Department of Veterans Affairs § 4.115B

Department of Veterans Affairs § 4.115b

Rat- Rat- ing ing

Renal dysfunction: Long-term drug therapy, 1–2 hospitalizations per Requiring regular dialysis, or precluding more year and/or requiring intermittent intensive than sedentary activity from one of the fol- management ...... 10 lowing: persistent edema and albuminuria; or, BUN more than 80mg%; or, creatinine more than 8mg%; or, markedly decreased function [59 FR 2527, Jan. 18, 1994; 59 FR 10676, Mar. 7, of kidney or other organ systems, estpecially 1994] cardiovascular ...... 100 Persistent edema and albuminuria with BUN 40 § 4.115b Ratings of the genitourinary to 80mg%; or, creatinine 4 to 8mg%; or, gen- system—diagnoses. eralized poor health characterized by lethargy, weakness, anorexia, weight loss, or limitation of exertion ...... 80 Rat- Constant albuminuria with some edema; or, defi- ing nite decrease in kidney function; or, hypertension at least 40 percent disabling under di- Note: When evaluating any claim in- agnostic code 7101 ...... 60 volving loss or loss of use of one or Albumin constant or recurring with hyaline and more creative organs, refer to granular casts or red blood cells; or, transient § 3.350 of this chapter to determine or slight edema or hypertension at least 10 percent disabling under diagnostic code 7101 30 whether the veteran may be enti- Albumin and casts with history of acute nephritis; tled to special monthly compensa- or, hypertension non-compensable under diag- tion. Footnotes in the schedule indi- nostic code 7101 ...... 0 cate conditions which potentially Voiding dysfunction: establish entitlement to special Rate particular condition as urine leakage, fre- monthly compensation; however, quency, or obstructed voiding there are other conditions in this Continual Urine Leakage, Post Surgical Urinary section which under certain cir- Diversion, Urinary Incontinence, or Stress In- cumstances also establish entitle- continence: ment to special monthly compensa- Requiring the use of an appliance or the wearing tion. of absorbent materials which must be changed more than 4 times per day ...... 60 7500 Kidney, removal of one: Requiring the wearing of absorbent materials Minimum evaluation ...... 30 which must be changed 2 to 4 times per day .. 40 Or rate as renal dysfunction if there is Requiring the wearing of absorbent materials nephritis, infection, or pathology of which must be changed less than 2 times per day ...... 20 the other. Urinary frequency: 7501 Kidney, abscess of: Daytime voiding interval less than one hour, or; Rate as urinary tract infection ...... awakening to void five or more times per night 40 7502 Nephritis, chronic: Daytime voiding interval between one and two Rate as renal dysfunction. hours, or; awakening to void three to four times per night ...... 20 7504 Pyelonephritis, chronic: Daytime voiding interval between two and three Rate as renal dysfunction or urinary hours, or; awakening to void two times per tract infection, whichever is pre- night ...... 10 dominant. Obstructed voiding: 7505 Kidney, tuberculosis of: Urinary retention requiring intermittent or contin- Rate in accordance with §§ 4.88b or uous catheterization ...... 30 4.89, whichever is appropriate. Marked obstructive symptomatology (hesitancy, slow or weak stream, decreased force of 7507 Nephrosclerosis, arteriolar: stream) with any one or combination of the fol- Rate according to predominant symp- lowing: toms as renal dysfunction, hyper- 1. Post void residuals greater than 150 cc. tension or heart disease. If rated 2. Uroflowmetry; markedly diminished peak under the cardiovascular schedule, flow rate (less than 10 cc/sec). however, the percentage rating 3. Recurrent urinary tract infections sec- which would otherwise be assigned ondary to obstruction. will be elevated to the next higher 4. Stricture disease requiring periodic dilatation every 2 to 3 months ...... 10 evaluation. Obstructive symptomatology with or without stric- 7508 Nephrolithiasis: ture disease requiring dilatation 1 to 2 times Rate as hydronephrosis, except for per year ...... 0 recurrent stone formation requiring Urninary tract infection: one or more of the following: Poor renal function: Rate as renal dysfunction. 1. diet therapy Recurrent symptomatic infection requiring drain- 2. drug therapy age/frequent hospitalization (greater than two times/year), and/or requiring continuous inten- 3. invasive or non-invasive proce- sive management ...... 30 dures more than two times/year 30

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7509 Hydronephrosis: Both—30 1 Severe; Rate as renal dysfunction. One—0 1 Frequent attacks of colic with infection Note: In cases of the removal of one (pyonephrosis), kidney function im- testis as the result of a service-in- paired ...... 30 curred injury or disease, other than Frequent attacks of colic, requiring cath- an undescended or congenitally un- eter drainage ...... 20 developed testis, with the absence Only an occasional attack of colic, not or nonfunctioning of the other testis infected and not requiring catheter unrelated to service, an evaluation drainage ...... 10 of 30 percent will be assigned for 7510 Ureterolithiasis: the service-connected testicular Rate as hydronephrosis, except for loss. Testis, underscended, or con- recurrent stone formation requiring genitally undeveloped is not a rat- one or more of the following: able disability. 1. diet therapy 7525 Epididymo-orchitis, chronic only: 2. drug therapy Rate as urinary tract infection. 3. invasive or non-invasive proce- dures more than two times/year 30 For tubercular infections: Rate in accordance with §§ 4.88b or 4.89, 7511 Ureter, stricture of: whichever is appropriate. Rate as hydronephrosis, except for 7527 Prostate gland injuries, infections, hy- recurrent stone formation requiring pertrophy, postoperative residuals: one or more of the following: Rate as voiding dysfunction or urinary 1. diet therapy tract infection, whichever is pre- 2. drug therapy dominant. 3. invasive or non-invasive proce- 7528 Malignant neoplasms of the genito- dures more than two times/year 30 urinary system ...... 100 7512 Cystitis, chronic, includes interstitial Note—Following the cessation of sur- and all etiologies, infectious and non-in- gical, X-ray, antineoplastic chemo- fectious: therapy or other therapeutic proce- Rate as voiding dysfunction. dure, the rating of 100 percent shall 7515 Bladder, calculus in, with symptoms continue with a mandatory VA ex- interfering with function: amination at the expiration of six Rate as voiding dysfunction months. Any change in evaluation 7516 Bladder, fistula of: based upon that or any subsequent Rate as voiding dysfunction or urinary examination shall be subject to the tract infection, whichever is pre- provisions of § 3.105(e) of this dominant. chapter. If there has been no local Postoperative, suprapubic cystotomy 100 reoccurrence or metastasis, rate on 7517 Bladder, injury of: residuals as voiding dysfunction or Rate as voiding dysfunction. renal dysfunction, whichever is predominant. 7518 Urethra, stricture of: 7529 Benign neoplasms of the genito- Rate as voiding dysfunction. urinary system: 7519 Urethra, fistual of: Rate as voiding dysfunction or renal Rate as voiding dysfunction. dysfunction, whichever is predomi- Multiple urethroperineal fistulae ...... 100 nant. 7520 Penis, removal of half or more ...... 30 7530 Chronic renal disease requiring reg- Or rate as voiding dysfunction. ular dialysis: 7521 Penis removal of glans ...... 20 Rate as renal dysfunction. Or rate as voiding dysfunction. 7531 Kidney transplant: 7522 Penis, deformity, with loss of erectile Following transplant surgery ...... 100 1 power—20 . Thereafter: Rate on residuals as renal 7523 Testis, atrophy complete:. dysfunction, minimum rating ...... 30 Both—20 1 One—0 1 7524 Testis, removal:.

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Rat- GYNECOLOGICAL CONDITIONS AND ing DISORDERS OF THE BREAST

Note—The 100 percent evaluation § 4.116 Schedule of ratings—gyneco- shall be assigned as of the date of logical conditions and disorders of hospital admission for transplant the breast. surgery and shall continue with a mandatory VA examination one Rating year following hospital discharge. Any change in evaluation based Note 1: Natural menopause, primary amenorrhea, and pregnancy and child- upon that or any subsequent exam- birth are not disabilities for rating pur- ination shall be subject to the provi- poses. Chronic residuals of medical or sions of § 3.105(e) of this chapter. surgical complications of pregnancy may 7532 Renal tubular disorders (such as be disabilities for rating purposes. renal glycosurias, aminoacidurias, renal Note 2: When evaluating any claim involv- tubular acidosis, Fanconi’s syndrome, ing loss or loss of use of one or more creative organs or anatomical loss of Bartter’s syndrome, related disorders of one or both breasts, refer to § 3.350 of Henle’s loop and proximal or distal this chapter to determine whether the nephron function, etc.): veteran may be entitled to special Minimum rating for symptomatic con- monthly compensation. Footnotes in the dition ...... 20 schedule indicate conditions which potentially establish entitlement to special Or rate as renal dysfunction. monthly compensation; however, almost 7533 Cystic diseases of the kidneys (poly- any condition in this section might, under cystic disease, uremic medullary cystic certain circumstances, establish entitle- disease, Medullary sponge kidney, and ment to special monthly compensation. similar conditions): 7610 Vulva, disease or injury of (including vulvovaginitis). Rate as renal dysfunction. 7611 Vagina, disease or injury of. 7534 Atherosclerotic renal disease (renal 7612 Cervix, disease or injury of. artery stenosis or atheroembolic renal dis- 7613 Uterus, disease, injury, or adhesions of. ease): 7614 Fallopian tube, disease, injury, or adhesions Rate as renal dysfunction. of (including pelvic inflammatory disease (PID)). 7615 Ovary, disease, injury, or adhesions of. 7535 Toxic nephropathy (antibotics, General Rating Formula for Disease, Injury, or Ad- radiocontrast agents, nonsteroidal anti-in- hesions of Female Reproductive Organs (diag- flammatory agents, heavy metals, and nostic codes 7610 through 7615): similar agents): Symptoms not controlled by continuous Rate as renal dysfunction. treatment ...... 30 Symptoms that require continuous treat- 7536 Glomerulonephritis: ment ...... 10 Rate as renal dysfunction. Symptoms that do not require continuous 7537 Interstitial nephritis: treatment ...... 0 Rate as renal dysfunction. 7617 Uterus and both ovaries, removal of, complete: 7538 Papillary necrosis: For three months after removal ...... 1 100 Rate as renal dysfunction. Thereafter ...... 1 50 7539 Renal amyloid disease: 7618 Uterus, removal of, including corpus: 1 Rate as renal dysfunction. For three months after removal ...... 100 Thereafter ...... 1 30 7540 Disseminated intravascular coagula- 7619 Ovary, removal of: tion with renal cortical necrosis: For three months after removal ...... 1 100 Rate as renal dysfunction. Thereafter: 1 7541 Renal involvement in diabetes Complete removal of both ovaries 30 Removal of one with or without mellitus, sickle cell anemia, systemic partial removal of the other ...... 1 0 lupus erythematosus, vasculitis, or other 7620 Ovaries, atrophy of both, complete ...... 1 20 systemic disease processes. 7621 Uterus, prolapse: Rate as renal dysfunction. Complete, through vagina and introitus ...... 50 7542 Neurogenic bladder: Incomplete ...... 30 7622 Uterus, displacement of: Rate as voiding dysfunction. With marked displacement and frequent or 1 continuous menstrual disturbances ...... 30 Review for entitlement to special monthly com- With adhesions and irregular menstruation 10 pensation under § 3.350 of this chapter. 7623 Pregnancy, surgical complications of: With rectocele or cystocele ...... 50 [59 FR 2527, Jan. 18, 1994; 59 FR 14567, Mar. 29, With relaxation of perineum ...... 10 1994, as amended at 59 FR 46339, Sept. 8, 1994] 7624 Fistula, rectovaginal: Vaginal fecal leakage at least once a day requiring wearing of pad ...... 100 Vaginal fecal leakage four or more times per week, but less than daily, requiring wearing of pad ...... 60

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