14308 Federal Register / Vol. 80, No. 53 / Thursday, March 19, 2015 / Rules and Regulations 

transits to minimize any impact caused 

by the temporary deviation. 

In accordance with 33 CFR 117.35(e), 

the drawbridge must return to its regular 

operating schedule immediately at the 

end of the designated time period. This 

deviation from the operating regulations 

is authorized under 33 CFR 117.35. 

Dated: March 11, 2015. 

Steven M. Fischer, 

Bridge Administrator, Thirteenth Coast Guard 

District. 

[FR Doc. 2015–06289 Filed 3–18–15; 8:45 am] 

BILLING CODE 9110–04–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

38 CFR Parts 3 and 4 

RIN 2900–AO96 

Schedule for Rating Disabilities— 

Mental Disorders and Definition of 

Psychosis for Certain VA Purposes 

AGENCY: Department of Veterans Affairs. 

ACTION: Final rule. 

SUMMARY: The Department of Veterans 

Affairs (VA) adopts as final, without 

change, an interim final rule amending 

its Schedule for Rating Disabilities 

(VASRD) dealing with mental disorders 

and its adjudication regulations that 

define the term ‘‘psychosis.’’ Outdated 

references are replaced with references 

to the Diagnostic and Statistical Manual 

of Mental Disorders, Fifth Edition 

(DSM–5). Nomenclature used to refer to 

certain mental disorders is amended to 

conform to DSM–5. This rule also 

provides clarification of the 

applicability date. 

DATES: Effective Date: This rule is 

effective on March 19, 2015. The 

incorporation by reference of certain 

publications listed in the rule is 

approved by the Director of the Federal 

Register as of March 19, 2015. 

Applicability Date: The provisions of 

this final rule shall apply to all 

applications for benefits that are 

received by VA or that are pending 

before the agency of original jurisdiction 

on or after August 4, 2014. The 

Secretary does not intend for the 

provisions of this final rule to apply to 

claims that were pending before the 

Board of Veterans’ Appeals (i.e., 

certified for appeal to the Board of 

Veterans’ Appeals on or before August 

4, 2014), the United States Court of 

Appeals for Veterans Claims, or the 

United States Court of Appeals for the 

Federal Circuit on August 4, 2014, even 

if such claims are subsequently 

remanded to the agency of original 

jurisdiction. 

FOR FURTHER INFORMATION CONTACT: 

Ioulia Vvedenskaya, Medical Officer, 

VASRD Regulations Staff (211C), 

Compensation Service, Veterans 

Benefits Administration, Department of 

Veterans Affairs, 810 Vermont Avenue 

NW., Washington, DC 20420, (202) 461– 

9700. (This is not a toll-free telephone 

number.) 

SUPPLEMENTARY INFORMATION: VA 

published an interim final rule in the 

Federal Register at 79 FR 45093 on 

August 4, 2014, to amend the portion of 

the VASRD dealing with mental 

disorders and its adjudication 

regulations which define the term 

‘‘psychosis.’’ The DSM–5, which was 

published by the American Psychiatric 

Association in May 2013, provides a 

common language and standard criteria 

for the classification of mental 

disorders. The amendments in the 

interim final rule deleted outdated 

references to the DSM–IV and DSM–IV– 

TR and replaced them with references to 

DSM–5. Additionally, the rulemaking 

updated the nomenclature in the 

VASRD to refer to certain mental 

disorders to conform to DSM–5 

terminology. 

VA provided a 60-day public 

comment period, which ended on 

October 3, 2014, and received no public 

comments in response to the 

publication of this interim final rule. 

One non-comment was received from a 

VA employee suggesting additional 

changes to Part 3 regulations which are 

outside the scope of this rulemaking. No 

changes were made as a result of the 

non-comment. Although no comments 

were received on this issue, in 

reviewing the interim final rule to 

prepare for publication of the final rule, 

VA determined that the applicability 

date should be clarified. For the reasons 

set forth in the interim final rule and 

below, we are adopting the interim final 

rule as final, with changes to the 

applicability date, as explained below. 

Upon further review, VA has 

amended the language of the 

applicability date to ensure clarity and 

avoid potential misapplication of this 

final rule. In the interim final rule, VA 

stated that the provisions applied to all 

applications for benefits that are 

received by VA or that are pending 

before the agency of original jurisdiction 

on or after the effective date of the 

interim final rule. For clarity, this 

language has been amended to specify 

that the provisions of the final rule 

apply to claims received by VA or 

pending before the agency of original 

jurisdiction as of August 4, 2014, the 

date the interim final rule was 

published in the Federal Register and 

became effective. Similarly, the interim 

final rule stated that the provisions did 

not apply to claims that were certified 

for appeal to the Board of Veterans’ 

Appeals or were pending before the 

Board of Veterans’ Appeals, the United 

States Court of Appeals for Veterans 

Claims, or the United States Court of 

Appeals for the Federal Circuit. For 

clarity, this language has been amended 

to specify that the provisions of the final 

rule do not apply to claims that were 

pending before the Board of Veterans’ 

Appeals (i.e., certified for appeal to the 

Board of Veterans’ Appeals on or before 

August 4, 2014), the United States Court 

of Appeals for Veterans Claims, or the 

United States Court of Appeals for the 

Federal Circuit on August 4, 2014, even 

if such claims are subsequently 

remanded to the agency of original 

jurisdiction. No other changes or 

amendments to the applicability date 

language are made. 

Incorporation by Reference 

The Director of the Federal Register 

approves the incorporation by reference 

of the American Psychiatric 

Association’s Diagnostic and Statistical 

Manual of Mental Disorders, Fifth 

Edition (DSM–5) (2013) for the purposes 

of 38 CFR 4.125(a) in accordance with 

5 U.S.C. 552(a) and 1 CFR part 51. You 

may obtain a copy from the American 

Psychiatric Association, 1000 Wilson 

Boulevard, Arlington, VA 22209–3901. 

You may inspect a copy at the Office of 

Regulation Policy and Management, 

Department of Veterans Affairs, 810 

Vermont Avenue NW., Room 1068, 

Washington, DC 20420 or the Office of 

the Federal Register, 800 North Capitol 

Street NW., Suite 700, Washington, DC. 

Although §§ 3.384 and 4.130 also 

mention DSM–5, incorporation by 

reference is not required because those 

sections merely refer to the DSM–5 as a 

source and not as a requirement. In 

contrast, § 4.125 requires claims 

adjudicators to use the DSM–5. 

Administrative Procedure Act 

Pursuant to 5 U.S.C. 553(b)(B) and 

(d)(3), VA found that there was good 

cause to dispense with advance public 

notice and opportunity to comment on 

the interim final rule and good cause to 

publish that rule with an immediate 

effective date. The interim final rule was 

necessary to implement immediately the 

Secretary’s decision that health 

professionals must utilize the latest 

diagnostic standards—the DSM–5—the 

same standards used to diagnose and 

treat veterans with mental disorders—to 

adjudicate claims pertaining to mental 


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Federal Register / Vol. 80, No. 53 / Thursday, March 19, 2015 / Rules and Regulations 14309 

disorders. Delay in the implementation 

of this rule would have been 

impracticable, unnecessary, and 

contrary to public interest, particularly 

to veterans. 

It would have been impracticable to 

provide opportunity for prior notice and 

comment for this rulemaking because a 

delay in implementation would have 

required the Veterans Health 

Administration (VHA) to continue to 

diagnose mental disorders under two 

versions of the DSM until this 

regulation became effective, one for 

clinical purposes (under DSM–5) and 

one for compensation purposes (under 

DSM–IV). It would have been 

unnecessary because it was inevitable 

that the Veterans Benefits 

Administration (VBA) would adopt the 

DSM–5 for diagnostic purposes because 

VHA clinicians have a professional duty 

as licensed medical practitioners to use 

the most current medical guidelines, in 

this case the DSM–5. It would have been 

contrary to the public interest because a 

delay in VBA’s transition to the DSM– 

5 would have denied veterans timely 

access to benefits based on current and 

accurate clinical diagnostic criteria 

already adopted by the psychiatric 

community. 

The change to the references from 

DSM–IV and DSM–IV–TR to DSM–5 in 

VBA’s adjudication regulations did not 

present a change in how mental 

disorders are evaluated under the 

VASRD, nor were any disorders 

removed from the VASRD. VA has 

reviewed the contents of the DSM–5 to 

ensure that, while some disabilities 

have been renamed, re-categorized, or 

consolidated into another diagnosis, all 

mental disorders currently listed in the 

VASRD are accounted for. In cases of 

periodic updates of clinical guidelines 

and medical terminology used by the 

medical community, such as DSM–5, 

VA has no authority to comment, 

challenge, or change the content, 

terminology, or nomenclature based on 

public comment. VA’s use of the DSM– 

5 is limited to conforming to the most 

current medical standards and practices 

in diagnosing mental disabilities. 

For the foregoing reasons, and as 

explained in further detail in the 

interim final rule, the Secretary issued 

the rule as an interim final rule with 

immediate effect. 

Executive Orders 12866 and 13563 

Executive Orders 12866 and 13563 

direct agencies to assess the costs and 

benefits of available regulatory 

alternatives and, when regulation is 

necessary, to select regulatory 

approaches that maximize net benefits 

(including potential economic, 

environmental, public health and safety 

effects, and other advantages; 

distributive impacts; and equity). 

Executive Order 13563 (Improving 

Regulation and Regulatory Review) 

emphasizes the importance of 

quantifying both costs and benefits, 

reducing costs, harmonizing rules, and 

promoting flexibility. Executive Order 

12866 (Regulatory Planning and 

Review) defines a ‘‘significant 

regulatory action,’’ which requires 

review by the Office of Management and 

Budget (OMB), as ‘‘any regulatory action 

that is likely to result in a rule that may: 

(1) Have an annual effect on the 

economy of $100 million or more or 

adversely affect in a material way the 

economy, a sector of the economy, 

productivity, competition, jobs, the 

environment, public health or safety, or 

State, local, or tribal governments or 

communities; (2) Create a serious 

inconsistency or otherwise interfere 

with an action taken or planned by 

another agency; (3) Materially alter the 

budgetary impact of entitlements, 

grants, user fees, or loan programs or the 

rights and obligations of recipients 

thereof; or (4) Raise novel legal or policy 

issues arising out of legal mandates, the 

President’s priorities, or the principles 

set forth in this Executive Order.’’ 

The economic, interagency, 

budgetary, legal, and policy 

implications of this final rule have been 

examined, and it has been determined 

not to be a significant regulatory action 

under Executive Order 12866. VA’s 

impact analysis can be found as a 

supporting document at http://

www.regulations.gov, usually within 48 

hours after the rulemaking document is 

published. Additionally, a copy of this 

rulemaking and its impact analysis are 

available on VA’s Web site at http://

www.va.gov/orpm/, by following the 

link for ‘‘VA Regulations Published 

From FY 2004 Through Fiscal Year to 

Date.’’ 

Regulatory Flexibility Act 

The Secretary hereby certifies that 

this final rule will not have a significant 

economic impact on a substantial 

number of small entities as they are 

defined in the Regulatory Flexibility 

Act, 5 U.S.C. 601–612. This final rule 

will not affect any small entities. Only 

certain VA beneficiaries could be 

directly affected. Therefore, pursuant to 

5 U.S.C. 605(b), this rulemaking is 

exempt from the initial and final 

regulatory flexibility analysis 

requirements of sections 603 and 604. 

Unfunded Mandates 

The Unfunded Mandates Reform Act 

of 1995 requires, at 2 U.S.C. 1532, that 

agencies prepare an assessment of 

anticipated costs and benefits before 

issuing any rule that may result in the 

expenditure by State, local, and tribal 

governments, in the aggregate, or by the 

private sector, of $100 million or more 

(adjusted annually for inflation) in any 

one year. This final rule will have no 

such effect on State, local, and tribal 

governments, or on the private sector. 

Paperwork Reduction Act 

This final rule contains no provisions 

constituting a collection of information 

under the Paperwork Reduction Act of 

1995 (44 U.S.C. 3501–3521). 

Catalog of Federal Domestic Assistance 

Numbers and Titles 

The Catalog of Federal Domestic 

Assistance program numbers and titles 

for this rule are 64.009, Veterans 

Medical Care Benefits; 64.104, Pension 

for Non-Service-Connected Disability 

for Veterans; 64.109, Veterans 

Compensation for Service-Connected 

Disability; and 64.110, Veterans 

Dependency and Indemnity 

Compensation for Service-Connected 

Death. 

Signing Authority 

The Secretary of Veterans Affairs, or 

designee, approved this document and 

authorized the undersigned to sign and 

submit the document to the Office of the 

Federal Register for publication 

electronically as an official document of 

the Department of Veterans Affairs. Jose 

D. Riojas, Chief of Staff, Department of 

Veterans Affairs, approved this 

document on March 12, 2015, for 

publication. 

List of Subjects 

38 CFR Part 3 

Administrative practice and 

procedure, Claims, Disability benefits, 

Health care, Pensions, Radioactive 

materials, Veterans, Vietnam. 

38 CFR Part 4 

Disability benefits, Incorporation by 

reference, Pensions, Veterans. 

Dated: March 13, 2015. 

Jeffrey M. Martin, 

Office Manager, Office of Regulation Policy 

& Management, Office of the General Counsel, 

U.S. Department of Veterans Affairs. 

Based on the rationale set forth in the 

interim final rule published in the 

Federal Register at 79 FR 45093 on 

August 4, 2014, and in this document, 

VA is adopting the provisions of the 

interim final rule as a final rule without 

change. 

[FR Doc. 2015–06212 Filed 3–18–15; 8:45 am] 

BILLING CODE 8320–01–P 


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