Book C, Supplement No. 29

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. 29

Covering period of Federal Register issues

through June 24, 2002

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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. 29

25 June 2002

Covering the period of Federal Register issues

through June 24, 2002

When Book C was originally prepared, it was current through final regulations published in the Federal Register of 24 March 1992. These supplemental 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.

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.

FILING INSTRUCTIONS

Book C, Supplement No. 29

June 25, 2002

Remove theseAdd theseSection(s)

old pagesnew pagesAffected

Do not file this supplement until you confirm that

all prior supplements have been filed

4.116-3 to 4.116-44.116-3 to 4.116-4§4.116

Be sure to complete the

Supplement Filing Record (page C-8)

when you have finished filing this material.

HIGHLIGHTS

Book C, Supplement No. 29

June 25, 2002

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 30 May 2002, the VA published a correction to a rule originally published on 14 February 2002. This was a formatting issue that we had already addressed in the last supplement covering §4.116. The only change in this supplement is to add a citation reference for the correction.

C29–1

4.116-1§4.116—Schedule of ratings–gynecological conditions and disorders of the breast 4.116-1

Following simple mastectomy or wide local excision

with significant alteration of size or form:

Both...... 501

One...... 301

Following wide local excision without significant

alteration of size or form:

Both or one...... 0

Note: For VA purposes:

(1) Radical mastectomy means removal of the entire breast, underlying pectoral muscles, and regional lymph nodes up to the coracoclavicular ligament.

(2) Modified radical mastectomy means removal of the entire breast and axillary lymph nodes (in continuity with the breast). Pectoral muscles are left intact.

(3) Simple (or total) mastectomy means removal of all of the breast tissue, nipple, and a small portion of the overlying skin, but lymph nodes and muscles are left intact.

(4) Wide local excision (including partial mastectomy, lumpectomy, tylectomy, segmentectomy, and quadrantectomy) means removal of a portion of the breast tissue.

7627Malignant neoplasms of gynecological system or breast...... 100

Note: A rating of 100 percent shall continue beyond the cessation of any surgical, X-ray, antineoplastic chemotherapy or other therapeutic procedure. Six months after discontinuance of such treatment, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of §3.105(e) of this chapter. If there has been no local recurrence or metastasis, rate on residuals.

7628Benign neoplasms of the gynecological system or breast. Rate according to impairment in function of the urinary or gynecological systems, or skin.

7629Endometriosis:

Lesions involving bowel or bladder confirmed by laparoscopy, pelvic

pain or heavy or irregular bleeding not controlled by treatment,

and bowel or bladder symptoms...... 50

Pelvic pain or heavy or irregular bleeding not controlled

by treatment...... 30

Pelvic pain or heavy or irregular bleeding requiring

continuous treatment for control...... 10

Note: Diagnosis of endometriosis must be substantiated by laparoscopy.

1Review for entitlement to special monthly compensation under §3.350 of this chapter.

[29 FR 6718, May 22, 1964, as amended at 41 FR 11301, Mar. 18, 1976; 41 FR 34258, Aug. 13, 1976; redesignated and revised, 60 FR 19855, Apr. 21, 1995; 67 FR 6874, Feb. 14, 2002; 67 FR 37695, May 30, 2002]

Supplement Highlights references: 12(1), 28(1).

(No. 29 6/25/02)