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Electronic Code of Federal Regulations

e-CFR Data is current as of April 21, 2014

Title 38: Pensions, Bonuses, and Veterans' Relief
PART 4—SCHEDULE FOR RATING DISABILITIES
Subpart B—Disability Ratings


§4.124a   Schedule of ratings—neurological conditions and convulsive disorders.

[With the exceptions noted, disability from the following diseases and their residuals may be rated from 10 percent to 100 percent in proportion to the impairment of motor, sensory, or mental function. Consider especially psychotic manifestations, complete or partial loss of use of one or more extremities, speech disturbances, impairment of vision, disturbances of gait, tremors, visceral manifestations, etc., referring to the appropriate bodily system of the schedule. With partial loss of use of one or more extremities from neurological lesions, rate by comparison with the mild, moderate, severe, or complete paralysis of peripheral nerves]

Organic Diseases of the Central Nervous System

   Rating
8000   Encephalitis, epidemic, chronic:
As active febrile disease100
Rate residuals, minimum10
Brain, new growth of:
8002   Malignant100
Note: The rating in code 8002 will be continued for 2 years following cessation of surgical, chemotherapeutic or other treatment modality. At this point, if the residuals have stabilized, the rating will be made on neurological residuals according to symptomatology.
Minimum rating30
8003   Benign, minimum60
Rate residuals, minimum10
8004   Paralysis agitans:
Minimum rating30
8005   Bulbar palsy100
8007   Brain, vessels, embolism of.
8008   Brain, vessels, thrombosis of.
8009   Brain, vessels, hemorrhage from:
Rate the vascular conditions under Codes 8007 through 8009, for 6 months100
Rate residuals, thereafter, minimum10
8010   Myelitis:
Minimum rating10
8011   Poliomyelitis, anterior:
As active febrile disease100
Rate residuals, minimum10
8012   Hematomyelia:
For 6 months100
Rate residuals, minimum10
8013   Syphilis, cerebrospinal.
8014   Syphilis, meningovascular.
8015   Tabes dorsalis.
Note: Rate upon the severity of convulsions, paralysis, visual impairment or psychotic involvement, etc.
8017   Amyotrophic lateral sclerosis100
Note: Consider the need for special monthly compensation.
8018   Multiple sclerosis:
Minimum rating30
8019   Meningitis, cerebrospinal, epidemic:
As active febrile disease100
Rate residuals, minimum10
8020   Brain, abscess of:
As active disease100
Rate residuals, minimum10
Spinal cord, new growths of:
8021   Malignant100
Note: The rating in code 8021 will be continued for 2 years following cessation of surgical, chemotherapeutic or other treatment modality. At this point, if the residuals have stabilized, the rating will be made on neurological residuals according to symptomatology.
Minimum rating30
8022   Benign, minimum rating60
Rate residuals, minimum10
8023   Progressive muscular atrophy:
Minimum rating30
8024   Syringomyelia:
Minimum rating30
8025   Myasthenia gravis:
Minimum rating30
Note: It is required for the minimum ratings for residuals under diagnostic codes 8000-8025, that there be ascertainable residuals. Determinations as to the presence of residuals not capable of objective verification, i.e., headaches, dizziness, fatigability, must be approached on the basis of the diagnosis recorded; subjective residuals will be accepted when consistent with the disease and not more likely attributable to other disease or no disease. It is of exceptional importance that when ratings in excess of the prescribed minimum ratings are assigned, the diagnostic codes utilized as bases of evaluation be cited, in addition to the codes identifying the diagnoses.
8045   Residuals of traumatic brain injury (TBI):
There are three main areas of dysfunction that may result from TBI and have profound effects on functioning: cognitive (which is common in varying degrees after TBI), emotional/behavioral, and physical. Each of these areas of dysfunction may require evaluation.
Cognitive impairment is defined as decreased memory, concentration, attention, and executive functions of the brain. Executive functions are goal setting, speed of information processing, planning, organizing, prioritizing, self-monitoring, problem solving, judgment, decision making, spontaneity, and flexibility in changing actions when they are not productive. Not all of these brain functions may be affected in a given individual with cognitive impairment, and some functions may be affected more severely than others. In a given individual, symptoms may fluctuate in severity from day to day. Evaluate cognitive impairment under the table titled “Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified.”
Subjective symptoms may be the only residual of TBI or may be associated with cognitive impairment or other areas of dysfunction. Evaluate subjective symptoms that are residuals of TBI, whether or not they are part of cognitive impairment, under the subjective symptoms facet in the table titled “Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified.” However, separately evaluate any residual with a distinct diagnosis that may be evaluated under another diagnostic code, such as migraine headache or Meniere's disease, even if that diagnosis is based on subjective symptoms, rather than under the “Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified” table
Evaluate emotional/behavioral dysfunction under §4.130 (Schedule of ratings—mental disorders) when there is a diagnosis of a mental disorder. When there is no diagnosis of a mental disorder, evaluate emotional/behavioral symptoms under the criteria in the table titled “Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified.”
Evaluate physical (including neurological) dysfunction based on the following list, under an appropriate diagnostic code: Motor and sensory dysfunction, including pain, of the extremities and face; visual impairment; hearing loss and tinnitus; loss of sense of smell and taste; seizures; gait, coordination, and balance problems; speech and other communication difficulties, including aphasia and related disorders, and dysarthria; neurogenic bladder; neurogenic bowel; cranial nerve dysfunctions; autonomic nerve dysfunctions; and endocrine dysfunctions.
The preceding list of types of physical dysfunction does not encompass all possible residuals of TBI. For residuals not listed here that are reported on an examination, evaluate under the most appropriate diagnostic code. Evaluate each condition separately, as long as the same signs and symptoms are not used to support more than one evaluation, and combine under §4.25 the evaluations for each separately rated condition. The evaluation assigned based on the “Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified” table will be considered the evaluation for a single condition for purposes of combining with other disability evaluations
Consider the need for special monthly compensation for such problems as loss of use of an extremity, certain sensory impairments, erectile dysfunction, the need for aid and attendance (including for protection from hazards or dangers incident to the daily environment due to cognitive impairment), being housebound, etc
Evaluation of Cognitive Impairment and Subjective Symptoms
The table titled “Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified” contains 10 important facets of TBI related to cognitive impairment and subjective symptoms. It provides criteria for levels of impairment for each facet, as appropriate, ranging from 0 to 3, and a 5th level, the highest level of impairment, labeled “total.” However, not every facet has every level of severity. The Consciousness facet, for example, does not provide for an impairment level other than “total,” since any level of impaired consciousness would be totally disabling. Assign a 100-percent evaluation if “total” is the level of evaluation for one or more facets. If no facet is evaluated as “total,” assign the overall percentage evaluation based on the level of the highest facet as follows: 0 = 0 percent; 1 = 10 percent; 2 = 40 percent; and 3 = 70 percent. For example, assign a 70 percent evaluation if 3 is the highest level of evaluation for any facet.
Note (1): There may be an overlap of manifestations of conditions evaluated under the table titled “Evaluation Of Cognitive Impairment And Other Residuals Of TBI Not Otherwise Classified” with manifestations of a comorbid mental or neurologic or other physical disorder that can be separately evaluated under another diagnostic code. In such cases, do not assign more than one evaluation based on the same manifestations. If the manifestations of two or more conditions cannot be clearly separated, assign a single evaluation under whichever set of diagnostic criteria allows the better assessment of overall impaired functioning due to both conditions. However, if the manifestations are clearly separable, assign a separate evaluation for each condition.
Note (2): Symptoms listed as examples at certain evaluation levels in the table are only examples and are not symptoms that must be present in order to assign a particular evaluation.
Note (3): “Instrumental activities of daily living” refers to activities other than self-care that are needed for independent living, such as meal preparation, doing housework and other chores, shopping, traveling, doing laundry, being responsible for one's own medications, and using a telephone. These activities are distinguished from “Activities of daily living,” which refers to basic self-care and includes bathing or showering, dressing, eating, getting in or out of bed or a chair, and using the toilet.
Note (4): The terms “mild,” “moderate,” and “severe” TBI, which may appear in medical records, refer to a classification of TBI made at, or close to, the time of injury rather than to the current level of functioning. This classification does not affect the rating assigned under diagnostic code 8045.
Note (5): A veteran whose residuals of TBI are rated under a version of §4.124a, diagnostic code 8045, in effect before October 23, 2008 may request review under diagnostic code 8045, irrespective of whether his or her disability has worsened since the last review. VA will review that veteran's disability rating to determine whether the veteran may be entitled to a higher disability rating under diagnostic code 8045. A request for review pursuant to this note will be treated as a claim for an increased rating for purposes of determining the effective date of an increased rating awarded as a result of such review; however, in no case will the award be effective before October 23, 2008. For the purposes of determining the effective date of an increased rating awarded as a result of such review, VA will apply 38 CFR 3.114, if applicable.
8046   Cerebral arteriosclerosis:
Purely neurological disabilities, such as hemiplegia, cranial nerve paralysis, etc., due to cerebral arteriosclerosis will be rated under the diagnostic codes dealing with such specific disabilities, with citation of a hyphenated diagnostic code (e.g., 8046-8207).
Purely subjective complaints such as headache, dizziness, tinnitus, insomnia and irritability, recognized as symptomatic of a properly diagnosed cerebral arteriosclerosis, will be rated 10 percent and no more under diagnostic code 9305. This 10 percent rating will not be combined with any other rating for a disability due to cerebral or generalized arteriosclerosis. Ratings in excess of 10 percent for cerebral arteriosclerosis under diagnostic code 9305 are not assignable in the absence of a diagnosis of multi-infarct dementia with cerebral arteriosclerosis.
Note: The ratings under code 8046 apply only when the diagnosis of cerebral arteriosclerosis is substantiated by the entire clinical picture and not solely on findings of retinal arteriosclerosis.

Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified

Facets of cognitive
impairment and other
residuals of TBI not
otherwise classified
Level of
impairment
Criteria
Memory, attention, concentration, executive functions0No complaints of impairment of memory, attention, concentration, or executive functions.
   1A complaint of mild loss of memory (such as having difficulty following a conversation, recalling recent conversations, remembering names of new acquaintances, or finding words, or often misplacing items), attention, concentration, or executive functions, but without objective evidence on testing.
   2Objective evidence on testing of mild impairment of memory, attention, concentration, or executive functions resulting in mild functional impairment.
   3Objective evidence on testing of moderate impairment of memory, attention, concentration, or executive functions resulting in moderate functional impairment.
   TotalObjective evidence on testing of severe impairment of memory, attention, concentration, or executive functions resulting in severe functional impairment.
Judgment0Normal.
   1Mildly impaired judgment. For complex or unfamiliar decisions, occasionally unable to identify, understand, and weigh the alternatives, understand the consequences of choices, and make a reasonable decision.
   2Moderately impaired judgment. For complex or unfamiliar decisions, usually unable to identify, understand, and weigh the alternatives, understand the consequences of choices, and make a reasonable decision, although has little difficulty with simple decisions.
   3Moderately severely impaired judgment. For even routine and familiar decisions, occasionally unable to identify, understand, and weigh the alternatives, understand the consequences of choices, and make a reasonable decision.
   TotalSeverely impaired judgment. For even routine and familiar decisions, usually unable to identify, understand, and weigh the alternatives, understand the consequences of choices, and make a reasonable decision. For example, unable to determine appropriate clothing for current weather conditions or judge when to avoid dangerous situations or activities.
Social interaction0Social interaction is routinely appropriate.
   1Social interaction is occasionally inappropriate.
   2Social interaction is frequently inappropriate.
   3Social interaction is inappropriate most or all of the time.
Orientation0Always oriented to person, time, place, and situation.
   1Occasionally disoriented to one of the four aspects (person, time, place, situation) of orientation.
   2Occasionally disoriented to two of the four aspects (person, time, place, situation) of orientation or often disoriented to one aspect of orientation.
   3Often disoriented to two or more of the four aspects (person, time, place, situation) of orientation.
   TotalConsistently disoriented to two or more of the four aspects (person, time, place, situation) of orientation.
Motor activity (with intact motor and sensory system)0Motor activity normal.
   1Motor activity normal most of the time, but mildly slowed at times due to apraxia (inability to perform previously learned motor activities, despite normal motor function).
   2Motor activity mildly decreased or with moderate slowing due to apraxia.
   3Motor activity moderately decreased due to apraxia.
   TotalMotor activity severely decreased due to apraxia.
Visual spatial orientation0Normal.
   1Mildly impaired. Occasionally gets lost in unfamiliar surroundings, has difficulty reading maps or following directions. Is able to use assistive devices such as GPS (global positioning system).
   2Moderately impaired. Usually gets lost in unfamiliar surroundings, has difficulty reading maps, following directions, and judging distance. Has difficulty using assistive devices such as GPS (global positioning system).
   3Moderately severely impaired. Gets lost even in familiar surroundings, unable to use assistive devices such as GPS (global positioning system).
   TotalSeverely impaired. May be unable to touch or name own body parts when asked by the examiner, identify the relative position in space of two different objects, or find the way from one room to another in a familiar environment.
Subjective symptoms0Subjective symptoms that do not interfere with work; instrumental activities of daily living; or work, family, or other close relationships. Examples are: mild or occasional headaches, mild anxiety.
   1Three or more subjective symptoms that mildly interfere with work; instrumental activities of daily living; or work, family, or other close relationships. Examples of findings that might be seen at this level of impairment are: intermittent dizziness, daily mild to moderate headaches, tinnitus, frequent insomnia, hypersensitivity to sound, hypersensitivity to light.
   2Three or more subjective symptoms that moderately interfere with work; instrumental activities of daily living; or work, family, or other close relationships. Examples of findings that might be seen at this level of impairment are: marked fatigability, blurred or double vision, headaches requiring rest periods during most days.
Neurobehavioral effects0One or more neurobehavioral effects that do not interfere with workplace interaction or social interaction. Examples of neurobehavioral effects are: Irritability, impulsivity, unpredictability, lack of motivation, verbal aggression, physical aggression, belligerence, apathy, lack of empathy, moodiness, lack of cooperation, inflexibility, and impaired awareness of disability. Any of these effects may range from slight to severe, although verbal and physical aggression are likely to have a more serious impact on workplace interaction and social interaction than some of the other effects.
   1One or more neurobehavioral effects that occasionally interfere with workplace interaction, social interaction, or both but do not preclude them.
   2One or more neurobehavioral effects that frequently interfere with workplace interaction, social interaction, or both but do not preclude them.
   3One or more neurobehavioral effects that interfere with or preclude workplace interaction, social interaction, or both on most days or that occasionally require supervision for safety of self or others.
Communication0Able to communicate by spoken and written language (expressive communication), and to comprehend spoken and written language.
   1Comprehension or expression, or both, of either spoken language or written language is only occasionally impaired. Can communicate complex ideas.
   2Inability to communicate either by spoken language, written language, or both, more than occasionally but less than half of the time, or to comprehend spoken language, written language, or both, more than occasionally but less than half of the time. Can generally communicate complex ideas.
   3Inability to communicate either by spoken language, written language, or both, at least half of the time but not all of the time, or to comprehend spoken language, written language, or both, at least half of the time but not all of the time. May rely on gestures or other alternative modes of communication. Able to communicate basic needs.
   TotalComplete inability to communicate either by spoken language, written language, or both, or to comprehend spoken language, written language, or both. Unable to communicate basic needs.
ConsciousnessTotalPersistently altered state of consciousness, such as vegetative state, minimally responsive state, coma.

Miscellaneous Diseases

   Rating
8100   Migraine:
With very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability50
With characteristic prostrating attacks occurring on an average once a month over last several months30
With characteristic prostrating attacks averaging one in 2 months over last several months10
With less frequent attacks0
8103   Tic, convulsive:
Severe30
Moderate10
Mild0
Note: Depending upon frequency, severity, muscle groups involved.
8104   Paramyoclonus multiplex (convulsive state, myoclonic type):
Rate as tic; convulsive; severe cases60
8105   Chorea, Sydenham's:
Pronounced, progressive grave types100
Severe80
Moderately severe50
Moderate30
Mild10
Note: Consider rheumatic etiology and complications.
8106   Chorea, Huntington's.
Rate as Sydenham's chorea. This, though a familial disease, has its onset in late adult life, and is considered a ratable disability.
8107   Athetosis, acquired.
Rate as chorea.
8108   Narcolepsy.
Rate as for epilepsy, petit mal.

Diseases of the Cranial Nerves

   Rating
Disability from lesions of peripheral portions of first, second, third, fourth, sixth, and eighth nerves will be rated under the Organs of Special Sense. The ratings for the cranial nerves are for unilateral involvement; when bilateral, combine but without the bilateral factor.
Fifth (trigeminal) cranial nerve
8205   Paralysis of:
Complete50
Incomplete, severe30
Incomplete, moderate10
Note: Dependent upon relative degree of sensory manifestation or motor loss.
8305   Neuritis.
8405   Neuralgia.
Note: Tic douloureux may be rated in accordance with severity, up to complete paralysis.
Seventh (facial) cranial nerve
8207   Paralysis of:
Complete30
Incomplete, severe20
Incomplete, moderate10
Note: Dependent upon relative loss of innervation of facial muscles.
8307   Neuritis.
8407   Neuralgia.
Ninth (glossopharyngeal) cranial nerve
8209   Paralysis of:
Complete30
Incomplete, severe20
Incomplete, moderate10
Note: Dependent upon relative loss of ordinary sensation in mucous membrane of the pharynx, fauces, and tonsils.
8309   Neuritis.
8409   Neuralgia.
Tenth (pneumogastric, vagus) cranial nerve
8210   Paralysis of:
Complete50
Incomplete, severe30
Incomplete, moderate10
Note : Dependent upon extent of sensory and motor loss to organs of voice, respiration, pharynx, stomach and heart.
8310   Neuritis.
8410   Neuralgia.
Eleventh (spinal accessory, external branch) cranial nerve.
8211   Paralysis of:
Complete30
Incomplete, severe20
Incomplete, moderate10
Note: Dependent upon loss of motor function of sternomastoid and trapezius muscles.
8311   Neuritis.
8411   Neuralgia.
Twelfth (hypoglossal) cranial nerve.
8212   Paralysis of:
Complete50
Incomplete, severe30
Incomplete, moderate10
Note: Dependent upon loss of motor function of tongue.
8312   Neuritis.
8412   Neuralgia.

Diseases of the Peripheral Nerves

Schedule of ratings Rating
Major Minor
The term “incomplete paralysis,” with this and other peripheral nerve injuries, indicates a degree of lost or impaired function substantially less than the type picture for complete paralysis given with each nerve, whether due to varied level of the nerve lesion or to partial regeneration. When the involvement is wholly sensory, the rating should be for the mild, or at most, the moderate degree. The ratings for the peripheral nerves are for unilateral involvement; when bilateral, combine with application of the bilateral factor.
Upper radicular group (fifth and sixth cervicals)
8510   Paralysis of:
Complete; all shoulder and elbow movements lost or severely affected, hand and wrist movements not affected7060
Incomplete:
Severe5040
Moderate4030
Mild2020
8610   Neuritis.
8710   Neuralgia.
Middle radicular group
8511   Paralysis of:
Complete; adduction, abduction and rotation of arm, flexion of elbow, and extension of wrist lost or severely affected7060
Incomplete:
Severe5040
Moderate4030
Mild2020
8611   Neuritis.
8711   Neuralgia.
Lower radicular group
8512   Paralysis of:
Complete; all intrinsic muscles of hand, and some or all of flexors of wrist and fingers, paralyzed (substantial loss of use of hand)7060
Incomplete:
Severe5040
Moderate4030
Mild2020
8612   Neuritis.
8712   Neuralgia.
All radicular groups
8513   Paralysis of:
Complete9080
Incomplete:
Severe7060
Moderate4030
Mild2020
8613   Neuritis.
8713   Neuralgia.
The musculospiral nerve (radial nerve)
8514   Paralysis of:
Complete; drop of hand and fingers, wrist and fingers perpetually flexed, the thumb adducted falling within the line of the outer border of the index finger; can not extend hand at wrist, extend proximal phalanges of fingers, extend thumb, or make lateral movement of wrist; supination of hand, extension and flexion of elbow weakened, the loss of synergic motion of extensors impairs the hand grip seriously; total paralysis of the triceps occurs only as the greatest rarity7060
Incomplete:
Severe5040
Moderate3020
Mild2020
8614   Neuritis.
8714   Neuralgia.
Note: Lesions involving only “dissociation of extensor communis digitorum” and “paralysis below the extensor communis digitorum,” will not exceed the moderate rating under code 8514.
The median nerve
8515   Paralysis of:
Complete; the hand inclined to the ulnar side, the index and middle fingers more extended than normally, considerable atrophy of the muscles of the thenar eminence, the thumb in the plane of the hand (ape hand); pronation incomplete and defective, absence of flexion of index finger and feeble flexion of middle finger, cannot make a fist, index and middle fingers remain extended; cannot flex distal phalanx of thumb, defective opposition and abduction of the thumb, at right angles to palm; flexion of wrist weakened; pain with trophic disturbances7060
Incomplete:
Severe5040
Moderate3020
Mild1010
8615   Neuritis.
8715   Neuralgia.
The ulnar nerve
8516   Paralysis of:
Complete; the “griffin claw” deformity, due to flexor contraction of ring and little fingers, atrophy very marked in dorsal interspace and thenar and hypothenar eminences; loss of extension of ring and little fingers cannot spread the fingers (or reverse), cannot adduct the thumb; flexion of wrist weakened6050
Incomplete:
Severe4030
Moderate3020
Mild1010
8616   Neuritis.
8716   Neuralgia.
Musculocutaneous nerve
8517   Paralysis of:
Complete; weakness but not loss of flexion of elbow and supination of forearm3020
Incomplete:
Severe2020
Moderate1010
Mild00
8617   Neuritis.
8717   Neuralgia.
Circumflex nerve
8518   Paralysis of:
Complete; abduction of arm is impossible, outward rotation is weakened; muscles supplied are deltoid and teres minor5040
Incomplete:
Severe3020
Moderate1010
Mild00
8618   Neuritis.
8718   Neuralgia.
Long thoracic nerve
8519   Paralysis of:
Complete; inability to raise arm above shoulder level, winged scapula deformity3020
Incomplete:
Severe2020
Moderate1010
Mild00
Note: Not to be combined with lost motion above shoulder level.
8619   Neuritis.
8719   Neuralgia.
Note: Combined nerve injuries should be rated by reference to the major involvement, or if sufficient in extent, consider radicular group ratings.
   Rating
Sciatic nerve
8520   Paralysis of:
Complete; the foot dangles and drops, no active movement possible of muscles below the knee, flexion of knee weakened or (very rarely) lost80
Incomplete:
Severe, with marked muscular atrophy60
Moderately severe40
Moderate20
Mild10
8620   Neuritis.
8720   Neuralgia.
External popliteal nerve (common peroneal)
8521   Paralysis of:
Complete; foot drop and slight droop of first phalanges of all toes, cannot dorsiflex the foot, extension (dorsal flexion) of proximal phalanges of toes lost; abduction of foot lost, adduction weakened; anesthesia covers entire dorsum of foot and toes40
Incomplete:
Severe30
Moderate20
Mild10
8621   Neuritis.
8721   Neuralgia.
Musculocutaneous nerve (superficial peroneal)
8522   Paralysis of:
Complete; eversion of foot weakened30
Incomplete:
Severe20
Moderate10
Mild0
8622   Neuritis.
8722   Neuralgia.
Anterior tibial nerve (deep peroneal)
8523   Paralysis of:
Complete; dorsal flexion of foot lost30
Incomplete:
Severe20
Moderate10
Mild0
8623   Neuritis.
8723   Neuralgia.
Internal popliteal nerve (tibial)
8524   Paralysis of:
Complete; plantar flexion lost, frank adduction of foot impossible, flexion and separation of toes abolished; no muscle in sole can move; in lesions of the nerve high in popliteal fossa, plantar flexion of foot is lost40
Incomplete:
Severe30
Moderate20
Mild10
8624   Neuritis.
8724   Neuralgia.
Posterior tibial nerve
8525   Paralysis of:
Complete; paralysis of all muscles of sole of foot, frequently with painful paralysis of a causalgic nature; toes cannot be flexed; adduction is weakened; plantar flexion is impaired30
Incomplete:
Severe20
Moderate10
Mild10
8625   Neuritis.
8725   Neuralgia.
Anterior crural nerve (femoral)
8526   Paralysis of:
Complete; paralysis of quadriceps extensor muscles40
Incomplete:
Severe30
Moderate20
Mild10
8626   Neuritis.
8726   Neuralgia.
Internal saphenous nerve
8527   Paralysis of:
Severe to complete10
Mild to moderate0
8627   Neuritis.
8727   Neuralgia.
Obturator nerve
8528   Paralysis of:
Severe to complete10
Mild or moderate0
8628   Neuritis.
8728   Neuralgia.
External cutaneous nerve of thigh
8529   Paralysis of:
Severe to complete10
Mild or moderate0
8629   Neuritis.
8729   Neuralgia.
Ilio-inguinal nerve
8530   Paralysis of:
Severe to complete10
Mild or moderate0
8630   Neuritis.
8730   Neuralgia.
8540   Soft-tissue sarcoma (of neurogenic origin)100
Note: The 100 percent rating will be continued for 6 months following the cessation of surgical, X-ray, antineoplastic chemotherapy or other therapeutic procedure. At this point, if there has been no local recurrence or metastases, the rating will be made on residuals.

The Epilepsies

   Rating
A thorough study of all material in §§4.121 and 4.122 of the preface and under the ratings for epilepsy is necessary prior to any rating action.
8910   Epilepsy, grand mal.
Rate under the general rating formula for major seizures.
8911   Epilepsy, petit mal.
Rate under the general rating formula for minor seizures.
Note (1): A major seizure is characterized by the generalized tonic-clonic convulsion with unconsciousness.
Note (2): A minor seizure consists of a brief interruption in consciousness or conscious control associated with staring or rhythmic blinking of the eyes or nodding of the head (“pure” petit mal), or sudden jerking movements of the arms, trunk, or head (myoclonic type) or sudden loss of postural control (akinetic type).
General Rating Formula for Major and Minor Epileptic Seizures:
Averaging at least 1 major seizure per month over the last year100
Averaging at least 1 major seizure in 3 months over the last year; or more than 10 minor seizures weekly80
Averaging at least 1 major seizure in 4 months over the last year; or 9-10 minor seizures per week60
At least 1 major seizure in the last 6 months or 2 in the last year; or averaging at least 5 to 8 minor seizures weekly40
At least 1 major seizure in the last 2 years; or at least 2 minor seizures in the last 6 months20
A confirmed diagnosis of epilepsy with a history of seizures10
Note (1): When continuous medication is shown necessary for the control of epilepsy, the minimum evaluation will be 10 percent. This rating will not be combined with any other rating for epilepsy.
Note (2): In the presence of major and minor seizures, rate the predominating type.
Note (3): There will be no distinction between diurnal and nocturnal major seizures.
8912   Epilepsy, Jacksonian and focal motor or sensory.
8913   Epilepsy, diencephalic.
Rate as minor seizures, except in the presence of major and minor seizures, rate the predominating type.
8914   Epilepsy, psychomotor.
Major seizures:
Psychomotor seizures will be rated as major seizures under the general rating formula when characterized by automatic states and/or generalized convulsions with unconsciousness.
Minor seizures:
Psychomotor seizures will be rated as minor seizures under the general rating formula when characterized by brief transient episodes of random motor movements, hallucinations, perceptual illusions, abnormalities of thinking, memory or mood, or autonomic disturbances.

Mental Disorders in Epilepsies: A nonpsychotic organic brain syndrome will be rated separately under the appropriate diagnostic code (e.g., 9304 or 9326). In the absence of a diagnosis of non-psychotic organic psychiatric disturbance (psychotic, psychoneurotic or personality disorder) if diagnosed and shown to be secondary to or directly associated with epilepsy will be rated separately. The psychotic or psychroneurotic disorder will be rated under the appropriate diagnostic code. The personality disorder will be rated as a dementia (e.g., diagnostic code 9304 or 9326).

Epilepsy and Unemployability: (1) Rating specialists must bear in mind that the epileptic, although his or her seizures are controlled, may find employment and rehabilitation difficult of attainment due to employer reluctance to the hiring of the epileptic.

(2) Where a case is encountered with a definite history of unemployment, full and complete development should be undertaken to ascertain whether the epilepsy is the determining factor in his or her inability to obtain employment.

(3) The assent of the claimant should first be obtained for permission to conduct this economic and social survey. The purpose of this survey is to secure all the relevant facts and data necessary to permit of a true judgment as to the reason for his or her unemployment and should include information as to:

(a) Education;

(b) Occupations prior and subsequent to service;

(c) Places of employment and reasons for termination;

(d) Wages received;

(e) Number of seizures.

(4) Upon completion of this survey and current examination, the case should have rating board consideration. Where in the judgment of the rating board the veteran's unemployability is due to epilepsy and jurisdiction is not vested in that body by reason of schedular evaluations, the case should be submitted to the Compensation Service or the Director, Pension and Fiduciary Service.

(Authority: 38 U.S.C. 1155)

[29 FR 6718, May 22, 1964, as amended at 40 FR 42540, Sept. 15, 1975; 41 FR 11302, Mar. 18, 1976; 43 FR 45362, Oct. 2, 1978; 54 FR 4282, Jan. 30, 1989; 54 FR 49755, Dec. 1, 1989; 55 FR 154, Jan. 3, 1990; 56 FR 51653, Oct. 15, 1991; 57 FR 24364, June 9, 1992; 70 FR 75399, Dec. 20, 2005; 73 FR 54705, Sept. 23, 2008; 73 FR 69554, Nov. 19, 2008; 76 FR 78824, Dec. 20, 2011; 79 FR 2100, Jan. 13, 2014]



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