M21-1 and 38 CFR changes, week of Nov 8, 2021

Added

• (2) When a 100% evaluation can be assigned on another basis.
• 6, 2006, as amended at 86 FR 54093, Sept.

and 4 more added passages

Removed

• Link to an amendment published at 86 FR 54093, Sept.
• Link to a correction published at 86 FR 62095, Nov.
• (2) When the left ventricular ejection fraction has been measured and is 50% or less.
• (3) When chronic congestive heart failure is present or there has been more than one episode of congestive heart failure within the past year.
• (4) When a 100% evaluation can be assigned on another basis.

and 3 more removed passages

Added

• Diseases of the Heart[Unless otherwise directed, use this general rating formula to evaluate diseases of the heart.] | Rating
• When the level of METs at which breathlessness, fatigue, angina, dizziness, or syncope develops is required for evaluation, and a laboratory determination of METs by exercise testing cannot be done for medical reasons, a medical examiner may estimate the level of activity (expressed in METs and supported by specific examples, such as slow stair climbing or shoveling snow) that results in those sy…
• For this general formula, heart failure symptoms include, but are not limited to, breathlessness, fatigue, angina, dizziness, arrhythmia, palpitations, or syncope.
• GENERAL RATING FORMULA FOR DISEASES OF THE HEART:
• Workload of 3.0 METs or less results in heart failure symptoms | 100
• Workload of 3.1-5.0 METs results in heart failure symptoms | 60
• Workload of 5.1-7.0 METs results in heart failure symptoms;

and 170 more added passages

Removed

• Link to an amendment published at 86 FR 54093, Sept.
• Link to a correction published at 86 FR 62095, Nov.
• Diseases of the Heart | Rating
• When the level of METs at which dyspnea, fatigue, angina, dizziness, or syncope develops is required for evaluation, and a laboratory determination of METs by exercise testing cannot be done for medical reasons, an estimation by a medical examiner of the level of activity (expressed in METs and supported by specific examples, such as slow stair climbing or shoveling snow) that results in dyspnea,…
• 7000 Valvular heart disease (including rheumatic heart disease):

and 230 more removed passages

Added

• Where diagnostic codes refer the decision maker to these specific areas of dysfunction, only the predominant area of dysfunction shall be considered for rating purposes.
• Distinct disabilities may be evaluated separately under this section, pursuant to § 4.14, if the symptoms do not overlap.
• Chronic kidney disease with glomerular filtration rate (GFR) less than 15 mL/min/1.73 m2 for at least 3 consecutive months during the past 12 months;
• or requiring regular routine dialysis;
• or eligible kidney transplant recipient | 100
• Chronic kidney disease with GFR from 15 to 29 mL/min/1.73 m2 for at least 3 consecutive months during the past 12 months | 80
• Chronic kidney disease with GFR from 30 to 44 mL/min/1.73 m2 for at least 3 consecutive months during the past 12 months | 60
• Chronic kidney disease with GFR from 45 to 59 mL/min/1.73 m2 for at least 3 consecutive months during the past 12 months | 30

and 15 more added passages

Removed

• Link to an amendment published at 86 FR 54085, Sept.
• Where diagnostic codes refer the decisionmaker to these specific areas dysfunction, only the predominant area of dysfunction shall be considered for rating purposes.
• Requiring regular dialysis, or precluding more than sedentary activity from one of the following:
• persistent edema and albuminuria;
• or, BUN more than 80mg%;
• or, creatinine more than 8mg%;
• or, markedly decreased function of kidney or other organ systems, especially cardiovascular | 100

and 14 more removed passages

Added

• Rate as hydronephrosis, except for recurrent stone formation requiring invasive or non-invasive procedures more than two times/year | 30
• 7519 Urethra, fistula of:
• 7520 Penis, removal of half or more | 1 30
• 7521 Penis, removal of glans | 1 20
• 7522 Erectile dysfunction, with or without penile deformity | 1 0
• For the purpose of VA disability evaluation, a disease or traumatic injury of the penis resulting in scarring or deformity shall be rated under diagnostic code 7522.

and 28 more added passages

Removed

• Link to an amendment published at 86 FR 54086, Sept.
• Rate as hydronephrosis, except for recurrent stone formation requiring one or more of the following:
• diet therapy |
• drug therapy |
• invasive or non-invasive procedures more than two times/year | 30

and 28 more removed passages

Added

• Link to a correction published at 86 FR 62095, Nov.

and 1 more added passages

Added

• Link to a correction published at 86 FR 62095, Nov.

and 1 more added passages

Added

• A member of the Armed Forces serving on active duty must have a disability that was incurred or aggravated in line of duty in active military, naval, or air service and meets the requirements described in paragraph (b) of this section.
• A veteran must be entitled to compensation under chapter 11 of title 38, United States Code, for a service-connected disability that meets the requirements described in paragraph (b) of this section.
• The disability must be rated as one of the following:
• (1) A permanent and total disability due to the loss or loss of use of both lower extremities, such as to preclude locomotion without the aid of braces, crutches, canes, or a wheelchair.
• (2) A permanent disability due to blindness in both eyes, having central visual acuity of 20/200 or less in the better eye with the use of a standard correcting lens.
• For the purposes of this paragraph (b)(2), an eye with a limitation in the fields of vision such that the widest diameter of the visual field subtends an angle no greater than 20 degrees shall be considered as having a central visual acuity of 20/200 or less.
• (3) A permanent and total disability due to the loss or loss of use of one lower extremity together with residuals of organic disease or injury which so affect the functions of balance or propulsion as to preclude locomotion without the aid of braces, crutches, canes, or a wheelchair.
• (4) A permanent and total disability due to the loss or loss of use of one lower extremity together with the loss or loss of use of one upper extremity which so affect the functions of balance or propulsion as to preclude locomotion without the aid of braces, crutches, canes, or a wheelchair.

and 4 more added passages

Removed

• Link to an amendment published at 86 FR 56215, Oct.
• A member of the Armed Forces serving on active duty must have a disability rated as permanent and total that was incurred or aggravated in line of duty in active military, naval, or air service.
• A veteran must be entitled to compensation under chapter 11 of title 38, United States Code, for a disability rated as permanent and total.
• The disability must be due to:
• (1) The loss or loss of use of both lower extremities, such as to preclude locomotion without the aid of braces, crutches, canes, or a wheelchair,
• (2) Blindness in both eyes, having only light perception, plus the anatomical loss or loss of use of one lower extremity,
• (3) The loss or loss of use of one lower extremity together with residuals of organic disease or injury which so affect the functions of balance or propulsion as to preclude locomotion without the aid of braces, crutches, canes, or a wheelchair,

and 5 more removed passages

Added

• (b) A member of the Armed Forces serving on active duty must have a disability that was incurred or aggravated in line of duty in active military, naval, or air service and meets the requirements described in paragraph (c) of this section.
• A veteran must be entitled to compensation under chapter 11 of title 38, United States Code, for a disability that meets the requirements described in paragraph (c) of this section.
• (c) VA has rated the disability as permanently and totally disabling and it:
• (1) Includes the anatomical loss or loss of use of both hands;
• (2) Is due to deep partial thickness burns that have resulted in contracture(s) with limitation of motion of two or more extremities or of at least one extremity and the trunk;
• (3) Is due to full thickness or subdermal burns that have resulted in contracture(s) with limitation of motion of one or more extremities or the trunk;
• (4) Is due to residuals of an inhalation injury (including, but not limited to, pulmonary fibrosis, asthma, and chronic obstructive pulmonary disease).

and 3 more added passages

Removed

• Link to an amendment published at 86 FR 56216, Oct.
• (b) A member of the Armed Forces serving on active duty must have a disability that was incurred or aggravated in line of duty in active military, naval, or air service and meets the requirements described in either paragraph (b)(1) or (b)(2) of this section.
• A veteran must be entitled to compensation under chapter 11 of title 38, United States Code, for a disability that meets the requirements described in either paragraph (b)(1) or (b)(2) of this section.
• (1) VA has rated the disability as permanently and totally disabling and it:
• (i) Includes the anatomical loss or loss of use of both hands;
• (ii) Is due to deep partial thickness burns that have resulted in contracture(s) with limitation of motion of two or more extremities or of at least one extremity and the trunk;
• (iii) Is due to full thickness or subdermal burns that have resulted in contracture(s) with limitation of motion of one or more extremities or the trunk;

and 6 more removed passages