Document ID: chunk:federal_register_of_legislation:F2023C00151:reg:54:p2
Version: federal_register_of_legislation:F2023C00151
Segment Type: reg
Provision Reference: reg 54 (pt 2/36)
Character Range: 72827–76590

measured  FVC  expressed as a percentage of predicted   FVC. "%MEF" means measured MEF 25‑75 expressed as a percentage of predicted MEF 25–75.

In each case the percentage is to be rounded to the nearest integer before the formula is applied.

If these formulas are applied the resulting impairment rating is always to be rounded to the nearest integer.

Step 5: Calculate the total accepted cardiorespiratory functional impairment rating.

At this stage there will usually be an impairment rating derived from effort tolerance information and there may also be an impairment rating derived from measurements of lung function. These must be combined into a single cardiorespiratory functional impairment rating. The method by which that is to be done is set out in Table 1.5.

For the purposes of Table 1.5, the following abbreviations have been used:

Abbreviation                       Meaning
"FI"                               means cardiorespiratory functional impairment rating.
"No FI"                            means a cardiorespiratory functional impairment rating cannot be calculated from either effort tolerance information or measurements of lung function.
"METs"                             means the cardiorespiratory functional impairment rating is to be taken as the impairment rating derived from METs alone.
"Spirometry"                       means the cardiorespiratory functional impairment rating is to be taken as the impairment rating derived from measurements of respiratory function.
"average of METs and Spirometry"   means the average of the cardiorespiratory functional impairment rating derived from METs alone and the cardiorespiratory functional impairment rating derived from measurements of respiratory function alone — using the ordinary formula for averaging two quantities or by use of the nomogram in Figure 1c. In either case, the result is to be rounded to the nearest integer.

Procedural Table 1.5
CARDIORESPIRATORY FUNCTIONAL IMPAIRMENT
                                                                                                                       Respiratory disease present          No respiratory disease
                                                                                                                       Spirometry obtainable                Spirometry not obtainable
Cardiac disease present                                                                          METs data obtainable  FI = higher of METs and Spirometry   FI = METs                  FI = METs
METs data not obtainable                                                                         FI = Spirometry       No FI                                No FI
No cardiac disease                                                                               METs data obtainable  FI = average of METs and Spirometry  FI = METs
METs data not obtainable                                                                         FI = Spirometry       No FI
In applying this table, both accepted and non-accepted conditions are to be taken into account.

No age adjustment permitted for this table

From Table 1.5 it will be seen that:

    if cardiac conditions exist in the absence of respiratory disease, cardiorespiratory functional impairment should be measured by effort tolerance alone;
    if respiratory conditions exist in the absence of cardiac disease, the cardiorespiratory functional impairment rating is the rounded average of (i) impairment as measured by effort tolerance, and (ii) impairment as measured by spirometry;
    if both cardiac and respiratory conditions co-exist, the cardiorespiratory functional impairment rating is the greater of (i) the impairment rating as measured by effort tolerance,