sections 27 and 28, Public, No. 141, 73d Congress, as amended by Public, No. 344, 74th Congress, and to disabilities service connected under section 31, under the latter section provided there was World War service. For periods on or after March 28, 1934, claims filed on or after March 20, 1933, by veterans who served in the active military or naval service between April 6, 1917, and November 12, 1918, (or prior to April 2, 1920, with the United States military forces in Russia), for service connected diseases or injuries, will be rated under both schedules.

(d) When one and not the other of the two schedules applies, only the rating of the applicable rating schedule will be cited. When both apply, concurrent ratings are required under both schedules, with separate evaluations under a single diagnosis and rating code.*† *88 2.1141 to 2.1178, inclusive, issued under the authority contained in R.S. 471, sec. 5, 43 Stat. 608, secs. 1, 2, 46 Stat. 1016, sec. 7, 48 Stat. 9; 38 U.S.C. 2, 11, 11a, 426, 707: interpret secs. 202, 8, 9, 43 Stat. 618, 1306, 1307, sec. 3, 48 Stat. 9; 38 U.S.C. 473-480, 482-491, 703.

CROSS REFERENCE: For presumption of service connection for chronic constitutional diseases, listed in the Schedule of Disability Ratings, see § 2.1088.

2.1142 Special action where evaluations provided under rating schedules are considered inadequate or excessive. Exceptional cases to which the application of either schedule is not understood, or with regard to which the 1933 schedule is considered inadequate or excessive, may be submitted for advisory opinion or for revaluation to the director, veterans' claims service, central office. Severe disabilities considered total, but for which current procedure does not authorize a total rating, questionable special monthly pension cases, and double total and permanent disability cases, will be similarly submitted. The submission will include the case file, a recent medical examination, and definite recommendation from the submitting agency concerning service connection and evaluation of every disability, under both the applicable schedules as interpreted by the submitting agency, and concerning schedular changes deemed advisable by reason of the particular situation encountered.**

2.1143 Protected ratings, 1925 schedule. Evaluations under the 1925 schedule, including the percentage rating, the occupational determination and variant thereunder, and the occupational analogy, are to be continued without reduction in the absence of clear and unmistakable error, or as regards percentage ratings, in the absence of subsequent medical examinations adequately covering the specified disabilities and showing a material change in the physical condition. When the record shows that an extension to the 1925 schedule has not been applied, the rating will be brought under the extensions, but a reduction will not be effected in the absence of an examination fully adequate for the purpose of the extension. Differences of opinion as to classification between adjacent severity grades, or as to the rating applicable within a prescribed flexible range, or as to the analysis of disabilities into several factors, the ratings for which have been in the past combined, or mere differences in description or diagnosis of substantially the same degree of disability, will not

*For statutory citation, see note to § 2.1141.

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warrant correction of the evaluation on the ground of clear and unmistakable error unless the rating exceeds a prescribed limit, or is grossly disproportionate to the degree of disability sustained.*t

2.1144 Determination of permanence. (a) The application of the 1925 schedule requires a determination of the permanent or temporary character of each separate disability; however, in the general application of the 1925 schedule permanent ratings will be made wherever possible, compatible with the facts. Under the 1933 schedule disability ratings require a determination of permanence as provided on page 4 thereof.

Under both schedules, a permanent disability is one which it is reasonably certain will continue unimproved throughout the disabled person's life.

Generally, with disabling diseases and injuries of long standing, the probability of improvement under treatment may be conceded to be remote, and unless specific treatment is indicated for a particular disability, a permanent, and not a temporary, rating is generally in order. A permanent rating may not, however, be granted for a disability under treatment with a good prognosis for permanent improvement, nor for acute infectious disease, recent accident or unhealed injury, unless, in the case of total disability, it is reasonably certain that the subsidence of the acute or temporary symptoms will be followed by irreducible totality of disability by way of residuals.

(b) All disability ratings relating to impairments, the lesions and symptoms of which have persisted at approximately the same level of severity as shown by two or more examinations at least 5 years apart, unless material improvement in the near future may be anticipated on the basis of evidence pertinent to the individual case, will be placed on a permanent basis. Mere differences in descriptive and diagnostic terms, or in emphasis or absence of emphasis on successive examinations, will be disregarded in this connection. With a major disability rated on a permanent basis, minor disabilities will be placed on a permanent rating, without regard to fluctuations in the past, except as set forth below.

(c) In the case of diseases or injuries of fluctuating severity over the past 5 year period, where the conversion of the current temporary rating to a permanent rating of the same degree would not be justified, permanent ratings may be made on the basis of the average severity disclosed by examinations covering this 5 year period, including a recent examination, or an examination conducted under §3.1265 if necessary. In such cases the several examinations utilized will be individually cited with dates, in connection with the diagnoses in question.

(d) Nothing herein will prevent rating on a permanent basis the residuals of all healed injuries.**

2.1145 Use of 1933 schedule for remedial conditions. Ratings, including ratings of total disability are authorized under the 1933 schedule for remediable conditions without regard to permanence, when the conditions were caused by or aggravated in the service.*†

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*For statutory citation, see note to § 2.1141.

2.1146 Original occupational determinations, 1925 schedule. (a) An occupation is that which occupies, or engages, the time and attention; the principal business of one's life; vocation, employment, calling, trade.

(b) The employment in which the claimant was last engaged prior to his enlistment for military service in the World War, or if the claimant, during this period of employment, was engaged simultaneously in more than one line of work, then the employment which usually occupied the greater number of hours per day, will be regarded as his occupation at the time of enlistment; except, if it is established on the basis of conclusive evidence that the claimant's training and experience has sufficiently qualified him for some other occupation, that he had engaged in this other occupation regularly and habitually and had temporarily left it, such other occupation shall be selected as his true occupation at the time of enlistment.*t 2.1148 Effective date of evaluations, 1925 and 1933 schedules in original ratings. (a) Evaluations under the 1933 schedule will be effective as of the date of receipt of the application by the Veterans' Administration under Public, No. 2, 73d Congress, and regulations issued pursuant thereto, or the date the evidence shows a compensable or pensionable degree of disability to have existed, whichever is the later, but in no event prior to March 20, 1933; except that total disability or permanent total evaluations under §§ 2.1166 (c), 2.1167, 2.1168 will be effective from the date of the receipt of the claim (original, reopening or increase), or the date the evidence shows entitlement, whichever is the later, but in no event prior to October 16, 1934, (effective date of the change in criteria for establishing total disability under Public, No. 2, 73d Congress), provided, however, that where the claim was in a pending or appellate status as of October 16, 1934, the evaluation will be made effective as of the date of administrative determination (date rating or decision is signed) by the original or appellate rating agency. The effective date of the evaluation will not, however, necessarily control award action.

(b) Evaluations under the 1925 schedule and extensions thereto will be effective as of the date of receipt of the application by the Veterans' Administration under Public, No. 141, 73d Congress, or the date the evidence shows entitlement, whichever is the later, but in no event prior to March 28, 1934.*+

CROSS REFERENCES: For determinations as to basic entitlement, see § 2.1059. For schedule for rating disabilities, see § 35.03.

2.1149 Effective dates of evaluations, 1925 and 1933 schedules, in claims for increase. Evaluations under the 1933 schedule, and the 1925 schedule and extensions thereto, in claims for increase, will be effective from the date of the receipt of the evidence, i. e., affidavits of physicians or other evidence submitted by the veteran showing an additional disability, or an increase in the condition for which he is receiving compensation or pension; or the date of the official report of physical examination made in a Veterans' Administration facility, or by a designated examiner in connection with compensation, pension,

*For statutory citation, see note to § 2.1141.

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or treatment pursuant to proper authority. The effective date of the evaluation will not, however, necessarily control award action.*+

CROSS REFERENCE: For applications for increase based upon changed physical condition, see § 3.1216.

2.1155 Combined ratings. (a) When there are two or more ratable disabilities, combined ratings, following the tables and rules prescribed in the appropriate schedule, are authorized under the 1933 schedule or the 1925 schedule, whichever is applicable in the individual case.

(b) Under § 35.014 a combined rating under the 1933 schedule is authorized as between ratings for one or more disabilities resulting from wartime service and ratings for one or more disabilities resulting from peacetime service.

(c) For the purpose of determining the existence of permanent and total disability under § 35.013 evaluations for diseases or injuries service connected under §§ 35.011, 35.012 may be combined with evaluations for diseases or injuries not shown to be connected with active military or naval service.

(d) Pursuant to section 202 (15), World War Veterans' Act, 1924 (43 Stat. 621; 38 U.S.C. 489), as amended, reenacted by Public, No. 141, 73d Congress, a veteran of the World War, as defined by Public, No. 141, 73d Congress, suffering from a disability of compensable degree connected with World War service, who is entitled to a pension for a service connected disability by reason of other military or naval service, is entitled to the evaluation and combination of his compensable and pensionable service connected disabilities in accordance with the Schedule of Disability Ratings, 1925, and extensions thereto. Therefore when a World War veteran served in other war or peacetime service, it is necessary to evaluate his disabilities incident to such other service under the Schedule of Disability Ratings, 1925, and the Schedule for Rating Disabilities, 1933, provided, however, that no evaluations will be made pursuant to the latter schedule for disabilities incident to service prior to April 21, 1898.

(e) Ratings for disabilities acquired in peacetime service may not under section 202 (15), World War Veterans' Act, 1924, as amended, be combined with a rating for a disability acquired prior to April 6, 1917, merely because the compensation being paid for the latter disability on March 19, 1933, is protected by section 28, Public, No. 141, 73d Congress.

(f) Where there is doubt as to whether a veteran, who served during a war period and a peacetime enlistment, is entitled to combination and payment at wartime rates because of disabilities connected with peacetime service, or there is doubt as to the matter of combination, the case will be submitted to the veterans' claim service, central office, for review and appropriate advice.*+

CROSS REFERENCES: For regulation relating to combination of ratings under section 31, Public, No. 141, 73d Congress, see § 2.1124. For service connection and evaluation, veterans' claim service, central office section, see $$ 4.2050-4.2073. For regulation relating to schedule for rating disabilities, see § 35.03.

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*For statutory citation, see note to § 2.1141.

2.1156 Special combination ratings, 1933 schedule. Whenever a veteran is suffering from two or more separate permanent disabilities of such character as clearly to interfere with his normal employability, even though none of the disabilities may be of compensable degree under the 1933 schedule, the rating agency is authorized to apply_a 10 percent rating, but not in combination with any other rating. In instances of this character where there is a service connected wartime disability and also a service connected peacetime disability, the evaluation will be made under §§ 35.011, 35.014.*†

2.1157 Separate combined ratings, direct and presumptive. Where the rating involves both direct and statutory presumptive service connections, under Public, No. 141, 73d Congress, two combined ratings under the 1925 schedule will be entered, one showing the evaluation of all directly service connected diseases or injuries, and the other covering all directly and presumptively service connected diseases or injuries.*†

2.1158 Rating of noncompensable disabilities under 1925 and 1933 schedules. (a) Percentage ratings will be assigned to service connected disabilities of noncompensable degrees, irrespective of whether they are temporary or permanent in nature, which according to the 1925 schedule cause a reduction in earning capacity. When a percentage rating is assigned to a service connected disability of noncompensable degree, the rating will be combined with any other noncompensable or compensable rating or ratings.

(b) For the purposes of the 1933 schedule, a disability under any diagnostic classification which does not meet the minimum rating schedule standard under that classification will be rated as no percent.**

2.1159 Rating of disabilities aggravated by active service. (a) In cases involving aggravation by active service, the rating will reflect only the degree of disability over and above the degree existing at the time of entrance into the active service, whether the particular condition was noted at the time of entrance into the active service, or is determined upon the evidence of record to have existed at that time. It is necessary, therefore, in all cases of this character to deduct from the present degree of disability the degree, if ascertainable, of the disability existing at the time of entrance into active service, in terms of the 1933 schedule, or the 1925 schedule, except that if the disability is total (100 percent) no deduction will be made. The resulting difference will be recorded on the rating sheet. If the degree of disability at the time of entrance into the service is not ascertainable in terms of the schedules, no deduction will be made.

(b) Where a disease or injury incurred in peacetime service is aggravated during wartime service, or conversely, where a disease or injury incurred in wartime service is aggravated during peacetime service the entire disability flowing from the disease or injury will be considered incurred in war service and rated accordingly.

(c) The special monthly pension or compensation or statutory allowances are payable whether the injury or disease basically was incurred in or aggravated by active service.*+

*For statutory citation, see note to § 2.1141. †For source citation, see note to § 2.1000.

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