71

Principles of combined ratings for muscle injuries 4.55

Ratings, combined for muscle injuries, principles of 4.55

Sacroiliac joint 4.66

Static foot deformities 4.57

Strain, arthritis due to 4.58

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

**Acute, Subacute, or Chronic Diseases**

Arthritis:

Degenerative 5003 4.71a

Gonorrheal 5004 4.71a

Other types 5009 4.71a

Pneumococcic 5005 4.71a

Rheumatoid (atrophic) 5002 4.71a

Streptococcic 5008 4.71a

Syphilitic 5007 4.71a

Trauma, due to 5010 4.71a

Typhoid 5006 4.71a

Bones:

Caisson disease of, 5011 4.71a

New growths of, benign 5015 4.71a

New growths of, malignant 5012 4.71a

Bones and joints, tuberculosis of,

active or inactive 5001 4.71a

Bursitis 5019 4.71a

Fibromyalgia 5025 4.71a

Gout 5017 4.71a

Hydrarthrosis, intermittent 5018 4.71a

Myositis 5021 4.71a

Myositis ossificans 5023 4.71a

Osteitis deformans 5016 4.71a

Osteomalacia 5014 4.71a

Osteomyelitis, acute, subacute, or chronic 5000 4.71a

Osteoporosis, with joint manifestation 5013 4.71a

Periostitis 5022 4.71a

Synovitis 5020 4.71a

Tenosynovitis 5024 4.71a

**Amputations: Lower Extremity**

Thigh, amputation of:

Disarticulation, with loss of extrinsic

pelvic girdle muscles 5160 4.71a

Middle or lower thirds 5162 4.71a

Upper third 5161 4.71a

Leg, amputation of:

Amputation not improvable by prosthesis

controlled by natural knee action 5164 4.71a

At a lower level, permitting prosthesis 5165 4.71a

Foot, loss of use of 5167 4.71a

Forefoot 5166 4.71a

Toe, great, amputation of 5171 4.71a

Toes, all, amputation of 5170 4.71a

Toes, other than great, amputation of 5172 4.71a

Toes, three or four, amputation of 5173 4.71a

With defective stump, thigh, amputation

recommended 5163 4.71a

**Amputations: Upper Extremity**

Arm, amputation of:

Above insertion of deltoid 5121 4.71a

Below insertion of deltoid 5122 4.71a

Disarticulation 5120 4.71a

Forearm, amputation of:

Above insertion of pronator teres 5123 4.71a

Below insertion of pronator teres 5124 4.71a

Hand, loss of use of 5125 4.71a

Multiple finger amputations:

Five digits of one hand, amputation 5126 4.71a

Four digits of one hand, amputation of:

Thumb, index, long and ring 5127 4.17a

Thumb, index, long and little 5128 4.17a

Thumb, index, ring and little 5129 4.17a

Thumb, long, ring and little 5130 4.17a

Index, long, ring and little 5131 4.17a

Three digits of one hand, amputation of:

Thumb, index, and long 5132 4.17a

Thumb, index and ring 5133 4.17a

Thumb, index and little 5134 4.17a

Thumb, long and ring 5135 4.17a

Thumb, long and little 5136 4.17a

Thumb, ring and little 5137 4.17a

Index, long and ring 5138 4.17a

Index, long and little 5139 4.17a

Index, ring and little 5140 4.17a

Long, ring and little 5141 4.17a

Two digits of one hand, amputation of:

Thumb and index 5142 4.17a

Thumb and long 5143 4.17a

Thumb and ring 5144 4.17a

Thumb and little 5145 4.17a

Index and long 5146 4.17a

Index and ring 5147 4.17a

Index and little 5148 4.17a

Long and ring 5149 4.17a

Long and little 5150 4.17a

Ring and little 5151 4.17a

Single finger amputations:

Thumb, amputation of 5152 4.17a

Index finger, amputation of 5153 4.17a

Long finger, amputation of 5154 4.17a

Ring finger, amputation of 5155 4.17a

Little finger, amputation of 5156 4.17a

**Ankle**

Ankylosis of 5270 4.71a

Astragalectomy 5274 4.71a

Limited motion of 5271 4.71a

Os calcis or astragalus, malunion of 5273 4.71a

Subastragalar or tarsal joint, ankylosis of 5272 4.71a

**Ankylosis of Individual Digits**

Index finger 5225 4.71a

Long finger 5226 4.71a

Ring or little finger 5227 4.71a

Thumb 5224 4.71a

**Coccyx**

Removal of 5298 4.71a

**Combinations of Disabilities**

Anatomical loss of one hand and

loss of use of one foot 5104 4.71a

Anatomical loss of one foot and

loss of use of one hand 5105 4.71a

Anatomical loss of both hands 5106 4.71a

Anatomical loss of both feet 5107 4.71a

Anatomical loss of one hand and one foot 5108 4.71a

Loss of use of both hands 5109 4.71a

Loss of use of both feet 5110 4.71a

Loss of use of one hand and one foot 5111 4.71a

**Elbow and Forearm**

Elbow, ankylosis of 5205 4.71a

Elbow, other impairment of Flail joint 5209 4.71a

Forearm, flexion limited to 100º

and extension to 45º 5208 4.71a

Forearm, limitation of extension of 5207 4.71a

Forearm, limitation of flexion of 5206 4.71a

Radius and ulna, nonunion of 5210 4.71a

Radius, impairment of 5212 4.71a

Supination and pronation, impairment of 5213 4.71a

Ulna, impairment of 5211 4.71a

**Foot**

Claw foot (pes cavus), acquired 5278 4.71a

Flatfoot, acquired 5276 4.71a

Hallux rigidus, unilateral, severe 5281 4.71a

Hallux valgus, unilateral 5280 4.71a

Hammer toe 5282 4.71a

Injuries, other 5284 4.71a

Metatarsalgia, anterior (Morton's disease) 5279 4.71a

Tarsal, or metatarsal bones, malunion of 5283 4.71a

Tarsal, or metatarsal bones, nonunion of 5283 4.71a

Weak foot, bilateral 5277 4.71a

**Hip and Thigh**

Femur, impairment of 5255 4.71a

Hip, ankylosis of 5250 4.71a

Hip, flail joint 5254 4.71a

Thigh, impairment of 5253 4.71a

Thigh, limitation of extension of 5251 4.71a

Thigh, limitation of flexion of 5252 4.71a

**Knee and Leg**

Cartilage, semilunar, dislocated 5258 4.71a

Cartilage, semilunar, removal of 5259 4.71a

Genu recurvatum 5263 4.71a

Knee, ankylosis of 5256 4.71a

Knee, other impairment of 5257 4.71a

Leg, limitation of extension of 5261 4.71a

Leg, limitation of flexion of 5260 4.71a

Tibia and fibula, impairment of 5262 4.71a

**Lower Extremity, Shortening of the**

Bones of the lower extremity, shortening of 5275 4.71a

**Multiple Digits: 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

**Multiple Digits: 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

**Multiple Losses of Extremities, Ratings for** Table II 4.71a

**Prosthetic Implants**

Ankle replacement (prosthesis) 5056 4.71a

Hip replacement (prosthesis) 5054 4.71a

Shoulder replacement (prosthesis) 5051 4.71a

Elbow replacement (prosthesis) 5052 4.71a

Knee replacement (prosthesis) 5055 4.71a

Wrist replacement (prosthesis) 5053 4.71a

**Ribs**

Removal of 5297 4.71a

**Shoulder and Arm**

Arm, limitation of motion of 5201 4.71a

Clavicle or scapula, impairment of 5203 4.71a

Humerus, other impairment of 5202 4.71a

Scapulohumeral articulation, ankylosis of 5200 4.71a

**Skull**

Loss of part of, both inner and outer tables 5296 4.71a

**Spine**

Ankylosis of, cervical 5287 4.71a

Ankylosis of, dorsal 5288 4.71a

Ankylosis of, lumbar 5289 4.71a

Complete bony fixation (ankylosis) of 5286 4.71a

Intervertebral disc syndrome 5293 4.71a

Limitation of motion of, cervical 5290 4.71a

Limitation of motion of, dorsal 5291 4.71a

Limitation of motion of, lumbar 5292 4.71a

Lumbosacral strain 5295 4.71a

Sacro-iliac injury and weakness 5294 4.71a

Vertebra, fracture of, residuals 5285 4.71a

**Wrist**

Ankylosis of 5214 4.71a

Limitation of motion of 5215 4.71a

Myasthenia gravis 8025 4.124a

Myelitis 8010 4.124a

Myocardial infarction 7006 4.104

Myositis 5021 4.71a

Myositis ossificans 5023 4.71a

**N**

Narcolepsy 8108 4.124a

Neck and Torso (see Torso and Neck)

Neoplasms, benign:

Breast 7628 4.116

Digestive system 7344 4.114

Ear 6209 4.87

Endocrine system, any specified part 7915 4.119

Genitourinary system 7529 4.115b

Gynecological system 7628 4.116

Skin 7819 4.118

Neoplasms, malignant:

Breast 7627 4.116

Digestive system 7343 4.114

Ear 6208 4.87

Endocrine system, any specified part 7914 4.119

Genitourinary system 7528 4.115b

Gynecological system 7627 4.116

Respiratory system, any specified part

exclusive of skin growths 6819 4.97

Skin 7818 4.118

Nephritis:

Chronic 7502 4.115b

Interstitial 7537 4.115b

Nephrolithiasis 7508 4.115b

Nephropathy, toxic 7535 4.115b

Nephrosclerosis, arteriolar 7507 4.115b

Neuralgia, cranial or peripheral 4.124

Neuritis:

Cranial or peripheral 4.123

Optic 6026 4.84a

Neurogenic bladder 7542 4.115b

Neurological conditions and convulsive disorders:

Evaluations by comparison 4.120

Identification of epilepsy 4.121

Neuralgia, cranial or peripheral 4.124

Neuritis, cranial or peripheral 4.123

Psychomotor epilepsy 4.122

**[Neurological system and convulsive disorders---schedule of
ratings:]{.smallcaps}**

**Cranial Nerves, Diseases of the**

Fifth (trigeminal) cranial nerve:

Paralysis of 8205 4.124a

Neuritis 8305 4.124a

Neuralgia 8405 4.124a

Seventh (facial) cranial nerve:

Paralysis of 8207 4.124a

Neuritis 8307 4.124a

Neuralgia 8407 4.124a

Ninth (glossopharyngeal) cranial nerve:

Paralysis of 8209 4.124a

Neuritis 8309 4.124a

Neuralgia 8409 4.124a

Tenth (pneumogastric, vagus) cranial nerve:

Paralysis of 8210 4.124a

Neuritis 8310 4.124a

Neuralgia 8410 4.124a

Eleventh (spinal accessory, external branch) cranial nerve:

Paralysis of 8211 4.124a

Neuritis 8311 4.124a

Neuralgia 8411 4.124a

Twelfth (hypoglossal) cranial nerve:

Paralysis of 8212 4.124a

Neuritis 8312 4.124a

Neuralgia 8412 4.124a

**Epilepsies, the**

Epilepsy, grand mal 8910 4.124a

Epilepsy, petit mal 8911 4.124a

Epilepsy, Jacksonian and focal motor

or sensory 8912 4.124a

Epilepsy, diencephalic 8913 4.124a

Epilepsy, psychomotor 8914 4.124a

Mental disorders in epilepsies Note 4.124a

Epilepsy and unemployability Note 4.124a

**Miscellaneous Diseases**

Athetosis, acquired 8107 4.124a

Chorea, Huntington's 8106 4.124a

Chorea, Sydenham's 8105 4.124a

Migraine 8100 4.124a

Narcolepsy 8108 4.124a

Paramyoclonus multiplex 8104 4.124a

Tic, convulsive 8103 4.124a

**Organic Diseases of the Central Nervous System**

Amyotrophic lateral sclerosis 8017 4.124a

Brain disease due to trauma 8045 4.124a

Brain, abscess of 8020 4.124a

Brain, new growth of, benign 8003 4.124a

Brain, new growth of, malignant 8002 4.124a

Brain, vessels, embolism of 8007 4.124a

Brain, vessels, hemorrhage from 8009 4.124a

Brain, vessels, thrombosis of 8008 4.124a

Bulbar palsy 8005 4.124a

Cerebral arteriosclerosis 8046 4.124a

Encephalitis, epidemic, chronic 8000 4.124a

Hematomyelia 8012 4.124a

Meningitis, cerebrospinal, epidemic 8019 4.124a

Multiple sclerosis 8018 4.124a

Myasthenia gravis 8025 4.124a

Myelitis 8010 4.124a

Paralysis agitans 8004 4.124a

Poliomyelitis, anterior 8011 4.124a

Progressive muscular atrophy 8023 4.124a

Spinal cord, new growths of, benign 8022 4.124a

Spinal cord, new growths of, malignant 8021 4.124a

Syphilis, cerebrospinal 8013 4.124a

Syphilis, meningovascular 8014 4.124a

Syringomyelia 8024 4.124a

Tabes dorsalis 8015 4.124a

**Peripheral Nerves, Diseases of the**

All radicular groups:

Paralysis of 8513 4.124a

Neuritis 8613 4.124a

Neuralgia 8713 4.124a

Anterior crural nerve (femoral):

Paralysis of 8526 4.124a

Neuritis 8626 4.124a

Neuralgia 8726 4.124a

Anterior tibial nerve (deep peroneal):

Paralysis of 8523 4.124a

Neuritis 8623 4.124a

Neuralgia 8723 4.124a

Circumflex nerve:

Paralysis of 8518 4.124a

Neuritis 8618 4.124a

Neuralgia 8718 4.124a

External cutaneous nerve of thigh:

Paralysis of 8529 4.124a

Neuritis 8629 4.124a

Neuralgia 8729 4.124a

External popliteal nerve (common peroneal):

Paralysis of 8521 4.124a

Neuritis 8621 4.124a

Neuralgia 8721 4.124a

Ilio-inguinal nerve:

Paralysis of 8530 4.124a

Neuritis 8630 4.124a

Neuralgia 8730 4.124a

Internal popliteal nerve (tibial):

Paralysis of 8524 4.124a

Neuritis 8624 4.124a

Neuralgia 8724 4.124a

Internal saphenous nerve:

Paralysis of 8527 4.124a

Neuritis 8627 4.124a

Neuralgia 8727 4.124a

Long thoracic nerve:

Paralysis of 8519 4.124a

Neuritis 8619 4.124a

Neuralgia 8719 4.124a

Lower radicular group:

Paralysis of 8512 4.124a

Neuritis 8612 4.124a

Neuralgia 8712 4.124a

Median nerve:

Paralysis of 8515 4.124a

Neuritis 8615 4.124a

Neuralgia 8715 4.124a

Middle radicular group:

Paralysis of 8511 4.124a

Neuritis 8611 4.124a

Neuralgia 8711 4.124a

Musculocutaneous nerve:

Paralysis of 8517 4.124a

Neuritis 8617 4.124a

Neuralgia 8717 4.124a

Musculocutaneous nerve (superficial peroneal):

Paralysis of 8522 4.124a

Neuritis 8622 4.124a

Neuralgia 8722 4.124a

Musculospiral nerve (radial nerve):

Paralysis of 8514 4.124a

Neuritis 8614 4.124a

Neuralgia 8714 4.124a

Obturator nerve:

Paralysis of 8528 4.124a

Neuritis 8628 4.124a

Neuralgia 8728 4.124a

Posterior tibial nerve:

Paralysis of 8525 4.124a

Neuritis 8625 4.124a

Neuralgia 8725 4.124a

Sciatic nerve:

Paralysis of 8520 4.124a

Neuritis 8620 4.124a

Neuralgia 8720 4.124a

Soft-tissue sarcoma (of neurogenic origin) 8540 4.124a

Ulnar nerve:

Paralysis of 8516 4.124a

Neuritis 8616 4.124a

Neuralgia 8716 4.124a

Upper radicular group (fifth and sixth cervicals):

Paralysis of 8510 4.124a

Neuritis 8610 4.124a

Neuralgia 8710 4.124a

New growths (neoplasms):

Benign:

Brain 8003 4.124a

Ear 6209 4.87

Eye 6015 4.84a

Spinal cord 8022 4.124a

Malignant:

Brain 8002 4.124a

Ear 6208 4.87

Eyeball only 6014 4.84a

Spinal cord 8021 4.124a

Nocardiosis 6823 4.97

No-percent rating 4.31

Non-Hodgkin's lymphoma 7715 4.117

Nose, loss of part of, or scars 6504 4.97

Nose and throat, diseases of:

Allergic or vasomotor rhinitis 6522 4.97

Aphonia, complete organic 6519 4.97

Bacterial rhinitis 6523 4.97

Granulomatous rhinitis 6524 4.97

Laryngectomy, total 6518 4.97

Laryngitis:

Chronic 6516 4.97

Tuberculous, active or inactive 6515 4.97

Larynx, stenosis of, including residuals 6520 4.97

Nose, loss of part of, or scars 6504 4.97

Pharynx, injuries to 6521 4.97

Rhinitis:

Allergic 6522 4.97

Bacterial 6523 4.97

Granulomatous 6524 4.97

Vasomotor 6522 4.97

Septum, nasal, deviation of 6502 4.97

Sinusitis:

Ethmoid, chronic 6511 4.97

Frontal, chronic 6512 4.97

Maxillary, chronic 6513 4.97

Pansinusitis, chronic 6510 4.97

Sphenoid, chronic 6514 4.97

Nutritional deficiencies (*see* Infectious Diseases, Immune Disorders,

and Nutritional Deficiencies)

Nystagmus, central 6016 4.84a

**O**

Obsessive compulsive disorder 9404 4.130

Obstructed voiding 4.115a

Obstructive pulmonary disease, chronic 6604 4.97

Oral conditions (*see* Dental and Oral Conditions)

Organs of special sense:

Computation of average concentric contraction of visual fields 4.76a

Computing aggravation 4.78

Differences between distant and near visual acuity 4.84

Examination of field vision 4.76

Examination of muscle function 4.77

Examination of visual acuity 4.75

Impairment of central visual acuity:

General 4.83a

Table Table V 4.84a

Loss of use of one eye, having only light perception 4.79

Normal visual field extent Table III 4.76a

Rating of one eye 4.80

Ratings at scheduled steps and distances 4.83

Osteitis deformans 5016 4.71a

Osteomalacia 5014 4.71a

Osteomyelitis, acute, subacute, or chronic 5000 4.71a

Osteoporosis, with join manifestation 5013 4.71a

Otitis, externa (chronic) 6210 4.87

Otitis media:

Nonsuppurative, chronic 6201 4.87

Suppurative, chronic 6200 4.87

Otosclerosis 6202 4.87

Ovaries, atrophy of both, complete 7620 4.116

Ovary:

Disease, injury, or adhesions of 7615 4.116

Removal of 7619 4.116

**P**

Pacemakers, cardiac (implantable) 7018 4.104

Pain disorder 9422 4.130

Pancreatitis 7347 4.114

Panic disorder 9412 4.130

Papillary necrosis 7538 4.115b

Papulosquamous disorders (not listed elsewhere) 7822 4.118

Paralysis agitans 8004 4.124a

Paramyoclonus multiplex 8104 4.124a

Parasitic diseases otherwise not specified 6320 4.88b

Pectus carinatum 6842 4.97

Pectus excavatum 6842 4.97

Pellagra 6315 4.88b

Pelvic girdle and thigh---muscle injury:

Group XIII 5313 4.73

Group XIV 5314 4.73

Group XV 5315 4.73

Group XVI 5316 4.73

Group XVII 5317 4.73

Group XVIII 5318 4.73

Penis:

Deformity, with loss of erectile power 7522 4.115b

Removal of glans 7521 4.115b

Removal of half or more 7520 4.115b

Pericardial adhesions 7003 4.104

Pericarditis 7002 4.104

Periostitis 5022 4.71a

Peripheral nerves, diseases of (*see* Neurological Conditions and
Convulsive Disorders---Schedule of Ratings)

Peripheral vestibular disorders 6204 4.87

Peritoneum, adhesions of 7301 4.114

Peritonitis, tuberculous, active or inactive 7331 4.114

Pernicious anemia 7700 4.117

Personality disorders and mental retardation 4.127

Pharynx, injuries to 6521 4.97

Pheochromocytoma (benign or malignant) 7918 4.119

Phobia, specific (simple) 9403 4.130

Plague 6307 4.88b

**Plates:**

Ankylosis and joint motion, measurement Plates I--II 4.71

Bones of the foot Plate IV 4.71

Bones of the hand Plate III 4.71

Pleural effusion or fibrosis, chronic 6845 4.97

Pluriglandular syndrome 7912 4.119

Pneumococcic arthritis 5005 4.71a

Pneumoconiosis (silicosis, anthracosis, etc.) 6832 4.97

Pneumonitis:

Desquamative interstitial 6826 4.97

Pulmonary, and fibrosis, drug-induced 6829 4.97

Hypersensitivity (extrinsic allergic

alveolitis) 6831 4.97

Pulmonary, and fibrosis, drug-induced 6829 4.97

Poliomyelitis, anterior 8011 4.124a

Polycystic disease 7533 4.115b

Polycythemia vera 7704 4.117

Postgastrectomy syndromes:

General 4.111

Rating 7308 4.114

Post-phlebitic syndrome of any etiology 7121 4.104

Post-surgical residual (lobectomy,

pneumonectomy, etc.) 6844 4.97

Post-traumatic stress disorder 9411 4.130

Pregnancy, surgical complications of 7623 4.116

Prestabilization rating from date of discharge

from service 4.28

Progressive muscular atrophy 8023 4.124a

Prolactin secreting pituitary dysfunction 7916 4.119

Prostate gland injuries, infections, hypertrophy,

post-operative residuals 7527 4.115b

Pruritus ani 7337 4.114

Psoriasis 7816 4.118

Psychotic disorders (*see* Mental Disorders---Schedule of Ratings)

Pterygium 6034 4.84a

Ptosis, unilateral or bilateral 6019 4.84a

Pulmonary alveolar proteinosis 6827 4.97

Pulmonary disease, obstructive, chronic 6604 4.97

Pulmonary pneumonitis and fibrosis:

Drug-induced 6829 4.97

Radiation-induced 6830 4.97

Pulmonary vascular disease 6817 4.97

Pyelonephritis, chronic 7504 4.115b

Pyramiding, avoidance of 4.14

**Q**

No entries

**R**

Radiation-induced pulmonary pneumonitis

and fibrosis 6830 4.97

Radius and ulna, nonunion of 5210 4.71a

Radius, impairment of 5212 4.71a

Ramus:

Loss of less than one-half the substance

of, not involving loss of continuity 9907 4.150

Loss of whole or part of 9906 4.150

Rating, no-percent 4.31

Rating of disabilities aggravated by active service 4.22

Rating officers, attitude of 4.23

Rating, prestabilization, from date of discharge

from service 4.28

Rating schedule, application of 4.21

Ratings table, combined Table I 4.25

Ratings, analogous 4.20

Ratings, convalescent 4.30

Ratings for service-connected disabilities requiring

hospital treatment or observation 4.29

Ratings, total disability 4.15

Raynaud's syndrome 7117 4.104

Reasonable doubt, resolution of 4.3

Rectum, prolapse of 7334 4.114

Rectum and anus:

Impairment of sphincter control 7332 4.114

Stricture of 7333 4.114

Relapsing fever 6308 4.88b

Renal cortical necrosis (disseminated

intravascular coagulation) 7540 4.115b

Renal disease:

Amyloid 7539 4.115b

Atherosclerotic 7534 4.115b

Chronic, requiring regular dialysis 7530 4.115b

Diabetes mellitus 7541 4.115b

Glycosurias 7532 4.115b

Sickle cell anemia 7541 4.115b

Systemic lupus erythematosus 7541 4.115b

Tubular acidosis 7532 4.115b

Tubular disorders 7532 4.115b

Vasculitis 7541 4.115b

Renal dysfunction 4.115a

Resolution of reasonable doubt 4.3

Respiratory system, special provisions 4.96

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

**Diseases of the Lungs and Pleura---Tuberculosis**

Tuberculosis, pulmonary, chronic (entitled on August 19, 1968):

Active, advancement unspecified 6704 4.97

Far advanced, active 6701 4.97

Far advanced, inactive 6721 4.97

Inactive, advancement unspecified 6724 4.97

Minimal, active 6703 4.97

Minimal, inactive 6723 4.97

Moderately advanced, active 6702 4.97

Moderately advanced, inactive 6722 4.97

Tuberculosis, pulmonary, chronic (evaluated after August 19, 1968):

Active 6730 4.97

Inactive 6731 4.97

**Diseases of the Nose and Throat**

Allergic or vasomotor rhinitis 6522 4.97

Aphonia, complete organic 6519 4.97

Bacterial rhinitis 6523 4.97

Granulomatous rhinitis 6524 4.97

Laryngectomy, total 6518 4.97

Laryngitis:

Chronic 6516 4.97

Tuberculous, active or inactive 6515 4.97

Larynx, stenosis of, including residuals 6520 4.97

Nose, loss of part of, or scars 6504 4.97

Pharynx, injuries to 6521 4.97

Rhinitis:

Allergic 6522 4.97

Bacterial 6523 4.97

Granulomatous 6524 4.97

Vasomotor 6522 4.97

Septum, nasal, deviation of 6502 4.97

Sinusitis:

Ethmoid, chronic 6511 4.97

Frontal, chronic 6512 4.97

Maxillary, chronic 6513 4.97

Pansinusitis, chronic 6510 4.97

Sphenoid, chronic 6514 4.97

**Diseases of the Trachea and Bronchi**

Asthma, bronchial 6602 4.97

Bronchiectasis 6601 4.97

Bronchitis, chronic 6600 4.97

Chronic obstructive pulmonary disease 6604 4.97

Emphysema, pulmonary 6603 4.97

Obstructive pulmonary disease, chronic 6604 4.97

Pulmonary disease, obstructive, chronic 6604 4.97

**Nontuberculous Diseases**

Bacterial infections of the lung:

Actinomycosis 6822 4.97

Chronic lung abscess 6824 4.97

Lung abscess, chronic 6824 4.97

Nocardiosis 6823 4.97

Interstitial lung disease:

Asbestosis 6833 4.97

Desquamative interstitial

pneumonitis 6826 4.97

Diffuse interstitial fibrosis 6825 4.97

Drug-induced pulmonary

pneumonitis and fibrosis 6829 4.97

Eosinophilic granuloma of lung 6828 4.97

Hypersensitivity pneumonitis

(extrinsic allergic alveolitis) 6831 4.97

Pneumoconiosis (silicosis,

anthracosis, etc.) 6832 4.97

Pulmonary alveolar proteinosis 6827 4.97

Radiation-induced pulmonary

pneumonitis and fibrosis 6830 4.97

Neoplasms, malignant, any specified part

of respiratory system exclusive of

skin growths 6819 4.97

Mycotic lung disease:

Aspergillosis 6838 4.97

Blastomycosis 6836 4.97

Coccidioidomycosis 6835 4.97

Cryptococcosis 6837 4.97

Histoplasmosis of lung 6834 4.97

Mucormycosis 6839 4.97

Pulmonary vascular disease 6817 4.97

Restrictive lung disease:

Chronic pleural effusion or fibrosis 6845 4.97

Diaphragm paralysis or paresis 6840 4.97

Kyphoscoliosis, pectus excavatum,

pectus carinatum 6842 4.97

Post-surgical residual (lobectomy,

pneumonectomy, etc.) 6844 4.97

Sarcoidosis 6846 4.97

Sleep apnea syndromes 6847 4.97

Spinal cord injury with respiratory

insufficiency 6841 4.97

Traumatic chest wall defect,

pneumothorax, hernia, etc. 6843 4.97

Retina:

Detachment of 6008 4.84a

Localized scars, atrophy, or irregularities of 6011 4.84a

Retinitis 6006 4.84a

Rheumatic fever 6309 4.88b

Rheumatic heart disease, rating 7000 4.104

Rheumatoid arthritis (atrophic) 5002 4.71a

Rhinitis:

Allergic 6522 4.97

Bacterial 6523 4.97

Granulomatous 6524 4.97

Vasomotor 6522 4.97

Ribs:

Removal of 5297 4.71a

**S**

Sarcoidosis 6846 4.97

Sarcoma, soft tissue:

Muscle, fat, or fibrous connective tissue 5329 4.73

Vascular origin 7123 4.104

Scapula or clavicle, impairment of 5203 4.71a

Scapulohumeral articulation, ankylosis of 5200 4.71a

Scars:

Other than head, face, or neck:

Deep or cause limited motion 7801 4.118

Superficial; do not cause limited motion 7802 4.118

Superficial:

Painful on examination 7804 4.118

Unstable 7803 4.118

Other 7805 4.118

[**Schedule of ratings** (]{.smallcaps}for subheadings*, see* individual
entries[):]{.smallcaps}

Cardiovascular system 4.104

Convulsive disorders 4.124a

Dental and oral conditions 4.150

Digestive system 4.114

Ear 4.87

Endocrine system 4.119

Eye 4.84a

Genitourinary system 4.115a, 4.115b

Gynecological conditions and disorders of the breast 4.116

Heart 4.104

Hemic system 4.117

Immune disorders 4.88b

Infectious diseases 4.88b

Lymphatic system 4.117

Mental disorders 4.130

Muscle injuries 4.72

Musculoskeletal system 4.71a

Neurological conditions 4.124a

Nutritional deficiencies 4.88b

Other sense organs 4.87a

Respiratory system 4.97

Skin 4.118

Smell 4.87a

Taste 4.87a

Schizophrenia (*see* Mental Disorders---Schedule of Ratings)

Scleritis 6002 4.84a

Scotoma, pathological, unilateral 6081 4.84a

Septum, nasal, deviation of 6502 4.97

Service-connected claims, age in 4.19

Service-connected disabilities requiring hospital

treatment or observation, ratings for 4.29

Shortening of the lower extremity, bones of 5275 4.71a

Shoulder and arm:

Arm, limitation of motion of 5201 4.71a

Clavicle or scapula, impairment of 5203 4.71a

Humerus, other impairment of 5202 4.71a

Scapulohumeral articulation, ankylosis of 5200 4.71a

Shoulder Girdle and Arm---muscle injuries:

Group I 5301 4.73

Group II 5302 4.73

Group III 5303 4.73

Group IV 5304 4.73

Group V 5305 4.73

Group VI 5306 4.73

Shoulder replacement (prosthesis) 5051 4.71a

Sickle cell anemia 7714 4.117

Sinusitis:

Ethmoid, chronic 6511 4.97

Frontal, chronic 6512 4.97

Maxillary, chronic 6513 4.97

Pansinusitis, chronic 6510 4.97

Sphenoid, chronic 6514 4.97

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

Acne 7828 4.118

Alopecia

Areata 7831 4.118

Scarring 7830 4.118

Bullous disorders 7815 4.118

Chloracne 7829 4.118

Cutaneous manifestations of collagen-vascular

diseases 7821 4.118

Dermatitis or eczema 7806 4.118

Dermatophytosis 7813 4.118

Discoid lupus erythematosus 7809 4.118

Disfigurement of the head, face, or neck 7800 4.118

Erythema multiforme 7827 4.118

Exfoliative dermatitis 7817 4.118

Hyperhidrosis 7832 4.118

Infections (not listed elsewhere) 7820 4.118

Keratinization 7824 4.118

Leishmaniasis:

American (New World) 7807 4.118

Old World 7808 4.118

Melanoma, malignant 7833 4.118

Neoplasms, skin

Benign 7819 4.118

Malignant 7818 4.118

Papulosquamous disorders (not listed elsewhere) 7822 4.118

Psoriasis 7816 4.118

Scars:

Other 7805 4.118

Other than head, face, or neck:

Deep or cause limited motion 7801 4.118

Superficial; do not cause limited motion 7802 4.118

Superficial:

Painful on examination 7804 4.118

Unstable 7803 4.118

Tuberculosis luposa, active or inactive 7811 4.118

Urticaria 7825 4.118

Vasculitis, primary cutaneous 7826 4.118

Vitiligo 7823 4.118

Skull:

Loss of part of, both inner and outer tables 5296 4.71a

Sleep apnea syndromes 6847 4.97

Smell, loss of sense of, complete 6275 4.87a

Social phobia 9403 4.130

Soft-tissue sarcoma (of vascular origin) 7123 4.104

Somatization disorder 9421 4.130

Somatoform disorders (*see* Mental Disorders---Schedule of Ratings)

Spinal cord:

Injury with respiratory insufficiency 6841 4.97

New growths of:

Benign 8022 4.124a

Malignant 8021 4.124a

Spine:

Ankylosis of, cervical 5287 4.71a

Ankylosis of, dorsal 5288 4.71a

Ankylosis of, lumbar 5289 4.71a

Complete bony fixation (ankylosis) of 5286 4.71a

Intervertebral disc syndrome 5293 4.71a

Limitation of motion of, cervical 5290 4.71a

Limitation of motion of, dorsal 5291 4.71a

Limitation of motion of, lumbar 5292 4.71a

Lumbosacral strain 5295 4.71a

Sacro-iliac injury and weakness 5294 4.71a

Vertebra, fracture of, residuals 5285 4.71a

Spleen, injury of, healed 7707 4.117

Splenectomy 7706 4.117

Stomach:

Injury of 7310 4.114

Stenosis of 7309 4.114

Streptococcic arthritis 5008 4.71a

Stress (post-traumatic) disorder 9411 4.130

Stress (traumatic), mental disorders due to 4.129

Supination and pronation, impairment of 5213 4.71a

Supraventricular arrhythmias 7010 4.104

Symblepharon 6091 4.84a

Synovitis 5020 4.71a

Syphilis:

And other treponemal infections 6310 4.88b

Cerebrospinal 8013 4.124a

Meningovascular 8014 4.124a

Syphilitic arthritis 5007 4.71a

Syphilitic heart disease 7004 4.104

Syringomyelia 8024 4.124a

**T**

Tabes dorsalis 8015 4.124a

**Tables:**

Bilateral blindness combined with

hearing loss Table IV 4.84a

Combined ratings Table I 4.25

Hearing impairment:

Numeric designation Tables VI, VIA 4.85

Percentage evaluations Table VII 4.85

Multiple losses of extremities, ratings for Table II 4.71a

Normal visual field extent Table III 4.76a

Visual acuity (central) impairment, ratings Table V 4.84a

Visual field extent, normal Table III 4.76a

Taste, loss of sense of, complete 6276 4.87a

Teeth, loss of, due to loss of substance of body of

maxilla or mandible without loss of continuity 9913 4.150

Temporomandibular articulation, limited

motion of 9905 4.150

Tenosynovitis 5024 4.71a

Testis:

Atrophy complete 7523 4.115b

Removal 7524 4.115b

Thigh,

Amputation of:

Disarticulation, with loss of extrinsic

pelvic girdle muscles 5160 4.71a

Middle or lower thirds 5162 4.71a

Upper third 5161 4.71a

Impairment of 5253 4.71a

Limitation of extension of 5251 4.71a

Limitation of flexion of 5252 4.71a

Thigh and Pelvic Girdle (*see* Pelvic Girdle and Thigh)

Throat and nose, diseases of:

Allergic or vasomotor rhinitis 6522 4.97

Aphonia, complete organic 6519 4.97

Bacterial rhinitis 6523 4.97

Granulomatous rhinitis 6524 4.97

Laryngectomy, total 6518 4.97

Laryngitis:

Chronic 6516 4.97

Tuberculous, active or inactive 6515 4.97

Larynx, stenosis of, including residuals 6520 4.97

Nose, loss of part of, or scars 6504 4.97

Pharynx, injuries to 6521 4.97

Rhinitis:

Allergic 6522 4.97

Bacterial 6523 4.97

Granulomatous 6524 4.97

Vasomotor 6522 4.97

Septum, nasal, deviation of 6502 4.97

Sinusitis:

Ethmoid, chronic 6511 4.97

Frontal, chronic 6512 4.97

Maxillary, chronic 6513 4.97

Pansinusitis, chronic 6510 4.97

Sphenoid, chronic 6514 4.97

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

Thrombocytopenia, primary, idiopathic

or immune 7705 4.117

Thyroid gland:

Nontoxic adenoma of 7902 4.119

Toxic adenoma of 7901 4.119

Tibia and fibula, impairment of 5262 4.71a

Tic, convulsive 8103 4.124a

Tinnitus, recurrent 6260 4.87

Tongue, loss of whole or part 7202 4.114

Torso and Neck---Muscle injuries:

Group XIX 5319 4.73

Group XX 5320 4.73

Group XXI 5321 4.73

Group XXII 5322 4.73

Group XXIII 5323 4.73

Total disability ratings:

General 4.15

For compensation based on unemployability of the individual 4.16

For pension based on unemployability and age of the individual 4.17

Toxic nephropathy 7535 4.115b

Trachea and bronchi, diseases of:

Asthma, bronchial 6602 4.97

Bronchiectasis 6601 4.97

Bronchitis, chronic 6600 4.97

Chronic obstructive pulmonary disease 6604 4.97

Emphysema, pulmonary 6603 4.97

Obstructive pulmonary disease, chronic 6604 4.97

Pulmonary disease, obstructive, chronic 6604 4.97

Transplant:

Cardiac 7019 4.104

Kidney 7531 4.115b

Liver 7351 4.114

Traumatic stress, mental disorders due to 4.129

Tuberculosis:

Bones and joints, active or inactive 5001 4.71a

Kidney 7505 4.115b

Miliary 6311 4.88b

Nonpulmonary, inactive 4.88c, 4.89

Pulmonary, chronic (entitled on August 19, 1968):

Active, advancement unspecified 6704 4.97

Far advanced, active 6701 4.97

Far advanced, inactive 6721 4.97

Inactive, advancement unspecified 6724 4.97

Minimal, active 6703 4.97

Minimal, inactive 6723 4.97

Moderately advanced, active 6702 4.97

Moderately advanced, inactive 6722 4.97

Pulmonary, chronic (evaluated after August 19, 1968):

Active 6730 4.97

Inactive 6731 4.97

Tuberculosis luposa (lupus vulgaris), active

or inactive 7811 4.118

Tympanic membrane, perforation of 6211 4.87

Typhoid arthritis 5006 4.71a

Typhus, scrub 6317 4.88b

**U**

Ulcerative colitis 7323 4.114

Ulcers:

Duodenal 7305 4.114

Gastric 7304 4.114

General 4.110

Marginal 7306 4.114

Ulna, impairment of 5211 4.71a

Unemployability:

Age of the individual, total disability rating

for pension based on 4.17

General 4.18

Of the individual, Total disability ratings for

compensation based on 4.16

Uremic medullary cystic disease 7533 4.115b

Ureter, stricture of 7511 4.115b

Ureterolithiasis 7510 4.115b

Urethra:

Fistula of 7519 4.115b

Stricture of 7518 4.115b

Urinary frequency, dysfunction 4.115a

Urinary tract infection 4.115a

Urticaria 7825 4.118

Use of diagnostic code numbers 4.27

Uterus and both ovaries, removal of, complete 7617 4.116

Uterus:

Disease, injury, or adhesions of 7613 4.116

Displacement of 7622 4.116

Prolapse 7621 4.116

Removal of, including corpus 7618 4.116

Uveitis 6000 4.84a

**V**

Vagina, disease or injury of 7611 4.116

Vagotomy with pyloroplasty or

gastroenterostomy 7348 4.114

Valvular heart disease 7000 4.104

Varicose veins:

Rating 7120 4.104

Vascular dementia 9305 4.130

Vascular disease, pulmonary 6817 4.97

Vasculitis, primary cutaneous 7826 4.118

Veins, diseases of (*see* Arteries and veins, diseases of)

Ventricular arrhythmias (sustained) 7011 4.104

Vestibular disorders, peripheral 6204 4.87

Visceral leishmaniasis 6301 4.88b

Visceroptosis, symptomatic, marked 7342 4.114

Vision, field, examination of 4.76

Vision, field of, impairment of 6080 4.84a

Visual acuity:

Blindness (bilateral) combined with hearing loss (Table) 4.84a

Central:

Impairment of 6061--6079 4.84a

Impairment, ratings for Table V 4.84a

Differences between distant and near 4.84a

Examination of 4.75

Impairment of central 4.83a

Visual field:

Chart Figure 1 4.76

Normal visual field extent Table III 4.76a

Visual fields, computation of average concentric contractions 4.76a

Vitiligo 7823 4.118

Voiding:

Dysfunction 4.115a

Obstructed 4.115a

Vulva, disease or injury of 7610 4.116

**W**

Weight loss 4.112

Wrist:

Ankylosis of 5214 4.71a

Limitation of motion of 5215 4.71a

Replacement (prosthesis) 5053 4.71a

**X**

No entries

**Y**

No entries

**Z**

No entries

Reserved

**§4.68 Amputation rule.**

The combined rating for disabilities of an extremity shall not exceed
the rating for the amputation at the elective level, were amputation to
be performed. For example, the combined evaluations for disabilities
below the knee shall not exceed the 40 percent evaluation, diagnostic
code 5165. This 40 percent rating may be further combined with
evaluation for disabilities above the knee but not to exceed the above
the knee amputation elective level. Painful neuroma of a stump after
amputation shall be assigned the evaluation for the elective site of
reamputation.

**§4.69 Dominant hand.**

Handedness for the purpose of a dominant rating will be determined by
the evidence of record, or by testing on VA examination. Only one hand
shall be considered dominant. The injured hand, or the most severely
injured hand, of an ambidextrous individual will be considered the
dominant hand for rating purposes. (Authority: 38 U.S.C. 1155)

\[29 FR 6718, May 22, 1964, as amended at 62 FR 30239, June 3, 1997\]

**Supplement *Highlights* reference**: 20(1)

**§4.70 Inadequate examinations.**

If the report of examination is inadequate as a basis for the required
consideration of service connection and evaluation, the rating agency
may request a supplementary report from the examiner giving further
details as to the limitations of the disabled person's ordinary activity
imposed by the disease, injury, or residual condition, the prognosis for
return to, or continuance of, useful work. When the best interests of
the service will be advanced by personal conference with the examiner,
such conference may be arranged through channels.

**§4.71 Measurement of ankylosis and joint motion.**

Plates I and II provide a standardized description of ankylosis and
joint motion measurement. The anatomical position is considered as 0º,
with two major exceptions:

\(a\) Shoulder rotation---arm abducted to 90º, elbow flexed to 90º with
the position of the forearm reflecting the midpoint 0º between internal
and external rotation of the shoulder; and

\(b\) Supination and pronation---the arm next to the body, elbow flexed
to 90º, and the forearm in midposition 0º between supination and
pronation.

Motion of the thumb and fingers should be described by appropriate
reference to the joints (See Plate III) whose movement is limited, with
a statement as to how near, in centimeters, the tip of the thumb can
approximate the fingers, or how near the tops of the fingers can
approximate the proximal transverse crease of palm.

\[29 FR 6718, May 22, 1964, as amended at 43 FR 45349, Oct. 2, 1978; 67
FR 48785, July 26, 2002\]

**Supplement *Highlights* reference**: 30(1)

*Plates I, II, III, and IV on following pages*

*Next Section is §4.71a*

**5055** Knee replacement (prosthesis).

Prosthetic replacement of knee joint:

For 1 year following implantation of prosthesis 100

With chronic residuals consisting of severe painful motion or

weakness in the affected extremity 60

With intermediate degrees of residual weakness, pain or limitation

of motion rate by analogy to diagnostic codes 5256, 5261, or 5262.

Minimum rating 30

**5056** Ankle replacement (prosthesis).

Prosthetic replacement of ankle joint:

For 1 year following implantation of prosthesis 100

With chronic residuals consisting of severe painful motion

or weakness 40

With intermediate degrees of residual weakness, pain or

limitation of motion rate by analogy to 5270 or 5271.

Minimum rating 20

Note (1): The 100 pct rating for 1 year following implantation of
prosthesis will commence after initial grant of the 1-month total rating
assigned under § 4.30 following hospital discharge.

Note (2): Special monthly compensation is assignable during the 100 pct
rating period the earliest date permanent use of crutches is
established.

[combinations of disabilities]{.smallcaps}

**5104** Anatomical loss of one hand and loss of use of one foot 1001

**5105** Anatomical loss of one foot and loss of use of one hand 1001

**5106** Anatomical loss of both hands 1001

**5107** Anatomical loss of both feet 1001

**5108** Anatomical loss of one hand and one foot 1001

**5109** Loss of use of both hands 1001

**5110** Loss of use of both feet 1001

**5111** Loss of use of one hand and one foot 1001

1Also entitled to special monthly compensation.

**[Amputations: Upper Extremity]{.smallcaps}**

Rating

*Major Minor*

Arm, amputation of:

**5120** Disarticulation 901 901

**5121** Above insertion of deltoid 901 801

**5122** Below insertion of deltoid 801 701

Forearm, amputation of:

**5123** Above insertion of pronator teres 801 701

**5124** Below insertion of pronator teres 701 601

**5125** Hand, loss of use of 701 601

[multiple finger amputations]{.smallcaps}

**5126** Five digits of one hand, amputation 701 601

Four digits of one hand, amputation of:

**5127** Thumb, index, long and ring 701 601

**5128** Thumb, index, long and little 701 601

**5129** Thumb, index, ring and little 701 601

**5130** Thumb, long, ring and little 701 601

**5131** Index, long, ring and little 60 50

Three digits of one hand, amputation of:

**5132** Thumb, index and long 60 50

**5133** Thumb, index and ring 60 50

**5134** Thumb, index and little 60 50

**5135** Thumb, long and ring 60 50

**5136** Thumb, long and little 60 50

**5137** Thumb, ring and little 60 50

**5138** Index, long and ring 50 40

**5139** Index, long and little 50 40

**5140** Index, ring and little 50 40

**5141** Long, ring and little 40 30

Two digits of one hand, amputation of:

**5142** Thumb and index 50 40

**5143** Thumb and long 50 40

**5144** Thumb and ring 50 40

**5145** Thumb and little 50 40

**5146** Index and long 40 30

**5147** Index and ring 40 30

**5148** Index and little 40 30

**5149** Long and ring 30 20

**5150** Long and little 30 20

**5151** Ring and little 30 20

\(a\) The ratings for multiple finger amputations apply to amputations
at the proximal interphalangeal joints or through proximal phalanges.

\(b\) Amputation through long phalanges will be rated as prescribed for
unfavorable ankylosis of the fingers.

\(c\) Amputations at distal joints, or through distal phalanges, other
than negligible losses, will be rated as prescribed for favorable
ankylosis of the fingers.

\(d\) Amputation or resection of metacarpal bones (more than one-half
the bone lost) in multiple fingers injuries will require a rating of 10
percent added to (not combined with) the ratings, multiple finger
amputations, subject to the amputation rule applied to the forearm.

\(e\) Combinations of finger amputations at various levels, or finger
amputations with ankylosis or limitation of motion of the fingers will
be rated on the basis of the grade of disability; i.e., amputation,
unfavorable ankylosis, most representative of the levels or
combinations. With an even number of fingers involved, and adjacent
grades of disability, select the higher of the two grades.

\(f\) Loss of use of the hand will be held to exist when no effective
function remains other than that which would be equally well served by
an amputation stump with a suitable prosthetic appliance.

[single finger amputations]{.smallcaps}

**5152** Thumb, amputation of:

With metacarpal resection 40 30

At metacarpophalangeal joint or through proximal phalanx 30 20

At distal joint or through distal phalanx 20 20

**5153** Index finger, amputation of

With metacarpal resection (more than one-half the bone lost) 30 20

**5153** Index finger, amputation of (cont.)

Without metacarpal resection, at proximal interphalangeal joint

or proximal thereto 20 20

Through long phalanx or at distal joint 10 10

**5154** Long finger, amputation of:

With metacarpal resection (more than one-half the bone lost) 20 20

Without metacarpal resection, at proximal interphalangeal joint

or proximal thereto 10 10

**5155** Ring finger, amputation of:

With metacarpal resection (more than one-half the bone lost) 20 20

Without metacarpal resection, at proximal interphalangeal joint

or proximal thereto 10 10

**5156** Little finger, amputation of:

With metacarpal resection (more than one-half the bone lost) 20 20

Without metacarpal resection, at proximal interphalangeal joint

or proximal thereto 10 10

Note: The single finger amputation ratings are the only applicable
ratings for amputations of whole or part of single fingers.

1Entitled to special monthly compensation.

**[The Wrist]{.smallcaps}**

Rating

*Major Minor*

**5214** Wrist, ankylosis of:

Unfavorable, in any degree of palmar flexion, or with

ulnar or radial deviation 50 40

Any other position, except favorable 40 30

Favorable in 20º to 30º dorsiflexion 30 20

Note: Extremely unfavorable ankylosis will be rated as loss of use of
hands under diagnostic code 5125.

**5215** Wrist, limitation of motion of:

Dorsiflexion less than 15º 10 10

Palmar flexion limited in line with forearm 10 10

**[Evaluation of Ankylosis or Limitation of Motion]{.smallcaps}**

**[of Single or Multiple Digits of the Hand]{.smallcaps}**

\(1\) For the index, long, ring, and little fingers (digits II, III, IV,
and V), zero degrees of flexion represents the fingers fully extended,
making a straight line with the rest of the hand. The position of
function of the hand is with the wrist dorsiflexed 20 to 30 degrees, the
metacarpophalangeal and proximal interphalangeal joints flexed to 30
degrees, and the thumb (digit I) abducted and rotated so that the thumb
pad faces the finger pads. Only joints in these positions are considered
to be in favorable position. For digits II through V, the
metacarpophalangeal joint has a range of zero to 90 degrees of flexion,
the proximal interphalangeal joint has a range of zero to 100 degrees of
flexion, and the distal (terminal) interphalangeal joint has a range of
zero to 70 or 80 degrees of flexion.

\(2\) When two or more digits of the same hand are affected by any
combination of amputation, ankylosis, or limitation of motion that is
not otherwise specified in the rating schedule, the evaluation level
assigned will be that which best represents the overall disability
(i.e., amputation, unfavorable or favorable ankylosis, or limitation of
motion), assigning the higher level of evaluation when the level of
disability is equally balanced between one level and the next higher
level.

\(3\) Evaluation of ankylosis of the index, long, ring, and little
fingers:

> \(i\) If both the metacarpophalangeal and proximal interphalangeal
> joints of a digit are ankylosed, and either is in extension or full
> flexion, or there is rotation or angulation of a bone, evaluate as
> amputation without metacarpal resection, at proximal interphalangeal
> joint or proximal thereto.
>
> \(ii\) If both the metacarpophalangeal and proximal interphalangeal
> joints of a digit are ankylosed, evaluate as unfavorable ankylosis,
> even if each joint is individually fixed in a favorable position.
>
> \(iii\) If only the metacarpophalangeal or proximal interphalangeal
> joint is ankylosed, and there is a gap of more than two inches (5.1
> cm.) between the fingertip(s) and the proximal transverse crease of
> the palm, with the finger(s) flexed to the extent possible, evaluate
> as unfavorable ankylosis.
>
> \(iv\) If only the metacarpophalangeal or proximal interphalangeal
> joint is ankylosed, and there is a gap of two inches (5.1 cm.) or less
> between the fingertip(s) and the proximal transverse crease of the
> palm, with the finger(s) flexed to the extent possible, evaluate as
> favorable ankylosis.

\(4\) Evaluation of ankylosis of the thumb:

> \(i\) If both the carpometacarpal and interphalangeal joints are
> ankylosed, and either is in extension or full flexion, or there is
> rotation or angulation of a bone, evaluate as amputation at
> metacarpophalangeal joint or through proximal phalanx.
>
> \(ii\) If both the carpometacarpal and interphalangeal joints are
> ankylosed, evaluate as unfavorable ankylosis, even if each joint is
> individually fixed in a favorable position.
>
> \(iii\) If only the carpometacarpal or interphalangeal joint is
> ankylosed, and there is a gap of more than two inches (5.1 cm.)
> between the thumb pad and the fingers, with the thumb attempting to
> oppose the fingers, evaluate as unfavorable ankylosis.
>
> \(iv\) If only the carpometacarpal or interphalangeal joint is
> ankylosed, and there is a gap of two inches (5.1 cm.) or less between
> the thumb pad and the fingers, with the thumb attempting to oppose the
> fingers, evaluate as favorable ankylosis.

\(5\) If there is limitation of motion of two or more digits, evaluate
each digit separately and combine the evaluations.

**I. Multiple Digits: Unfavorable Ankylosis**

Rating

*Major Minor*

**5216** Five digits of one hand, unfavorable ankylosis of 60 50

**Note:** Also consider whether evaluation as amputation is warranted.

**5217** Four digits of one hand, unfavorable ankylosis of:

Thumb and any three fingers 60 50

Index, long, ring, and little fingers 50 40

**Note:** Also consider whether evaluation as amputation is warranted.

**5218** Three digits of one hand, unfavorable ankylosis of:

Thumb and any two fingers 50 40

Index, long, and ring; index, long, and little; or

index, ring and little fingers 40 30

Long, ring, and little fingers 30 20

**Note:** Also consider whether evaluation as amputation is warranted.

**5219** Two digits of one hand, unfavorable ankylosis of:

Thumb and any finger 40 30

Index and long; index and ring; or index and little fingers 30 20

Long and ring; long and little; or ring and little fingers 20 20

**Note:** Also consider whether evaluation as amputation is warranted.

**II. Multiple Digits: Favorable Ankylosis**

Rating

*Major Minor*

**5220** Five digits of one hand, favorable ankylosis of 50 40

**5221** Four digits of one hand, favorable ankylosis of:

Thumb and any three fingers 50 40

Index, long, ring, and little 40 30

**5222** Three digits of one hand, favorable ankylosis of:

Thumb and any two fingers 40 30

Index, long, and ring; index, long, and little;

or index, ring, and little fingers 30 20

Long, ring, and little fingers 20 20

**5223** Two digits of one hand, favorable ankylosis of:

Thumb and any finger 30 20

Index and long; index and ring; or index and little fingers 20 20

Long and ring; long and little; or ring and little fingers 10 10

**III. Ankylosis of Individual Digits**

Rating

*Major Minor*

**5224** Thumb, ankylosis of:

Unfavorable 20 20

Favorable 10 10

> **Note**: Also consider whether evaluation as amputation is warranted
> and whether an additional evaluation is warranted for resulting
> limitation of motion of other digits or interference with overall
> function of the hand.

**5225** Index finger, ankylosis of:

Unfavorable or favorable 10 10

> **Note**: Also consider whether evaluation as amputation is warranted
> and whether an additional evaluation is warranted for resulting
> limitation of motion of other digits or interference with overall
> function of the hand.

**5226** Long finger, ankylosis of:

Unfavorable or favorable 10 10

> **Note**: Also consider whether evaluation as amputation is warranted
> and whether an additional evaluation is warranted for resulting
> limitation of motion of other digits or interference with overall
> function of the hand.

**5227** Ring or little finger, ankylosis of:

Unfavorable or favorable 10 10

> **Note**: Also consider whether evaluation as amputation is warranted
> and whether an additional evaluation is warranted for resulting
> limitation of motion of other digits or interference with overall
> function of the hand.

**IV. Limitation of Motion of Individual Digits**

Rating

*Major Minor*

**5228** Thumb, limitation of motion:

With a gap of more than two inches (5.1 cm.) between the

thumb pad and the fingers, with the thumb attempting to

oppose the fingers 20 20

With a gap of one to two inches (2.5 to 5.1 cm.) between the

thumb pad and the fingers, with the thumb attempting to

oppose the fingers\...\...\...\...\...\...\...\...\...\...\...\..... 10
10

With a gap of less than one inch (2.5 cm.) between the thumb

pad and the fingers, with the thumb attempting to oppose

the fingers 0 0

**5229** Index or long finger, limitation of motion:

With a gap of one inch (2.5 cm.) or more between the fingertip

and the proximal transverse crease of the palm, with the

finger flexed to the extent possible, or; with extension limited

by more than 30 degrees 10 10

With a gap of less than one inch (2.5 cm.) between the fingertip

and the proximal transverse crease of the palm, with the finger

flexed to the extent possible, and; extension is limited by no

more than 30 degrees 0 0

**5230** Ring or little finger, limitation of motion:

Any limitation of motion 0 0

**[The Hip and Thigh]{.smallcaps}**

Rating

**5250** Hip, ankylosis of:

Unfavorable, extremely unfavorable ankylosis,

the foot not reaching ground, crutches necessitated 903

Intermediate 70

Favorable in flexion at an angle between 20º and 40º and

slight adduction or abduction 60

**5251** Thigh, limitation of extension of:

Extension limited to 5º 10

**5252** Thigh, limitation of flexion of:

Flexion limited to 10º 40

Flexion limited to 20º 30

Flexion limited to 30º 20

Flexion limited to 45º 10

**5253** Thigh, impairment of:

Limitation of abduction of, motion lost beyond 10º 20

Limitation of adduction of, cannot cross legs 10

Limitation of rotation of, cannot toe-out more than 15º,

affected leg 10

**5254** Hip, flail joint 80

**5255** Femur, impairment of:

Fracture of shaft or anatomical neck of:

With nonunion, with loose motion (spiral or oblique fracture) 80

With nonunion, without loose motion, weightbearing preserved

with aid of brace. 60

Fracture of surgical neck of, with false joint 60

Malunion of:

With marked knee or hip disability 30

With moderate knee or hip disability 20

With slight knee or hip disability 10

3Entitled to special monthly compensation.

[**The Knee and Leg**]{.smallcaps}

Rating

**5256** Knee, ankylosis of:

Extremely unfavorable, in flexion at an angle of 45° or more 60

In flexion between 20° and 45° 50

In flexion between 10° and 20° 40

Favorable angle in full extension, or in slight flexion between 0° and
10° 30

**5257** Knee, other impairment of:

Recurrent subluxation or lateral instability:

Severe 30

Moderate 20

Slight 10

**5258** Cartilage, semilunar, dislocated, with frequent episodes of

"locking," pain, and effusion into the joint 20

**5259** Cartilage, semilunar, removal of, symptomatic. 10

**5260** Leg, limitation of flexion of:

Flexion limited to 15° 30

Flexion limited to 30° 20

Flexion limited to 45° 10

Flexion limited to 60° 0

**5261** Leg, limitation of extension of:

Extension limited to 45° 50

Extension limited to 30° 40

Extension limited to 20° 30

Extension limited to 15° 20

Extension limited to 10° 10

Extension limited to 5° 0

**5262** Tibia and fibula, impairment of:

Nonunion of, with loose motion, requiring brace 40

Malunion of:

With marked knee or ankle disability 30

With moderate knee or ankle disability 20

With slight knee or ankle disability 10

**5263** Genu recurvatum (acquired, traumatic, with weakness and

insecurity in weight-bearing objectively demonstrated) 10

**[The Ankle]{.smallcaps}**

Rating

**5270** Ankle, ankylosis of:

In plantar flexion at more than 40º, or in dorsiflexion at more

than 10˚ or with abduction, adduction, inversion or eversion

deformity 40

In plantar flexion, between 30º and 40º, or in dorsiflexion,

between 0º and 10º 30 30

In plantar flexion, less than 30º 20

**5271** Ankle, limited motion of:

Marked 20

Moderate 10

**5272** Subastragalar or tarsal joint, ankylosis of:

In poor weight-bearing position 20 ,,,,,, 20

In good weight-bearing position 10

**5273** Os calcis or astragalus, malunion of:

Marked deformity 20 ,,,., ,,,,,,,, .,,,,, 20

Moderate deformity 10

**5274** Astragalectomy 20

**[Shortening of the Lower Extremity]{.smallcaps}**

Rating

**5275** Bones, of the lower extremity, shortening of:

Over 4 inches (1 0.2 cms.) 603 3 60

3-1/2 to 4 inches (8.9 cms. to 10.2 cms.) 503

3 to 3-1/2 inches (7.6 cms.to 8.9 cms.) 40

2-1/2 to 3 inches (6.4 cms. to 7.6 cms.) 30 30

2 to 2-1/2 inches (5.1 cms. to 6.4 cms.) 20 20

1-1/4 to 2 inches (3.2 cms. to 5.1 cms.) 10

Note: Measure both lower extremities from anterior superior spine of the
ilium to the internal malleolus of the tibia. Not to be combined with
other ratings for fracture or faulty union in the same extremity.

3Also entitled to special monthly compensation.

**[The Foot]{.smallcaps}**

Rating

**5276** Flatfoot, acquired:

Pronounced; marked pronation, extreme tenderness of plantar

surfaces of the feet, marked inward displacement and severe spasm

of the tendo achillis on manipulation, not improved by orthopedic

shoes or appliances:

Bilateral 50 ,.,, ,,,,.,,,,,,,,.,,,,,.,,, , ,,,,,,,,,,,,,,,,,,,,, 50

Unilateral 30

Severe; objective evidence of marked deformity (pronation,

abduction, etc.), pain on manipulation and use accentuated,

indication of swelling on use, characteristic callosities:

Bilateral 30

Unilateral 20 , ,, ,,,,,,,,,,, 20

Moderate; weight-bearing line over or medial to great toe, inward

bowing of the tendo achillis, pain on manipulation and use of

the feet, bilateral or unilateral 10

Mild: symptoms relieved by built-up shoe or arch support 0

**5277** Weak Foot, bilateral:

A symptomatic condition secondary to many constitutional conditions,

characterized by atrophy of the musculature, disturbed circulation,

and weakness:

Rate the underlying condition, minimum rating 10

**5278** Claw foot (pes cavus), acquired:

Marked contraction of plantar fascia with dropped forefoot, all toes

hammer toes, very painful callosities, marked varus deformity:

Bilateral 50

Unilateral 30

All toes tending to dorsiflexion, limitation of dorsiflexion at ankle

to right angle, shortened plantar fascia, and marked tenderness

under metatarsal heads:

Bilateral 30

Unilateral 20

Great toe dorsiflexed, some limitation of dorsiflexion at ankle,

definite tenderness under metatarsal heads:

Bilateral 10

Unilateral 10

Slight 0

**5279** Metatarsalgia, anterior (Morton's disease), unilateral, or
bilateral 10

**5280** Hallux valgus, unilateral:

Operated with resection of metatarsal head 10

Severe, if equivalent to amputation of great toe 10

**5281** Hallux rigidus, unilateral, severe:

Rate as hallux valgus, severe.

Note: Not to be combined with claw foot ratings.

**5282** Hammer toe:

All toes, unilateral without claw foot 10

Single toes 0

**5283** Tarsal, or metatarsal bones, malunion of, or nonunion of:

Severe 30

Moderately severe 20

Moderate 10

Note: With actual loss of use of the foot, rate 40 percent.

**5284** Foot injuries, other:

Severe 30

Moderately severe 20

Moderate 10

Note: With actual loss of use of the foot, rate 40 percent.

**[The Spine]{.smallcaps}**

Rating

**5285** Vertebra, fracture of, residuals:

With cord involvement, bedridden, or requiring long leg braces 100

Consider special monthly compensation; with lesser involvements

rate for limited motion, nerve paralysis.

Without cord involvement; abnormal mobility requiring neck

brace (jury mast) 60

In other cases rate in accordance with definite limited motion or

muscle spasm, adding 10 percent for demonstrable deformity of

vertebral body.

Note: Both under ankylosis and limited motion, ratings should not be
assigned for more than one segment by reason of involvement of only the
first or last vertebrae of an adjacent segment.

**5286** Spine, complete bony fixation (ankylosis) of:

Unfavorable angle, with marked deformity and involvement of

major joints (Marie-Strumpell type) or without other joint

involvement (Bechterew type) 100

Favorable angle 60

**5287** Spine, ankylosis of, cervical:

Unfavorable 40

Favorable 30

**5288** Spine, ankylosis of, dorsal:

Unfavorable 30

Favorable 20

**5289** Spine, ankylosis of, lumbar:

Unfavorable 50

Favorable 40

**5290** Spine, limitation of motion of, cervical:

Severe 30

Moderate 20

Slight 10

**5291** Spine, limitation of motion of, dorsal:

Severe 10

Moderate 10

Slight 0

**5292** Spine, limitation of motion of, lumbar:

Severe 40

Moderate 20

Slight 10

**5293** Intervertebral disc syndrome:

Pronounced; with persistent symptoms compatible with sciatic

neuropathy with characteristic pain and demonstrable muscle

spasm, absent ankle jerk, or other neurological findings appropriate

to site of diseased disc, little intermittent relief 60

Severe; recurring attacks, with intermittent relief 40 Moderate;
recurring attacks 20

Mild 10

Postoperative, cured 0

**5294** Sacro-iliac injury and weakness:

**5295** Lumbosacral strain:

Severe; with listing of whole spine to opposite side, positive

Goldthwaite's sign, marked limitation of forward bending in

standing position, loss of lateral motion with osteo-arthritic

changes, or narrowing or irregularity of joint space, or some

of the above with abnormal mobility on forced motion 40

With muscle spasm on extreme forward bending, loss of lateral

spine motion unilateral, in standing position 20

With characteristic pain on motion 10

With slight subjective symptoms only 0

**[The Skull]{.smallcaps}**

Rating

**5296** Skull, loss of part of, both inner and outer tables:

With brain hernia 80

Without brain hernia:

Area larger than size of a 50-cent piece or 1.140 in2 (7.355 cm2 ) 50

Area intermediate 30

Area smaller than the size of a 25-cent piece

or 0.716 in2 (4.619 cm2 ) 10

Note: Rate separately for intracranial complications.

**[The Ribs]{.smallcaps}**

Rating

**5297** Ribs, removal of:

More than six 50

Five or six 40

Three or four 30

Two 20

One or resection of two or more ribs without regeneration 10

Note (1): The rating for rib resection or removal is not to be applied
with ratings for purulent pleurisy, lobectomy, pneumonectomy or injuries
of pleural cavity.

Note (2): However, rib resection will be considered as rib removal in
thoracoplasty performed for collapse therapy or to accomplish
obliteration of space and will be combined with the rating for lung
collapse, or with the rating for lobectomy, pneumonectomy or the
graduated ratings for pulmonary tuberculosis.

**[The Coccyx]{.smallcaps}**

Rating

**5298** Coccyx, removal of:

Partial or complete, with painful residuals 10

Without painful residuals 0

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

\[29 FR 6718, May 22,1964, as amended at 34 FR 5062, Mar. 11, 1969; 40
FR 42536, Sept. 15, 1975; 41 FR 11294, Mar. 18, 1976; 43 FR 45350, Oct.
2, 1978; 51 FR 6411, Feb. 24, 1986; 61 FR 20439, May 7, 1996; 64 FR
32410, June 17, 1999; 67 FR 48785, July 26, 2002\]

**Supplement *Highlights* references**: 16(1), 26(2), 30(1).

**[Table II]{.smallcaps}**

**[Ratings for Multiple Losses of Extremities with Dictator's Rating
Code and 38 CFR Citation]{.smallcaps}**

Impairment of other extremity

+---------+---------+---------+---------+---------+---------+---------+
| Imp     | Ana     | Ana     | Ana     | Ana     | Ana     | Ana     |
| airment | tomical | tomical | tomical | tomical | tomical | tomical |
| of one  | loss or | loss or | loss or | loss or | loss    | loss    |
| ex      | loss of | loss of | loss of | loss of | near    | near    |
| tremity | use     | use     | use     | use     | s       | hip     |
|         | below   | below   | above   | above   | houlder | (pre    |
|         | elbow   | knee    | elbow   | knee    | (pre    | venting |
|         |         |         | (pre    | (pre    | venting | use of  |
|         |         |         | venting | venting | use of  | pros    |
|         |         |         | use of  | use of  | pros    | thesis) |
|         |         |         | pros    | pros    | thesis) |         |
|         |         |         | thesis) | thesis) |         |         |
+---------+---------+---------+---------+---------+---------+---------+
| Ana     | M Codes | L Codes | M 1/2   | L 1/2   | N Code  | M Code  |
| tomical | M-1 a,  | L-1 d,  | Code    | Code    | N-3, 38 | M-3 c,  |
| loss or | b,      | e, f,   | M-5,    | L-2 c,  | CFR     | 38 CFR  |
| loss of |         |         |         |         | 3       | 3.3     |
| use     | or c,   | or g,   | 38 CFR  | 38 CFR  | .350(f) | 50(f)(1 |
| below   | 38 CFR  | 38 CFR  | 3.350(f | 3       | (1)(xi) | )(viii) |
| elbow   | 3.350(c | 3       | )(1)(x) | .350(f) |         |         |
|         | )(1)(i) | .350(b) |         | (1)(vi) |         |         |
+---------+---------+---------+---------+---------+---------+---------+
| Ana     | 3       | L Codes | L 1/2   | L 1/2   | M Code  | M Code  |
| tomical | .350(b) | L-1 a,  | Code    | Code    | M-3 b,  | M-3 a,  |
| loss or |         | b,      | L-2 b,  | L-2 a,  |         |         |
| loss of |         |         |         |         | 38 CFR  | 38 CFR  |
| use     |         | or c,   | 38 CFR  | 38 CFR  | 3       | 3       |
| below   |         | 38 CFR  | 3.350(f | 3       | .350(f) | .350(f) |
| knee    |         | 3.350   | )(1)(i) | .350(f) | (1)(ii) |         |
|         |         | (       |         | (1)(iv) |         |         |
|         |         | 1)(iii) |         |         |         |         |
+---------+---------+---------+---------+---------+---------+---------+
| Ana     |         |         | N Code  | M Code  | N 1/2   | M 1/2   |
| tomical |         |         | N-1,    | M-2 a,  | Code    | Code    |
| loss or |         |         |         |         | N-4     | M-4 c,  |
| loss of |         |         | 38 CFR  | 38 CFR  |         |         |
| use     |         |         | 3.35    | 3       | 38 CFR  | 38 CFR  |
| above   |         |         | 0(d)(1) | .350(c) | 3       | 3       |
| elbow   |         |         |         | (       | .350(f) | .350(f) |
| (pre    |         |         |         | 1)(iii) | (1)(ix) |         |
| venting |         |         |         |         |         | (1)(xi) |
| use of  |         |         |         |         |         |         |
| pros    |         |         |         |         |         |         |
| thesis) |         |         |         |         |         |         |
+---------+---------+---------+---------+---------+---------+---------+
| Ana     |         |         |         | M Code  | M 1/2   | M 1/2   |
| tomical |         |         |         | M-2 a,  | Code    | Code    |
| loss or |         |         |         |         | M-4 b,  | M-4 a,  |
| loss of |         |         |         | 38 CFR  |         |         |
| use     |         |         |         | 3       | 38 CFR  | 38 CFR  |
| above   |         |         |         | .350(c) | 3       | 3       |
| knee    |         |         |         | (1)(ii) | .350(f) | .350(f) |
| (pre    |         |         |         |         |         |         |
| venting |         |         |         |         | (       | (1)(v)  |
| use of  |         |         |         |         | 1)(vii) |         |
| pros    |         |         |         |         |         |         |
| thesis) |         |         |         |         |         |         |
+---------+---------+---------+---------+---------+---------+---------+
| Ana     |         |         |         |         | O Code  | N Code  |
| tomical |         |         |         |         | O-1,    | N-2 b,  |
| loss    |         |         |         |         |         |         |
| near    |         |         |         |         | 38 CFR  | 38 CFR  |
| s       |         |         |         |         | 3       | 3       |
| houlder |         |         |         |         | .350(e) | .350(d) |
| (pre    |         |         |         |         | (1)(i)  | (3)     |
| venting |         |         |         |         |         |         |
| use of  |         |         |         |         |         |         |
| pros    |         |         |         |         |         |         |
| thesis) |         |         |         |         |         |         |
+---------+---------+---------+---------+---------+---------+---------+
| Ana     |         |         |         |         |         | N Code  |
| tomical |         |         |         |         |         | N-2 a,  |
| loss    |         |         |         |         |         |         |
| near    |         |         |         |         |         | 38 CFR  |
| hip     |         |         |         |         |         | 3       |
| (pre    |         |         |         |         |         | .350(d) |
| venting |         |         |         |         |         | (2)     |
| use of  |         |         |         |         |         |         |
| pros    |         |         |         |         |         |         |
| thesis) |         |         |         |         |         |         |
+---------+---------+---------+---------+---------+---------+---------+

Note: Need for aid attendance or permanently bedridden qualifies for
subpar. L. Code L-1 h, i (38 CFR 3.350(b)). Paraplegia with loss of use
of both lower extremities and loss of anal and bladder sphincter control
qualifies for subpar. O. Code O-2 (38 CFR 3.350(e)(2). Where there are
additional disabilities rated 50% or 100%, or anatomical or loss of use
of a third extremity see 38 CFR 3.350(f)(3), (4), or (5). (Authority: 38
U.S.C. 1115)

**The Skin**

4.118 Schedule of ratings---skin 4.118-1

**§4.118 Schedule of ratings---skin.**

Rating

**7800** Disfigurement of the head, face, or neck:

With visible or palpable tissue loss and either gross distortion or

asymmetry of three or more features or paired sets of features

(nose, chin, forehead, eyes (including eyelids), ears (auricles),

cheeks, lips), or; with six or more characteristics of disfigurement 80

With visible or palpable tissue loss and either gross distortion or

asymmetry of two features or paired sets of features (nose, chin,

forehead, eyes (including eyelids), ears (auricles), cheeks, lips), or;

with four or five characteristics of disfigurement 50

With visible or palpable tissue loss and either gross distortion or

asymmetry of one feature or paired set of features (nose, chin,

forehead, eyes (including eyelids), ears (auricles), cheeks, lips), or;

with two or three characteristics of disfigurement 30

With one characteristic of disfigurement 10

**Note (1)**: The 8 characteristics of disfigurement, for purposes of
evaluation

under §4.118, are:

Scar 5 or more inches (13 or more cm.) in length.

Scar at least one-quarter inch (0.6 cm.) wide at widest part.

Surface contour of scar elevated or depressed on palpation.

Scar adherent to underlying tissue.

Skin hypo-or hyper-pigmented in an area exceeding six square

inches (39 sq. cm.).

Skin texture abnormal (irregular, atrophic, shiny, scaly, etc.) in

an area exceeding six square inches (39 sq. cm.).

Underlying soft tissue missing in an area exceeding six square

inches (39 sq. cm.).

Skin indurated and inflexible in an area exceeding six square

inches (39 sq. cm.).

**Note (2)**: Rate tissue loss of the auricle under DC 6207 (loss of
auricle) and

anatomical loss of the eye under DC 6061 (anatomical loss of both eyes)
or

DC 6063 (anatomical loss of one eye), as appropriate.

**Note (3)**: Take into consideration unretouched color photographs when

evaluating under these criteria.

**7801** Scars, other than head, face, or neck, that are deep or that
cause limited motion:

Area or areas exceeding 144 square inches (929 sq. cm.) 40

Area or areas exceeding 72 square inches (465 sq. cm.) 30

Area or areas exceeding 12 square inches (77 sq. cm.) 20

Area or areas exceeding 6 square inches (39 sq. cm.) 10

**Note (1)**: Scars in widely separated areas, as on two or more
extremities or on

anterior and posterior surfaces of extremities or trunk, will be
separately

rated and combined in accordance with §4.25 of this part.

**Note (2)**: A deep scar is one associated with underlying soft tissue
damage.

**7802** Scars, other than head, face, or neck, that are superficial and
that

do not cause limited motion: Area or areas of 144 square inches

(929 sq. cm.) or greater 10

**Note (1)**: Scars in widely separated areas, as on two or more
extremities or on

anterior and posterior surfaces of extremities or trunk, will be
separately

rated and combined in accordance with §4.25 of this part.

**Note (2)**: A superficial scar is one not associated with underlying
soft tissue

damage.

**7803** Scars, superficial, unstable 10

**Note (1)**: An unstable scar is one where, for any reason, there is
frequent loss of

covering of skin over the scar.

**Note (2)**: A superficial scar is one not associated with underlying
soft tissue

damage.

**7804** Scars, superficial, painful on examination 10

**Note (1)**: A superficial scar is one not associated with underlying
soft tissue

damage.

**Note (2)**: In this case, a 10-percent evaluation will be assigned for
a scar on the

tip of a finger or toe even though amputation of the part would not
warrant a

compensable evaluation.

(See §4.68 of this part on the amputation rule.)

**7805** Scars, other; Rate on limitation of function of affected part.

**7806** Dermatitis or eczema.

More than 40 percent of the entire body or more than 40 percent of

exposed areas affected, or; constant or near-constant systemic therapy

such as corticosteroids or other immunosuppressive drugs required

during the past 12-month period 60

20 to 40 percent of the entire body or 20 to 40 percent of exposed areas

affected, or; systemic therapy such as corticosteroids or other

immunosuppressive drugs required for a total duration of six weeks

or more, but not constantly, during the past 12-month period 30

At least 5 percent, but less than 20 percent, of the entire body, or at

least 5 percent, but less than 20 percent, of exposed areas affected,

or; intermittent systemic therapy such as corticosteroids or other

immunosuppressive drugs required for a total duration of less than

six weeks during the past 12-month period 10

Less than 5 percent of the entire body or less than 5 percent of exposed

areas affected, and; no more than topical therapy required during the

past 12-month period 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.

**7807** American (New World) leishmaniasis (mucocutaneous, espundia):

Rate as disfigurement of the head, face, or neck (DC 7800), scars (DC's
7801,

7802, 7803, 7804, or 7805), or dermatitis (DC 7806), depending upon the

predominant disability.

**Note**: Evaluate non-cutaneous (visceral) leishmaniasis under DC 6301
(visceral

leishmaniasis).

**7808** Old World leishmaniasis (cutaneous, Oriental sore): Rate as
disfigurement of the head, face, or neck (DC 7800), scars (DC's 7801,
7802, 7803, 7804, or 7805), or dermatitis (DC 7806), depending upon the
predominant disability.

**Note**: Evaluate non-cutaneous (visceral) leishmaniasis under DC 6301
(visceral

leishmaniasis).

**7809** Discoid lupus erythematosus or subacute cutaneous lupus
erythematosus: Rate as disfigurement of the head, face, or neck (DC
7800), scars (DC's 7801, 7802,

7803, 7804, or 7805), or dermatitis (DC 7806), depending upon the

predominant disability. Do not combine with ratings under DC 6350.

**7811** Tuberculosis luposa (lupus vulgaris), active or inactive: Rate
under §§4.88c or

4.89, whichever is appropriate.

**7813** Dermatophytosis (ringworm: of body, tinea corporis; of head,
tinea capitis; of

feet, tinea pedis; of beard area, tinea barbae; of nails, tinea unguium;
of

inguinal area (jock itch), tinea cruris): Rate as disfigurement of the
head, face,

or neck (DC 7800), scars (DC's 7801, 7802, 7803, 7804, or 7805), or
dermatitis

(DC 7806), depending upon the predominant disability.

**7815** Bullous disorders (including pemphigus vulgaris, pemphigus
foliaceous, bullous

pemphigoid, dermatitis herpetiformis, epidermolysis bullosa acquisita,
benign

chronic familial pemphigus (Hailey-Hailey), and porphyri cutanea tarda):

More than 40 percent of the entire body or more than 40 percent of

exposed areas affected, or; constant or near-constant systemic therapy

such as corticosteroids or other immunosuppressive drugs required

during the past 12-month period 60

20 to 40 percent of the entire body or 20 to 40 percent of exposed

areas affected, or; systemic therapy such as corticosteroids or other

immunosuppressive drugs required for a total duration of six weeks or

more, but not constantly, during the past 12-month period 30

At least 5 percent, but less than 20 percent, of the entire body, or at

least 5 percent, but less than 20 percent, of exposed areas affected,

or; intermittent systemic therapy such as corticosteroids or other

immunosuppressive drugs required for a total duration of less than

six weeks during the past 12-month period 10

Less than 5 percent of the entire body or exposed areas affected, and;

no more than topical therapy required during the past 12-month

period 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.

**7816** Psoriasis:

More than 40 percent of the entire body or more than 40 percent

of exposed areas affected, or; constant or near-constant systemic

therapy such as corticosteroids or other immunosuppressive drugs

required during the past 12-month period 60

20 to 40 percent of the entire body or 20 to 40 percent of exposed

areas affected, or; systemic therapy such as corticosteroids or other

immunosuppressive drugs required for a total duration of six weeks

or more, but not constantly, during the past 12-month period 30

At least 5 percent, but less than 20 percent, of the entire body, or at

least 5 percent, but less than 20 percent, of exposed areas affected,

or; intermittent systemic therapy such as corticosteroids or other

immunosuppressive drugs required for a total duration of less than

six weeks during the past 12-month period 10

Less than 5 percent of the entire body or exposed areas affected, and;

no more than topical therapy required during the past 12-month

period 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.

**7817** Exfoliative dermatitis (erythroderma):

Generalized involvement of the skin, plus systemic manifestations

(such as fever, weight loss, and hypoproteinemia), and; constant or

near-constant systemic therapy such as therapeutic doses of

corticosteroids, immunosuppressive retinoids, PUVA (psoralen

with long-wave ultraviolet-A light) or UVB (ultraviolet-B light)

treatments, or electron beam therapy required during the past

12-month period 100

Generalized involvement of the skin without systemic manifestations,

and; constant or near-constant systemic therapy such as therapeutic

doses of corticosteroids, immunosuppressive retinoids, PUVA (psoralen

with long-wave ultraviolet-A light) or UVB (ultraviolet-B light)

treatments, or electron beam therapy required during the past

12-month period 60

Any extent of involvement of the skin, and; systemic therapy such

as therapeutic doses of corticosteroids, immunosuppressive retinoids,

PUVA (psoralen with long-wave ultraviolet-A light) or UVB

(ultraviolet-B light) treatments, or electron beam therapy required

for a total duration of six weeks or more, but not constantly, during

the past 12-month period 30

Any extent of involvement of the skin, and; systemic therapy such

as therapeutic doses of corticosteroids, immunosuppressive retinoids,

PUVA (psoralen with long-wave ultraviolet-A light) or UVB

(ultraviolet-B light) treatments, or electron beam therapy required

for a total duration of less than six weeks during the past 12-month

period 10

Any extent of involvement of the skin, and; no more than topical

therapy required during the past 12-month period 0

**7818** Malignant skin neoplasms (other than malignant melanoma): Rate
as disfigurement

of the head, face, or neck (DC 7800), scars (DC's 7801, 7802, 7803,
7804, or

7805), or impairment of function.

**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) of this chapter. 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.

**7819** Benign skin neoplasms: Rate as disfigurement of the head, face,
or neck (DC

7800), scars (DC's 7801, 7802, 7803, 7804, or 7805), or impairment of
function.

**7820** Infections of the skin not listed elsewhere (including
bacterial, fungal, viral,

treponemal and parasitic diseases): Rate as disfigurement of the head,
face, or

neck (DC 7800), scars (DC's 7801, 7802, 7803, 7804, or 7805), or
dermatitis (DC

7806), depending upon the predominant disability.

**7821** Cutaneous manifestations of collagen-vascular diseases not
listed elsewhere

(including scleroderma, calcinosis cutis, and dermatomyositis):

More than 40 percent of the entire body or more than 40 percent of

exposed areas affected, or; constant or near-constant systemic therapy

such as corticosteroids or other immunosuppressive drugs required

during the past 12-month period 60

20 to 40 percent of the entire body or 20 to 40 percent of exposed

areas affected, or; systemic therapy such as corticosteroids or

other immunosuppressive drugs required for a total duration of six

weeks or more, but not constantly, during the past 12-month period 30

At least 5 percent, but less than 20 percent, of the entire body, or at

least 5 percent, but less than 20 percent, of exposed areas affected,

or; intermittent systemic therapy such as corticosteroids or other

immunosuppressive drugs required for a total duration of less than

six weeks during the past 12-month period 10

Less than 5 percent of the entire body or exposed areas affected, and;

no more than topical therapy required during the past 12-month

period 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.

**7822** Papulosquamous disorders not listed elsewhere (including lichen
planus, large or

small plaque parapsoriasis, pityriasis lichenoides et varioliformis
acuta

(PLEVA), lymphomatoid papulosus, and pityriasis rubra pilaris (PRP)):

More than 40 percent of the entire body or more than 40 percent of

exposed areas affected, and; constant or near-constant systemic

medications or intensive light therapy required during the past

12-month period 60

20 to 40 percent of the entire body or 20 to 40 percent of exposed

areas affected, or; systemic therapy or intensive light therapy required

for a total duration of six weeks or more, but not constantly, during

the past 12-month period 30

At least 5 percent, but less than 20 percent, of the entire body, or at

least 5 percent, but less than 20 percent, of exposed areas affected,

or; systemic therapy or intensive light therapy required for a total

duration of less than six weeks during the past 12-month period 10

Less than 5 percent of the entire body or exposed areas affected, and;

no more than topical therapy required during the past 12-month

period 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.

**7823** Vitiligo:

With exposed areas affected 10

With no exposed areas affected 0

**7824** Diseases of keratinization (including icthyoses, Darier's
disease, and palmoplantar

keratoderma):

With either generalized cutaneous involvement or systemic

manifestations, and; constant or near-constant systemic medication,

such as immunosuppressive retinoids, required during the past

12-month period 60

With either generalized cutaneous involvement or systemic

manifestations, and; intermittent systemic medication, such as

immunosuppressive retinoids, required for a total duration of six

weeks or more, but not constantly, during the past 12-month period 30

With localized or episodic cutaneous involvement and intermittent

systemic medication, such as immunosuppressive retinoids, required

for a total duration of less than six weeks during the past 12-month

period 10

No more than topical therapy required during the past 12-month period 0

**7825** Urticaria:

Recurrent debilitating episodes occurring at least four times during the

past 12-month period despite continuous immunosuppressive therapy 60

Recurrent debilitating episodes occurring at least four times during the

past 12-month period, and; requiring intermittent systemic

immunosuppressive therapy for control 30

Recurrent episodes occurring at least four times during the past

12-month period, and; responding to treatment with antihistamines or

sympathomimetics 10

**7826** Vasculitis, primary cutaneous:

Recurrent debilitating episodes occurring at least four times during the

past 12-month period despite continuous immunosuppressive therapy 60

Recurrent debilitating episodes occurring at least four times during the

past 12-month period, and; requiring intermittent systemic

immunosuppressive therapy for control 30

Recurrent episodes occurring one to three times during the past

12-month period, and; requiring intermittent systemic

immunosuppressive therapy for control 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.

**7827** Erythema multiforme; Toxic epidermal necrolysis:

Recurrent debilitating episodes occurring at least four times during the

past 12-month period despite ongoing immunosuppressive therapy 60

Recurrent episodes occurring at least four times during the past

12-month period, and; requiring intermittent systemic

immunosuppressive therapy 30

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

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

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

**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)

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

**Supplement *Highlights* reference**: 30(2)

Reserved