Document ID: chunk:federal_register_of_legislation:F2016L01332:front:0:p7
Version: federal_register_of_legislation:F2016L01332
Segment Type: other
Provision Reference: 
Character Range: 20836–23608

17 are to be dealt with differently. Any applicable ratings from Chapters 13 and 17 are to be combined with any applicable ratings from other chapters in the final combining of all ratings.

 Conditions and their sequelae

 Only the clinical features of an accepted condition may be taken into account in making an assessment. If the accepted condition causes some other distinct and diagnosable condition (sequela), the symptoms of the sequela cannot be taken into

account when assessing the original accepted condition. Sequelae can only be assessed when they have themselves been separately determined to be war-caused or defence- caused.

    As a general guide, a condition that is the subject of a Statement of Principles in force on 18 April 1998 should be taken as a separate disease entity.  For the purposes of the preceding sentence, "Statement of Principles" has the meaning given to it on page 2 of this Guide.

    Applying the instructions

    To the extent of any inconsistency between an instruction in "How to Use this Guide" and a specific instruction concerning a particular matter in another chapter of this Guide, the specific instruction in that other chapter is to apply to that particular matter.

    If assessment of impairment is not possible

    If it is impossible to assess the impairment of an accepted condition that has previously been assessed under this or an earlier edition of the Guide, the impairment rating that was last given for that accepted condition (under this or the earlier edition of the Guide, as the case may be) is to be taken to be the impairment rating for that condition.

    For example, if the veteran has an accepted visual loss, which at the last assessment had been given a rating of 15 impairment points, and is now afflicted with dementia, which prevents the assessment of that visual loss, the impairment rating for that visual loss would be taken to be 15 impairment points for the purposes of the current assessment.

    If the impairment from a particular accepted condition has not previously been assessed (under this or an earlier edition of the Guide) and it is otherwise impossible to assess the impairment of that condition in accordance with this Guide, a best estimate must be made based on what medical and other evidence is available concerning the extent of impairment from that condition.  Such assessment of impairment must take into account the contribution to impairment from other conditions and the expected course of the condition, including the effect of aging by reference to age adjustment tables, as appropriate. The impairment rating given by this method must be as consistent as possible with the relevant steps and tables in this Guide.

    Pain and suffering

    Pain