Appendix B
Committee Charge

STATEMENT OF TASKS

  1. How well do the medical criteria in the Department of Veterans Affairs (VA) Rating Schedule and VA rating regulations enable assessment and adjudication of the proper levels of disability to compensate both for the impact on quality of life and impairment in earnings capacity? Provide an analysis of the descriptions associated with each condition’s rating level that considers progression of severity of condition as it relates to quality-of-life impairment and impairment in average earnings capacity.

  2. Certain criteria and/or levels of disability are required for entitlement to ancillary and special-purpose benefits. To what extent, if any, do the required thresholds need to change? Determine from a medical perspective at what disability rating level a veteran’s medical or vocational impairment caused by disability could be improved by various special benefits such as adapted housing, automobile grants, clothing allowance, and vocational rehabilitation. Consideration should be given to existing and additional benefits.

  3. Analyze the current application of the individual unemployability (IU) extraschedular benefit to determine whether the Rating Schedule descriptions need to more accurately reflect a veteran’s ability to participate in the economic marketplace. Propose alternative medical approaches, if any, to IU that would more appropriately reflect individual circumstances in the determination of benefits. For the population of disabled veterans, analyze



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A 21st Century System for Evaluating Veterans for Disability Benefits Appendix B Committee Charge STATEMENT OF TASKS How well do the medical criteria in the Department of Veterans Affairs (VA) Rating Schedule and VA rating regulations enable assessment and adjudication of the proper levels of disability to compensate both for the impact on quality of life and impairment in earnings capacity? Provide an analysis of the descriptions associated with each condition’s rating level that considers progression of severity of condition as it relates to quality-of-life impairment and impairment in average earnings capacity. Certain criteria and/or levels of disability are required for entitlement to ancillary and special-purpose benefits. To what extent, if any, do the required thresholds need to change? Determine from a medical perspective at what disability rating level a veteran’s medical or vocational impairment caused by disability could be improved by various special benefits such as adapted housing, automobile grants, clothing allowance, and vocational rehabilitation. Consideration should be given to existing and additional benefits. Analyze the current application of the individual unemployability (IU) extraschedular benefit to determine whether the Rating Schedule descriptions need to more accurately reflect a veteran’s ability to participate in the economic marketplace. Propose alternative medical approaches, if any, to IU that would more appropriately reflect individual circumstances in the determination of benefits. For the population of disabled veterans, analyze

OCR for page 302
A 21st Century System for Evaluating Veterans for Disability Benefits the cohort of IU recipients. Examine the base rating level to identify patterns. Determine if the Rating Schedule descriptions of conditions provide a barrier to assigning the base disability rating level commensurate with the veteran’s vocational impairment. What are the advantages and disadvantages of adopting universal medical diagnostic codes rather than using a unique system? Compare and contrast the advantages and disadvantages of the VA Schedule for Rating Disabilities and the American Medical Association Guides to the Evaluation of Permanent Impairment. From a medical perspective, analyze the current VA practice of assigning service connection on “secondary” and “aggravation” bases. In secondary claims, determine what medical principles and practices should be applied in determining whether a causal relationship exists between two conditions. In aggravation claims, determine what medical principles and practices should be applied in determining whether a preexisting disease was increased due to military service or was increased due to the natural process of the disease. Compare and contrast the role of health-care professionals in the claims and appeals processes in VA and the Department of Defense (DoD), the Social Security Administration, and federal employee disability benefits programs. What skills, knowledge, training, and certification are required of the persons performing the examinations and assigning the ratings?