Federal Register / Vol. 75, No. 204 / Friday, October 22, 2010 / Proposed Rules 65279 

therefore, preparation of an 

environmental impact statement will 

not be required. After the comment 

period, an environmental assessment 

will be prepared and it may be reviewed 

at the District office listed at the end of 

the FOR FURTHER INFORMATION CONTACT, 

above. 

d. Unfunded Mandates Act. The 

proposed rule does not impose an 

enforceable duty among the private 

sector and, therefore, is not a Federal 

private sector mandate and is not 

subject to the requirements of Section 

202 or 205 of the Unfunded Mandates 

Reform Act (Pub. L. 104–4, 109 Stat. 48, 

2 U.S.C. 1501 et seq.). We have also 

found under Section 203 of the Act, that 

small governments will not be 

significantly or uniquely affected by this 

proposed rule. 

List of Subjects in 33 CFR Part 334 

Danger zones, Navigation (water), 

Restricted areas, Waterways. 

For the reasons set out in the 

preamble, the Corps proposes to amend 

33 CFR part 334 as follows: 

PART 334—DANGER ZONE AND 

RESTRICTED AREA REGULATIONS 

1. The authority citation for 33 CFR 

part 334 continues to read as follows: 

Authority: 40 Stat. 266 (33 U.S.C. 1) and 

40 Stat. 892 (33 U.S.C. 3). 

2. In § 334.420 add paragraphs 

(b)(1)(v) and (b)(2)(iii) to read as follows: 

§ 334.420 Pamlico Sound and adjacent 

waters, N.C.; danger zones for Marine 

Corps operations. 

* * * * * 

(b) * * * 

(1) * * * 

(v) The waters within a circular band 

with an inner radius of 1.8 statute miles 

and an outer radius of 2.5 statute miles 

having its center at latitude 35°02′12′′, 

longitude 76°28′00′′. 

(2) * * * 

(iii) The areas described in paragraph 

(b)(1)(v) of this section shall be used as 

a strafing area. Practice and dummy 

ammunition will be used. Operations 

will be conducted on five consecutive 

days (Monday through Friday) per 

month during the months of February 

through November between the hours of 

4 p.m. to 11 p.m. The block training 

dates will be scheduled two weeks in 

advance of the actual training start date. 

Marine Corps Air Station, Cherry Point 

will have a call-in number for public 

use to provide information on the 

current use of the training area. The 

Notification to Mariners System will 

also be utilized to inform the public on 

the status of the training area. No vessel 

or person shall enter the area during the 

scheduled block training session except 

for such vessels as may be directed by 

the enforcing agency to enter on 

assigned duties. The area will be 

patrolled and vessels ‘‘buzzed’’ by the 

patrol plane prior to the conduct of 

operations in the area. Vessels or 

personnel which have inadvertently 

entered the danger zone shall leave the 

area immediately upon being so warned. 

* * * * * 

Dated: October 8, 2010. 

Michael G. Ensch, 

Chief, Operations, Directorate of Civil Works. 

[FR Doc. 2010–26442 Filed 10–21–10; 8:45 am] 

BILLING CODE 3720–58–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

38 CFR Part 4 

RIN 2900–AN75 

Schedule for Rating Disabilities; AL 

Amyloidosis (Primary Amyloidosis) 

AGENCY: Department of Veterans Affairs. 

ACTION: Proposed rule. 

SUMMARY: This document proposes to 

amend the Department of Veterans 

Affairs (VA) Schedule for Rating 

Disabilities (rating schedule) by 

updating the schedule of ratings for the 

hemic and lymphatic systems to include 

AL amyloidosis. This regulatory action 

is necessary to add AL amyloidosis as 

one of the disease conditions and 

establish criteria for disability 

evaluation to fully implement the 

decision by the Secretary of Veterans 

Affairs to grant presumptive service 

connection based on herbicide exposure 

for this disease. The intended effects are 

to provide consistency in disability 

ratings and to ease tracking of AL 

amyloidosis for statistical analysis. 

DATES: Comments must be received by 

VA on or before December 21, 2010. 

ADDRESSES: Written comments may be 

submitted through http:// 

www.Regulations.gov; by mail or handdelivery to Director, Regulations 

Management (02REG), Department of 

Veterans Affairs, 810 Vermont Ave., 

NW., Room 1068, Washington, DC 

20420; or by fax to (202) 273–9026. 

Comments should indicate that they are 

submitted in response to ‘‘RIN 2900– 

AN75—Schedule for Rating Disabilities; 

AL Amyloidosis (Primary 

Amyloidosis).’’ All comments received 

will be available for public inspection in 

the Office of Regulation Policy and 

Management, Room 1063B, between the 

hours of 8 a.m. and 4:30 p.m., Monday 

through Friday (except holidays). Please 

call (202) 461–4902 for an appointment. 

(This is not a toll-free number.) In 

addition, during the comment period, 

comments are available online through 

the Federal Docket Management System 

(FDMS) at http://www.Regulations.gov. 

FOR FURTHER INFORMATION CONTACT: 

Thomas J. Kniffen, Chief, Regulations 

Staff (211D), Compensation and Pension 

Service, Veterans Benefits 

Administration, Department of Veterans 

Affairs, 810 Vermont Avenue, NW., 

Washington, DC 20420, (202) 461–9725. 

(This is not a toll-free number.) 

SUPPLEMENTARY INFORMATION: A final 

rule was published in the Federal 

Register at 74 FR 21258 amending 38 

CFR 3.309(e) by adding AL amyloidosis 

to the list of diseases associated with 

exposure to certain herbicide agents. 

Currently, the rating schedule does not 

have a diagnostic code for AL 

amyloidosis. As an unlisted condition, 

it is rated by analogy to non-Hodgkin’s 

lymphoma using the ‘‘built-up’’ 

diagnostic code 7799–7715. However, 

AL amyloidosis is not part of the group 

of diseases under the non-Hodgkin’s 

lymphoma classification, but a disorder 

of the bone marrow characterized by the 

accumulation and deposition of 

abnormal, insoluble proteins called light 

chain amyloid proteins in any organ of 

the body, interfering with the structure 

and function of the organ. Therefore, AL 

amyloidosis requires a set of evaluation 

criteria with a unique diagnostic code, 

which will serve as a basis for disability 

rating. VA proposes a regulation that 

would amend the rating schedule by 

adding rating guidance and a diagnostic 

code specifically for AL amyloidosis. 

AL amyloidosis is a seriously 

disabling, progressive, and incurable 

condition. It is usually fatal within 1 to 

2 years of diagnosis. Because of its rarity 

and rapid progression, AL amyloidosis 

may not be diagnosed until it has 

resulted in considerable multi-organ 

damage (to heart, kidney, liver, spleen, 

intestine, etc.). At the time of diagnosis, 

the most common findings are nephrotic 

syndrome with or without renal 

insufficiency, congestive 

cardiomyopathy, peripheral neuropathy, 

and hepatomegaly. The extent of the 

disease limits the specific types of 

treatments that can be used. Stem cell 

transplantation with high dose 

chemotherapy, an aggressive and risky 

treatment with serious side effects and 

a significant mortality rate, can be used 

in a limited number of patients who 

meet the criteria to undergo such severe 

treatment. This treatment has shown 

promise in prolonging life but does not 


emcdonald on DSK2BSOYB1PROD with PROPOSALS
65280 Federal Register / Vol. 75, No. 204 / Friday, October 22, 2010 / Proposed Rules 

cure the disease. Accumulations of 

amyloid in a specific area of the body 

can sometimes be removed surgically. 

Organ transplants (for example, of a 

kidney or the heart) have extended the 

lives of a small number of people with 

organ failure due to amyloidosis but 

eventually the transplanted organ 

accumulates amyloid. In general, 

treatment can slow the course of the 

disease and help alleviate the symptoms 

of organ damage, but it is not curative. 

AL amyloidosis is a disease most 

closely aligned with other diseases of 

the hemic and lymphatic systems. 

Therefore, VA proposes diagnostic code 

7717 for AL amyloidosis because it is 

the first available diagnostic code in the 

Hemic and Lymphatic Systems listed in 

§ 4.117. 

VA proposes to assign a 100 percent 

rating because the disease is incurable 

and progressive, generally causing death 

in a few years. While AL amyloidosis 

may or may not be totally disabling at 

the time of diagnosis or time of claim for 

VA compensation, its clinical course is 

usually associated with rapid disease 

progression and involvement of 

multiple organ systems. The usual cause 

of death is cardiac, hepatic, or renal 

failure, or infection. The median 

survival rate for AL amyloidosis is 

12–18 months in the United States. 

Providing a 100-percent evaluation in 

all cases would obviate the need to 

reassess and reevaluate veterans with 

AL amyloidosis repeatedly over a short 

period of time. Because of the poor 

prognosis, no follow-up examination 

will be required for re-evaluation of this 

disability rating. 

We also propose to refer to AL 

amyloidosis as ‘‘primary amyloidosis’’, 

which is another common name for the 

same disease. Although the disease may 

also be identified as ‘‘immunocytederived amyloidosis’’ and ‘‘light chainrelated amyloidosis’’, these terms for the 

disease are much less common. 

Therefore, we propose not to include 

them under diagnostic code 7717 

because their inclusion would not be 

useful to the public or VA personnel. 

Finally, we propose to amend 38 CFR 

Part 4, Appendices A, B, and C to reflect 

the proposed addition of diagnostic 

code 7717 for AL amyloidosis to the 

rating schedule. 

Regulatory Flexibility Act 

The Secretary hereby certifies that 

this proposed rule would 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 et seq. This 

proposed rule will not directly affect 

small entities. Only VA beneficiaries 

will be directly affected. Therefore, 

pursuant to 5 U.S.C. 605(b), this 

amendment is exempt from the initial 

and final regulatory flexibility analysis 

requirements of sections 603 and 604. 

Executive Order 12866 

Executive Order 12866 directs 

agencies to assess all 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, and other advantages; 

distributive impacts; and equity). The 

Executive Order classifies a ‘‘significant 

regulatory action,’’ requiring review by 

the Office of Management and Budget 

(OMB) unless OMB waives such review, 

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 the Executive 

Order. 

The economic, interagency, 

budgetary, legal, and policy 

implications of this proposed rule have 

been examined and it has been 

determined not to be a significant 

regulatory action under Executive Order 

12866. 

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 

1 year. This proposed rule would have 

no such effect on State, local, and Tribal 

governments, or on the private sector. 

Catalog of Federal Domestic Assistance 

Numbers and Titles 

The Catalog of Federal Domestic 

Assistance program numbers and titles 

for this proposal are 64.104, Pension for 

Non-Service-Connected Disability for 

Veterans, and 64.109, Veterans 

Compensation for Service-Connected 

Disability. 

Paperwork Reduction Act 

This action contains no provisions 

constituting a collection of information 

under the Paperwork Reduction Act 

(44 U.S.C. 3501 et seq.). 

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. John 

R. Gingrich, Chief of Staff, Department 

of Veterans Affairs, approved this 

document on October 4, 2010, for 

publication. 

List of Subjects in 38 CFR Part 4 

Disability benefits, Pensions, 

Veterans. 

Dated: October 18, 2010. 

Robert C. McFetridge, 

Director, Regulation Policy and Management, 

Office of the General Counsel, Department 

of Veterans Affairs. 

For the reasons stated in the 

preamble, the Department of Veterans 

Affairs proposes to amend 38 CFR part 

4 as set forth below: 

PART 4—SCHEDULE FOR RATING 

DISABILITIES 

1. The authority citation for part 4 

continues to read as follows: 

Authority: 38 U.S.C. 1155, unless 

otherwise noted. 

Subpart B—Disability Ratings 

§ 4.117 [Amended] 

2. In § 4.117, add diagnostic code 

7717, immediately following the note at 

the end of diagnostic code 7716, to read 

as follows: 

§ 4.117 Schedule of ratings—hemic and 

lymphatic systems. 

Rating 

* * * * * 

7717 AL amyloidosis (primary 

amyloidosis) .......................... 100 

* * * * * 

Appendix A to Part 4 [Amended] 

3. In Appendix A to Part 4, under Sec. 

4.117, add diagnostic code 7717 in numerical 

order (following diagnostic code number 

7716) to the table to read as follows: 


emcdonald on DSK2BSOYB1PROD with PROPOSALS
Federal Register / Vol. 75, No. 204 / Friday, October 22, 2010 / Proposed Rules 65281 

APPENDIX A TO PART 4—TABLE OF AMENDMENTS AND EFFECTIVE DATES SINCE 1946 

Sec. Diagnostic 

Code No. 

*******

4.117 

*******

7717 Added [Date 30 days after date of publication of the final rule in the Federal Register]. 

Appendix B to Part 4 [Amended] 

4. In Appendix B to Part 4 add diagnostic 

code 7717 to the table in numerical order 

(following the entry for diagnostic code 

number 7716) and its disability entry ‘‘AL 

amyloidosis (primary amyloidosis)’’ to read 

as follows: 

APPENDIX B TO PART 4—NUMERICAL INDEX OF DISABILITIES

Diagnostic Code No. 

*******

THE HEMIC AND LYMPHATIC SYSTEMS 

*******

7717 .................................... AL amyloidosis (primary amyloidosis). 

*******

Appendix C to Part 4 [Amended] 

5. Appendix C to Part 4 is amended by 

adding in alphabetical order (following 

‘‘Agranulocytosis’’) a new entry ‘‘AL 

amyloidosis’’ and its diagnostic code number 

‘‘7717’’ to read as follows: 

APPENDIX C TO PART 4— 

ALPHABETICAL INDEX OF DISABILITIES

Diagnostic 

Code No. 

* * * * * 

AL amyloidosis ..................... 7717 

* * * * * 

[FR Doc. 2010–26661 Filed 10–21–10; 8:45 am] 

BILLING CODE 8320–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

42 CFR Part 84 

[Docket Numbers NIOSH–221, NIOSH–082A, 

NIOSH–147] 

Public Meeting To Discuss NIOSH’s 

Respirator Standards Development 

Efforts 

AGENCY: National Institute for 

Occupational Safety and Health 

(NIOSH), Centers for Disease Control 

and Prevention (CDC), Department of 

Health and Human Services (HHS). 

ACTION: Notice of a public meeting. 

SUMMARY: The National Institute for 

Occupational Safety and Health 

(NIOSH), National Personal Protective 

Technology Laboratory (NPPTL), will 

conduct a public meeting to discuss 

current respirator standards 

development projects, including the 

NIOSH Regulatory Agenda for updating 

42 CFR part 84, CBRN Combination 

Unit Respirator Performance 

Requirements, and the NIOSH policy on 

SCBA ‘‘Buddy-Breathing’’. There will be 

an opportunity for discussion following 

each topic’s presentations. 

DATES: The public meeting will be held 

8:30 a.m. to 5 p.m., December 9, 2010. 

On-site registration will be held 

beginning at 7:45 a.m. 

ADDRESSES: The public meeting will be 

held at Hyatt Regency Pittsburgh 

International Airport, 1111 Airport 

Boulevard, Pittsburgh, PA 15231, 

telephone 800–233–1234. 

FOR FURTHER INFORMATION CONTACT: 

Jonathan Szalajda, NPPTL, Policy and 

Standards Development Branch Chief, 

P.O. Box 18070, 626 Cochrans Mill 

Road, Pittsburgh, PA 15236, telephone 

412–386–5200, fax 412–386–4089, 

E-mail npptlevents@cdc.gov. 

SUPPLEMENTARY INFORMATION: 

Status: The meeting will be open to 

the public, limited only by the space 

available. The meeting room 

accommodates approximately 125 

people. 

Instructions: Requests to make 

presentations at the public meeting 

should be mailed to the NIOSH Docket 

Officer, Robert A. Taft Laboratories, 

MS–C34, 4676 Columbia Parkway, 

Cincinnati, Ohio 45226. Requests may 

also be submitted by telephone 

513–533–8611, fax 513–533–8285, or 

e-mailed to niocindocket@cdc.gov. All 

requests to present should contain the 

name, address, and telephone number, 

relevant business affiliations of the 

presenter, topic of the presentation, and 

the approximate time requested for the 

presentation. Oral presentations should 

be limited to 15 minutes. 

After reviewing the requests for 

presentations, NIOSH will notify the 

presenters that their presentations are 

scheduled. If a participant is not present 

when his/her presentation is scheduled 

to begin, the remaining participants will 

be heard in order. At the conclusion of 

the meeting, an attempt will be made to 

allow presentations by scheduled 

participants who missed their assigned 

times. Attendees who wish to speak but 

did not submit a request for the 

opportunity to make a presentation may 

be given this opportunity at the 

conclusion of the meeting, at the 

discretion of the presiding officer. 

This meeting will also be using 

Audio/Live Meeting Conferencing, 


emcdonald on DSK2BSOYB1PROD with PROPOSALS