A single evaluation will be assigned under the diagnostic code which reflects the predominant disability picture, with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation. The figures appearing in the space where the column and row intersect will represent the combined value of the two. Evaluation July 6, 1950; criterion and note February 7, 2021. (3) The assent of the claimant should first be obtained for permission to conduct this economic and social survey. 8625 Neuritis, posterior tibial nerve. See nerve involved for diagnostic code number and rating. We recommend you directly contact the agency responsible for the content in question. Depending on the specific residuals, separately evaluate as adhesions of peritoneum (diagnostic code 7301), cirrhosis of liver (diagnostic code 7312), and chronic liver disease without cirrhosis (diagnostic code 7345). Where there is lung or pleural involvement, ratings under diagnostic codes 6819 and 6820 will not be combined with each other or with diagnostic codes 6600 through 6817 or 6822 through 6847. FEV-1 less than 40-percent predicted, or; FEV-1/FVC less than 40 percent, or; more than one attack per week with episodes of respiratory failure, or; requires daily use of systemic (oral or parenteral) high dose corticosteroids or immuno-suppressive medications, FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; at least monthly visits to a physician for required care of exacerbations, or; intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids, FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; daily inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication, FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; intermittent inhalational or oral bronchodilator therapy. (c) The assignment of a total disability rating on the basis of hospital treatment or observation will not preclude the assignment of a total disability rating otherwise in order under other provisions of the rating schedule, and consideration will be given to the propriety of such a rating in all instances and to the propriety of its continuance after discharge. Not improvable by prosthesis controlled by natural knee action, Toes, all, amputation of, without metatarsal loss or transmetatarsal, amputation of, with up to half of metatarsal loss, Toe, other than great, with removal metatarsal head, Toes, three or more, without metatarsal involvement. between the thumb pad and the fingers, with the thumb attempting to oppose the fingers, With a gap of less than one inch (2.5 cm.) Evaluation September 9, 1975; evaluation September 22, 1978; evaluation January 12, 1998; criterion November 14, 2021. Features of the disability which must have persisted unchanged may be overlooked or a change for the better or worse may not be accurately appreciated or described. If you have another service-connected disability that led to your shoulder condition, you may qualify for disability compensation via secondary service connection. 7621 Complete or incomplete pelvic organ prolapse due to injury or disease or surgical complications of pregnancy. A clear statement will be made of the point or points upon which information is desired, and the complete case file will be simultaneously forwarded to Central Office. In 2022, flat feet VA disability ratings range from 0 percent to 50 percent, with interim breaks at 10 percent, 20 percent, and 30 percent. Well cover the different types of shoulder injuries that can qualify for disability benefits, how the VA rates shoulder injuries, and what evidence is needed to support a claim. (d) The combined evaluation of muscle groups acting upon a single unankylosed joint must be lower than the evaluation for unfavorable ankylosis of that joint, except in the case of muscle groups I and II acting upon the shoulder. (vi) fatigue lasting 24 hours or longer after exercise. The individual is thus 72 percent disabled, as shown in table I opposite 60 percent and under 30 percent. The joints involved should be tested for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with the range of the opposite undamaged joint. Evaluation February 17, 1994; title, criterion November 14, 2021. 7312 Liver, cirrhosis, primary biliary cirrhosis, or cirrhotic phase of sclerosing cholangitis. Great care will be exercised in the selection of the applicable code number and in its citation on the rating sheet. Criterion May 22, 1995; criterion March 18, 2002. For residuals not listed here that are reported on an examination, evaluate under the most appropriate diagnostic code. Persistently altered state of consciousness, such as vegetative state, minimally responsive state, coma. For application in rating cases in which the protective provisions of Pub. 7537 Interstitial nephritis, including gouty nephropathy, disorders of calcium metabolism. (d) Under diagnostic codes 5301 through 5323, disabilities resulting from muscle injuries shall be classified as slight, moderate, moderately severe or severe as follows: (i) Type of injury. The first option for obtaining a VA disability rating for knee pain is to establish a direct service connection. Post void residuals greater than 150 cc. (iii) When there have been one or more episodes of acute respiratory failure. View the most recent official publication: These links go to the official, published CFR, which is updated annually. The manifestations of a chronic mental disorder associated with psychomotor epilepsy, like those of the seizures, are protean in character. 6000 Choroidopathy, including uveitis, iritis, cyclitis, or choroiditis. Microsoft Edge, Google Chrome, Mozilla Firefox, or Safari. (b) Even if the requirement for a 10% (based on the need for continuous medication) or 30% (based on the presence of cardiac hypertrophy or dilatation) evaluation is met, METs testing is required in all cases except: (1) When there is a medical contraindication. Nor will ratings assigned to organic diseases and injuries be assigned by analogy to conditions of functional origin. 8212 Twelfth (hypoglossal), paralysis. 7807 American (New World) leishmaniasis (mucocutaneous, espundia): Rate as disfigurement of the head, face, or neck (DC 7800), scars (DC's 7801, 7802, 7803, 7804, or 7805), or dermatitis (DC 7806), depending upon the predominant disability. The functional loss may be due to absence of part, or all, of the necessary bones, joints and muscles, or associated structures, or to deformity, adhesions, defective innervation, or other pathology, or it may be due to pain, supported by adequate pathology and evidenced by the visible behavior of the claimant undertaking the motion. Retinal scars, atrophy, or irregularities. (2) Following a period of hospitalization in excess of 21 days, an authorized absence in excess of 14 days or a third consecutive authorized absence of 14 days will be regarded as the equivalent of hospital discharge and will interrupt hospitalization effective on the last day of the month in which either the authorized absence in excess of 14 days or the third 14 day period begins, except where there is a finding that convalescence is required as provided by paragraph (e) or (f) of this section. 7718 Essential thrombocythemia and primary myelofibrosis: Requiring either continuous myelosuppressive therapy, or, for six months following hospital admission for any of the following treatments: peripheral blood or bone marrow stem cell transplant, or chemotherapy, or interferon treatment, Requiring continuous or intermittent myelosuppressive therapy, or chemotherapy, or interferon treatment to maintain platelet count <500 10, Requiring continuous or intermittent myelosuppressive therapy, or chemotherapy, or interferon treatment to maintain platelet count of 200,000-400,000, or white blood cell (WBC) count of 4,000-10,000. Were here to help you receive the compensation and care you rightfully earned. A little used part of the musculoskeletal system may be expected to show evidence of disuse, either through atrophy, the condition of the skin, absence of normal callosity or the like. Muscle spasm will greatly assist the identification. Note July 6, 1950; evaluation February 17, 1994, criterion September 8, 1994; criterion November 14, 2021. VA Rating Criteria for GERD: 10 percent a veteran is rated at 10% if they have two or more of the common signs of GERD from the 30% schedule but not severe enough to justify the full 30% rating. In each prestabilization rating an examination will be requested to be accomplished not earlier than 6 months nor more than 12 months following discharge. cm. Often disoriented to two or more of the four aspects (person, time, place, situation) of orientation. Dyspnea, tachycardia, nervousness, fatigability, etc., may result from many causes; some may be service connected, others, not. Rate as minor seizures, except in the presence of major and minor seizures, rate the predominating type. Neuritis, external cutaneous nerve of thigh. Note (2): Evaluate each affected part (e.g., hand, foot, ear, nose) separately and combine the ratings in accordance with, 7123 Soft tissue sarcoma (of vascular origin). Evaluate based on disfigurement (diagnostic code 7800). 4. The Complete Guide to Getting a Narcolepsy VA Rating, 6 Things Every Veteran Needs to Know About VA Disability for Medication Side Effects. Some shoulder injuries may require surgery. 5160 Complete amputation, lower extremity. Consider especially psychotic manifestations, complete or partial loss of use of one or more extremities, speech disturbances, impairment of vision, disturbances of gait, tremors, visceral manifestations, etc., referring to the appropriate bodily system of the schedule. Both the use of manifestations not resulting from service-connected disease or injury in establishing the service-connected evaluation, and the evaluation of the same manifestation under different diagnoses are to be avoided. All of the criteria include severe, moderately severe, moderate, or slight and corresponds to a disability rating ranging from 0 to 40 percent. Degenerative arthritis, other than post-traumatic. 20, 2007, as amended at 73 FR 54708, 54712, Sept. 23, 2008; 73 FR 69554, Nov. 19, 2008; 74 FR 18467, Apr. Ratings for Pulmonary Tuberculosis (Chronic) Entitled on August 19, 1968: 6704 Active, advancement unspecified. For evaluation of Raynaud's syndrome (also known as secondary Raynaud's phenomenon, or secondary Raynaud's), see DC 7117. If it is not clear from the available records what the change of diagnosis represents, the rating agency shall return the report to the examiner for a determination. 6841 Spinal cord injury with respiratory insufficiency. 4.55 Principles of combined ratings for muscle injuries. Ratings for Impairment of Muscle Function. (iii) Objective findings. Criterion March 10, 1976; removed December 17, 1987. The importance of complete medical examination of injury cases at the time of first medical examination by the Department of Veterans Affairs cannot be overemphasized. Neuritis, internal popliteal (tibial) nerve. Note following July 6, 1950; evaluation January 12, 1998; criterion November 14, 2021. 7124 Raynaud's disease (also known as primary Raynaud's): Characteristic attacks associated with trophic change(s), such as tight, shiny skin, Characteristic attacks without trophic change(s). 8727 Neuralgia, internal saphenous nerve. [61 FR 39875, July 31, 1996, as amended at 84 FR 28230, June 18, 2019], [34 FR 5062, Mar. 10, 2018]. Since 2016, VA Claims Insider has helped thousands of Veterans just like you get the VA rating and compensation they deserve in less time. Rate any residual disability of infection within the appropriate body system as indicated by the notes in the evaluation criteria. Can communicate complex ideas. 8045 Residuals of traumatic brain injury (TBI). Prosthetic replacement of the shoulder joint: For 1 year following implantation of prosthesis, With chronic residuals consisting of severe, painful motion or weakness in the affected extremity. Without cardiac involvement but with chronic edema, stasis dermatitis, and either ulceration or cellulitis: Without cardiac involvement but with chronic edema or stasis dermatitis: At least one of the following: Ankle/brachial index less than or equal to 0.39; ankle pressure less than 50 mm Hg; toe pressure less than 30 mm Hg; or transcutaneous oxygen tension less than 30 mm Hg, At least one of the following: Ankle/brachial index of 0.40-0.53; ankle pressure of 50-65 mm Hg; toe pressure of 30-39 mm Hg; or transcutaneous oxygen tension of 30-39 mm Hg, At least one of the following: Ankle/brachial index of 0.54-0.66; ankle pressure of 66-83 mm Hg; toe pressure of 40-49 mm Hg; or transcutaneous oxygen tension of 40-49 mm Hg, At least one of the following: Ankle/brachial index of 0.67-0.79; ankle pressure of 84-99 mm Hg; toe pressure of 50-59 mm Hg; or transcutaneous oxygen tension of 50-59 mm Hg, Note (1): The ankle/brachial index (ABI) is the ratio of the systolic blood pressure at the ankle divided by the simultaneous brachial artery systolic blood pressure. 9900 Maxilla or mandible, chronic osteomyelitis, osteonecrosis or osteoradionecrosis of: Rate as osteomyelitis, chronic under diagnostic code 5000. Bones, neoplasm, malignant, primary or secondary. 9902 Mandible, loss of, including ramus, unilaterally or bilaterally: Not involving temporomandibular articulation. Thus, if there are three disabilities ratable at 60 percent, 40 percent, and 20 percent, respectively, the combined value for the first two will be found opposite 60 and under 40 and is 76 percent. (b) A total rating under this section will require full justification on the rating sheet and may be extended as follows: (1) Extensions of 1, 2 or 3 months beyond the initial 3 months may be made under paragraph (a) (1), (2) or (3) of this section. 7911 Addisons disease (adrenocortical insufficiency). Prosthetic replacement of the elbow joint: With chronic residuals consisting of severe painful motion or weakness in the affected extremity. For phakic (normal) individuals, as well as for pseudophakic or aphakic individuals who are well adapted to intraocular lens implant or contact lens correction, visual field examinations must be conducted using a standard target size and luminance, which is Goldmann's equivalent III/4e. Evaluation February 17, 1994; removed November 14, 2021. 5, 2007, as amended at 73 FR 54708, 54711, Sept. 23, 2008; 73 FR 69554, Nov. 19, 2008; 77 FR 6467, Feb. 8, 2012; 79 FR 45101, Aug. 4, 2014; 80 FR 42042, July 16, 2015; 82 FR 36084, Aug. 3, 2017; 82 FR 50806, Nov. 2, 2017; 83 FR 15072, Apr. Introduction paragraph revised March 10, 1976. VA DISABILITY FOR NEUROLOGICAL CONDITIONS AND CONVULSIVE DISORDERS. Medial tibial stress syndrome (MTSS), or shin splints: Requiring treatment for no less than 12 consecutive months, and unresponsive to surgery and either shoe orthotics or other conservative treatment, both lower extremities, Requiring treatment for no less than 12 consecutive months, and unresponsive to surgery and either shoe orthotics or other conservative treatment, one lower extremity, Requiring treatment for no less than 12 consecutive months, and unresponsive to either shoe orthotics or other conservative treatment, one or both lower extremities, Treatment less than 12 consecutive months, one or both lower extremities, 5263 Genu recurvatum (acquired, traumatic, with weakness and insecurity in weight-bearing objectively demonstrated), In plantar flexion at more than 40, or in dorsiflexion at more than 10 or with abduction, adduction, inversion or eversion deformity, In plantar flexion, between 30 and 40, or in dorsiflexion, between 0 and 10, Marked (less than 5 degrees dorsiflexion or less than 10 degrees plantar flexion), Moderate (less than 15 degrees dorsiflexion or less than 30 degrees plantar flexion). Psychomotor seizures will be rated as major seizures under the general rating formula when characterized by automatic states and/or generalized convulsions with unconsciousness. Added August 30, 1996; criterion, note August 11, 2019. WebAs reported in the VAs most recent Annual Benefits Report, musculoskeletal disabilities are the most commonly claimed condition in the VA disability benefits system, making up 36.9 percent of all disability claims. In view of the number of atypical instances it is not expected, especially with the more fully described grades of disabilities, that all cases will show all the findings specified. Thereafter: Rate residuals under the specific body system or systems affected. The term psychomotor epilepsy refers to a condition that is characterized by seizures and not uncommonly by a chronic psychiatric disturbance as well. VA ratings for shoulder pain require an accurate Range of Motion (ROM) test of the flexion and abduction of the arm or shoulder. 9908 Condyloid process, loss of, one or both sides, Loss of half or more, not replaceable by prosthesis, Loss of less than half, not replaceable by prosthesis, Loss of half or more, replaceable by prosthesis, Loss of less than half, replaceable by prosthesis. 8514 Musculospiral nerve (radial), paralysis. Added July 6, 1950; title February 7, 2021. Remaining field 500 minus 320 = 180. For complex or unfamiliar decisions, occasionally unable to identify, understand, and weigh the alternatives, understand the consequences of choices, and make a reasonable decision. (Authority: 38 U.S.C. With dietary restrictions to all mechanically altered foods, Without dietary restrictions to mechanically altered foods. You're not alone. 7005 Arteriosclerotic heart disease (coronary artery disease). 9304 Major or mild neurocognitive disorder due to traumatic brain injury(Dementia). Web5257 VA disability rating for knee instability: Excessive side to side motion or frequent dislocation of the knee. Each ear will be evaluated separately. (b) Rating protected tuberculosis cases. Evaluation October 23, 1995; evaluation December 9, 2018. Evaluation October 23, 1995; title December 9, 2018; evaluation December 9, 2018; criterion December 9, 2018. For aphakic individuals not well adapted to contact lens correction or pseudophakic individuals not well adapted to intraocular lens implant, visual field examinations must be conducted using Goldmann's equivalent IV/4e. 9435 Unspecified depressive disorder. (1) Evaluate central visual acuity on the basis of corrected distance vision with central fixation, even if a central scotoma is present. If youve filed your VA disability claim and have been denied or have received a low ratingor youre unsure how to get startedreach out to us! 7319 Irritable colon syndrome (spastic colitis, mucous colitis, etc. It provides criteria for levels of impairment for each facet, as appropriate, ranging from 0 to 3, and a 5th level, the highest level of impairment, labeled total. However, not every facet has every level of severity. 5166 Forefoot, proximal to metatarsal bones. Added August 30, 2002; criterion August 13, 2018. A symptomatic condition secondary to many constitutional conditions, characterized by atrophy of the musculature, disturbed circulation, and weakness: Rate the underlying condition, minimum rating. One eye, with visual acuity of other eye: 10/200 (3/60); 15/200 (4.5/60); 20/200 (6/60), 20/100 (6/30); 20/70 (6/21); 20/50 (6/15), Multi-joint (except post-traumatic and gout). Dissociative amnesia; dissociative identity disorder. Is able to use assistive devices such as GPS (global positioning system). Pro Tip: In accordance with the Painful Motion principle, if you have pain upon flexion or abduction of your shoulder, the VA is required to award the minimum compensable rating for the condition, which is 10%. All Rights Reserved. Title May 13, 2018. Organization and Purpose user convenience only and is not intended to alter agency intent Neuritis, musculocutaneous (superficial peroneal) nerve. (c) Table VIa, Numeric Designation of Hearing Impairment Based Only on Puretone Threshold Average, is used to determine a Roman numeral designation (I through XI) for hearing impairment based only on the puretone threshold average. 7541 Renal involvement in diabetes mellitus type I or II. 5279 Metatarsalgia, anterior (Mortons disease). (a) For VA purposes, the diagnosis of chronic fatigue syndrome requires: (1) new onset of debilitating fatigue severe enough to reduce daily activity to less than 50 percent of the usual level for at least six months; and, (2) the exclusion, by history, physical examination, and laboratory tests, of all other clinical conditions that may produce similar symptoms; and. 4.56 Evaluation of muscle disabilities. Ratings of the genitourinary system - dysfunctions. Moderately impaired. 8529 External cutaneous nerve of thigh, paralysis. When any change in evaluation is to be made, the rating agency should assure itself that there has been an actual change in the conditions, for better or worse, and not merely a difference in thoroughness of the examination or in use of descriptive terms. 5120 Complete amputation, upper extremity: Forequarter amputation (involving complete removal of the humerus along with any portion of the scapula, clavicle, and/or ribs), Disarticulation (involving complete removal of the humerus only), 5126 Five digits of one hand, amputation of. 8311 Neuritis, eleventh cranial nerve. No cardinal signs or symptoms of muscle disability as defined in paragraph (c) of this section. And, youll get to work with a Veteran Coach (VC) who will lead you to VA claim success. Proceeding from this 40 percent efficiency, the effect of a further 30 percent disability is to leave only 70 percent of the efficiency remaining after consideration of the first disability, or 28 percent efficiency altogether. 8724 Neuralgia, internal popliteal nerve (tibial). Maxilla or mandible, chronic osteomyelitis, osteonecrosis, or osteoradionecrosis of. If more than one extremity is affected, evaluate each extremity separately and combine (under. For use in rating cases in which the protective provisions of Pub. Noncompensable complications are considered part of the diabetic process under DC 7913. 1 Review for entitlement to special monthly compensation under 3.350 of this chapter. If you have questions or comments regarding a published document please Veterans Benefits Administration (VBA) personnel utilize the Veterans Benefit Management System for Rating (VBMS-R) to process disability compensation claims that involve disability evaluations made under the VASRD. 7110 Aortic aneurysm: ascending, thoracic, abdominal. 7917 Hyperaldosteronism(benign or malignant). The muscles that power your lungs are also part of the respiratory system. Eleventh (spinal accessory, external branch), paralysis. 9902 Mandible loss of, including ramus, unilaterally or bilaterally. (c) Weakened movement (due to muscle injury, disease or injury of peripheral nerves, divided or lengthened tendons, etc.). Ratings for service-connected disabilities requiring hospital treatment or observation. Severe; associated with nausea, sweating, circulatory disturbance after meals, diarrhea, hypoglycemic symptoms, and weight loss with malnutrition and anemia, Moderate; less frequent episodes of epigastric disorders with characteristic mild circulatory symptoms after meals but with diarrhea and weight loss, Mild; infrequent episodes of epigastric distress with characteristic mild circulatory symptoms or continuous mild manifestations. 6305 Lymphatic filariasis, to include elephantiasis. The maximum scheduler rating for severe bilateral pes planus (flat feet) is 50 percent. ), pain on manipulation and use accentuated, indication of swelling on use, characteristic callosities: Moderate; weight-bearing line over or medial to great toe, inward bowing of the tendo achillis, pain on manipulation and use of the feet, bilateral or unilateral, Mild; symptoms relieved by built-up shoe or arch support. 7540 Disseminated intravascular coagulation. 6000 Choroidopathy, including uveitis, iritis, cyclitis, or choroiditis. As active, progressive disease, including areas of osteoporosis, hypertension, and proximal upper and lower extremity muscle wasting that results in inability to rise from squatting position, climb stairs, rise from a deep chair without assistance, or raise arms, Proximal upper or lower extremity muscle wasting that results in inability to rise from squatting position, climb stairs, rise from a deep chair without assistance, or raise arms, With striae, obesity, moon face, glucose intolerance, and vascular fragility. Evaluation March 10, 1976; evaluation February 17, 1994. Criterion May 22, 1995; note May 13, 2018. Following the total rating for the 2-year period after date of inactivity, the schedular evaluation for residuals of nonpulmonary tuberculosis. 5312 Group XII Function: Dorsiflexion. No other numbers than these listed or hereafter furnished are to be employed for rating purposes, with an exception as described in this section, as to unlisted conditions. 7101 Hypertensive vascular disease (hypertension and isolated systolic hypertension): Diastolic pressure predominantly 130 or more, Diastolic pressure predominantly 120 or more, Diastolic pressure predominantly 110 or more, or; systolic pressure predominantly 200 or more, Diastolic pressure predominantly 100 or more, or; systolic pressure predominantly 160 or more, or; minimum evaluation for an individual with a history of diastolic pressure predominantly 100 or more who requires continuous medication for control. Note (2): One MET (metabolic equivalent) is the energy cost of standing quietly at rest and represents an oxygen uptake of 3.5 milliliters per kilogram of body weight per minute. In these cases, evaluate based on corrected distance vision adjusted to one step poorer than measured. 8912 Jacksonian and focal motor or sensory. Copyright 2023 VA Claims Insider, LLC. However, disability resulting from a mental disorder that is superimposed upon intellectual disability (intellectual developmental disorder) or a personality disorder may be service-connected. Moderately severely impaired judgment. You have a very severe disability or loss of limb, or You have a spouse, child, or dependent parent and your combined disability rating is 30% or greater, or You have a 9424 Conversion disorder (functional neurological symptom disorder). All of these conditions can lead to chronic shoulder pain and disability. Scar 5 or more inches (13 or more cm.) With service incurred lower extremity amputation or shortening, a disabling arthritis, developing in the same extremity, or in both lower extremities, with indications of earlier, or more severe, arthritis in the injured extremity, including also arthritis of the lumbosacral joints and lumbar spine, if associated with the leg amputation or shortening, will be considered as service incurred, provided, however, that arthritis affecting joints not directly subject to strain as a result of the service incurred amputation will not be granted service connection. 7811 Tuberculosis luposa (lupus vulgaris), active or inactive: 7813 Dermatophytosis (ringworm: Of body, tinea corporis; of head, tinea capitis; of feet, tinea pedis; of beard area, tinea barbae; of nails, tinea unguium (onychomycosis); of inguinal area (jock itch), tinea cruris; tinea versicolor). It is the intention to recognize actually painful, unstable, or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint. 6841 Spinal cord injury with respiratory insufficiency. Your military records are important. (2) In the case of an ankylosed shoulder, if muscle groups I and II are severely disabled, the evaluation of the shoulder joint under diagnostic code 5200 will be elevated to the level for unfavorable ankylosis, if not already assigned, but the muscle groups themselves will not be rated. 7613 Uterus, disease, injury, or adhesions of. Or, you can get help from an expert veteran coach who can help you navigate the VA claims process. If the report of examination is inadequate as a basis for the required consideration of service connection and evaluation, the rating agency may request a supplementary report from the examiner giving further details as to the limitations of the disabled person's ordinary activity imposed by the disease, injury, or residual condition, the prognosis for return to, or continuance of, useful work. Other specified forms of arthropathy (excluding gout). Thereafter, with diagnosis confirmed by findings on physical examination and either echocardiogram, Doppler echocardiogram, or cardiac catheterization, use the General Rating Formula. In cases involving aggravation by active service, the rating will reflect only the degree of disability over and above the degree existing at the time of entrance into the active service, whether the particular condition was noted at the time of entrance into the active service, or it is determined upon the evidence of record to have existed at that time.