Document ID: chunk:federal_register_of_legislation:F2016L01332:reg:207:p1
Version: federal_register_of_legislation:F2016L01332
Segment Type: reg
Provision Reference: reg 207 (pt 1/4)
Character Range: 336326–339323

207

STEP            Compare the ratings obtained in Steps 3 and 6. Take             Page
   7 the higher rating. 207

 STEP            If the rating obtained in Step 3 is higher than that           Page
   8 obtained in Step 6, separate the components of the 207
          rating obtained in Step 3 so that each can be included
          in the final combining of all ratings.

 Step 1: Establish which body systems are affected by the malignant condition.

 Before a malignant condition is assessed, information regarding the extent of the condition must be available. Such information includes the site of the primary, the sites of any secondaries, the effects of any surgery and the effects of any radiotherapy or chemotherapy.

 From that information the affected body systems can be established and the applicable chapters of this Guide applied.

 For example, in the case of an accepted carcinoma of the rectum, there may be surgical resection of the rectum with a colostomy, secondary spread of the cancer to the lungs and spine, and radiotherapy with some resultant digestive disturbances. In such a case, Chapters 1, 3, and 6 of this Guide will have to be applied in Step 1 to arrive at an appropriate functional impairment rating.

 Step 2: Determine the functional impairment ratings for the affected body systems.

 Depending on the body systems that are affected by the malignant condition and its treatment, each of the relevant chapters of the Guide is to be used and appropriate ratings obtained.

 If other accepted or non-accepted conditions also affect any of the same body systems, Chapter 19 (Partially Contributing Impairment) or Chapter 20 (Apportionment) may have to be applied depending upon the circumstances.

Step 3: Determine the total combined impairment rating for the various body system impairments attributable to the malignant condition.

    The total combined impairment rating for the various body system impairments associated with the malignant condition is determined by combining the attributable impairment ratings by applying Chapter 18 (Combined Values Chart).

    Unless the malignant condition is the only accepted condition, this combined rating is to be regarded as an intermediate rating only.

    Step 4: Determine the impairment rating based on Table 14.1 (Malignant
Disorders).

    Apply Table 14.1 and find the relevant impairment rating for the entire set of effects which have arisen from the malignant disorder treatment, including surgical resection, chemotherapy and radiotherapy.

    For the purposes of Table 14.1, "symptoms" encompasses the symptoms of both the malignant condition itself and the symptoms of the effects of its treatment.

    If non-accepted conditions or accepted but non-malignant conditions have contributed to the impairment rating obtained from Table 14.1, Chapter 19 (Apportionment) or Chapter 20 (Partially Contributing  Impairment) are to be applied depending on the circumstances of the case.