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The Department of Veterans Affairs (VA) amends its regulations to revise the sections that address the ear, nose, throat, audiology, and respiratory systems and adds a diagnostic code for constrictive bronchiolitis (or obliterative bronchiolitis) to the regulations that govern the respiratory system. The purpose of these changes is to update medical terminology, incorporate medical advances that have occurred since the last review, and provide well-defined criteria in accordance with actual clinical practice.

Statement of Need:

The VA Schedule for Rating Disabilities (VASRD) has not undergone a complete revision since 1945 and contains certain outdated, inaccurate, or obsolete medical, scientific, and/or economic information. With this final rule, VA will incorporate medical advancements that have occurred since the last revision, update current medical terminology, and provide clear evaluation criteria for disabilities of the ear, nose, and throat (ENT), audiology, and respiratory systems.

Summary of the Legal Basis:

38 U.S.C. 1155. VA will revise the regulations in 38 CFR parts 3 and 4 that address ENT, audiology, and respiratory systems.

Alternatives:

VA cannot update the VASRD through non-regulatory action. VA could choose to leave the VASRD criteria as is, but failure to update the criteria would result in continued application of outdated medical, scientific, and economic data in the evaluation of disabilities. Applying outdated criteria could render disability evaluations inadequate, inaccurate, and, in some cases, in conflict with current medical and economic understanding of disability. This would result in inadequate assessment of disabilities and lead to reduced efficiency in claims processing and delivery of benefits, as VA could not rely on modern medical records (when available) to quickly assess impairment. 

Anticipated Costs and Benefits:

The total budgetary impact is estimated to be a savings of $6.6 billion over five years and $25.5 billion over 10 years. This final rule will allow for more accurate and adequate disability evaluations.

Risks:

By processing claims for disability compensation benefits using outdated criteria, VA risks overcompensating or undercompensating Veterans for these service-connected conditions.