Document ID: chunk:federal_register_of_legislation:F2023C00151:reg:45:p2
Version: federal_register_of_legislation:F2023C00151
Segment Type: reg
Provision Reference: reg 45 (pt 2/4)
Character Range: 450851–453680

for a given accepted condition, to compare an impairment rating derived from one table with an impairment rating derived from another table, and when two or more accepted conditions contribute to the impairment ratings from either table.
STEP 2  Find the relative contribution of each contributing condition.

        The relative contribution of each accepted condition to the impairment rating that is to be apportioned should be expressed as a simple ratio. (The ratio should always be expressed in terms of small integers, e.g. 1:2, 1:3, 1:1:2, etc.)

        The judgement of the ratio should be based on appropriate medical advice.
STEP 3  Apportion the single impairment rating into parts.

        Once the ratio is known the single rating is to be apportioned to all the contributing conditions. In common cases (2 or 3 contributing conditions) the apportioned ratings are to be read off Tables 20.1 to 20.13. In unusual cases that are not covered in these tables, the method described on page 197 is to be applied.
STEP 4  For each condition, compare ratings from two relevant tables.

        For each condition, the higher of the two relevant ratings is to be selected.
STEP 5  Do not combine individual ratings until the end.

        Individual ratings obtained from applying the apportionment process are not to be combined until the end of the overall assessment process, when ratings for all of the veteran's assessable conditions are combined to obtain a single value representing the combined impairment rating for accepted conditions.

HOW TO USE APPORTIONMENT

Example
The apportionment process can be illustrated by using the example mentioned in the introduction.

STEP 1  Determine if apportionment is to be used.

        When ischaemic heart disease and chronic bronchitis are both accepted conditions, apportionment has to be used because each of these conditions can be rated from separate Other Impairment tables in Chapter 1.
STEP 2  Find the relative contribution of each contributing condition.

        Suppose that, on medical advice, it is found that the contributions by chronic bronchitis and ischaemic heart disease are in the ratio of 2:1.
STEP 3  Break up the single impairment rating into parts.

        As the ratio is 2:1, Table 20.1 or Table 20.4 is to be used. From either of these it is found that 20 points apportioned in the ratio of 2:1 gives 14 and 7 as the two contributory impairment ratings. Thus the functional impairment rating for chronic bronchitis is 14 points and for ischaemic heart disease it is 7 points.
STEP 4  Compare ratings from two tables for each condition.

        Compare the ratings for ischaemic heart disease (7 versus 10 from Table 1.6) and for chronic bronchitis (14 versus 5 from Table 1.10). Taking the higher rating in each case, the assessment