Alternative Criteria

[kevlarsamurai]

Greetings,

I had asked this in other forums and received no response so I wanted to ask here as well.  Apologies if you had to read this twice.  I might have spent too long looking at codes, regs, etc and I may be reading to much into it... but what exactly does that mean and where is it defined?  This is from Title 38; Chapter I; Part 4; Subpart B; §4.96.  It is also found in M21-1, Part III, Subpart iv, Chapter 4, Section D

.

"(d) Special provisions for the application of evaluation criteria for diagnostic codes 6600, 6603, 6604, 6825-6833, and 6840-6845. (1) Pulmonary function tests (PFT's) are required to evaluate these conditions except:

(i) When the results of a maximum exercise capacity test are of record and are 20 ml/kg/min or less. If a maximum exercise capacity test is not of record, evaluate based on alternative criteria."

What is that "alternative criteria?"  Does it mean, use something else to evaluate such as symptoms or is there a chart or something?  Thank you in advance.

S/
K

[Berta]

It could mean other tests done by a private doctor-not sure at all 

There was a change in the ratings in 2006, that is included in this BVA decision:

https://www.va.gov/vetapp14/files3/1420703.txt

You might find somethig to help in the BVA search feature I just used:

https://www.index.va.gov/search/va/bva_search.jsp?QT=Pulmonary+function+tests+(PFT's)+&EW="alternative+criteria&AT=&ET=&RPP=10&DB=2018&DB=2017&DB=2016&DB=2015&DB=2014&DB=2013&DB=2012&DB=2011&DB=2010&DB=2009&DB=2008&DB=2007&DB=2006&DB=2005&DB=2004&DB=2003&DB=2002&DB=2001&DB=2000&DB=1999&DB=1998&DB=1997&DB=1996&DB=1995&DB=1994&DB=1993&DB=1992

[kevlarsamurai]

16 minutes ago, Berta said:

It could mean other tests done by a private doctor-not sure at all 

 

Greetings,

Thank you very much.  The case history was next on my list.  I have been trying to find it in M21-1 and it has just eluded me.

Basically, I won my CUE at the RO on a remand, but lacking PFT's I couldn't get the full EED.  I actually requested an exam back then and none was scheduled.  So, I think, an argument can be made that because I was denied an exam... extra-schedular might apply or... if we truly are benefit of the doubt on rating going to the veteran, 100% now could have been 100% then.  But I don't think that is fair.  Thanks again.  You do great work on here.

S/

K