Diseases of the Ear------------------------------------------------------------------------
Rating------------------------------------------------------------------------6200 Chronic suppurative otitis media, mastoiditis, or
cholesteatoma (or any combination):
During suppuration, or with aural polyps...................... 10
Note: Evaluate hearing impairment, and complications such as
labyrinthitis, tinnitus, facial nerve paralysis, or bone loss
of skull, separately.6201 Chronic nonsuppurative otitis media with effusion (serous
otitis media):
Rate hearing impairment6202 Otosclerosis:
Rate hearing impairment6204 Peripheral vestibular disorders:
Dizziness and occasional staggering........................... 30
Occasional dizziness.......................................... 10
Note: Objective findings supporting the diagnosis of
vestibular disequilibrium are required before a compensable
evaluation can be assigned under this code. Hearing
impairment or suppuration shall be separately rated and
combined.6205 Meniere's syndrome (endolymphatic hydrops):
Hearing impairment with attacks of vertigo and cerebellar gait 100
occurring more than once weekly, with or without tinnitus....
Hearing impairment with attacks of vertigo and cerebellar gait 60
occurring from one to four times a month, with or without
tinnitus.....................................................
Hearing impairment with vertigo less than once a month, with 30
or without tinnitus..........................................
Note: Evaluate Meniere's syndrome either under these criteria
or by separately evaluating vertigo (as a peripheral
vestibular disorder), hearing impairment, and tinnitus,
whichever method results in a higher overall evaluation. But
do not combine an evaluation for hearing impairment,
tinnitus, or vertigo with an evaluation under diagnostic code
6205.6207 Loss of auricle:
Complete loss of both......................................... 50
Complete loss of one.......................................... 30
Deformity of one, with loss of one-third or more of the 10
substance....................................................6208 Malignant neoplasm of the ear (other than skin only)....... 100
Note: A rating of 100 percent shall continue beyond the
cessation of any surgical, radiation treatment,
antineoplastic chemotherapy or other therapeutic procedure.
Six months after discontinuance of such treatment, the
appropriate disability rating shall be determined by
mandatory VA examination. Any change in evaluation based on
that or any subsequent examination shall be subject to the
provisions of Sec. 3.105(e) of this chapter. If there has
been no local recurrence or metastasis, rate on residuals.6209 Benign neoplasms of the ear (other than skin only):
Rate on impairment of function.6210 Chronic otitis externa:
Swelling, dry and scaly or serous discharge, and itching 10
requiring frequent and prolonged treatment...................6211 Tympanic membrane, perforation of.......................... 06260 Tinnitus, recurrent........................................ 10
Note (1): A separate evaluation for tinnitus may be combined
with an evaluation under diagnostic codes 6100, 6200, 6204,
or other diagnostic code, except when tinnitus supports an
evaluation under one of those diagnostic codes.
Note (2): Assign only a single evaluation for recurrent
tinnitus, whether the sound is perceived in one ear, both
ears, or in the head.
Note (3): Do not evaluate objective tinnitus (in which the
sound is audible to other people and has a definable cause
that may or may not be pathologic) under this diagnostic
code, but evaluate it as part of any underlying condition
causing it.------------------------------------------------------------------------ (Authority: 38 U.S.C. 1155) [64 FR 25210, May 11, 1999, as amended at 68 FR 25823, May 14, 2003] Sec. 4.87a Schedule of ratings--other sense organs. ------------------------------------------------------------------------
Rating------------------------------------------------------------------------6275 Sense of smell, complete loss.............................. 106276 Sense of taste, complete loss.............................. 10
Note: Evaluation will be assigned under diagnostic codes 6275
or 6276 only if there is an anatomical or pathological basis
for the condition.------------------------------------------------------------------------ (Authority: 38 U.S.C. 1155) [64 FR 25210, May 11, 1999]
Infectious Diseases, Immune Disorders and Nutritional Deficiencies Sec. 4.88 [Reserved] Sec. 4.88a Chronic fatigue syndrome.
(a) For VA purposes, the diagnosis of chronic fatigue syndrome requires:
(1) new onset of debilitating fatigue severe enough to reduce daily activity to less than 50 percent of the usual level for at least six months; and
(2) the exclusion, by history, physical examination, and laboratory tests, of all other clinical conditions that may produce similar symptoms; and
(3) six or more of the following:
(i) acute onset of the condition,
(ii) low grade fever,
(iii) nonexudative pharyngitis,
(iv) palpable or tender cervical or axillary lymph nodes,
(v) generalized muscle aches or weakness,
(vi) fatigue lasting 24 hours or longer after exercise,
(vii) headaches (of a type, severity, or pattern that is different from headaches in the pre-morbid state),
(viii) migratory joint pains,
(ix) neuropsychologic symptoms,
(x) sleep disturbance.
(b) [Reserved] [59 FR 60902, Nov. 29, 1994] Sec. 4.88b Schedule of ratings--infectious diseases, immune disorders and nutritional deficiencies. ------------------------------------------------------------------------
Rating------------------------------------------------------------------------6300 Cholera, Asiatic:
As active disease, and for 3 months convalescence...... 100
Thereafter rate residuals such as renal necrosis under the
appropriate system6301 Visceral Leishmaniasis:
During treatment for active disease.................... 100
Note: A 100 percent evaluation shall continue beyond the cessation
of treatment for active disease. Six months after discontinuance of
such treatment, the appropriate disability rating shall be
determined by mandatory VA examination. Any change in evaluation
based upon that or any subsequent examination shall be subject to
the provisions of Sec. 3.105(e) of this chapter. Rate residuals
such as liver damage or lymphadenopathy under the appropriate
system.
6302 Leprosy (Hansen's Disease):
As active disease...................................... 100
Note: A 100 percent evaluation shall continue beyond the date that
an examining physician has determined that this has become
inactive. Six months after the date of inactivity, the appropriate
disability rating shall be determined by mandatory VA examination.
Any change in evaluation based upon that or any subsequent
examination shall be subject to the provisions of Sec. 3.105(e)
of this chapter. Rate residuals such as skin lesions or peripheral
neuropathy under the appropriate system.
6304 Malaria:
As active disease...................................... 100
Note: The diagnosis of malaria depends on the identification of the
malarial parasites in blood smears. If the veteran served in an
endemic area and presents signs and symptoms compatible with
malaria, the diagnosis may be based on clinical grounds alone.
Relapses must be confirmed by the presence of malarial parasites in
blood smears.
Thereafter rate residuals such as liver or spleen damage under the
appropriate system
6305 Lymphatic Filariasis:
As active disease...................................... 100
Thereafter rate residuals such as epididymitis or lymphangitis under
the appropriate system6306 Bartonellosis:
As active disease, and for 3 months convalescence...... 100
Thereafter rate residuals such as skin lesions under the appropriate
system6307 Plague:
As active disease...................................... 100
Thereafter rate residuals such as lymphadenopathy under the
appropriate system6308 Relapsing Fever:
As active disease...................................... 100
Thereafter rate residuals such as liver or spleen damage or central
nervous system involvement under the appropriate system6309 Rheumatic fever:
As active disease...................................... 100
Thereafter rate residuals such as heart damage under the appropriate
system6310 Syphilis, and other treponemal infections:
Rate the complications of nervous system, vascular system, eyes or
ears. (See DC 7004, syphilitic heart disease, DC 8013,
cerebrospinal syphilis, DC 8014, meningovascular syphilis, DC 8015,
tabes dorsalis, and DC 9301, dementia associated with central
nervous system syphilis)6311 Tuberculosis, miliary:
As active disease...................................... 100
Inactive: See Sec. Sec. 4.88c and 4.89.6313 Avitaminosis:
Marked mental changes, moist dermatitis, inability to 100
retain adequate nourishment, exhaustion, and cachexia.
With all of the symptoms listed below, plus mental 60
symptoms and impaired bodily vigor....................
With stomatitis, diarrhea, and symmetrical dermatitis.. 40
With stomatitis, or achlorhydria, or diarrhea.......... 20
Confirmed diagnosis with nonspecific symptoms such as: 10
decreased appetite, weight loss, abdominal discomfort,
weakness, inability to concentrate and irritability...6314 Beriberi:
As active disease:
With congestive heart failure, anasarca, or Wernicke- 100
Korsakoff syndrome....................................
With cardiomegaly, or; with peripheral neuropathy with 60
footdrop or atrophy of thigh or calf muscles..........
With peripheral neuropathy with absent knee or ankle 30
jerks and loss of sensation, or; with symptoms such as
weakness, fatigue, anorexia, dizziness, heaviness and
stiffness of legs, headache or sleep disturbance......
Thereafter rate residuals under the appropriate body
system.6315 Pellagra:
Marked mental changes, moist dermatitis, inability to 100
retain adequate nourishment, exhaustion, and cachexia.
With all of the symptoms listed below, plus mental 60
symptoms and impaired bodily vigor....................
With stomatitis, diarrhea, and symmetrical dermatitis.. 40
With stomatitis, or achlorhydria, or diarrhea.......... 20
Confirmed diagnosis with nonspecific symptoms such as: 10
decreased appetite, weight loss, abdominal discomfort,
weakness, inability to concentrate and irritability...6316 Brucellosis:
As active disease...................................... 100
Thereafter rate residuals such as liver or spleen damage or
meningitis under the appropriate system6317 Typhus, scrub:
As active disease, and for 3 months convalescence...... 100
Thereafter rate residuals such as spleen damage or skin conditions
under the appropriate system6318 Melioidosis:
As active disease...................................... 100
Thereafter rate residuals such as arthritis, lung lesions or
meningitis under the appropriate system6319 Lyme Disease:
As active disease...................................... 100
Thereafter rate residuals such as arthritis under the appropriate
system6320 Parasitic diseases otherwise not specified:
As active disease...................................... 100
Thereafter rate residuals such as spleen or liver damage under the
appropriate system6350 Lupus erythematosus, systemic (disseminated):
Not to be combined with ratings under DC 7809 Acute, 100
with frequent exacerbations, producing severe
impairment of health..................................
Exacerbations lasting a week or more, 2 or 3 times per 60
year..................................................
Exacerbations once or twice a year or symptomatic 10
during the past 2 years...............................
Note: Evaluate this condition either by combining the evaluations
for residuals under the appropriate system, or by evaluating DC
6350, whichever method results in a higher evaluation.
6351 HIV-Related Illness:
AIDS with recurrent opportunistic infections or with 100
secondary diseases afflicting multiple body systems;
HIV-related illness with debility and progressive
weight loss, without remission, or few or brief
remissions............................................
Refractory constitutional symptoms, diarrhea, and 60
pathological weight loss, or; minimum rating following
development of AIDS-related opportunistic infection or
neoplasm..............................................
Recurrent constitutional symptoms, intermittent 30
diarrhea, and on approved medication(s), or; minimum
rating with T4 cell count less than 200, or Hairy Cell
Leukoplakia, or Oral Candidiasis......................
Following development of definite medical symptoms, T4 10
cell of 200 or more and less than 500, and on approved
medication(s), or; with evidence of depression or
memory loss with employment limitations...............
Asymptomatic, following initial diagnosis of HIV 0
infection, with or without lymphadenopathy or
decreased T4 cell count...............................
Note (1): The term ``approved medication(s)'' includes medications
prescribed as part of a research protocol at an accredited medical
institution.
Note (2): Psychiatric or central nervous system manifestations,
opportunistic infections, and neoplasms may be rated separately
under appropriate codes if higher overall evaluation results, but
not in combination with percentages otherwise assignable above.6354 Chronic Fatigue Syndrome (CFS):
Debilitating fatigue, cognitive impairments (such as inability to
concentrate, forgetfulness, confusion), or a combination of other
signs and symptoms:
Which are nearly constant and so severe as to restrict 100
routine daily activities almost completely and which
may occasionally preclude self-care...................
Which are nearly constant and restrict routine daily 60
activities to less than 50 percent of the pre-illness
level, or; which wax and wane, resulting in periods of
incapacitation of at least six weeks total duration
per year..............................................
Which are nearly constant and restrict routine daily 40
activities to 50 to 75 percent of the pre-illness
level, or; which wax and wane, resulting in periods of
incapacitation of at least four but less than six
weeks total duration per year.........................
Which are nearly constant and restrict routine daily 20
activities by less than 25 percent of the pre-illness
level, or; which wax and wane, resulting in periods of
incapacitation of at least two but less than four
weeks total duration per year.........................
Which wax and wane but result in periods of 10
incapacitation of at least one but less than two weeks
total duration per year, or; symptoms controlled by
continuous medication.................................
Note: For the purpose of evaluating this disability, the condition
will be considered incapacitating only while it requires bed rest
and treatment by a physician.------------------------------------------------------------------------ [61 FR 39875, July 31, 1996] Sec. 4.88c Ratings for inactive nonpulmonary tuberculosis initially entitled after August 19, 1968. ------------------------------------------------------------------------
Rating------------------------------------------------------------------------For 1 year after date of inactivity, following active 100
tuberculosis...................................................Thereafter: Rate residuals under the specific body system or
systems affected.Following the total rating for the 1 year period after date of
inactivity, the schedular evaluation for residuals of
nonpulmonary tuberculosis, i.e., ankylosis, surgical removal of
a part, etc., will be assigned under the appropriate diagnostic
code for the residual preceded by the diagnostic code for
tuberculosis of the body part affected. For example,
tuberculosis of the hip joint with residual ankylosis would be
coded 5001-5250. Where there are existing residuals of
pulmonary and nonpulmonary conditions, the evaluations for
residual separate functional impairment may be combined.Where there are existing pulmonary and nonpulmonary conditions,
the total rating for the 1 year, after attainment of
inactivity, may not be applied to both conditions during the
same period. However, the total rating during the 1-year period
for the pulmonary or for the nonpulmonary condition will be
utilized, combined with evaluation for residuals of the
condition not covered by the 1-year total evaluation, so as to
allow any additional benefit provided during such period.------------------------------------------------------------------------ [34 FR 5062, Mar. 11, 1969. Redesignated at 59 FR 60902, Nov. 29, 1994]