Document ID: chunk:federal_register_of_legislation:F2023C00151:reg:15:p26
Version: federal_register_of_legislation:F2023C00151
Segment Type: reg
Provision Reference: reg 15 (pt 26/28)
Character Range: 399163–401899

year survival less than 50% of normal.
SEVENTY                     One year survival less than 25% of normal.

No age adjustment permitted for this table

Step 6: Compare the ratings obtained in Steps 4 and 5. Take the higher rating.

The higher of these two ratings will be the rating for the malignant condition on the basis of this chapter.

Step 7: Compare the ratings obtained in Steps 3 and 6. Take the higher rating.

If the rating obtained in Step 3 is higher than that obtained in Step 6, go to Step 8.

If the rating obtained in Step 6 is higher than that obtained in Step 3, then the rating obtained in Step 6 becomes the final rating for the malignant condition and is to be included in the final combining of all ratings.

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

For example, in the case of an accepted carcinoma of the rectum postulated under Step 1, each of the ratings from Chapters 1, 3, and 6 of the Guide is to be separately included in the final combining of all impairment ratings.

CHAPTER 15

INTERMITTENT IMPAIRMENT

INTRODUCTION

Intermittent disorders are conditions:
    that remain at a low level of impairment between discrete episodes of increased impairment;
    or
    where there is one basic type of impairment on which is superimposed episodes of significantly greater impairment of another type.

A sufferer from epilepsy who remains well between "fits" exemplifies the first type of intermittent disorder. A sufferer from Menière's disease whose condition is characterised by deafness and occasional episodes of vertigo exemplifies the second type of intermittent disorder. The deafness may be regarded as the basic type of impairment and the episodes of vertigo may be regarded as the superimposed intermittent impairment. Both elements of the condition are to be assessed.

In this chapter, "attacks" refers to the episode may increased or superimposed impairment. Attacks are to be categorised by reference to their severity, duration and frequency:

    "severity of an attack" refers to the degree to which self-care and normal everyday activities are disrupted by the attack;
    "duration of an attack" refers to the average length of time for which an attack lasts, that is, seconds, minutes, hours or days; and
    "frequency of an attack" refers to the number of affected days in a year.

Intermittent disorders are also disorders that affect one or more body systems. For example, asthma is both an intermittent condition and a cardio-respiratory condition. Hence, potentially, any