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Custom Federal Regulations Service



This is supplemental material
for Book C of your set of
Federal Regulations

Title 38, Part 4



Schedule for Rating Disabilities

Veterans Benefits Administration

Supplement No. 30


Covering period of Federal Register issues

through August 18, 2002

Copyright © 2002 Jonathan Publishing
Need Assistance?

Printing for all supplements is performed by the United States Government

Printing Office. Distribution is the responsibility of the

VA Forms and Publications Depot. Accordingly:


Questions concerning missing supplements, need for additional books, and other distribution list issues for this loose-leaf service should be directed to:


Department of Veterans Affairs

Veterans Benefits Administration

Directives, Forms and Records Staff

Mail Code: 20S5

810 Vermont Avenue, N.W.

Washington DC 20420

Telephone: 202/273-7080

Fax: 202/275-5947


Questions concerning the filing instructions for this loose-leaf service,

or the reporting of substantive errors in the text,

may be directed to:


Jonathan Publishing

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Austin TX 78746

Telephone: 512/328-2480

Fax: 512/328-5365

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Internet: http://www.jonpub.com

Copyright © 2002 Jonathan Publishing


GENERAL INSTRUCTIONS

Custom Federal Regulations Service



Supplemental Materials for Book C
Code of Federal Regulations
Title 38, Part 4
Schedule for Rating Disabilities

Veterans Benefits Administration
Supplement No. 30
25 August 2002
Covering the period of Federal Register issues

through August 18, 2002


When Book C was originally prepared, it was current through final regulations published in the Federal Register of 24 March 1992. These supple­mental materials are designed to keep your regulations up to date. You should file the attached pages immediately, and record the fact that you did so on the Supplement Filing Record which is at page C-8 of Book C, Schedule for Rating Disabilities.

To ensure accuracy and timeliness of your materials,

it is important that you follow these simple procedures:
1. Always file your supplemental materials immediately upon receipt.
2. Before filing, always check the Supplement Filing Record (page C-8) to be sure that all prior supplements have been filed. If you are missing any supple­ments, contact the Veterans Benefits Administration at the address listed on page C-2.
3. After filing, enter the relevant information on the Supplement Filing Record sheet (page C-8)—the date filed, name/initials of filer, and date through which the Federal Register is covered.
4. If as a result of a failure to file, or an undelivered supplement, you have more than one supplement to file at a time, be certain to file them in chronological order, lower number first.
5. Always retain the filing instructions (simply insert them at the back of the book) as a backup record of filing and for reference in case of a filing error.
6. Be certain that you permanently discard any pages indicated for removal in the filing instructions in order to avoid confusion later.

To execute the filing instructions, simply remove and throw away the pages listed under Remove These Old Pages, and replace them in each case with the corres­pond­ing pages from this supplement listed under Add These New Pages. Occasionally new pages will be added without removal of any old material (reflecting new regulations), and occasionally old pages will be removed with­out addition of any new material (reflecting rescinded regulations)—in these cases the word None will appear in the appropriate column.


FILING INSTRUCTIONS

Book C, Supplement No. 30

August 25, 2002


Remove these Add these Section(s)

old pages new pages Affected

Do not file this supplement until you confirm that

all prior supplements have been filed
Index-1 to Index-64 Index-1 to Index-64 Index to Book C

4.68-1 to 4.71-1 4.68-1 to 4.71-1 §4.71
4.71a-5 to 4.71a-8 4.71a-5 to 4.71a-8 §4.71a
4.71a-13 to 4.71a-28 4.71a-13 to 4.71a-28 §4.71a

4.118-1 to 4.118-4 4.118-1 to 4.118-10 §4.118



Be sure to complete the

Supplement Filing Record (page C-8)

when you have finished filing this material.

HIGHLIGHTS

Book C, Supplement No. 30

August 25, 2002
Supplement Highlights references: Where substantive changes are made in the text of regulations, the paragraphs of Highlights sections are cited at the end of the relevant section of text. Thus, if you are reading §3.263, you will see a note at the end of that section which reads: “Supplement Highlights references—6(2).” This means that paragraph 2 of the Highlights section in Supplement No. 6 contains information about the changes made in §3.263. By keeping and filing the Highlights sections, you will have a reference source explaining all substantive changes in the text of the regulations.
Supplement frequency: This Book C (Schedule for Rating Disabilities) was originally supplemented four times a year, in February, May, August, and November. Beginning 1 August 1995, supplements will be issued every month during which a final rule addition or modification is made to the parts of Title 38 covered by this book. Supplements will be numbered consecutively as issued.

Modifications in this supplement include the following:
1. On 26 July 2002, the VA published a final rule, effective 26 August 2002, to amend the Schedule for Rating Disabilities by revising the evaluation criteria for ankylosis and limitation of motion of the fingers and thumb in order to assure that veterans diagnosed with these conditions receive consistent evaluations. Changes:

• In §4.71, revised the last sentence;

• In §4.71a, in tables Multiple Finger Amputations and Single Finger Amputations, replaced middle with long; and

• In §4.71a, removed tables Multiple Fingers: Unfavorable Ankylosis, Multiple Fingers: Favorable Ankylosis, and Ankylosis of Individual Fingers, and replaced them with a new table Evaluation of Ankylosis or Limitation of Motion of Single or Multiple Digits of the Hand.

2. On 31 July 2002, the VA published a final rule, effective 30 August 2002, to amend the Schedule for Rating Disabilities in order to update the portion of the rating schedule that deals with skin to ensure that it uses current medical terminology and unambiguous criteria, and that it reflects medical advances that have occurred since the last review. Changes:

• Revised §4.118.



Index 2 — Alphabetical

Note: This index is not part of the Code of Federal Regulations.

It was created, and is maintained, by Jonathan Publishing

specifically for this looseleaf service.


Note to users of this index — We want to continually improve this index as a

search tool in any way that will be useful to you. If you have suggestions for

additional cross-references, multiple entries, special groupings of terms, or

any other change, simply fax your ideas to Jonathan Publishing at:


512/328-5365


Diagnostic Code

Term (where applicable) Section
A
Abdominal conditions, coexisting 4.113

Abscess:


Kidney 7501 4.115b

Lung, chronic 6824 4.97

Accommodation, paralysis of (eye) 6030 4.84a

Acne 7828 4.118

Acromegaly 7908 4.119

Actinomycosis 6822 4.97

Addison’s disease (adrenal cortical

hypofunction) 7911 4.119

Adenitis, tuberculous, active or inactive 7710 4.117

Adhesions, pericardial 7003 4.104

Adjustment disorder, chronic (see Mental Disorders—Schedule of Ratings)

Adrenal cortical hypofunction 7911 4.119

Age in service-connected claims 4.19

Agoraphobia 9412 4.130

Agranulocytosis, acute 7702 4.117

Alopecia:

Areata 7831 4.118

Scarring 7830 4.118

Alzheimer’s type dementia 9312 4.130

Amebiasis 7321 4.114

Aminoacidurias 7532 4.115b

Amnestic disorders (see Mental Disorders—Schedule of Ratings)

Amputation, generally (see specific item)

Amputations: Upper Extremity (see Musculoskeletal System—Schedule

of Ratings—Amputations, Upper Extremity and Lower Extremity)

Amyotrophic lateral sclerosis 8017 4.124a

Analogous ratings 4.20

Anemia, hypochromic-microcytic and

megaloblastic 7700 4.117

Aneurysm, aortic 7110 4.104

Angioneurotic edema 7118 4.104

Anorexia nervosa 9520 4.130

Ankle:

Ankylosis of 5270 4.71a



Astragalectomy 5274 4.71a

Limited motion of 5271 4.71a

Os calcis or astragalus, malunion of 5273 4.71a

Replacement (prosthesis) 5056 4.71a

Subastragalar or tarsal joint, ankylosis of 5272 4.71a

Ankylosis and joint motion, measurement Plates I–II 4.71

Ano, fistula in 7335 4.114

Anxiety disorders (see Mental Disorders—Schedule of Ratings)

Aphakia 6029 4.84a

Aphonia, complete organic 6519 4.97

Aplastic anemia 7716 4.117

Application of rating schedule 4.21

Arm, amputation of:

Above insertion of deltoid 5121 4.71a

Below insertion of deltoid 5122 4.71a

Disarticulation 5120 4.71a

Limitation of motion of 5201 4.71a

Arrhythmias:

Supraventricular 7010 4.104

Ventricular (sustained) 7011 4.104

Arteries and veins, diseases of:

Aneurysm, aortic 7110 4.104

Angioneurotic edema 7118 4.104

Arteriosclerosis obliterans 7114 4.104

Arteriovenous fistula, traumatic 7113 4.104

Artery, any large, aneurysm of 7111 4.104

Artery, any small, aneurysm of 7112 4.104

Cold injury residuals 7122 4.104

Erythromelalgia 7119 4.104

Hypertensive vascular disease 7101 4.104 Post-phlebitic syndrome of any etiology 7121 4.104

Raynaud’s syndrome 7117 4.104

Soft-tissue sarcoma (of vascular origin) 7123 4.104

Thrombo-angiitis obliterans (Buerger’s disease) 7115 4.104

Varicose veins 7120 4.104

Arteriosclerosis:

Cerebral 8046 4.124a

Obliterans 7114 4.104

Arteriosclerotic heart disease 7005 4.104

Arteriovenous fistula, traumatic 7113 4.104
Artery:

Large, any, aneurysm of 7111 4.104

Small, any, aneurysm of 7112 4.104

Arthritis

Degenerative 5003 4.71a

Gonorrheal 5004 4.71a

Other types 5009 4.71a

Pneumococcic 5005 4.71a

Rheumatoid (atrophic) 5002 4.71a

Streptococcic 5008 4.71a

Syphilitic 5007 4.71a

Trauma, due to 5010 4.71a

Typhoid 5006 4.71a

Asbestosis 6833 4.97

Aspergillosis 6838 4.97

Asthma, bronchial 6602 4.97

Atherosclerotic renal disease 7534 4.115b

Athetosis, acquired 8107 4.124a

Attitude of rating officers 4.23

Auditory acuity, impairment of (see also Ear, Hearing):

Evaluation of hearing impairment 4.85

Hearing impairment, evaluation of 4.85

Auricle, loss of 6207 4.87

Atrioventricular block 7015 4.104

Avitaminosis 6313 4.88b

Avoidance of pyramiding 4.14



B
Bacillary dysentery 7322 4.114

Bartonellosis 6306 4.88b

Bartter’s syndrome 7532 4.115b

Beriberi 6314 4.88b

Bilateral factor 4.26

Bipolar disorder 9432 4.130

Bladder:

Calculus in 7513 4.115b

Fistula of 7516 4.115b

Injury of 7517 4.115b

Neurogenic 7542 4.115b

Blastomycosis 6836 4.97

Blindness (see Visual acuity)

Bones:


Caisson disease of, 5011 4.71a

New growths of, benign 5015 4.71a

New growths of, malignant 5012 4.71a

Bones and joints, tuberculosis of,

active or inactive 5001 4.71a

Bones of the foot Plate IV 4.71

Bones of the hand Plate III 4.71

Brain:


Abscess of 8020 4.124a

Disease due to trauma 8045 4.124a

New growth of:

Benign 8003 4.124a

Malignant 8002 4.124a

Vessels:


Embolism of 8007 4.124a

Hemorrhage from 8009 4.124a

Thrombosis of 8008 4.124a

Breast:


Surgery of 7626 4.116

Neoplasms of:

Benign 7628 4.116

Malignant 7627 4.116

Bronchi and trachea, diseases of:

Asthma, bronchial 6602 4.97

Bronchiectasis 6601 4.97

Bronchitis, chronic 6600 4.97

Chronic obstructive pulmonary disease 6604 4.97

Emphysema, pulmonary 6603 4.97

Obstructive pulmonary disease, chronic 6604 4.97

Pulmonary disease, obstructive, chronic 6604 4.97

Bronchiectasis 6601 4.97

Bronchitis, chronic 6600 4.97

Brucellosis 6316 4.88b

Buerger’s disease (thrombo-angiitis obliterans) 7115 4.104

Bulbar palsy 8005 4.124a

Bulimia nervosa 9521 4.130

Bullous disorders 7815 4.118

Bursitis 5019 4.71a

Bypass, coronary artery 7017 4.104
C

C-cell hyperplasia of the thyroid 7919 4.119

Cardiac pacemakers, implantable 7018 4.104

Cardiac transplantation 7019 4.104

Cardiomyopathy 7020 4.104


cardiovascular system—schedule of ratings:
Arteries and veins, diseases of
Aneurysm, aortic 7110 4.104

Angioneurotic edema 7118 4.104

Arteriosclerosis obliterans 7114 4.104

Arteriovenous fistula, traumatic 7113 4.104

Artery, any large, aneurysm of 7111 4.104

Artery, any small, aneurysm of 7112 4.104

Cold injury residuals 7122 4.104

Erythromelalgia 7119 4.104

Hypertensive vascular disease 7101 4.104 Post-phlebitic syndrome of any etiology 7121 4.104

Raynaud’s syndrome 7117 4.104

Soft-tissue sarcoma (of vascular origin) 7123 4.104

Thrombo-angiitis obliterans (Buerger’s disease) 7115 4.104

Varicose veins 7120 4.104
Heart, diseases of

Adhesions, pericardial 7003 4.104

Arteriosclerotic heart disease 7005 4.104

Atrioventricular block 7015 4.104

Cardiac transplantation 7019 4.104

Cardiomyopathy 7020 4.104

Coronary artery bypass 7017 4.104

Coronary artery disease 7005 4.104

Endocarditis 7001 4.104

Heart valve replacement (prosthesis) 7016 4.104

Hypertensive heart disease 7007 4.104

Hyperthyroid heart disease 7008 4.104

Implantable cardiac pacemakers 7018 4.104

Myocardial infarction 7006 4.104

Pericardial adhesions 7003 4.104

Pericarditis 7002 4.104

Rheumatic heart disease 7000 4.104

Syphilitic heart disease 7004 4.104

Valvular heart disease 7000 4.104

Ventricular arrhythmias (sustained) 7011 4.104




Cartilage:

Semilunar, dislocated 5258 4.71a

Semilunar, removal of 5259 4.71a

Cataract:

Senile, and others 6028 4.84a

Traumatic 6027 4.84a

Cerebral arteriosclerosis 8046 4.124a

Cervix, disease of injury of 7612 4.116

Change of diagnosis, effect 4.13

Chest wall defect, traumatic 6843 4.97

Chloracne 7829 4.118

Cholangitis, chronic 7316 4.114

Cholecystitis, chronic 7314 4.114

Cholera, Asiatic 6300 4.88b

Chorea:


Huntington’s 8106 4.124a

Sydenham’s 8105 4.124a

Choroiditis 6005 4.84a

Chronic adjustment disorder (see Mental Disorders—Schedule of Ratings)

Chronic fatigue syndrome 4.88a

Chronic fatigue syndrome 6354 4.88b

Cirrhosis of liver 7312 4.114

Clavicle or scapula, impairment of 5203 4.71a

Coccidioidomycosis 6835 4.97

Coccyx, removal of 5298 4.71a

Code numbers, diagnostic, use of 4.27

Cognitive disorders (see Mental Disorders—Schedule of Ratings)

Cold injury residuals 7122 4.104

Colitis:


Mucous 7319 4.114

Spastic 7319 4.114

Ulcerative 7323 4.114

Combined ratings table Table I 4.25

Condyloid process, loss of, one or both sides 9908 4.150

Congenital or developmental defects 4.9

Conjunctivitis:

Other, chronic 6018 4.84a

Trachomatous, chronic 6017 4.84a

Convalescent ratings 4.30

Convalescence ratings following extended hospitalization 4.128

Conversion disorder 9424 4.130

Convulsive disorders (see Neurological Conditions and Convulsive Disorders)

Coronary artery:

Bypass 7017 4.104

Disease 7005 4.104

Coronoid process, loss of 9909 4.150

Correspondence 4.24

Cranial Nerves, diseases of (see Neurological System and Convulsive Disorders— Schedule of Ratings)

Cryptococcosis 6837 4.97

Cushing’s syndrome 7906 4.119

Cutaneous manifestations of collagen-vascular

disease (not listed elsewhere) 7821 4.118

Cyclitis 6004 4.84a

Cyclothymic disorder 9431 4.130

Cystic diseases of the kidney 7533 4.115b

Cystitis, chronic 7512 4.115b

D
Dacryocystitis 6031 4.84a

Degenerative arthritis 5003 4.71a

Delirium (see Mental Disorders—Schedule of Ratings)

Dermatitis, exfoliative 7817 4.118

Dermatitis or eczema 7806 4.118

Dementia (see Mental Disorders—Schedule of Ratings)





Dental and oral conditions—schedule of ratings:
Condyloid process, loss of, one or both sides 9908 4.150

Coronoid process, loss of 9909 4.150

Hard palate, loss of half or more 9911 4.150

Hard palate, loss of less than half of 9912 4.150

Mandible, loss of approximately one-half 9902 4.150

Mandible, loss of, complete, between angles 9901 4.150

Mandible, malunion of 9904 4.150

Mandible, nonunion of 9903 4.150

Maxilla or mandible, chronic osteomyelitis or

osteoradionecrosis of 9900 4.150

Maxilla, loss of half or less 9915 4.150

Maxilla, loss of more than half 9914 4.150

Maxilla, malunion or nonunion of 9916 4.150

Ramus, loss of less than one-half the substance

of, not involving loss of continuity 9907 4.150

Ramus, loss of whole or part of 9906 4.150

Teeth, loss of, due to loss of substance of body

of maxilla or mandible without loss of

continuity 9913 4.150

Temporomandibular articulation, limited

motion of 9905 4.150


Depersonalization disorder 9417 4.130

Depressive disorder, major 9434 4.130

Dermatophytosis 7813 4.118

Desquamative interstitial pneumonitis 6826 4.97

Developmental or congenital defects 4.9

Diabetes:

Insipidus 7909 4.119

Mellitus 7913 4.119

Diagnosis, change of, effect 4.13

Diagnostic code numbers, use of 4.27

Diaphragm:

Paralysis or paresis 6840 4.97

Rupture of, with herniation 5324 4.73

Diffuse interstitial fibrosis 6825 4.97

Digestive system:

Abdominal conditions, coexisting 4.113

Postgastrectomy syndromes 4.111

Ulcers 4.110

Weight loss 4.112


digestive system—schedule of ratings:
Amebiasis 7321 4.114

Ano, fistula in 7335 4.114

Benign neoplasms of the digestive system 7344 4.114

Cholangitis, chronic 7316 4.114

Cholecystitis, chronic 7314 4.114

Cholelithiasis, chronic 7315 4.114

Colitis, ulcerative 7323 4.114

Distomiasis, intestinal or hepatic 7324 4.114

Diverticulitis 7327 4.114

Dysentery, bacillary 7322 4.114

Enteritis, chronic 7325 4.114

Enterocolitis, chronic 7326 4.114

Esophagus, diverticulum of, acquired 7205 4.114

Esophagus, spasm of (cardiospasm) 7204 4.114

Esophagus, stricture of 7203 4.114

Gall bladder, injury of 7317 4.114

Gall bladder, removal of 7318 4.114

Gastritis, hypertrophic 7307 4.114

Hemochromatosis 7345 4.114

Hemorrhoids, external or internal 7336 4.114

Hepatitis (B & C) 7345, 7354 4.114

Hernia hiatal 7346 4.114

Hernia, femoral 7340 4.114

Hernia, inguinal 7338 4.114

Hernia, ventral, postoperative 7339 4.114

Intestine, fistula of, persistent 7330 4.114

Intestine, large, resection of 7329 4.114

Intestine, small, resection of 7328 4.114

Irritable colon syndrome (spastic colitis,

mucous colitis, etc.) 7319 4.114

Lips, injuries of 7201 4.114

Liver, cirrhosis of 7312 4.114

Liver, injury of 7311 4.114

Liver, transplant 7351 4.114

Malignant neoplasms of the digestive system 7343 4.114

Mouth, injuries of 7200 4.114

Pancreatitis 7347 4.114

Peritoneum, adhesions of 7301 4.114

Peritonitis, tuberculous, active or inactive 7331 4.114

Postgastrectomy syndromes 7308 4.114

Pruritus ani 7337 4.114

Rectum and anus, impairment of sphincter

control 7332 4.114

Rectum, prolapse of 7334 4.114

Rectum and anus, stricture of 7333 4.114

Stomach, injury of 7310 4.114

Stomach, stenosis of 7309 4.114

Tongue, loss of whole or part 7202 4.114

Ulcer, duodenal 7305 4.114

Ulcer, gastric 7304 4.114

Ulcer, marginal 7306 4.114

Vagotomy with pyloroplasty or

gastroenterostomy 7348 4.114

Visceroptosis, symptomatic, marked 7342 4.114



Digits (see Fingers)

Diplopia 6090 4.84a

Diplopia, due to limited muscle function 6092 4.84a

Disabilities:

Aggravated by active service, rating of 4.22

Service-connected, requiring hospital

treatment or observation, ratings for 4.29

Disability:

Ratings, total 4.15

Ratings, total, for compensation based

on unemployability of the individual 4.16

Rating, total, for pension based on

unemployability and age of the individual 4.17

Disfigurement of the head, fact, or neck 7800 4.118

Disseminated intravascular coagulation with

renal cortical necrosis 7540 4.115b

Dissociative disorders (see Mental Disorders—Schedule of Ratings)

Distomiasis, intestinal or hepatic 7324 4.114

Diverticulitis 7327 4.114

Drug-induced pulmonary pneumonitis

and fibrosis 6829 4.97

Dysentery, bacillary 7322 4.114

Dysthymic disorder 9433 4.130



E

Ear—Schedule of Ratings
Auricle, loss of 6207 4.87

Benign neoplasms of the ear 6209 4.87

Cholesteatoma 6200 4.87

Chronic nonsuppurative otitis media 6201 4.87

Chronic otitis externa 6210 4.87

Chronic suppurative otitis media 6200 4.87

Endolymphatic hydrops 6205 4.87

Malignant neoplasm of the ear 6208 4.87

Mastoiditis 6200 4.87

Meniere’s syndrome 6205 4.87

Otosclerosis 6202 4.87

Peripheral vestibular disorders 6204 4.87

Tinnitus, recurrent 6260 4.87

Tympanic membrane, perforation of 6211 4.87




Eating disorders (see Mental Disorders—Schedule of Ratings)

Ectropion 6020 4.84a

Effect of change of diagnosis 4.13

Elbow and Forearm:

Elbow, ankylosis of 5205 4.71a

Elbow, other impairment of Flail joint 5209 4.71a

Forearm, flexion limited to 100º

and extension to 45º 5208 4.71a

Forearm, limitation of extension of 5207 4.71a

Forearm, limitation of flexion of 5206 4.71a

Radius and ulna, nonunion of 5210 4.71a

Radius, impairment of 5212 4.71a

Supination and pronation, impairment of 5213 4.71a

Ulna, impairment of 5211 4.71a

Elbow:

Ankylosis of 5205 4.71a



Other impairment of Flail joint 5209 4.71a

Replacement (prosthesis) 5052 4.71a

Emphysema, pulmonary 6603 4.97

Encephalitis, epidemic, chronic 8000 4.124a

Endocarditis 7001 4.104

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