M21-1 and 38 CFR changes, week of May 13, 2024

Added

• The following terms apply when evaluating conditions in § 4.114:
• (a) Weight loss.
• Substantial weight loss means involuntary loss greater than 20% of an individual's baseline weight sustained for three months with diminished quality of self-care or work tasks.
• The term minor weight loss means involuntary weight loss between 10% and 20% of an individual's baseline weight sustained for three months with gastrointestinal-related symptoms, involving diminished quality of self-care or work tasks, or decreased food intake.
• The term inability to gain weight means substantial weight loss with the inability to regain it despite following appropriate therapy.
• (b) Baseline weight.
• Baseline weight means the clinically documented average weight for the two-year period preceding the onset of illness or, if relevant, the weight recorded at the veteran's most recent discharge physical.
• If neither of these weights is available or currently relevant, then use ideal body weight as determined by either the Hamwi formula or Body Mass Index tables, whichever is most favorable to the veteran.

and 14 more added passages

Removed

• Link to an amendment published at 89 FR 19743, Mar.
• For purposes of evaluating conditions in § 4.114, the term “substantial weight loss” means a loss of greater than 20 percent of the individual's baseline weight, sustained for three months or longer;
• and the term “minor weight loss” means a weight loss of 10 to 20 percent of the individual's baseline weight, sustained for three months or longer.
• The term “inability to gain weight” means that there has been substantial weight loss with inability to regain it despite appropriate therapy.
• “Baseline weight” means the average weight for the two-year-period preceding onset of the disease.

and 5 more removed passages

Added

• Do not combine ratings under diagnostic codes 7301 through 7329 inclusive, 7331, 7342, 7345 through 7350 inclusive, 7352, and 7355 through 7357 inclusive, with each other.
• Instead, when more than one rating is warranted under those diagnostic codes, assign a single evaluation under the diagnostic code that reflects the predominant disability picture, and elevate it to the next higher evaluation if warranted by the severity of the overall disability.
• 7200 Soft tissue injury of the mouth, other than tongue or lips:
• Rate as for disfigurement (diagnostic codes 7800 and 7804) and impairment of mastication.
• 7201 Lips, injuries of:
• Rate as disfigurement (diagnostic codes 7800 and 7804).
• Absent oral nutritional intake | 100
• Intact oral nutritional intake with permanently impaired swallowing function that requires prescribed dietary modification | 60

and 430 more added passages

Removed

• Link to an amendment published at 89 FR 19743, Mar.
• Ratings under diagnostic codes 7301 to 7329, inclusive, 7331, 7342, and 7345 to 7348 inclusive will not be combined with each other.
• A single evaluation will be assigned under the diagnostic code which reflects the predominant disability picture, with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation.
• 7200 Mouth, injuries of.
• Rate as for disfigurement and impairment of function of mastication.
• 7201 Lips, injuries of.
• Rate as for disfigurement of face.

and 231 more removed passages