Document ID: chunk:federal_register_of_legislation:F2023C00151:front:0:p18
Version: federal_register_of_legislation:F2023C00151
Segment Type: other
Provision Reference: 
Character Range: 46686–49562

and 1.3, a veteran's age is taken to be his or her age in whole years at the date of the report relating to the exercise tolerance (unless the report is of a retrospective type and clearly refers to some earlier period, in which case the veteran's age is taken to be his or her age in whole years at the relevant time).

Step 4: (Omit this step if no respiratory disease is present.) Determine the impairment rating based on measurements of lung function.

FEVl, FVC, and MEF 25–75 are the usual physiological measurements of lung function. Determinations of FEVl, FVC, and MEF 25–75 should be conducted by an experienced operator without specific administration of a bronchodilator. The best set of results should be selected, that is, the set of results which indicates the greatest degree of health and, consequently, the lowest degree of impairment.

If both pre-bronchodilator and post-bronchodilator results are available the pre-bronchodilator results are to be applied in determining the impairment rating based on measurements of lung function.

To determine the impairment rating based on measurements of lung function, follow the substeps below.

Substep 4A  Obtain the measured FEVl, FVC, and MEF 25–75 from the data.
Substep 4B  Work out the predicted FEVl, FVC, and MEF 25–75 for a person of the same age, height, and gender. This can be done either by applying the nomograms Figure 1a (for males) or Figure 1b (for females) or by applying the formula relating to each nomogram.
Substep 4C  Express the measured FEV1 as a percentage of the predicted FEV1, and Express the measured FVC as a percentage of the predicted FVC, and Express the measured MEF 25–75 (if appropriate) as a percentage of the predicted MEF 25–75.

            These conversions are performed by applying the formula:
Substep 4D  Determine an impairment rating from a physiological measurement by using the percentage obtained in substep 4C in conjunction with Table 1.4. Separate impairment ratings can be obtained from each physiological measurement (that is, from the FEV1, FVC, and MEF 25–75).
Substep 4E  The final impairment rating is the highest (or equal highest) of the ratings obtained in substep 4D.

Function Loss Table 1.2
LOSS OF CARDIORESPIRATORY FUNCTION: EXERCISE TOLERANCE
(Males)
Age                                                                                                              Symptomatic Activity Level  Age  Symptomatic Activity Level
                                                                                                                 (METs*)                          (METs*)
less than                                                                                                        1–2                         2–3  3–4                         4–5  5–6  6–7  7–8  8–9  10+           1–2  2–3  3–4  4–5  5–6  6–7  7–8  8–9  10+
25