Document ID: chunk:federal_register_of_legislation:F2016L01332:front:0:p13
Version: federal_register_of_legislation:F2016L01332
Segment Type: other
Provision Reference: 
Character Range: 37243–38574

that it would result in a combined impairment rating of at least 68 points.

 The date of the spirometry used must be appropriate to the period of assessment: the spirometry should be not more than six months older than the relevant time in the assessment period to which the information is to be applied.

 The nature of the spirometry should be appropriate: the nature of the spirometric readings should be consistent with the known conditions affecting the veteran and should also be consistent with such other information (eg, old spirometry) as is available or can reasonably be obtained.  There should be no unexplained inconsistencies between the various reports.

 If the nature of the spirometry cannot be reconciled with other relevant information, the spirometry may need to be repeated or the veteran referred to a respiratory physician for clarification of the situation.

If a veteran has emphysema, as evidenced by diminished carbon monoxide diffusing capacity, and diagnosed by a specialist respiratory physician, assessment can be made on the basis of effort tolerance alone.

    Step 3: Determine the impairment rating based on effort tolerance.

    To determine the impairment rating based on effort tolerance follow the substeps below.

    (Each step is elaborated in the following pages.)

    Substep