[Code of Federal Regulations]

[Title 38, Volume 1]

[Revised as of July 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 38CFR4.45]



[Page 376]

 

            TITLE 38--PENSIONS, BONUSES, AND VETERANS' RELIEF

 

                CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS

 

PART 4_SCHEDULE FOR RATING DISABILITIES--Table of Contents

 

                      Subpart B_Disability Ratings

 

Sec. 4.45  The joints.



    As regards the joints the factors of disability reside in reductions 

of their normal excursion of movements in different planes. Inquiry will 

be directed to these considerations:

    (a) Less movement than normal (due to ankylosis, limitation or 

blocking, adhesions, tendon-tie-up, contracted scars, etc.).

    (b) More movement than normal (from flail joint, resections, 

nonunion of fracture, relaxation of ligaments, etc.).

    (c) Weakened movement (due to muscle injury, disease or injury of 

peripheral nerves, divided or lengthened tendons, etc.).

    (d) Excess fatigability.

    (e) Incoordination, impaired ability to execute skilled movements 

smoothly.

    (f) Pain on movement, swelling, deformity or atrophy of disuse. 

Instability of station, disturbance of locomotion, interference with 

sitting, standing and weight-bearing are related considerations. For the 

purpose of rating disability from arthritis, the shoulder, elbow, wrist, 

hip, knee, and ankle are considered major joints; multiple involvements 

of the interphalangeal, metacarpal and carpal joints of the upper 

extremities, the interphalangeal, metatarsal and tarsal joints of the 

lower extremities, the cervical vertebrae, the dorsal vertebrae, and the 

lumbar vertebrae, are considered groups of minor joints, ratable on a 

parity with major joints. The lumbosacral articulation and both 

sacroiliac joints are considered to be a group of minor joints, ratable 

on disturbance of lumbar spine functions.