Section B. Conditions of the Organs of Special Sense Overview In this Section




Download 108.62 Kb.
NameSection B. Conditions of the Organs of Special Sense Overview In this Section
page1/4
A typeDocumentation
manual-guide.com > manual > Documentation
  1   2   3   4

M21-1MR, Part III, Subpart iv, Chapter 4, Section B

Section B. Conditions of the Organs of Special Sense

Overview




In this Section

This section contains the following topics:




Topic

Topic Name

See Page

10

General Information About Eye Conditions

4-B-2

11

Specific Eye Conditions

4-B-6

12

Hearing Impairment

4-B-10

13

Exhibit 1: Examples of Rating Decisions for Diplopia

4-B-22



10. General Information About Eye Conditions




Introduction

This topic contains general information about eye conditions, including


  • measuring field of vision

  • citing disease or injury in the diagnosis

  • excluding congenital or developmental defects

  • considering service connection for refractive errors

  • reconciling inconsistent findings with refractive error

  • establishing service connection for unusual developments, and

  • considering visual acuity in a non-service-connected (NSC) eye.



Change Date

August 3, 2011



a. Measuring Field of Vision

In all claims, when the extent of the field of vision is measured by the Goldmann Bowl perimeter and not a tangent screen, employ the Target III/4e in the kinetic mode. The examiner should record perimeter type, illuminating light level, test object size, color, and test distance with testing done, unseen to seen, with at least 16 meridians, 22-1/2 degrees apart, charted for each eye.
Notes:

  • If the above guidelines are adhered to, the results equate with those found by the methods of testing required in 38 CFR 4.76.

  • The examining medical facility may use an automated perimetric device, such as the Humphrey Model 750 or the Octopus Model 101, to determine visual field loss as long as the results are reported on a standard Goldmann chart.


Reference: See TOOLS in RBA2000 for a visual field calculator that may be used to calculate the field of vision.



b. Citing Disease or Injury in Diagnosis

Show the actual disease, injury, or other basic condition as the diagnosis, rather than a mere citation of impaired visual acuity, field of vision, or motor efficiency.
Note: Actual pathology, other than refractive error, is required to support impairment of visual acuity. Impaired field of vision and impaired motor field function must be supported by actual appropriate pathology.

Continued on next page

10. General Information About Eye Conditions, Continued

c. Excluding Congenital or Developmental Defects

Defects of form or structure of the eye that are of congenital or developmental origin may not be considered as disabilities or SC on the basis of incurrence or aggravation beyond natural progress during service.
The fact that a Veteran was supplied with glasses for correcting refractive error from any of the eye defects named above is not, in itself, considered indicative of aggravation by service that would warrant compensation.
Exception: Malignant or pernicious myopia may be considered SC.


d. Considering Service Connection for Refractive Errors

Refractive errors are


  • due to anomalies in the shape and conformation of the eye structures, and

  • generally of congenital or developmental origin.


Examples: Astigmatism, myopia, hyperopia, and presbyopia.
The effect of uncomplicated refractive errors must be excluded in considering impairment of vision from the standpoint of service connection and evaluation.
Exception: Myopia may progress rapidly during the periods of service and lead to destructive changes, such as

  • changes in the choroid

  • retinal hemorrhage, and

  • retinal detachment.


Notes:

  • Children are usually hyperopic at birth and subsequently become less so, or they become emmetropic, or even myopic.

  • In adults, refractive errors are generally stationary or change slowly until the stage of presbyopia, also a developmental condition.


Reference: For more information on considering service connection for refractive error of the eye, see 38 CFR 3.303(c).

Continued on next page

10. General Information About Eye Conditions, Continued


e. Reconciling Inconsistent Findings with Refractive Error

When dealing with refractive error only, if the best corrected vision on any examination by the Department of Veterans Affairs (VA) is better than prior determinations, assume these prior determinations to be erroneous or at least as not representing best correction.


f. Establishing Service Connection for Unusual Developments

Long-established policy permits establishment of service connection for such unusual developments as choroidal degeneration, retinal hemorrhage or detachment, or rapid increase of myopia producing uncorrectable impairment of vision.
Consider refractive error service-connected (SC) only under these unusual circumstances and when combined with uncorrectable residual visual impairment.
Note: Irregular astigmatism may be due to corneal inflammation due to injury or operation.

Continued on next page

10. General Information About Eye Conditions, Continued


g. Considering Visual Acuity in an NSC Eye

When visual impairment of only one eye is SC, either directly or by aggravation, consider the visual acuity of the nonservice-connected (NSC) eye to be 20/40, subject to the provisions of 38 CFR 3.383(a).
Example 1 (Direct incurrence)

Situation:

  • Pre-service, a Veteran had visual acuity of 20/70 in the right eye and 20/20 in the left eye, with a history of bilateral inactive chorioretinitis.

  • The Veteran developed a cataract in the left eye in service.

  • Post-service, visual acuity was 20/70 in the right eye and 10/200 in the left eye.

  • At the time of the rating determination, the left eye cataract was pre-operative.


Result:

  • The SC evaluation is 30 percent for the left eye cataract that was incurred in service, based on visual acuity of 10/200.

  • Since the right eye is NSC, it is considered to have normal vision (20/40) for the purposes of this calculation.


Example 2 (Aggravation)

Situation:

  • Pre-service, a Veteran had visual acuity of 20/50 in each eye due to scarring from an old injury.

  • The Veteran’s left eye was re-injured in combat.

  • Post-service, visual acuity was 20/50 in the right eye and 10/200 in the left eye.


Result:

  • The SC evaluation is 20 percent for left eye aggravation (30 percent for 10/200 (current left eye) minus 10 percent for 20/50 (left eye on entrance)).

  • Since the Veteran’s right eye is NSC, it is considered to have normal vision (20/40) for the purposes of this calculation.


References: For more information on

  • evaluating visual acuity, see 38 CFR 4.75 and 38 CFR 4.79, diagnostic codes (DCs) 6063 through 6066, and

  • determining in-service aggravation of pre-service disability, see


  1   2   3   4

Share in:

Related:

Section B. Conditions of the Organs of Special Sense Overview In this Section iconSection V: Special Conditions of Contract (scc)

Section B. Conditions of the Organs of Special Sense Overview In this Section iconDrawing and general provisions of contract, including general and...

Section B. Conditions of the Organs of Special Sense Overview In this Section iconDrawing and general provisions of contract, including general and...

Section B. Conditions of the Organs of Special Sense Overview In this Section iconA. Drawings and general provisions of the Contract, including General...

Section B. Conditions of the Organs of Special Sense Overview In this Section iconI. general a. Related documents drawings and general provisions of...

Section B. Conditions of the Organs of Special Sense Overview In this Section iconSection – general conditions of contract

Section B. Conditions of the Organs of Special Sense Overview In this Section iconSection A: Introduction & Overview 7

Section B. Conditions of the Organs of Special Sense Overview In this Section icon[section two] captions and credits 3 [section three] general rules...

Section B. Conditions of the Organs of Special Sense Overview In this Section iconSection-A: General Information and System Overview. Key Topic #1: Fundamental Concepts

Section B. Conditions of the Organs of Special Sense Overview In this Section iconSection 1: Complete the model definition Overview for importing inp files into HyperMesh

Section B. Conditions of the Organs of Special Sense Overview In this Section iconThis Section uses the term "Architect." Change this term to match...

Section B. Conditions of the Organs of Special Sense Overview In this Section iconDrawings and general provisions of the Contract, including General...

Section B. Conditions of the Organs of Special Sense Overview In this Section iconThis Section uses the term "Architect." Change this term to match...

Section B. Conditions of the Organs of Special Sense Overview In this Section iconA. Drawings and general provisions of the Contract, including General...

Section B. Conditions of the Organs of Special Sense Overview In this Section iconA. Drawings and general provisions of the Contract, including General...

Section B. Conditions of the Organs of Special Sense Overview In this Section iconDrawings and general provisions of the Contract, including General...

Section B. Conditions of the Organs of Special Sense Overview In this Section iconSection 11. (Blank) section 12. BUILDING WORK section 12 general requirements

Section B. Conditions of the Organs of Special Sense Overview In this Section icon1 4 System Specifications This section contains information on the...

Section B. Conditions of the Organs of Special Sense Overview In this Section iconGeneral conditons related documents drawings and general provisions...

Section B. Conditions of the Organs of Special Sense Overview In this Section icon1introduction this section provides an overview of the information...




manual




When copying material provide a link © 2017
contacts
manual-guide.com
search