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year of discharge from that period of service. If the claimant was discharged after July 2, 1921, the 1 year period for the establish. ment of such service connection will begin on July 2, 1921. Service connection will not be considered as having been established when the evidence clearly shows that the disabilities or conditions existed or were recorded at the time of enlistment or originated subsequent to discharge from causes not related to service.*+ (Secs. 1, 28, 48 Stat. 8, 524; 38 U.S.C. 701, 722)

2.1106 Evidence to establish service connection. Service connection for dental disabilities will be established by service records, documentary evidence in the form of reports of examinations (dental or physical), affidavits of dentists or physicians, or affidavits of fact from two or more disinterested parties. The disability must be shown to have been incurred in or aggravated by service as provided herein. Affidavits by dentists or physicians must give the claimant's full name, the date he was first examined or treated, the date of subsequent treatments, if any, and contain a complete and detailed statement of the symptoms observed and diagnoses made. The name or number of all defective or missing teeth noted and the character and extent of any pathological condition of the investing tissues observed should be included. If exact dates cannot be given, the expression “on or about, an approximate date, may be considered. Vague ex. pressions, such as "sometime after discharge," or "since discharge," will not be accepted. Affidavits from disinterested parties must show the circumstances under which knowledge of the claimant's disability was obtained and as far as possible describe the symptoms and location of the disability observed.**

2.1107 Service connection where dental disability is not of pensionable or compensable degree. Determinations relating to the origin or aggravation in active service of dental conditions not of pensionable or compensable degree where claim is made for treatment will be in accordance with $8 2.1105, 2.1106. However, the statutory presumption provided in section 200 of the World War Veterans' Act, 1924, as amended, as reenacted by Public, No. 141, 73d Congress, as to soundness of condition at the time of entrance into active service will not be applicable in cases of dental conditions not of pensionable or compensable degree.

(a) The furnishing of treatment or prosthesis for non-compensable dental conditions during service will not be considered as aggravation of a dental condition shown to have existed prior to entrance into active service.

(b) Effective principles relating to the establishment of service connection for dental diseases and injuries by reason of their relationship to other associated service connected diseases or injuries will be observed in the adjudication of claims based upon dental conditions where a determination to that effect is properly in order.* (Sec. 11, 46 Stat. 995, sec. 27, 48 Stat. 524; 38 U.S.C. 471, 471a)

2.1108 Adjudication of application for dental treatment. A formal application by or in behalf of a veteran is not required where claim is made for dental treatment only. Whenever an application for dental treatment is received, the application will be forwarded

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**For statutory and source citations, see note to $ 2.1000.

by the responsible medical activity to the adjudication officer, field office, or chief, claims division, veterans' claims service, central office, where an official request for active service data will be prepared and forwarded in accordance with existing procedure. When the service data are received, the claim will be considered by the rating board for determination of service connection. The ratings in such cases will be made upon the regular rating sheets and the chief dental officer, or his designate, will be signatory to the rating.**

2.1109 Period of presumption of service connection for dental disability. The 1-year period of presumption of service connection for a dental disability will begin from the date of discharge, release from active duty, or furlough to the reserves, or July 2, 1921, whichever is the earlier.**

PENSION OR COMPENSATION FOR DISABILITY OR DEATH THE RESULT OF

TRAINING, HOSPITALIZATION, OR MEDICAL OR SURGICAL TREATMENT

2.1121 Award action under section 31, Public, No. 141, 73d Congress. (a) Where any veteran suffers or has suffered an injury, or the aggravation of any existing injury as the result of training, hospitalization, or medical or surgical treatment, awarded him under any of the laws granting monetary or other benefits to World War veterans, or as the result of having submitted to examination under authority of the War Risk Insurance Act (38 Stat. 711), as amended, or the World War Veterans' Act, 1924 (43 Stat. 607; 38 U.S.C. Chapter 10), as amended, and not the result of his misconduct, when such injury or aggravation results in additional disability to or the death of such veteran, the benefits of Public, No. 2; Public, No. 78; and Public, No. 141, 73d Congress (48 Stat. 8, 300ff., 518ff.), will be awarded in the same manner as if such disability, aggravation, or death was service connected within the meaning of such laws. The benefits of this section will be in lieu of the benefits, if payable, under the Act entitled "An Act to provide compensation for employees of the United States suffering injuries while in the performance of their duties, and for other purposes," approved September 7, 1916 (39 Stat. 742; 5 U.S.C. Chapter 15), as amended.

(b) The benefits granted under section 31, Public, No. 141, 73d Congress (48 Stat. 526; 38 U.S.C. 501a), will not be awarded, unless application is made therefor within 2 years after such injury or aggravation was suffered, or such death occurred, or after the passage of Public, No. 141, 73d Congress, whichever is the later date, except that in cases where payments being made as of March 19, 1933 under section 213, World War Veterans Act, 1924 (43 Stat. 623; 38 U.S.C. 501), as amended, were discontinued as a result of the review pursuant to section 17, Public, No. 2, 73d Congress (48 Stat. 11; 38 U.S.C. 717, 718), a new claim will not be necessary but all cases falling within this category will be reviewed and any payments hereunder will be effective as of March 28, 1934.*+ (Sec. 31, 48 Stat. 526; 38 U.S.C. 501a)

CROSS REFERENCE: For rates of pay for disability or death the result of training, hospitalization, or medical or surgical treatment under section 31, Public, No. 141, 73d Congress, see $ 3.1245. **For statutory and source citations, see note to $ 2.1000.

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2.1122 Jurisdiction in claims under section 31, Public, No. 141, 73d Congress. Rating boards in field offices are authorized to make recommendatory ratings in cases other than death properly under their jurisdiction, coming within the provisions of section 31, Public, No. 141, 73d Congress. These ratings will be forwarded together with the case file to central office for review and final rating by the central disability board, claims division, veterans' claims service. After entitlement is establishment, it will not be necessary thereafter, to submit ratings under section 31, Public, No. 141, 73d Congress, to central office for confirmation of the evaluation of the disability or disabilities involved. Ratings prepared in field offices involving only the evaluation of such disabilíties will be considered as final for purposes of appropriate award action.** (Sec. 31, 48 Stat. 526; 38 U.S.C. 501a)

CROSS REFERENCE: For determinations as to basic entitlement, see $$ 2.1059

2.1123 Initial determinations and adjudicative action under section 31, Public, No. 141, 73d Congress. (a) Disability compensation will be payable only when it is determined (1) that there is additional disability, and (2) that such additional disability resulted from an injury or an aggravation of an existing injury suffered as the result of training, hospitalization, medical or surgical treatment, or examination under the War Risk Insurance Act, as amended, or the World War Veterans' Act, 1924, as amended. The following principles will be observed :

(b) The determination that additional disability exists will be based upon a comparison of the beneficiary's physical condition immediately prior to the injury on which the claim for compensation is based, with the subsequent physical condition resulting from the injury. Where it is determined that there is additional disability resulting from an injury or an aggravation of an existing injury suffered as the result of training, hospitalization, medical or surgical treatment, or examination, compensation will be payable only for the additional disability from the date of the incurrence of the injury, in accordance with the terms of the Schedule of Disability Ratings, 1925. This comparison will be made separately for each body part involved. As applied to medical or surgical treatment, the physical condition prior to the injury will be the condition which the specific medical or surgical treatment was designed to relieve; as applied to examinations, the physical condition prior to the injury will be the condition at time of beginning the physical examination as a result of which the injury was sustained.

(c) In determining whether such additional disability results from an injury or an aggravation of an existing injury suffered as the result of training, hospitalization, medical or surgical treatment or examination, the following considerations will govern:

(1) It will be necessary to show that the additional disability is actually the result of such injury or an aggravation of an existing injury and not merely coincidental therewith.

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**For statutory and source citations, see note to $ 2.1000.

(2) Compensation will not be payable for the continuance or natural progress of diseases or injuries for which the training, or hospitalization, etc., was authorized.

(3) The mere fact that aggravation occurred will not suffice to make the additional disability compensable in the absence of proof that it resulted from an injury or an aggravation of an existing injury suffered as the result of training, or hospitalization, etc.

(4) Compensation is not payable for either the usual or the unusual after results of approved medical care properly administered, in the absence of a showing that the disability proximately resulted through carelessness, accident, negligence, lack of proper skill, error in judgment, etc. The question as to what is an accident, for the purpose of determining entitlement to benefits under section 31, Public

, No. 141, 73d Congress, is one for determination by the adjudicating agencies.

(5) Compensation will not be payable for the residuals of medical care or treatment given outside of a Government hospital or clinic unless such medical care or treatment was specifically authorized under one of the Acts referred to in the regulations in this chapter, or unless it is held to be adjunct treatment in connection with other treatment specifically authorized.

(6) The claimant's misconduct or failure to follow instructions in connection with training, hospitalization, medical or surgical treatment, or examination, will bar him from the receipt of compensation hereunder except in the case of incompetent claimants.*+ (Sec. 31, 48 Stat. 526; 38 U.S.C. 501a)

2.1124 Combination of ratings under section 31, Public, No. 141, 73d Congress. (a) With respect to payment of the greater monetary benefit, it is contemplated that where two or more disabilities exist, including the disability determinable under section 31, Public, No. 141, 73d Congress, the greater monetary benefit will be decided upon only after the several disabilities have been evaluated and combined separately under the alternative laws applicable as herein indicated. For example, under $ 3.1245, the several disabilities should be evaluated and combined under $ 35.011 in accordance with the Schedule for Rating Disabilities, 1933, and under section 28, Public, No. 141, 73d Congress (48 Stat. 524; 38 U.S.C. 722), in accordance with the Schedule of Disability Ratings, 1925, and extensions thereto; and a comparison of the results obtained will show the greater monetary benefit to be paid.

(b) For the purpose of section 31, ratings will not be combined with ratings for diseases or injuries not due to service. Consequently, where benefits are currently payable for a nonservice connected disability and benefits are found payable under section 31, payment under section 31 will not be authorized unless it is a greater benefit. Where a veteran with wartime service has suffered a compensable or pensionable disability and a service connected compensable or pensionable disability due to war or peacetime service, the evaluation of disability will be combined and payment will be made in accord

**For statutory and source citations, see note to $ 2.1000.

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[281] **For statutory and source citations, see note to $ 2.1000.

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ance with the rates provided in paragraph (a).*+ (Sec. 31, 48 Stat. 526; 38 U.S.C. 501a)

CROSS REFERENCE: For application of rating schedule, see $$ 2.1141-2.1178.

2.1125 Benefits not payable for disability resulting from examination under Public, No. 2, or Public, No. 141, 73d Congress. No provision is made for awarding monetary benefits for disability resulting from disease or injury incurred or aggravated in submitting to an examination under the authority of veterans' regulations issued pursuant to Public, No. 2, 73d Congress, or Public, No. 141, 73d Congress. However, benefits are payable to any veteran for additional disability or aggravation incurred while submitting to an examination under the War Risk Insurance Act, as amended, or the World War Veterans' Act, 1924, as amended.*(Sec. 31, 48 Stat. 526; 38 U.S.C. 501a)

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PRINCIPLES GOVERNING STATUTORY RATINGS

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Statutory award for loss of use of creative organ, or one or more feet or hands. Under the last paragraph of section 202 (3) of the World War Veterans' Act, as amended July 3, 1930, as reenacted by Public, No. 141, 73d Congress, any veteran shown to have suffered the loss of the use of a creative organ or one or more feet or hands as the result of an injury received in the active service in line of duty between April 6, 1017 and November 11, 1918, shall be entitled to a statutory award of $25 per month, independently of any other compensation which may be payable under said Act: Provided, however, That if such disability was incurred while the veteran was serving with the United States military forces in Russia, the dates herein stated shall extend from April 6, 1917 to April 1, 1920. This statutory award shall be payable from the date the loss of the use of the creative organ or one or more feet or hands is shown to exist, subject to the provisions of $ 35.021 and when payable shall be added to any other compensation payable to the veteran.** (Sec. 9, 26, 48 Stat. 10, 524, sec. 13, 46 Stat. 998; 38 U.S.C. 473, 473a, 479, 709)

2.1131 Principles for determining entitlement to the statutory award for loss of use of a creative organ. The following principles governing a rating as to entitlement to the statutory award provided by section 202 (3), World War Veterans' Act, 1924, as amended July 3, 1930, as reenacted by Public, No. 141, 73d Congress, for the “loss of use of a creative organ” will be observed :

(a) The loss of use must first be established. Avulsion of one or both testicles or ovaries will suffice for this purpose, as will atrophy when it is demonstrated by proper diagnostic methods that no procreative function remains in the atrophied organ.

(b) The loss being apparent or the loss of use having been properly demonstrated, the additional statutory award of $25 monthly will be authorized when it is established by the official records of the service departments or other competent evidence that the loss or loss of use is the result of trauma incurred in the line of duty in the

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