{"page":"https://casescribe.ai/explorer/regulation-changes/2021-11-22","generated_at":"2026-10-03T18:33:48.140Z","data_as_of":{"decisions":944125,"first_year":2017,"last_year":2026,"latest_decision":"2026-04-30","cfr":"2026-10-01","m21":"2026-09-29"},"about":{"publisher":"CaseScribe AI (VA Law Explorer)","source":"Public Board of Veterans' Appeals decisions (appeals of VA decisions, not VA's first decisions), M21-1 Adjudication Procedures Manual, 38 CFR Parts 3 and 4.","method":"Outcomes are issue-level: each condition the Board decided in a decision counts once. Decision data is extracted by AI and can contain errors. Rates describe past appeals and do not predict any claim.","disclaimer":"For research only. CaseScribe AI is not a law firm and this is not legal advice. Verify figures against the source decisions and regulations.","attribution":"Cite as: VA Law Explorer, CaseScribe AI, with the page URL."},"data":{"week_of":"2021-11-22","changes":[{"source":"38 CFR","section":"Schedule of ratings—cardiovascular system.","date":"2021-11-22","url":"https://www.ecfr.gov/current/title-38/section-4.104","formatting_only":false,"added":["| Rating","Transcutaneous oxygen tension (Tc PO2) is measured at the first intercostal space on the foot.","Normal Tc PO2 is greater than or equal to 60 mm Hg.","If AP, TP, and Tc PO2 testing are not of record, evaluate based on ABI unless the examiner states that an AP, TP, or Tc PO2 test is needed in a particular case because ABI does not sufficiently reflect the severity of the veteran's peripheral arterial disease."],"removed":["Diseases of the Heart[Unless otherwise directed, use this general rating formula to evaluate diseases of the heart.] | Rating","During active infection with valvular heart damage and for three months following cessation of therapy for the active infection | 100","Thereafter, with valvular heart disease (documented by findings on physical examination and either echocardiogram, Doppler echocardiogram, or cardiac catheterization) resulting in:","Chronic congestive heart failure, or;","workload of 3 METs or less results in dyspnea, fatigue, angina, dizziness, or syncope, or;","left ventricular dysfunction with an ejection fraction of less than 30 percent | 100","More than one episode of acute congestive heart failure in the past year, or;","workload of greater than 3 METs but not greater than 5 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or;"]}]}}