Document ID: chunk:federal_register_of_legislation:F2016L01332:reg:212:p1
Version: federal_register_of_legislation:F2016L01332
Segment Type: reg
Provision Reference: reg 212 (pt 1/6)
Character Range: 347555–350941

212

Determine the rating for the intermittent attack           Page duration.                                                                          213

Determine the intermittent grading code for the            Page intermittent attack.                                                            213

Determine the impairment rating for the intermittent           Page attack by reference to the number of affected days            214 per year.

Compare the impairment ratings obtained in Step 3            Page and Step 8. Take the higher rating.                                      214

Determine the rating for the impairment resulting           Page from the avoidance or preclusion of otherwise normal            215 activities between attacks.

Step 1: Establish which body systems the intermittent condition affects.

    Before an intermittent condition is assessed, information regarding the extent of the condition must be available. From that information, the affected body systems are to be established and the applicable chapters of this Guide applied.

    Step 2: Determine the functional impairment ratings attributable to the intermittent condition for each affected body system.

    Use the relevant chapters and determine the appropriate rating.

    Chapter 19 (Partially Contributing Impairment) or Chapter 20 (Apportionment) may also have to be applied to allow for the effect of other accepted conditions or non- accepted conditions respectively.

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

    Combine the attributable impairment ratings obtained in Step 2 by applying Table 18.1 (Combined Values Chart) in Chapter 18.

    The combined value so obtained is for use only in Step 9.

    Step 4: Determine whether the attacks are of one or more significant types and group them accordingly.

    If attacks vary in severity, duration or frequency, an average for each parameter is to be established except when the attacks fall naturally and very clearly into groups. In such cases separate the attacks into one or other of these groups. Determine the average severity, duration and frequency of the attacks in each group.

    Perform the following four steps separately for each identified group of attacks.
  Step 5: Determine the rating level for intermittent attack severity using
  Table 15.1.

   SCALE
15.1

INTERMITTENT ATTACK SEVERITY

      Level Criteria

      0 Minor symptoms that are easily tolerated.
I  Mild to moderate symptoms that are irritating or unpleasant but that rarely prevent completion of any activity. Symptoms may cause loss of efficiency in some activities.
II         More severe symptoms, that are distressing, but prevent few everyday activities. Loss of efficiency is discernible else- where. Self-care is unaffected and independence is retained.
      III  Loss of efficiency is discernible in many everyday activities.
Some elements of self-care are restricted but, in most respects, independence is retained.  Bed-rest is often necessary during an attack.
      IV  Major restrictions in many everyday activities. Capacity for
self-care is increasingly restricted, leading to partial dependence on others.
      V  Most everyday activities are prevented. Dependent on others