Document ID: chunk:federal_register_of_legislation:F2023C00151:reg:70:p8
Version: federal_register_of_legislation:F2023C00151
Segment Type: reg
Provision Reference: reg 70 (pt 8/25)
Character Range: 213561–216977

an accepted neurological condition

Follow the steps below to determine the impairment rating for neurological conditions:
(Each step is elaborated in the following pages.)

STEP 1  Determine an impairment rating for functional loss from the accepted neurological condition, by applying Tables 5.1, 5.2, 5.3, 5.4, and 5.5, as applicable.                                           Page 86
STEP 2  Determine an impairment rating for functional loss from the accepted neurological condition, by applying other applicable chapters of this Guide.                                                     Page 92
STEP 3  Determine a rating for Other Impairment from the accepted neurological condition, by applying Table 5.6 as applicable.                                                                                Page 93
STEP 4  (Omit this step if no rating was given in Step 3.)                                                                                                                                                    Page 93
        Combine the ratings obtained in Step 1 and Step 2, by applying Chapter 18 (Combined Values Chart). Compare the resultant combined rating with the rating obtained in Step 3. Take the higher rating.

Step 1: Determine an impairment rating for functional loss from the accepted neurological condition, by applying Tables 5.1, 5.2, 5.3, 5.4, and 5.5, as applicable.

Cognitive function

"Cognition" means "the faculty of knowledge". The cognitive function deals with such aspects of knowledge as acquisition (learning), retention and recall (memory), and use (reasoning and problem-solving).

Table 5.1 is applied only if an organic brain condition has been diagnosed. It is not to be applied to assess general mental capacity in a veteran with a condition of another body system unrelated to the brain condition. The impairment rating must relate only to cognitive deficits that were not present before the onset of the condition. Psychiatric conditions are to be assessed by applying Chapter 4 (Emotional and Behavioural).

Self-reports of deteriorating mental function must be interpreted with caution. Organic brain disease is often associated with a lack of insight or a tendency to deny failing abilities. Self-reported complaints about poor memory may be more closely related to depressive symptoms than to true memory deficits. If there is doubt about the nature or extent of the deficit, formal psychometric testing may be required.

Table 5.1 addresses memory and new learning ability as well as reasoning and problem-solving abilities. This requires:
    adequate levels of motivation and attention;
    restraint of impulsive tendencies;
    ability to organise, categorise and shift responses;
    use of feedback to modify behaviour; and
    capacity to evaluate final performance.

The ratings reflect increasing grades of severity.

Functional Loss Table 5.1
LOSS OF NEUROLOGICAL FUNCTION: COGNITION
Impairment Ratings                        Criteria
NIL                                        Negligible impairment: reasoning is comparable with that of peers.
                                           Memory similar to that of peers: written notes, etc., used in the manner of busy people of all ages.
TEN                                        Mild impairment: appropriate use is made of accumulated knowledge and reasonable judgement is shown