Federal Register / Vol. 60, No. 77 / Friday, April 21, 1995 / Rules and Regulations 19851

Paragraph 8. On page 13338 in

amendatory instruction 23, paragraph

(f)(6)(iii)(E) of § 31.303 was redesignated

as paragraph (f)(6)(iii)(D) of § 31.303.

Redesignated paragraph (f)(6)(iii)(D) is

corrected to read as follows:

* * * * *

(f) * * *

(6) * * *

(iii) * * *

(D) Waiver maximum. A State may

receive a waiver of termination of

eligibility from the Administrator under

paragraph (f)(6)(iii)(C) of this section for

a combined maximum of four Formula

Grant Awards through Fiscal Year 1993.

No additional waivers will be granted.

* * * * *

John J. Wilson,

Deputy Administrator, Office of Juvenile

Justice and Delinquency Prevention.

[FR Doc. 95–9826 Filed 4–20–95; 8:45 am]

BILLING CODE 4410–18–P

DEPARTMENT OF DEFENSE

Department of the Army

33 CFR Part 222

Periodic Inspection and Continuing

Evaluation of Completed Civil Works

Structures and Inspection and

Evaluation of Corps of Engineers

Bridges; Rescission

AGENCY: U.S. Army Corps of Engineers,

DOD.

ACTION: Rescission of regulations.

SUMMARY: This final rule rescinds

regulations concerning periodic

inspection and continuing evaluation of

completed civil works structures and

inspection and evaluation of Corps of

Engineers bridges. Both regulations are

no longer required to be published in

the Code of Federal Regulations because

they are for ‘‘in-house’’ guidance only.

This rule renumbers the remaining

regulations in part 222.

EFFECTIVE DATE: March 20, 1995.

ADDRESSES: U.S. Army Corps of

Engineers, Engineering Division,

Directorate of Civil Works, Washington,

DC 20314–1000.

FOR FURTHER INFORMATION CONTACT:

Paul D. Barber or Yung Kuo, (202) 504–

4533.

SUPPLEMENTARY INFORMATION:

List of Subjects in 33 CFR Part 222

Bridges, Dams, Reservoirs. Safety,

Water resources.

For the reasons set forth in the

preamble, 33 CFR part 222 is amended

as follows:

PART 222—ENGINEERING AND

DESIGN

1. The authority citations for part 222

continues to read as follows:

Authority: 23 U.S.C. 116(d); delegation in

49 CFR 1.45(b); 33 U.S.C. 467 et seq.; 33

U.S.C. 701, 701b, and 701c–1 and specific

legislative authorization Acts and Public

Laws listed in appendix E of § 222.7.

2. Sections 222.2 and 222.3 are

removed and §§ 222.4 through 222.8 are

redesignated as §§ 222.2 through 222.6.

Gregory D. Showalter,

Army Federal Register Liaison Officer.

[FR Doc. 95–9654 Filed 4–20–95; 8:45 am]

BILLING CODE 3710–92–M

DEPARTMENT OF VETERANS

AFFAIRS

38 CFR Part 4

RIN 2900–AE72

Schedule for Rating Disabilities;

Gynecological Conditions and

Disorders of the Breast

AGENCY: Department of Veterans Affairs.

ACTION: Final regulation.

SUMMARY: This document amends the

section of the Department of Veterans

Affairs (VA) Schedule for Rating

Disabilities on Gynecological

Conditions and Disorders of the Breast.

This amendment is based on a General

Accounting Office (GAO) study noting

that there has been no comprehensive

review of the rating schedule since

1945, and recommending that such a

review be conducted. The intended

effect of this action is to update the

gynecological and breast disorders

section of the rating schedule to ensure

that it uses current medical terminology,

unambiguous criteria, and that it reflects

medical advances which have occurred

since the last review.

EFFECTIVE DATE: This amendment is

effective May 22, 1995.

FOR FURTHER INFORMATION CONTACT:

Caroll McBrine, M.D., Consultant,

Regulations Staff, Compensation and

Pension Service, Veterans Benefits

Administration, Department of Veterans

Affairs, 810 Vermont Avenue NW.,

Washington, DC 20420, (202) 273–7210.

SUPPLEMENTARY INFORMATION: In

December 1988, the General Accounting

Office (GAO) recommended that VA

prepare a plan for a comprehensive

review of the rating schedule and, based

on the results, revise the medical

criteria accordingly. As part of the

process to implement these

recommendations, VA published in the

Federal Register of March 26, 1992 (57

FR 10450–53) a proposal to amend 38

CFR 4.116 and 4.116a. Interested

persons were invited to submit written

comments, suggestions, or objections on

or before April 27, 1992. We received

comments from Disabled American

Veterans, Veterans of Foreign Wars,

Paralyzed Veterans of America, and

from several VA employees.

Two commenters suggested that we

revise the proposed criteria for rating

endometriosis under diagnostic code

(DC) 7629, placing the emphasis on pain

and abnormal bleeding rather than on

headaches.

Upon further review, VA concurs that

symptoms such as headaches and

muscle cramps are not the most

appropriate criteria for evaluating

endometriosis, and we have therefore

modified the proposed criteria. At the

50 percent level, the proposed criteria

specified endometriomas larger than

2×2 cm., ovary or tubes bound down or

obstructed by adhesions, or obliteration

of the cul-de-sac. These criteria have

been modified to call for lesions

involving the bladder or bowel

confirmed by laparoscopy, pelvic pain

or heavy or irregular bleeding not

controlled by treatment, and bowel or

bladder symptoms. The proposed 30

percent level called for several lesions

or minimal adhesions with side effects

such as headaches, muscle cramps, or

edema despite treatment; but the

schedule has been revised to require

pelvic pain or heavy or irregular

bleeding not controlled by treatment.

One commenter suggested that we

include 10 percent and 100 percent

levels for evaluation of endometriosis.

Upon further consideration we have

added a 10 percent level for those cases

in which pain or bleeding requires

continuous treatment. However,

endometriosis does not in our judgment

reach the level of total disability. Some

women have incapacitating symptoms,

but on a cyclic basis related to their

menstrual periods. Others have milder

symptoms on a constant basis.

Providing a 50 percent level recognizes

the substantial level of disability that

women may experience because of

endometriosis, but we believe that, in

general, the highest level of disability

assigned for a condition should not

exceed the evaluation for absence of the

organ involved. In this case, 50 percent

for removal of the uterus and both

ovaries is the highest post-surgical

evaluation.

One individual suggested that a

convalescent period of six months at

100 percent should be provided for

endometriosis following surgery or

other corrective procedure.