NOTE. Demonstrable organic pathology commensurate with the functional loss will be required. The concentric contraction ratings require contraction within the stated degrees, temporally; the nasal contraction may be less. The alternative ratings are to be employed when there is ratable defect of visual acuity, or a different impairment of the visual field in the other eye. Concentric contraction resulting from demonstrable organic pathology to 5 degrees or less will be considered on a parity with reduction of central visual acuity to 5/200 or less for all purposes including entitlement under subparagraph (1), 38 U.S.C. 314; not, however, for the purpose of subparagraph (k). Entitlement on account of blindness requiring regular aid and attendance, subparagraph (m), will continue to be determined on the facts in the individual case. 20 Rating 10 Large or centrally located____ RATINGS FOR IMPAIRMENT OF MUSCLE FUNCTION NOTE. Correct diagnosis reflecting disease or injury should be cited. 6090 Muscle function, ocular, im 6091 6092 pairment of Producing diplopia in 19-20 rectangles Rate as 5/200. Producing diplopia in 17-18 rectangles Rate as 10/200. Producing diplopia in 14-16 rectangles Rate as 15/200. Producing diplopia in 12-13 rectangles Rate as 20/200. Producing diplopia in 9-11 rectangles Rate as 20/100. § 4.84b 6200 Otitis media, suppurative, chronic be determined by intersecting the horizontal row appropriate for percentage of discrimination and the vertical column appropriate to the speech reception decibel loss; thus, with a speech reception decibel loss of 52 db and a percentage discrimination of 72 percent, the literal designation is "D"; if the speech reception decibel loss is 52 db and the percentage discrimination is 70 percent, the literal designation is "E". (b) The percentage evaluation will be found from table II by intersecting the horizontal row appropriate for the literal designation for the ear having the better hearing and the vertical column appropriate to the literal designation for the ear having the poorer hearing. For example, if the better ear has a literal designation of "B" and the poorer ear has a literal designation of "C," the percentage evaluation is in the second horizontal row from the bottom and in the third vertical column from the right and is 10 percent. (c) If the results of pure tone audiometry (either pure tone air conduction or Galvanic Skin Response, PGSR) are used, the equivalent literal designation for each ear, separately, will be ascertained from table II, and the percentage evaluation determined in the same manner as for speech reception impairment in paragraph (b) of this section. For example, if the average pure tone decibel loss for the frequencies 500, 1,000, and 2,000 is not more than 45 db and there is no loss more than 60 db for any of these three frequencies, the equivalent literal designation is "C"; if in the other ear, the average is not more than 67 db, and there is no loss more than 80 db, the equivalent literal designation is "D". The percentage evaluation is therefore found in the horizontal row opposite "C", and in the vertical column under "D", and is 20 percent. Note that if in the first instance any of the 3 frequencies has a loss of more than 60 db, or in the second instance more than 80 db, the literal designation will be higher, i.e., further from "A" in the alphabetical series. § 4.86 Hearing aids. The evaluations derived from this schedule are intended to make proper allowance for improvement by hearing aids. Examination to determine this improvement is therefore unnecessary. זיין C § 4.87 Conversational voice in feet. The column and row containing entries in feet will not be used for the purpose of determining service connection or evaluation except in the rating of those unusual cases where no other data are available. In those cases showing no loss by spoken voice on induction but showing loss by spoken voice on discharge, evaluation will be deferred pending examination by controlled speech and pure tone apparatus. In those cases showing loss for spoken voice on induction, the footage equivalents on table II will be used to determine the extent of hearing loss at induction for comparison with the results of examination by controlled speech and pure tone. TABLE I Speech Reception Decibel Loss 10002 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 54 56 58 60 62 64 66 68 70 72 74 76 78 80 82 84 86 88 90 92 94 96 98 100 100 6283 Rated Column E, One Ear Row E, Other Ear Table II 6284 Rated Column E, One Ear Row D, Other Ear Table II 6285 Rated Column E, One Ear Row C, Other Ear Table II 6286 Rated Column E, One Ear Row B, Other Ear Table II 6287 Rated Column E, One Ear Row A, Other Ear Table II 6288 Rated Column D, One Ear Row D, Other Ear Table II 6289 Rated Column D, One Ear Row C, Other Ear Table II 6290 Rated Column D, One Ear Row B, Other Ear Table II 6291 Rated Column D, One Ear Row A, Other Ear Table II 6292 Rated Column C, One Ear Row C, Other Ear Table II A Clinically active so as to require hospital treatment for a contemplated or elapsed period of 14 days or more; or with a combination of cerebral symptoms, enlarged spleen, anemia or other severe symptoms---Clinically active so as to require intensive treatment; recently active with 3 or more relapses over past 6 months; or old cases with marked general impairment of health. Recently active with 2 relapses in past 6 months; or old cases with anemia_. Recently active with one relapse in the past year; or old cases with moderate disability NOTE (1). The evaluations under Code 6304 are to be assigned on the basis of dates and frequency of recurrences and relapses and severity of significant residuals, if any, based on the clinical records of the service department or other acceptable evidence relating to the period of service, or on medical evidence relating to the period after discharge, recording sufficient clinical findings, when considered 99-185-69-17 100 100 Rating in accordance with all other data of record, to support the conclusion that there exists a compensable or higher degree of disability from malaria. Hereafter, service connection will not be conceded based on notation in service records of history alone furnished by the veteran, nor will compensable ratings be assigned based on the veteran's unsupported claim or statement; however, determinations heretofore made will not be reversed on the basis of this change in policy. The evidence of others under oath may be accepted to establish frequency of relapses or recurrences over a period of 1 year only, from date of last medically confirmed relapse or recurrence in service or subsequently. NOTE (2). When evaluations are based on frequency of recurrences or relapses only, they will be assigned for a period of 1 year only from date of discharge or date established by medical evidence of record. At the expiration of this period, if medical evidence warranting an extension is not of record, the veteran will be notified that his compensation will be discontinued unless he submits evidence from a physician showing recurrent attacks or other disabling effects of malaria. After a malaria rating has run 24 months, an extension, if warranted, will carry ending date at expiration of 36 months from initial date of compensable rating. When this rating is assigned, veteran will be notified of ending date and of requirement that, to have rating continued or resumed after that date, he must report to Veterans Administration hospital, or outpatient clinic, or to a Veterans Administration fee-basis physician during an actual relapse of the disease. Following the expiration of the 36 months' period and the veteran's compliance with the requirement to report as indicated in this note, a prepared slide of the veteran's blood smear will be read in the local Veterans Administration laboratory, and, if the interpretation is positive, the prepared slide will be mailed in a suitable container addressed to the Director, Compensation and Pension Service, with proper identification of the veteran, |