Rule2021-24419
Schedule for Rating Disabilities: The Cardiovascular System
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
November 9, 2021
Effective
November 14, 2021
Issuing agencies
Veterans Affairs Department
Abstract
On September 30, 2021, the Department of Veterans Affairs (VA) published in the Federal Register a final rule that amended the portion of the VA Schedule for Rating Disabilities ("VASRD" or "rating schedule") that addresses the cardiovascular system. This correction addresses the instructions for evaluating peripheral arterial disease in the published final rule and corrects another minor technical error.
Full Text
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<title>Federal Register, Volume 86 Issue 214 (Tuesday, November 9, 2021)</title>
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[Federal Register Volume 86, Number 214 (Tuesday, November 9, 2021)]
[Rules and Regulations]
[Pages 62095-62096]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2021-24419]
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DEPARTMENT OF VETERANS AFFAIRS
38 CFR Part 4
RIN 2900-AQ67
Schedule for Rating Disabilities: The Cardiovascular System
AGENCY: Department of Veterans Affairs.
ACTION: Final rule; correction.
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SUMMARY: On September 30, 2021, the Department of Veterans Affairs (VA)
published in the Federal Register a final rule that amended the portion
of the VA Schedule for Rating Disabilities (``VASRD'' or ``rating
schedule'') that addresses the cardiovascular system. This correction
addresses the instructions for evaluating peripheral arterial disease
in the published final rule and corrects another minor technical error.
DATES: This correction is effective November 14, 2021.
FOR FURTHER INFORMATION CONTACT: Gary Reynolds, M.D., VASRD Program
Management Office (210), Compensation Service, Veterans Benefits
Administration, Department of Veterans Affairs, 810 Vermont Avenue NW,
Washington, DC 20420, (202) 461-9700. (This is not a toll-free
telephone number.)
SUPPLEMENTARY INFORMATION: VA is correcting its final rule, ``RIN 2900-
AQ67, Schedule for Rating Disabilities: The Cardiovascular System'',
that was published on September 30, 2021, in the Federal Register at 86
FR 54089. The error is with new Note (2) for diagnostic code (DC) 7114
peripheral arterial disease which fails to identify which of the four
tests are necessary before an evaluation can be assigned. In the
proposed rule, VA identified two major shortcomings in the rating
criteria for DC 7114 that were addressed by creating evaluation
criteria that use the ankle/brachial index (ABI), ankle pressure (AP),
toe pressure (TP) and transcutaneous oximetry
(T<INF>c</INF>PO<INF>2</INF>) to describe four different levels of
impairment. See 84 FR 37594, 37599 (Aug. 1, 2019). New Note (2)
instructed raters to select the highest impairment value of ABI, AP,
TP, or T<INF>c</INF>PO<INF>2</INF> for evaluation when rating a
condition under DC 7114. Upon further consideration, we believe the
note could be misconstrued as requiring medical examiners to conduct
all four tests. This is inconsistent with our intent, which was to
provide examiners with multiple options in the event that ABI was
unreliable due to non-compressible arteries. To address this issue, we
are correcting new Note (2) to read, ``If AP, TP, and
T<INF>c</INF>PO<INF>2</INF> testing are not of record, evaluate based
on ABI unless the examiner states that an AP, TP, or
T<INF>c</INF>PO<INF>2</INF> test is needed in a particular case because
ABI does not sufficiently reflect the severity of the veteran's
peripheral arterial disease. In all other cases, evaluate based on the
test that provides the highest impairment value.'' This correction
serves two purposes: (1) It reflects VA's intent that although ABI
should be the primary testing by which conditions should be rated under
DC 7114, raters should request AP, TP, or T<INF>c</INF>PO<INF>2</INF>
testing when the record reflects that an examiner believes ABI testing
does not sufficiently reflect a veteran's level of impairment, and (2)
when multiple tests are of record, it allows the rater to select the
test result that would grant the veteran the highest evaluation.
Additionally, VA is fixing a technical error with the section
heading for 38 CFR 4.100 to ensure that it is applicable to all
diagnostic codes that could use the general rating formula for diseases
of the heart in its evaluation criteria, such as DCs 7009 and 7110.
Correction
In FR Rule Doc. No. 2021-19998, published September 30, 2021, at 86
FR 54089, make the following corrections:
Sec. 4.100 [Corrected]
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1. On page 54093, at the top of the third column, remove the section
heading ``Sec. 4.100 Application of the evaluation criteria for
diagnostic codes 7000-7007, 7011, and 7015-7020.'' and add in its place
``Sec. 4.100 Application of the general rating formula for diseases of
the heart.''
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2. On page 54095, in Sec. 4.104, correct Note (2) in the entry for
diagnostic code 7114 ``Peripheral arterial disease'' to read as
follows:
[[Page 62096]]
Sec. 4.104 Schedule of ratings--cardiovascular system.
* * * * *
Diseases of the Heart
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Rating
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* * * * * * *
7114 Peripheral arterial disease:
* * * * * * *
Note (2): If AP, TP, and TcPO2 testing are not of
record, evaluate based on ABI unless the examiner
states that an AP, TP, or TcPO2 test is needed in a
particular case because ABI does not sufficiently
reflect the severity of the veteran's peripheral
arterial disease. In all other cases, evaluate based on
the test that provides the highest impairment value....
* * * * * * *
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Jeffrey M. Martin,
Assistant Director, Office of Regulation Policy & Management, Office of
the Secretary, Department of Veterans Affairs.
[FR Doc. 2021-24419 Filed 11-8-21; 8:45 am]
BILLING CODE 8320-01-P
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