Document ID: chunk:federal_register_of_legislation:F2016L01332:reg:0:p2
Version: federal_register_of_legislation:F2016L01332
Segment Type: reg
Provision Reference: reg 0 (pt 2/4)
Character Range: 158256–161576

56          52      47      42      38     33       28
  48     58          53      48      43      38     34       29
  49     59          54      49      44      39     34       29
  50     60          55      50      45      40     35       30
  51     61          56      51      46      41     36       31
  52     62          57      52      47      42     36       31
  53     64          58      53      48      42     37       32
  54     65          59      54      49      43     38       32
  55     66          61      55      50      44     39       33
  56     67          62      56      50      45     39       34
  57     68          63      57      51      46     40       34
  58     70          64      58      52      46     41       35
  59     71          65      59      53      47     41       35
  60     72          66      60      54      48     42       36
  61     73          67      61      55      49     43       37
  62     74          68      62      56      50     43       37
  63     76          69      63      57      50     44       38
  64     77          70      64      58      51     45       38
  65     78          72      65      59      52     46       39
  66     79          73      66      59      53     46       40
  67     80          74      67      60      54     47       40
  68     82          75      68      61      54     48       41
  69     83          76      69      62      55     48       41
  70     84          77      70      63      56     49       42

This is a table for making age adjustment

 Table 3.6.1 is to be applied only to impairment ratings derived from Tables 3.1.1,
 3.1.2, 3.2.1, 3.3.1, and 3.3.2.

 Table 3.6.1 is not to be applied to impairment ratings derived from Tables 3.1.3,
 3.1.4, 3.2.2, 3.2.3, 3.2.4, 3.3.3, or 3.4.1.

          Guide to the Assessment of  Lower Limbs Worksheet
          Rates of Veterans' Pensions
          5th edition
                                  File No:

    Veteran's given names:  Veteran's surname: Conditions of lower limbs for assessment:

                             The following entries and calculations are based on a report dated: Veteran's date of birth:

    The veteran has no amputations involving the lower limbs
    Right  ROM  Rating  Left  ROM  Rating

    Hip Knee Ankle Foot
    Foot

see below

Hip Knee Ankle Foot
Foot

see below

    criterion

    ROM rating for right leg =
    (highest from column above)

           criterion

= A  ROM rating for left leg =  = B
           (highest from column above)
Range of movement rating for both legs together (higher of A and B) =  = C Veteran's age =               Rating (adjusted for age) =               = D
    (at date of report)

    Lower limbs function:  Comments (Criterion selected from Table 3.2.2)

Rating:  = E Is the preceding impairment rating (E) wholly due to accepted disabilities?
    What proportion of the preceding rating (E) is due to accepted disabilities?

    What rating is attributable to accepted disabilities?  = F
    (Value E modified by use of Scale 19.2)

    Final functional impairment rating for legs (higher of D and F)  = G

    Signature  Name (Please print)  Date

/ /

       Guide to the Assessment of  Upper Limb Worksheet
       Rates of Veterans' Pensions