[Code of Federal Regulations]
[Title 38, Volume 1]
[Revised as of July 1, 2008]
From the U.S. Government Printing Office via GPO Access
[CITE: 38CFR4.45]

[Page 374-375]
 
            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

[[Page 375]]

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.