Custom Federal Regulations Service ™ This is supplemental material for Book C of your set of Federal Regulations Title 38, Part 4 Schedule for Rating Disabilities Veterans Benefits Administration Supplement No. 64 Covering period of Federal Register issues through March 1, 2021 Copyright © 2021 Jonathan Publishing Need Assistance? Questions concerning MISSING SUPPLEMENTS , need for ADDITIONAL BOOKS , and other DISTRIBUTION LIST issues for this loose-leaf service should be directed to: Department of Veterans Affairs Veterans Benefits Administration Administration Mail Code: 20M33 810 Vermont Avenue, N.W. Washington DC 20420 Telephone: 202/273-7588 Fax: 202/275-5947 E-mail: [email protected] Questions concerning the FILING INSTRUCTIONS for this loose-leaf service, or the reporting of SUBSTANTIVE ERRORS in the text, may be directed to: Jonathan Publishing 660 Laurel St, B-103 Baton Rouge LA 70802 Telephone: 225-205-573 Fax: 702-993-6003 E-mail: [email protected] Copyright © 2021 Jonathan Publishing C-64–2 GENERAL INSTRUCTIONS Custom Federal Regulations Service ™ Supplemental Materials for Book C Code of Federal Regulations Title 38, Part 4 Schedule for Rating Disabilities Veterans Benefits Administration Supplement No. 64 5 March 2021 Covering the period of Federal Register issues through March 1, 2021 When Book C was originally prepared, it was current through final regulations published in the Federal Register of 24 March 1992. These supple- mental materials are designed to keep your regulations up to date. You should file the attached pages immediately, and record the fact that you did so on the Supplement Filing Record which is at page C-8 of Book C, Schedule for Rating Disabilities . C-64–3 To ensure accuracy and timeliness of your materials, it is important that you follow these simple procedures: 1. Always file your supplemental materials immediately upon receipt. 2. Before filing, always check the Supplement Filing Record (page C-8) to be sure that all prior supplements have been filed. If you are missing any supplements, contact the Veterans Benefits Administration at the address listed on page C-2. 3. After filing, enter the relevant information on the Supplement Filing Record sheet (page C-8)—the date filed, name/initials of filer, and date through which the Federal Register is covered. 4. If as a result of a failure to file, or an undelivered supplement, you have more than one supplement to file at a time, be certain to file them in chronological order, lower number first. 5. Always retain the filing instructions (simply insert them at the back of the book) as a backup record of filing and for reference in case of a filing error. 6. Be certain that you permanently discard any pages indicated for removal in the filing instructions in order to avoid confusion later. To execute the filing instructions, simply remove and throw away the pages listed under Remove These Old Pages, and replace them in each case with the corresponding pages from this supplement listed under Add These New Pages . Occasionally new pages will be added without removal of any old material (reflecting new regulations), and occasionally old pages will be removed without addition of any new material (reflecting rescinded regulations)—in these cases the word None will appear in the appropriate column. C-64–4 FILING INSTRUCTIONS Book C, Supplement No. 64 March 5, 2021 Remove these Add these Section(s) old pages new pages Affected Do not file this supplement until you confirm that all prior supplements have been filed 4.71a-25 to 4.71a-30 4.71a-25 to 4.71a-30 §4.71a App. A-1 to App. A-2 App. A-1 to App. A-2 Appendix A App. A-13 to App. A-14 App. A-13 to App. A-14 Appendix A App. B-5 to App. B-6 App. B-5 to App. B-6 Appendix B App. B-21 to App. B-22 App. B-21 to App. B-22 Appendix B App. C-15 to App. C-16 App. C-15 to App. C-16 Appendix C App. C-19 to App. C-20 App. C-19 to App. C-20 Appendix C Be sure to complete the Supplement Filing Record (page C-8) when you have finished filing this material. C-64–5 HIGHLIGHTS Book C, Supplement No. 64 March 5, 2021 Supplement Highlights references : Where substantive changes are made in the text of regulations, the paragraphs of Highlights sections are cited at the end of the relevant section of text. Thus, if you are reading §3.263, you will see a note at the end of that section which reads: “Supplement Highlights references—6(2).” This means that paragraph 2 of the Highlights section in Supplement No. 6 contains information about the changes made in §3.263. By keeping and filing the Highlights sections, you will have a reference source explaining all substantive changes in the text of the regulations. Supplement frequency : This Book C ( Schedule for Rating Disabilities ) was originally supplemented four times a year, in February, May, August, and November. Beginning 1 August 1995, supplements will be issued every month during which a final rule addition or modification is made to the parts of Title 38 covered by this book. Supplements will be numbered consecutively as issued. Modifications in this supplement include the following: 1. On 4 February 2021, the VA published a final rule effective 7 February 2021, to making correcting amendments to the final rule published on November 30, 2020 – changing the diagnostic code for Plantar Fasciitis from 5285 to 5269. Changes: • In §4.71a, revised diagnostic code 5285 to 5269. • Revised Appendix A, B and C accordingly. ☼ C-64–6 4.71a-25 §4.71a—Schedule of ratings–musculoskeletal system 4.71a-25 THE ANKLE Rating 5270 Ankle, ankylosis of: In plantar flexion at more than 40º, or in dorsiflexion at more than 10˚ or with abduction, adduction, inversion or eversion deformity ..............................................................................................................40 In plantar flexion, between 30º and 40º, or in dorsiflexion, between 0º and 10º ................................................................................................30 In plantar flexion, less than 30º .................................................................................20 5271 Ankle, limited motion of: Marked (less than 5 degrees dorsiflexion or less than 10 degrees plantar flexion).. .................................................................................20 Moderate (less than 15 degrees dorsiflexion or less than 30 degrees plantar flexion) ..................................................................................10 5272 Subastragalar or tarsal joint, ankylosis of: In poor weight-bearing position ...............................................................................20 In good weight-bearing position ..............................................................................10 5273 Os calcis or astragalus, malunion of: Marked deformity .....................................................................................................20 Moderate deformity ..................................................................................................10 5274 Astragalectomy ...............................................................................................................20 SHORTENING OF THE LOWER EXTREMITY Rating 5275 Bones, of the lower extremity, shortening of: Over 4 inches (1 0.2 cms.) ..................................................................................... 60 3 3-1/2 to 4 inches (8.9 cms. to 10.2 cms.) ............................................................... 50 3 3 to 3-1/2 inches (7.6 cms.to 8.9 cms.) .....................................................................40 2-1/2 to 3 inches (6.4 cms. to 7.6 cms.) ....................................................................30 2 to 2-1/2 inches (5.1 cms. to 6.4 cms.) ....................................................................20 1-1/4 to 2 inches (3.2 cms. to 5.1 cms.) ....................................................................10 Note: Measure both lower extremities from anterior superior spine of the ilium to the internal malleolus of the tibia. Not to be combined with other ratings for fracture or faulty union in the same extremity. (No. 64 3/5/21) 4.71a-26 §4.71a—Schedule of ratings–musculoskeletal system 4.71a-26 3Also entitled to special monthly compensation. THE FOOT Rating 5269 Plantar fasciitis: No relief from both non-surgical and surgical treatment, bilateral ...........................30 No relief from both non-surgical and surgical treatment, unilateral .........................20 Otherwise, unilateral or bilateral...............................................................................10 Note (1): With actual loss of use of the foot, rate 40 percent. Note (2): If a veteran has been recommended for surgical intervention, but is not a surgical candidate, evaluate under the 20 percent or 30 percent criteria, whichever is applicable. 5276 Flatfoot, acquired: Pronounced; marked pronation, extreme tenderness of plantar surfaces of the feet, marked inward displacement and severe spasm of the tendo achillis on manipulation, not improved by orthopedic shoes or appliances: Bilateral ............................................................................................................50 Unilateral .........................................................................................................30 Severe; objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, indication of swelling on use, characteristic callosities: Bilateral ............................................................................................................30