Document ID: chunk:federal_register_of_legislation:F2016L01332:reg:114:p1
Version: federal_register_of_legislation:F2016L01332
Segment Type: reg
Provision Reference: reg 114 (pt 1/8)
Character Range: 184874–188197

114

Step 1: Determine an impairment rating for functional loss from the accepted neurological condition, by applying Tables 5.1, 5.2, 5.3, 5.4, and
  5.5, as applicable.

 Cognitive function

 "Cognition" means "the faculty of knowledge". The cognitive function deals with such aspects of knowledge as acquisition (learning), retention and recall (memory), and use (reasoning and problem-solving).

 Table 5.1 is applied only if an organic brain condition has been diagnosed. It is not to be applied to assess general mental capacity in a veteran with a condition of another body system unrelated to the brain condition. The impairment rating must relate only to cognitive deficits that were not present before the onset of the condition. Psychiatric conditions are to be assessed by applying Chapter 4 (Emotional and Behavioural).

 Self-reports of deteriorating mental function must be interpreted with caution. Organic brain disease is often associated with a lack of insight or a tendency to deny failing abilities. Self-reported complaints about poor memory may be more closely related to depressive symptoms than to true memory deficits. If there is doubt about the nature or extent of the deficit, formal psychometric testing may be required.

Functional Loss
Table 5.1
LOSS OF NEUROLOGICAL FUNCTION: COGNITION

        Impairment
        Ratings Criteria

                     * Negligible impairment: reasoning is comparable with that of peers.

                     * Memory similar to that of peers: written notes, etc., used in the manner of busy people of all ages.

                     * Mild impairment: appropriate use is made of accumulated knowledge and reasonable judgement is shown in routine daily activities most of the time. Difficulties are apparent in new circumstances.

                     * Mild but demonstrable impairment of memory: misplaces objects, and has increased difficulty in remembering names and appointments. Can learn, although at a slower rate than previously. Impairment has little impact on everyday activity because of compensation through reliance on written notes, schedules, checklists and spouse.

                     * Moderate impairment of memory: has frequent difficulty in recalling details of recent experiences; frequently misplaces objects; fails to follow through with intentions or obligations; tends to get lost more easily in unfamiliar areas. Compensation through use of aids, eg lists and diaries, is adequate.

                     * Moderate impairment of problem solving ability, relies on accumulated knowledge.  Suffers significant disadvantage in circumstances requiring complex decision-making or non-routine activities, i.e. when past decision-making is not directly relevant. Has reduced initiative, spontaneity, and capacity for abstract thinking.

                 FORTY        Symptoms as above, but more frequent and severe. Is partially able to compensate, but unable to function with complete independence, and needs some supervision.

   No age adjustment permitted for this table

(continued next page)

 Functional Loss Table 5.1 (cont'd)

      LOSS OF NEUROLOGICAL FUNCTION: COGNITION (continued)

      Impairment
      Ratings Criteria

                  * Severe impairment:  has difficulty in carrying out basic activities