Looking For A Reg

[carlie]

I'm looking for a reg for others on here. Berta, Vike or Pete can probably go right to it.

The reg deals with changing an existing diagnosis and states something to the effect that the diagnosis CAN NOT be changed due to only ONE exam.

Thanks for the help.

carlie

[Berta]

Carlie- will this help?:

http://64.233.167.104/custom?q=cache:1TVmy...326217334650925

M21-1 Part 6 Change 107 see under 1.07 b -3

(1) Reconciliation of Diagnoses. The precise cause of a disability is often difficult to determine. It is important that the same disability is not covered by more than one diagnosis. It is also essential that any inconsistency and duplication between the findings of various specialists and the general examination be resolved by conference among the examiners. It is of equal importance that a definite and unambiguous diagnosis be made for each complaint or symptom having a medical cause.

(2) Return an examination as insufficient for rating purposes if all claimed disabilities are not covered. See chapter 3 regarding partial rating decisions. Return a report as insufficient for rating purposes if the same disability is differently diagnosed by different examiners.

(3) Return the examination for clarification if an examination report shows a change in the diagnosis or etiology for a disability previously recognized as service-connected, and the medical examiner(s) has not made the required certification that the previous diagnosis or attributing etiology upon which service connection was based was "in error."

[carlie]

Berta,

That was close but I've just found the exact one I was referring to:

Hope this helps a vet.

carlie

§ 3.344 Stabilization of disability evaluations

(a) Examination reports indicating improvement. Rating agencies will handle cases affected by change of medical findings or diagnosis, so as to produce the greatest degree of stability of disability evaluations consistent with the laws and Department of Veterans Affairs regulations governing disability compensation and pension. It is essential that the entire record of examinations and the medical-industrial history be reviewed to ascertain whether the recent examination is full and complete, including all special examinations indicated as a result of general examination and the entire case history. This applies to treatment of intercurrent diseases and exacerbations, including hospital reports, bedside examinations, examinations by designated physicians, and examinations in the absence of, or without taking full advantage of, laboratory facilities and the cooperation of specialists in related lines. Examinations less full and complete than those on which payments were authorized or continued will not be used as a basis of reduction. Ratings on account of diseases subject to temporary or episodic improvement, e.g., manic depressive or other psychotic reaction, epilepsy, psychoneurotic reaction, arteriosclerotic heart disease, bronchial asthma, gastric or duodenal ulcer, many skin diseases, etc., will not be reduced on any one examination, except in those instances where all the evidence of record clearly warrants the conclusion that sustained improvement has been demonstrated. Ratings on account of diseases which become comparatively symptom free (findings absent) after prolonged rest, e.g. residuals of phlebitis, arteriosclerotic heart disease, etc., will not be reduced on examinations reflecting the results of bed rest. Moreover, though material improvement in the physical or mental condition is clearly reflected the rating agency will consider whether the evidence makes it reasonably certain that the improvement will be maintained under the ordinary conditions of life. When syphilis of the central nervous system or alcoholic deterioration is diagnosed following a long prior history of psychosis, psychoneurosis, epilepsy, or the like, it is rarely possible to exclude persistence, in masked form, of the preceding innocently acquired manifestations. Rating boards encountering a change of diagnosis will exercise caution in the determination as to whether a change in diagnosis represents no more than a progression of an earlier diagnosis, an error in prior diagnosis or possibly a disease entity independent of the service-connected disability. When the new diagnosis reflects mental deficiency or personality disorder only, the possibility of only temporary remission of a super-imposed psychiatric disease will be borne in mind.

(b) Doubtful cases. If doubt remains, after according due consideration to all the evidence developed by the several items discussed in paragraph (a) of this section, the rating agency will continue the rating in effect, citing the former diagnosis with the new diagnosis in parentheses, and following the appropriate code there will be added the reference “Rating continued pending reexamination ___ months from this date, §3.344.” The rating agency will determine on the basis of the facts in each individual case whether 18, 24 or 30 months will be allowed to elapse before the reexamination will be made.

© Disabilities which are likely to improve. The provisions of paragraphs (a) and (b) of this section apply to ratings which have continued for long periods at the same level (5 years or more). They do not apply to disabilities which have not become stabilized and are likely to improve. Reexaminations disclosing improvement, physical or mental, in these disabilities will warrant reduction in rating.

[26 FR 1586, Feb. 24, 1961; 58 FR 53660, Oct. 18, 1993]

[Vike17]

Carlie,

This regulation simply states that conditions that are subject to temporary improvment will not be reduce on the account of one exam unless the whole medical record indicates sustained improvement ect..., not soley because there was a change in diagnosis.

Granted, there may be a change in a diagnosis within a medical exam, but just because a diagnosis may have changed doesn't bar the VA from not reducing a rating.

Vike 17

Edited June 19, 2007 by Vike17

[carlie]

Vike,

I was checking out this reg to see if it would be helpful to a post by hp1030

in the thread titled, "Change Of Diagnosis, What are the rules???".

carlie