§ 4.85 Hearing impairments reported as a result of regional office or authorized audiology clinic examinations.

(a) If the results of controlled speech reception tests are used, the letter, A through F, designating the impairment in efficiency of each ear separately, will be ascertained from table VI. Table VI indicates six areas of impairment in efficiency. The literal designation of impaired efficiency (A, B, C, D, E, or F) will 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 62 db and a percentage discrimination of 72 percent the literal designation is "D"; if the speech reception decibel loss is 62 db and the percentage discrimination is 70 percent, the literal designation is “E”.

(b) The percentage evaluation will be found from table VII 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 and the diagnostic code is 6293.

(c) If the results of pure tone audiometry are used, the equivalent literal designation for each ear, separately, will be ascertained from table VII, 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 57 db and there is no loss more than 70 db for any of these three frequencies, the equivalent literal designation is "C"; if in the other ear, the average is not more than 79 db, and there is no loss more than 90 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 and the diagnostic code is 6289. Note that if in the first instance any of the 3 frequencies has a loss of more than 70 db, or in the second instance more than 90 db, the literal designation will be higher, i.e., further from "A" in the alphabetical series.

[43 FR 45358, Oct. 2, 1978]

§ 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.

§ 4.86a Conversational voice in feet.

The column and row containing entries in feet (meters) will not be used for the purpose of determining serviceconnection 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 appara

tus. In those cases showing loss for spoken voice on induction, the footage (metric) equivalents on table VII 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.

[41 FR 11298, Mar. 18, 1976, as amended at 43 FR 45358, Oct. 2, 1978]

§ 4.87 Determinations of auditory acuity.

By impairment of auditory acuity is meant the organic hearing loss for speech.

SYSTEMIC CONDITIONS

§ 4.88 Malaria.

As active disease, and for 6 months' convalescence.......

Hemoglobinuric fever (blackwater fever).

As active disease, and for 1 year's convales

A complication of aestivoautumnal malaria. 6301 Kala-azar (visceral leishmaniasis):

Rat

ing

cence.

6302 Leprosy (Hansen's Disease):

10

cence.

10

In rating disability from malaria, once identified by clinical and laboratory methods, or by clinical methods alone where the disease is endemic, the clinical course of the disease, the frequency and severity of recurrences, the necessity for and the reaction to

As active disease and for 1 year's convales

NOTE: Rate residuals as disfigurements, etc. The 100 percent rating applies to the active contagious disease requiring institutional care. Noncontagious cases will be treated under the appropriate schedule, for example, "The Skin".

6304 Malaria:

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....

90-122 0-82--22

100

50

30

10