Section J - Compensation Under 38 CFR 4.28, 38 CFR 4.29, and 38 CFR 4.30 - Updated 12/16/11

Chapter 2 - Rating

Overview


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In this Section
This section contains the following topics:   ''' '''
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59.   Prestabilization Ratings Under 38 CFR 4.28
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Introduction
This topic contains general information on prestabilization ratings under 38 CFR 4.28, including
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 ·      the purpose of prestabilization ratings under 38 CFR 4.28

 ·      when to prepare a prestabilization rating

 ·      duration of the grant under 38 CFR 4.28

 ·      effective date of reductions in combined evaluations under 38 CFR 3.105(e)

<span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the criteria for assigning   a prestabilization rating

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      when to assign 100 and 50 percent prestabilization ratings

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      assigning a prestabilization rating when potential eligibility for Special Monthly Compensation (SMC) exists

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      when a prestabilization rating is not appropriate

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      establishing future date control for provision of VA examination in prestabilization ratings

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      expediting reevaluation of the SC disability(ies) in prestabilization ratings, and

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      handling prestabilization ratings when severance pay is awarded. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
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Change Date
<p class="MsoBlockText">September 8, 2009 {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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a.   Purpose of Prestabilization Ratings Under 38 CFR 4.28
<p class="MsoBlockText">Prestabilization ratings under 38 CFR 4.28 are provided to assure earliest payment to those Veterans separated from service with a significant disability at a time when they are most likely in need and least likely to be self-sufficient. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 59. Prestabilization Ratings Under 38 CFR 4.28, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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b.   When to Prepare a Prestabilization Rating
<p class="MsoBlockText">If a Veteran has an unstable, significantly disabling service-connected (SC) disability at the time of separation that will continue for an indefinite period
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      prepare a prestabilization rating for the unstabilized disability(ies) without waiting for further development or examination, and

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      on the rating codesheet, show that decisions have been deferred on all other issues.

<p class="MsoBlockText">

<p class="MsoBlockText">Important:   Assign an evaluation of at least 50 percent under 38 CFR 4.129 when a Veteran is discharged for a mental disorder that developed in service as a result of a traumatic event. For more information, see M21-1MR, Part III, Subpart iv, 4.H.27.e. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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c.   Duration of Grant Under 38 CFR 4.28
<p class="MsoBlockText">Prepare prestabilization ratings under 38 CFR 4.28 as “open ratings.” <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
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d.   Effective Date of Reduction in Combined Evaluations Under 38 CFR 3.105(e)
<p class="MsoBlockText">Reductions in combined evaluations under 38 CFR 3.105(e) are effective the later of the following:
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the date specified in the provisions of 38 CFR 3.105(e), or

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the first day of the month following the twelfth month after discharge.

<p class="MsoBlockText">

<p class="MsoBlockText">Note:   Promptly accomplish rating action and provide notice of reduction in all cases. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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e.   Criteria for Assigning a Prestabilization Rating
<p class="MsoBlockText">Assign a prestabilization rating if service treatment records (STRs) show the existence of an unstabilized condition stemming from any disease or injury for which service connection may be awarded. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 59. Prestabilization Ratings Under 38 CFR 4.28, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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f.   When to Assign 100- and 50-Percent Prestabilization Ratings
<p class="MsoBlockText" style="tab-stops:4.55in">Use the information below to determine when to assign 100- and 50-percent prestabilization ratings. <p class="MsoNormal"> <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
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g.   Assigning a Prestabilization Rating When Potential Eligibility for SMC Exists
<p class="MsoBlockText">If there is an indication of possible entitlement to Special Monthly Compensation (SMC), but records are insufficient to make a determination
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      evaluate disabilities in a prestabilization rating at the level of loss that is shown, and

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      request an immediate examination to determine the full extent of disability {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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h.   When a Prestabilization Rating Is Not Appropriate
<p class="MsoBlockText">Do not assign a
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      total 100-percent prestabilization rating in any case in which a total rating is immediately assignable

<p class="BulletText2" style="mso-list:l1 level1 lfo9"> -     under other provisions of the rating schedule, or

<p class="BulletText2" style="mso-list:l1 level1 lfo9"> -     on the basis of individual unemployability, or

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      50-percent prestabilization rating in any case in which an evaluation of 50 percent or higher would otherwise be immediately assignable under other provisions of the rating schedule. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 59. Prestabilization Ratings Under 38 CFR 4.28, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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i.   Establishing Future Date Control for Provision of VA Examination in Prestabilization Ratings
<p class="MsoBlockText">Establish a future date control for a VA examination of all SC disabilities between 6 and 12 months following separation from service. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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j.   Expediting Reevaluation of the SC Disability(ies) in Prestabilization Ratings
<p class="MsoBlockText">Once the report of the examination, completed 6 to 12 months following separation, is received by the rating activity, reevaluation of the SC disability(ies) should be expedited.
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<p class="MsoBlockText">

<p class="MsoBlockText">Note:   A Veteran who, without good cause, fails to report for the VA examination scheduled in connection with a prestabilization rating under 38 CFR 4.28 is subject to adjustment of benefits under 38 CFR 3.655.

<p class="MsoBlockText">

<p class="MsoBlockText">References:   For more information on

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      a Veteran’s failure to report for an examination, see M21-1MR, Part IV, Subpart ii, 3.B, and

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      denials when a Veteran fails to report for an examination, see M21-1MR, Part III, Subpart v, 2.A.6.b. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
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k.   Handling Prestabilization Ratings When Severance Pay Is Awarded
<p class="MsoBlockText">In some cases, VA assigns a 50- or 100-percent prestabilization rating for one or more, but not all, of the same disabilities for which the Veteran received severance pay.
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<p class="MsoBlockText">

<p class="MsoBlockText">In such cases, assign separate evaluations for the disabilities for which severance pay was awarded, which will assist authorization activity in processing an award.

<p class="MsoBlockText">

<p class="MsoBlockText">Reference:   For more information on preparing rating decisions, see the ''RBA2000 User Guide. '' <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt"> '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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60.   General Information on Hospitalization Ratings Under 38 CFR 4.29
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Introduction
<p class="MsoBlockText">This topic contains general information on hospitalization ratings under 38 CFR 4.29, including
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      when to assign hospitalization ratings

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      assigning

<p class="BulletText2" style="mso-list:l1 level1 lfo9"> -     hospitalization benefits for a hospital admission for a nonservice-connected (NSC) condition

<p class="BulletText2" style="mso-list:l1 level1 lfo9"> -     a hospitalization rating for a hospital admission for an incarcerated Veteran

<p class="BulletText2" style="mso-list:l1 level1 lfo9"> -     a hospitalization rating for multiple conditions

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      when hospitalization ratings are not applicable

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      effective dates of hospitalization ratings

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      computer-generated messages, and

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the responsibilities of the authorization activity. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
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Change Date
<p class="MsoBlockText">December 16, 2011 {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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a.   When to Assign a Hospitalization Rating
<p class="MsoBlockText">Provided a total, 100-percent rating cannot be assigned under other provisions of the rating schedule, assign a temporary 100 percent evaluation under 38 CFR 4.29 for
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      periods of hospitalization in excess of 21 days for medical treatment of an SC disability, or

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      a disability for which compensation is payable under either 38 U.S.C. 1151 or 38 U.S.C. 1160.

<p class="MsoBlockText">

<p class="MsoBlockText">Note:   Do not put competency at issue when assigning a 100 percent evaluation for a mental disorder under 38 CFR 4.29 unless the issue is otherwise raised by the evidence in the case. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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b.   Granting Hospitalization Benefits When Admission is for an NSC Disability
<p class="MsoBlockText">Even when hospital admission is for a nonservice-connected (NSC) disability, hospitalization benefits are payable if, during the hospitalization, treatment for an SC disability is initiated and continues in excess of 21 days.
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<p class="MsoBlockText">

<p class="MsoBlockText">Reference:   For more information on hospitalization ratings when admission is for treatment of a NSC disability, see 38 CFR 4.29(b). <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 60. General Information on Hospitalization Ratings Under 38 CFR 4.29, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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c.   Granting a Hospitalization Rating Based on the Admission of an Incarcerated Veteran to a Hospital
<p class="MsoBlockText">If an incarcerated Veteran is confined to a prison hospital for treatment of an SC disability in excess of 21 days, the Veteran may be eligible for hospitalization benefits.
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<p class="MsoBlockText">

<p class="MsoBlockText">Reference:   For information on the effect of imprisonment on benefit payments, see M21-1MR, Part III, Subpart v, 8.

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d.   Granting a Hospitalization Rating Involving Multiple SC Disabilities
<p class="MsoBlockText">In cases in which two or more SC disabilities exist for which the provisions of 38 CFR 4.29 would apply, increase the evaluation of only one of the disabilities to100 percent. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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e.   When the Provisions of 38 CFR 4.29 Do Not Apply
<p class="MsoBlockText">Do not apply the provisions of 38 CFR 4.29 when a Veteran
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      is treated as a resident in a State Veterans’ home

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·        is currently receiving a total rating for the disability for which hospitalization was required, or

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      enters into a day hospital program but is not hospitalized as an inpatient in excess of 21 days.

<p class="MsoBlockText">

<p class="MsoBlockText">Exceptions:

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      Hospitalization in excess of 21 days for an SC disability in a medical facility located at a State Veterans’ home may entitle the Veteran to hospitalization benefits.

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      Veterans are entitled to hospitalization benefits for treatment in excess of 21 days in a day hospital program even though they are concurrently required to be housed in a VA domiciliary.

<p class="MsoBlockText">

<p class="MsoBlockText">Note:   A 100-percent evaluation under 38 CFR 4.29, in combination with another SC disability, independently rated 60 percent or more disabling, entitles the Veteran to statutory Housebound benefits under 38 U.S.C. 1114(s). <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 60. General Information on Hospitalization Ratings Under 38 CFR 4.29, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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f.   Effective Dates of Hospitalization Ratings
<p class="MsoBlockText">Use the information below to determine the effective date of hospitalization ratings. <p class="MsoNormal"> <p class="MsoNormal"> <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 60. General Information on Hospitalization Ratings Under 38 CFR 4.29, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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g.   Computer-Generated Messages
<p class="MsoBlockText">The following computer-generated message issues every 3 months when a 100-percent evaluation is assigned under 38 CFR 4.29:   Writeout Msg Code 884 - VERIFY HOSP STATUS OF VET - OVER 3 MONTHS.
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<p class="MsoBlockText">

<p class="MsoBlockText">It is the authorization activity’s responsibility to

<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      determine whether the Veteran continues to be hospitalized, and

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      refer the claims folder to the rating activity for

<p class="BulletText2" style="mso-list:l1 level1 lfo9"> -     consideration of a schedular 100-percent rating when a Veteran remains hospitalized for more than six months, or

<p class="BulletText2" style="mso-list:l1 level1 lfo9"> -     reevaluation of the Veteran’s disability(ies) if the Veteran is no longer hospitalized. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt"> '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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61.   Preparing the Rating Decision for Hospitalization Ratings Under 38 CFR 4.29
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Introduction
<p class="MsoBlockText">This topic contains information on preparing the rating decision for hospitalization ratings under 38 CFR 4.29, including
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the duration of

<p class="BulletText2" style="mso-list:l1 level1 lfo9"> -     awards under 38 CFR 4.29, and

<p class="BulletText2" style="mso-list:l1 level1 lfo9"> -     extensions of the hospitalization ratings allowed under 38 CFR 4.29

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      preparing an open-ended hospitalization rating decision, and

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      following-up on an open-ended hospitalization rating decision. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
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Change Date
<p class="MsoBlockText">September 15, 2011 {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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a.   Duration of Awards Under 38 CFR 4.29
<p class="MsoBlockText">Continue the 100-percent rating under 38 CFR 4.29 through the last day of the month in which hospitalization or treatment for the SC disability(ies) terminates.
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<p class="MsoBlockText">

<p class="MsoBlockText">Note:   Such termination may be due to

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      hospital discharge, regular or irregular, or

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the cessation of treatment or observation for SC disabilities prior to discharge from the hospital. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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b.   Duration of Extensions of Hospitalization Ratings Allowed Under 38 CFR 4.29
<p class="MsoBlockText">The 100-percent rating may initially be extended for one month, two months, or three months, based on a need for convalescence, only when the Veteran received an approved discharge from the hospital.
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<p class="MsoBlockText">

<p class="MsoBlockText">Following termination of the temporary 100-percent rating, assign the appropriate scheduler evaluation for any residual disability.

<p class="MsoBlockText">

<p class="MsoBlockText">Notes:

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      It is permissible to initially assign a one-month convalescence period and extend it another one or two months, if the facts warrant it.

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      Further extensions of one or more months, up to three months, may be made upon approval of the Veterans Service Center Manager (VSCM). <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 61. Preparing the Rating Decision for Hospitalization Ratings Under 38 CFR 4.29, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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c.   Preparing an Open-Ended Hospitalization Rating Decision
<p class="MsoBlockText">If a report of the required hospitalization, such as a 21-day certification, is received before the Veteran is discharged from the hospital, an open-ended rating may be prepared in accordance with the instructions in M21-1MR, Part III, Subpart v, 6.D.18.b.
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<p class="MsoBlockText">

<p class="MsoBlockText">Reference:   For more information on preparing rating decisions, see the RBA2000 User Guide. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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d.   Following Up on an Open-Ended Hospitalization Rating Decision
<p class="MsoBlockText">When following up on an open-ended hospitalization rating decision
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<p class="MsoBlockText">

<p class="BulletText1" style="margin-left:8.1pt;text-indent:-8.1pt;mso-list:  l2 level1 lfo4;tab-stops:list 8.1pt">  ·     request a reexamination sufficiently in advance to insure receipt of the report prior to expiration of the temporary 100-percent rating

<p class="BulletText1" style="margin-left:8.1pt;text-indent:-8.1pt;mso-list:  l2 level1 lfo4;tab-stops:list 8.1pt">  ·     continue the 100-percent evaluation in cases in which the Veteran immediately enters into a day hospital program following inpatient hospitalization in excess of 21 days for psychiatric illness, as this action indicates that the Veteran is still in need of treatment and not able to return to employment.

<p class="MsoBlockText">

<p class="MsoBlockText">Upon receipt of the reexamination report or cessation of treatment in the day hospital program, assign an applicable schedular evaluation for the residuals.

<p class="MsoBlockText">

<p class="MsoBlockText">Notes:

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      Do not apply the provisions of 38 CFR 3.105(e) unless the evaluation in effect prior to hospitalization is reduced following assignment of the 100-percent rating.

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      Authorization will establish a 30-day future diary to ensure receipt of confirmation of treatment or hospital release and the final hospital summary so that the Veteran’s award may be adjusted properly.

<p class="MsoBlockText">

<p class="MsoBlockText">Reference:   For more information on award or termination of entitlement to A&A during hospitalization, see M21-1MR, Part III, Subpart v, 6.C.14. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt"> '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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62.   General Information on Convalescent Ratings Under 38 CFR 4.30
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Introduction
<p class="MsoBlockText">This topic contains general information on convalescent ratings under 38 CFR 4.30, including
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      when to assign convalescent ratings

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      when the provisions of 38 CFR 4.30 are not applicable

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      determining the effective date of convalescent ratings

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      requesting future examinations, and

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      expediting reevaluation of the Veteran’s disability(ies). <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
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Change Date
<p class="MsoBlockText">September 29, 2006 {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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a.   When to Assign Convalescent Ratings
<p class="MsoBlockText">Assign a temporary 100 percent convalescent rating under 38 CFR 4.30 only following regular hospital discharge or outpatient release, regardless of the length of hospitalization, if treatment of an SC disability resulted in
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      surgery necessitating at least one-month convalescence

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      surgery with severe postoperative residuals, or

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      immobilization of at least one major joint by cast without surgery, including procedures performed at an outpatient clinic.

<p class="MsoBlockText">

<p class="MsoBlockText">Note:   The provision allowing assignment of a convalescent rating for outpatient surgery necessitating at least one-month of convalescence became effective March 1, 1989. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 62. General Information on Convalescent Ratings Under 38 CFR 4.30, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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b.   When the Provisions of 38 CFR 4.30 Are Not Applicable
<p class="MsoBlockText">The use of a convalescent rating is unnecessary if
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      a temporary total rating under 38 CFR 4.29 is in effect at time of hospital discharge, and

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the conditions requisite for extensions under 38 CFR 4.29 for an adequate convalescent period are present.

<p class="MsoBlockText">

<p class="MsoBlockText">However, assign the temporary 100-percent convalescent rating under 38 CFR 4.30 from the date of hospital treatment

<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      if the final hospital summary justifies an extension of the temporary 100-percent rating for periods beyond six months after discharge, and

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      upon approval by the VSCM. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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c.   Determining the Effective Date of Convalescent Ratings
<p class="MsoBlockText">The effective date of convalescent ratings is the date of hospitalization or a later date as warranted by the facts of the case, according to the criteria for hospitalization ratings under 38 CFR 4.29.
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<p class="MsoBlockText">

<p class="MsoBlockText">Reference:   For more information on hospitalization ratings, see

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      M21-1MR, Part IV, Subpart ii, 2.J.60, and

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      M2-1-MR, Part IV, Subpart ii, 2.J.61. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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d.   Requesting Future Examinations
<p class="MsoBlockText">If it is not possible to determine residual disability following a period of convalescence, request an examination sufficiently in advance to ensure receipt of the report prior to termination of the temporary 100-percent evaluation.
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<p class="MsoBlockText">

<p class="MsoBlockText">Note:   A computer control may be used for the issuance of VA Form 21-2507a, Request for Physical Examination. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 62. General Information on Convalescent Ratings Under 38 CFR 4.30, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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e.   Expediting Reevaluation of the Veteran’s Disability(ies)
<p class="MsoBlockText">Upon receipt of an examination report prepared following a period of convalescence, take immediate rating and award actions so that there is no interruption in the Veteran’s benefits.
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<p class="MsoBlockText">

<p class="MsoBlockText">If the residual disability is

<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      less disabling than prior to hospitalization, take rating action to show the temporary 100-percent evaluation, followed by the

<p class="BulletText2" style="mso-list:l1 level1 lfo9"> -     evaluation in effect prior to hospitalization for the period prescribed by 38 CFR 3.105(e), and

<p class="BulletText2" style="mso-list:l1 level1 lfo9"> -     appropriate reduced evaluation, or

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the same or more disabling than prior to hospitalization, the temporary 100-percent rating is not subject to the provisions of 38 CFR 3.105(e). <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt"> '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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63.   Preparing the Rating Decision for Convalescent Ratings Under 38 CFR 4.30
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Introduction
<p class="MsoBlockText">This topic contains information on preparing the rating decision for convalescent ratings under 38 CFR 4.30, including
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the duration of

<p class="BulletText2" style="mso-list:l1 level1 lfo9"> -     awards under 38 CFR 4.30, and

<p class="BulletText2" style="mso-list:l1 level1 lfo9"> -     extensions in the convalescent rating under 38 CFR 4.30, and

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      drafting the Reasons for Decision section of convalescent rating decisions. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
 * }

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Change Date
<p class="MsoBlockText">December 13, 2005 {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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a.   Duration of Awards Under 38 CFR 4.30
<p class="MsoBlockText">Assign a temporary 100-percent rating from the date of hospitalization through the month in which the Veteran was discharged from the hospital, plus one, two, or three additional months.
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<p class="MsoBlockText">

<p class="MsoBlockText">Note:   The 100-percent rating should last at least one month. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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b.   Duration of Extensions of the Convalescent Rating Under 38 CFR 4.30
<p class="MsoBlockText">Award an extension of the convalescent rating of one, two, or three months following an original three-month extension, as the facts warrant.
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<p class="MsoBlockText">

<p class="MsoBlockText">Make further extensions of one or more months, up to six months, upon approval by the VSCM. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
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c.   Drafting the Reasons for Decision Section of Convalescent Rating Decisions
<p class="MsoBlockText">In the Reasons for Decision section of the convalescent rating decision, explain why the
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      convalescent rating is limited to the number of months selected, and

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      schedular rating is not increased, if applicable.

<p class="MsoBlockText">

<p class="MsoBlockText">Note:   Following termination of the convalescent rating, assign the appropriate schedular evaluation for any residual disability.

<p class="MsoBlockText">

<p class="MsoBlockText">Reference:   For more information on preparing rating decisions, see the RBA2000 User Guide. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt"> '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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64.   Diagnostic Codes (DCs) That Provide for Periods of Convalescence
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Introduction
<p class="MsoBlockText">This topic contains information on diagnostic codes (DCs) that provide for periods of convalescence, including
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      assigning a temporary 100-percent evaluation under a DC for a period of convalescence

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      determining the period of convalescence

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      considering indefinite periods of convalescence

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      considering schedular periods of convalescence

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      requesting review examinations after the convalescence period

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      expediting reevaluation of the disability after the convalescence period

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      assigning disability evaluations after the convalescence period

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      notifying the Veteran of the initial rating for the convalescence period, and

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      VETSNET 800-series work items that establish a specific convalescence period. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
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Change Date
<p class="MsoBlockText">September 15, 2011 {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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a.   Assigning a Temporary 100 Percent Evaluation Under A DC for a Period of Convalescence
<p class="MsoBlockText">The rating schedule prescribes 100-percent evaluations under various diagnostic codes (DCs) for periods of convalescence following cessation of certain
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      treatment

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      surgery, or

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      manifestations of disease. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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b.   Determining the Period of Convalescence
<p class="MsoBlockText">The period of convalescence should begin on the first of the month following
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      a hospital discharge, if benefits under 38 CFR 4.29 were awarded, or

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      termination of a one-month temporary 100-percent rating under 38 CFR 4.30. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 64. Diagnostic Codes (DCs) That Provide for Periods of Convalescence, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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c.   Considering Indefinite Periods of Convalescence
<p class="MsoBlockText">Certain disabilities in the rating schedule require a convalescence rating of 100 percent for an indefinite period, with a mandatory examination at the end of a specified duration of time. After the specified duration, the condition is evaluated based on the degree of disability shown.
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<p class="MsoBlockText">

<p class="MsoBlockText">Examples:

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      A mandatory examination is conducted no sooner than one year following hospital discharge subsequent to kidney transplant surgery under DC 7531.

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      An examination is to be conducted six months following cessation of chemotherapy for a malignant neoplasm of the genitourinary system under DC 7528.

<p class="MsoBlockText">

<p class="MsoBlockText">Important:   When preparing a convalescence rating for these disabilities

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      enter the examination date in RBA2000

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      do not reduce the 100-percent evaluation until after consideration of the required examination report, and

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      apply the provisions of 38 CFR 3.105(e) for any reductions. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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d.   Considering Schedular Periods of Convalescence
<p class="MsoBlockText">When the rating schedule provides for a temporary 100-percent evaluation for a prescribed period of convalescence under a DC, the rating decision establishing the total evaluation will prospectively assign the minimum schedular evaluation effective the day following expiration of the prescribed total period, unless current medical evidence shows that a higher-than-minimum evaluation is warranted.
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<p class="MsoBlockText">

<p class="MsoBlockText">Example:   In the same rating decision, assign

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      a 100-percent evaluation for three months following removal of the uterus under DC 7618, and

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the minimum schedular 30 percent evaluation effective the day following expiration of the prescribed total period.

<p class="MsoBlockText">

<p class="MsoBlockText">Notes:

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      The award letter must fully advise the Veteran of the

<p class="BulletText2" style="mso-list:l1 level1 lfo9"> -     duration of the temporary total period, and

<p class="BulletText2" style="mso-list:l1 level1 lfo9"> -     effective date of the reduced schedular evaluation.

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      The provisions of 38 CFR 3.105(e) do not apply in these types of cases. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 64. Diagnostic Codes (DCs) That Provide for Periods of Convalescence, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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e.   Requesting Review Examinations After the Convalescence Period
<p class="BulletText1" style="margin-left:0in;text-indent:0in;mso-list:none;  tab-stops:.5in"> <p class="MsoBlockText">Schedule a future examination after the prescribed convalescence period has expired.
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<p class="MsoBlockText">

<p class="MsoBlockText">Exception:   If the evaluation prior to the temporary total evaluation

<p class="MsoBlockText">exceeds the minimum schedular evaluation and is protected under 38 CFR 3.951(b)

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      assign the higher protected evaluation the day following expiration of the temporary total period, and

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      do not schedule a future examination.

<p class="MsoBlockText">

<p class="MsoBlockText">Enter the examination date in RBA2000 to control for the issuance of Request for Physical Examination, VA Form 21-2507a.

<p class="MsoBlockText">

<p class="MsoBlockText">Reference:   For more information on scheduling review examinations, see M21-1MR, Part III, Subpart iv, 3.B.15. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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f.   Expediting Reevaluation of the Disability After the Convalescence Period
<p class="MsoBlockText">Take immediate rating and award actions following receipt of the examination report to ensure no interruption in the Veteran’s benefits. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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g.   Assigning Disability Evaluations after the Convalescence Period
<p class="MsoBlockText">Assign the appropriate disability evaluation from the date the convalescence rating terminates, if the review of the examination report or other current medical evidence reveals that a higher evaluation is warranted following the period of convalescence than had previously been anticipated.
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<p class="MsoBlockText">

<p class="MsoBlockText">Note:   Apply 38 CFR 3.105(e) if the examination report reveals a lower evaluation is warranted, following the period of convalescence, than had previously been anticipated. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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h.   Notifying the Veteran of the Initial Rating for the Convalescence Period
<p class="MsoBlockText">The Veteran must be notified of the initial rating for the period of convalescence, including the effective dates and the subsequent anticipated evaluation.
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<p class="MsoBlockText">

<p class="MsoBlockText">Apply the provisions of 38 CFR 3.105(e) in cases in which the Veteran was not properly notified. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 64. Diagnostic Codes (DCs) That Provide for Periods of Convalescence, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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i.   VETSNET 800 Series Work Items for Ratings That Establish a Specific Convalescence Period
<p class="MsoBlockText">Whenever a rating is processed that assigns a 100-percent evaluation for a specified period of convalescence under a DC
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      VETSNET generates

<p class="BulletText2" style="mso-list:l1 level1 lfo9"> -     a diary control that will expire at the appropriate time following the processing month, depending upon the DC, and

<p class="BulletText2" style="mso-list:l1 level1 lfo9"> -     an 800 series work item with the message, REVIEW NEED FOR REEVALUATION, and

<p class="BulletText1" style="mso-list:l9 level1 lfo6"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the authorization activity refers the 800 series work items and associated claims folders to the rating activity for review. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
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