b. Duration of Extensions of Hospitalization Ratings Allowed Under 38 CFR 4.29 The 100-percent rating may initially be extended for one two months, or three months, based on a need for convalescence, only when the Veteran received an approved discharge from the hospital. Following discontinuance of the temporary 100-percent rating, assign the appropriate schedular evaluation for any residual disability. Notes: It is permissible to initially assign a convalescence period and extend it another one or two months, if the facts warrant it. Further extensions of one or more months, up to months, may be made upon approval of the Veterans Service Center Manager (VSCM). c. Preparing an Hospitalization Rating Decision If a report of the required hospitalization, such as a 21-day certification, is received before the Veteran is discharged from the hospital, prepare an rating. References: For more information on preparing rating decisions, see , and and on the , and open ended awards under , see M21-1, Part III, Subpart v, 6.D.2.a. d. Following Up on an Hospitalization Rating Decision When following up on an open-ended hospitalization rating decision request a reexamination sufficiently in advance to ensure receipt of the report to expiration of the temporary 100-percent rating continue the 100-percent evaluation in cases in which the Veteran immediately enters into a day hospital program following inpatient hospitalization in excess of 21 days for psychiatric illness, as this action indicates that the Veteran is still in need of treatment and not able to return to employment. Upon receipt of the reexamination report or cessation of treatment in the day hospital program, assign an applicable schedular evaluation for the residuals. Notes: Do not apply the provisions of unless the evaluation in effect prior to hospitalization is reduced following assignment of the 100-percent rating. Authorization will establish a 30-day future diary to ensure receipt of confirmation of treatment or hospital release and the final hospital summary so that the Veteran’s award may be adjusted properly. Reference: For more information on award or discontinuance of entitlement to aid and attendance (A&A) during hospitalization, see M21-1, Part III, Subpart v, 6.C.3.
a. Indefinite Periods of Convalescence a DC The rating schedule prescribes temporary 100-percent evaluations various DCs for indefinite periods of time following treatment (including hospitalization), surgery or certain significant disease manifestations. For the purpose of this section consider these as providing for periods of convalescence regardless of whether or not the word “convalescence” is used or whether the DC refers to . Reference: For more information the interrelationship between convalescence under a DC generally and or , see M21-1, Part IV, Subpart ii, 2.J.5.b. b. Definition: Indefinite Periods of Convalescence A temporary 100-percent evaluation falls into the category indefinite periods of convalescence when the 100-percent criteria refers to an “indefinite” period or does not specify the period for the total evaluation is permitted, or the end point for total disability is not known, therefore may not be set, at the time of rating. Key features of DC provisions providing for indefinite periods of convalescence also include indication that current evidence of active disease or treatment will require a reexamination and reassessment of the disability and a statement that reduction of the total disability is subject to the provisions of . Examples: A mandatory examination is conducted no sooner than one year following hospital discharge subsequent to kidney transplant surgery under . The period that the disability will run may be a year or it may be longer, and the subsequent evaluation is dependent upon reexamination. When the exam will be completed and what subsequent evaluation may be appropriate will not be known at the time of rating. An examination is to be conducted under no sooner than six months following the point at which a malignant neoplasm of the genitourinary system becomes inactive and there is no further antineoplastic treatment or therapy. The period of total disability is not limited, and based on the need for evidence of inactivity, end of treatment and review examination, the end point for total disability will not be known and set at the time of rating. c. Prospective Ratings Under applies to reductions from the period of total disability specified in DCs providing for indefinite periods of convalescence because these evaluations