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Link For Principles For Rating And Service Connection

Guest Morgan


Here are two links that shows principles for rating. The second one has good information about pre-existing and aggravation of conditions in service.



One of the rating principles surprised me, as we have discussed PFTs often on Hadit. I am working with a vet who had normal elements of the pulmonary function tests, except a DLCO at 60 (I think that's the acronym) which, if rated alone, would have been a 30% rating instead of 10%, had it not been for this rating directive, which is in one of the above documents and was cited in his decision:

d. When there is disparity between the results of different tests (FEV-1, FVC, etc.) so that the level of evaluation would differ depending on which test result is used, the test with the better (higher) values (i.e. that would give the lower evaluation) will be used. The reason is that these tests are effort-dependent, and the difference is usually due to the effort applied in each test. However, if there is a substantial disparity in the results, the MEB physician may be asked for an explanation and/or request that the test be repeated if there is no clear reason.

This vet's medical record shows that the respiratory therapist remarked he had given "exceptional effort" and the doctor remarked that the reason for the disparity was unknown and noted probably indication of "early small airway disease." Could this be a CUE because a repeat was not requested even when it was noted, discussed, and concluded abnormal DLCO not effort related but PROBABLE early airway disease?


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