Document ID: chunk:federal_register_of_legislation:F2016L01332:reg:0:p4
Version: federal_register_of_legislation:F2016L01332
Segment Type: reg
Provision Reference: reg 0 (pt 4/4)
Character Range: 164368–166527

chapter. The higher rating is to be taken.

    Somatic effects

    Psychiatric disease may also be associated with somatic effects such as headache, dyspepsia and psychogenic impotence. If somatic effects occur, they are to be given separate ratings using the respective system-specific tables. It must be clearly established that the somatic effects are part of the psychiatric condition and do not constitute or form part of a separate disease or injury. Conditions in which stress may be implicated as an aetiological agent are not rated under this chapter. These are considered to be separate entitlement issues.

Substance abuse

 Substance abuse is to be assessed using Chapter 4 of this Guide. (For purposes of this chapter "substance abuse" includes "substance dependence".) Chapter 4 is also to be used if substance abuse has been diagnosed under a different, but still psychiatric, diagnostic label.

 If substance abuse is an accepted condition in its own right, it is to be assessed by applying Tables 4.1 to 4.8.

 If substance abuse is not an accepted condition in its own right but the veteran has an accepted psychiatric condition and substance abuse is a clinical feature of that condition, then substance abuse is to be assessed as part of the accepted psychiatric condition (by applying Tables 4.1 to 4.8) only if the substance abuse was present and part of the veteran's psychiatric condition when it was originally accepted.

 If substance abuse is a clinical feature of the veteran's accepted psychiatric condition during  the assessment period  but was not present and part of that condition when it was originally accepted, then substance abuse can only  be assessed if it is claimed and accepted as war-caused or defence-caused.

 See also the Emotional and Behavioural Medical Impairment Worksheet at pages 100-101.

  Calculation of the impairment rating for psychiatric conditions

 Follow the steps below to calculate the impairment rating of accepted psychiatric conditions:

 (Each step is elaborated in the following pages.)

 STEP            Determine an impairment rating from each of Tables          Page