4.104 Schedule of ratings - cardiovascular system. 1155, unless otherwise noted. The Jumi Application is Unpublished or Removed, International Alcoholic Beverages Expo, Guizhou, CHINA. 1114 (m) is payable for any of the following conditions: ( i) Anatomical loss or loss of use of both hands; ( ii) Anatomical 4.88c Ratings for inactive nonpulmonary tuberculosis initially entitled after August 19, 1968. WebeCFR :: 38 CFR 4.130 -- Schedule of ratings - Mental disorders. 1114 (n) and (o) plus special monthly compensation under 38 U.S.C. (4) Eye. View the Title 38 Code of Federal Regulations documents. This minimum special monthly compensation is not to be combined with or added to any other disability compensation. 4.28 Prestabilization rating from date of discharge from service. Copyright 2023, Thomson Reuters. Engine Type: Mercury 40HP Inline 3 Four Stroke; Horsepower: 40HP; Cylinders: 3 cyl . 1114 (l) and (m). 1 CFR 1.1 4.76a Computation of average concentric contraction of visual fields. Please verify the status of the code you are researching with the state legislature or via Westlaw before relying on it for your legal needs. WebElectronic Code of Federal Regulations (e-CFR) Title 38 - Pensions, Bonuses, and Veterans' Relief CHAPTER I - DEPARTMENT OF VETERANS AFFAIRS PART 4 - 4.100 Application of the evaluation criteria for diagnostic codes 7000-7007, 7011, and 7015-7020. Pensions, Bonuses, and Veterans' Relief 38.36.4251 Loans to finance the purchase of manufactured homes and the cost of necessary site preparation Current as of October 03, 2022 | Updated by FindLaw Staff (viii) Anatomical loss of one leg so near the hip as to prevent use of a prosthetic appliance with anatomical loss or loss of use of one hand shall entitle to the rate under 38 U.S.C. Contact us. WebElectronic Code of Federal Regulations (e-CFR) Title 38. Enhanced content is provided to the user to provide additional context. 29 FR 6718, May 22, 1964, unless otherwise noted. 4.73 Schedule of ratings - muscle injuries. Title 38. Web( 1) The special monthly compensation provided by 38 U.S.C. information or personal data. The special monthly compensation provided by 38 U.S.C. 1114 (o) or (p), or was based on an independent factual determination. Concentric contraction of the field of vision beyond 5 degrees in both eyes is the equivalent of 5/200 visual acuity. 4.124 Neuralgia, cranial or peripheral. Pensions, Bonuses, full text search results Power of attorney reg 262 Get the up-to-date power of attorney reg 262 2022 now Get Form Show details 4. 4.150 Schedule of ratings - dental and oral conditions. 3. The official, published CFR, is updated annually and available below under 9-13/09/2014. 4.115a Ratings of the genitourinary system - dysfunctions. WebElectronic Code of Federal Regulations (e-CFR) Title 38 - Pensions, Bonuses, and Veterans' Relief; CHAPTER I - DEPARTMENT OF VETERANS AFFAIRS; 7202 Tongue, loss of whole or part: With inability to communicate by speech: 100 One-half or more: 60 With marked speech impairment: 30 result, it may not include the most recent changes applied to the CFR. site when drafting amendatory language for Federal regulations: 4.88b Schedule of ratings - infectious diseases, immune disorders and nutritional deficiencies. 69 Part-time 438 W Illinois Ave Dallas, TX 75224 About this job Find your commute Certified Pharmacy Technician Title Certified Pharmacy Technician Job Description. The criteria for determining that a veteran is so helpless as to be in need of regular aid and attendance are contained in 3.352(a). CAlphabetical Index of Disabilities on Westlaw, Law Firm Tests Whether It Can Sue Associate for 'Quiet Quitting', The Onion Joins Free-Speech Case Against Police as Amicus, Bumpy Road Ahead for All in Adoption of AI in the Legal Industry. 4.97 Schedule of ratings - respiratory system. The special monthly compensation provided by 38 U.S.C. 1114(n). (vii) Blindness in both eyes rated under 38 U.S.C. (Authority: 38 U.S.C. 1114(o) or the maximum rate authorized under 38 U.S.C. user convenience only and is not intended to alter agency intent 4.129 Mental disorders due to traumatic stress. (iv) Blindness in both eyes with visual acuity of 5/200 or less, or blindness in both eyes rated under subparagraph (2) (i) or (ii) of this paragraph, when accompanied by service-connected total deafness in one ear, will afford entitlement to the next higher intermediate rate of if the veteran is already entitled to an intermediate rate, to the next higher statutory rate under 38 U.S.C. Essentials of evaluative rating. 4.96 Special provisions regarding evaluation of respiratory conditions. (See 3.552(b)(2) as to continuance following admission for hospitalization.). is available with paragraph structure matching the official CFR 1114(t) is payable to a veteran who, as the result of service-connected disability, is in need of regular aid and attendance for the residuals of traumatic brain injury, is not eligible for compensation under 38 U.S.C. 4.71a Schedule of ratings - musculoskeletal system. (iii) Blindness of one eye having only light perception and anatomical loss of, or blindness having no light perception in the other eye, will entitle to a rate between 38 U.S.C. An operation is not considered to be one of election where it is advised on sound medical judgment for the relief of a pathological condition or to prevent possible future pathological consequences. (4) Helplessness. switch to drafting.ecfr.gov. 4.127 Intellectual disability (intellectual developmental disorder) and personality disorders. (2) An allowance authorized under 38 U.S.C. The rates of special monthly compensation stated in this section are those provided under 38 U.S.C. Determinations must be based upon separate and distinct disabilities. 4.71 Measurement of ankylosis and joint motion. (3) Eyes, bilateral. (3) Additional independent 50 percent disabilities. contact the publishing agency. Microsoft Edge, Google Chrome, Mozilla Firefox, or Safari. Chapter I. The requirement of loss of anal and bladder sphincter control is met even though incontinence has been overcome under a strict regimen of rehabilitation of bowel and bladder training and other auxiliary measures. Pensions, Bonuses, and Veterans' Relief CFR prev | next 4.124a Schedule of ratings - neurological conditions and convulsive disorders. Comments or questions about document content can not be answered by OFR staff. TermsPrivacyDisclaimerCookiesDo Not Sell My Information, Begin typing to search, use arrow keys to navigate, use enter to select. 1114 (m) and (n). 1114 (l) through (n) and the intermediate or next higher rate provisions outlined above additional single permanent disability independently ratable at 100 percent apart from any consideration of individual unemployability will afford entitlement to the next higher statutory rate under 38 U.S.C. (1) The special monthly compensation provided by 38 U.S.C. WebTitle 38 Volume 1 Chapter I Part 4 Subpart B. Subpart B - Disability Ratings. (vi) Blindness in both eyes rated under 38 U.S.C. In addition to the statutory rates payable under 38 U.S.C. 1114(l) is payable for anatomical loss or loss of use of both feet, one hand and one foot, blindness in both eyes with visual acuity of 5/200 or less or being permanently bedridden or so helpless as to be in need of regular aid and attendance. - Pensions, Bonuses, and Veterans' Relief, - Pension, Compensation, and Dependency and Indemnity Compensation, https://www.ecfr.gov/current/title-38/chapter-I/part-3/subpart-A/subject-group-ECFR6477ad08d327384/section-3.350. 1114, but not above the (o) rate. 5/200 visual acuity or less bilaterally qualifies for entitlement under 38 U.S.C. Loss of use or blindness of one eye, having only light perception, will be held to exist when there is inability to recognize test letters at 1 foot and when further examination of the eye reveals that perception of objects, hand movements, or counting fingers cannot be accomplished at 3 feet. Organization and Purpose 4.127 Intellectual disability (intellectual developmental disorder) and personality disorders. 4.126 Evaluation of disability from mental disorders. (2) Eyes, bilateral. (3) Need for aid and attendance. Determination of the factual need for aid and attendance is subject to the criteria of 3.352: (3) Amount of the allowance. 4.71a Schedule of ratings - musculoskeletal system. visit VeteransCrisisLine.net for more resources. Where possible, determinations should be on the basis of permanently bedridden rather than for need of aid and attendance (except where 38 U.S.C. 1114(r). To access the menus on this page please perform the following steps. 1114(o), through the combination of loss of use of both legs and helplessness. 1114(l) through (n); (iii) Bilateral deafness rated at 60 percent or more disabling (and the hearing impairment in either one or both ears is service connected) in combination with service-connected blindness with bilateral visual acuity 20/200 or less. (eg: Anatomical loss or loss of use, or a combination of anatomical loss and loss of use, of three extremities shall entitle a veteran to the next higher rate without regard to whether that rate is a statutory rate or an intermediate rate. You can learn more about the process CAlphabetical Index of Disabilities - last updated October 03, 2022 An intermediate rate authorized by this paragraph shall be established at the arithmetic mean, rounded to the nearest dollar, between the two rates concerned. (4) Additional independent 100 percent ratings. 1114, but in no event higher than the rate for (o). 1114, but in no event higher than the rate for (o). (ii) The graduated ratings for arrested tuberculosis will not be utilized in this connection, but the permanent residuals of tuberculosis may be utilized. (i) Loss of use of a hand or a foot will be held to exist when no effective function remains other than that which would be equally well served by an amputation stump at the site of election below elbow or knee with use of a suitable prosthetic appliance. This web site is designed for the current versions of 4.115b Ratings of the genitourinary system - diagnoses. 4.126 Evaluation of disability from mental disorders. Web3. 4.116 Schedule of ratings - gynecological conditions and disorders of the breast. (2) Is permanently housebound by reason of service-connected disability or disabilities. WebElectronic Code of Federal Regulations (e-CFR) Title 38 - Pensions, Bonuses, and Veterans' Relief; CHAPTER I - DEPARTMENT OF VETERANS AFFAIRS; 7202 4.55 Principles of combined ratings for muscle injuries. 1114(m). 4.119 Schedule of ratings - endocrine system. Source:29 FR 6718, May 22, 1964, unless otherwise noted. Electronic Code of Federal Regulations (e-CFR), Title 38 - Pensions, Bonuses, and Veterans' Relief, CHAPTER I - DEPARTMENT OF VETERANS AFFAIRS, PART 4 - SCHEDULE FOR RATING DISABILITIES. 4.88c Ratings for inactive nonpulmonary tuberculosis initially entitled after August 19, 1968. guide. 1114(m). If you have comments or suggestions on how to improve the www.ecfr.gov website or have questions about using www.ecfr.gov, please choose the 'Website Feedback' button below. 4.55 Principles of combined ratings for muscle injuries. 1/1.1 1114(r)(2), and in the absence of such regular aid and attendance would require hospitalization, nursing home care, or other residential institutional care. 1114(r)(1). 4.71 Measurement of ankylosis and joint motion. Electronic Code of Federal Regulations (e-CFR), Title 38 - Pensions, Bonuses, and Veterans' Relief, CHAPTER I - DEPARTMENT OF VETERANS AFFAIRS, Subpart A - General Policy in Rating ( 4.1 - 4.31), Subpart B - Disability Ratings ( 4.40 - 4.150), Appendix A to Part 4 - Table of Amendments and Effective Dates Since 1946, Appendix B to Part 4 - Numerical Index of Disabilities, Appendix C to Part 4 - Alphabetical Index of Disabilities, PART 4 - SCHEDULE FOR RATING DISABILITIES. Pensions, Bonuses, and Veterans' Relief, https://codes.findlaw.com/cfr/title-38-pensions-bonuses-and-veterans-relief/cfr-pt-38-4-app-c/, Read this complete Code of Federal Regulations Title 38. The rating criteria for determining inactivity of tuberculosis are set out in 3.375. (a) Ratings under 38 U.S.C. WebCode of Federal Regulations Title 38, Part 4 Schedule for Rating Disabilities Veterans Benefits Administration Supplement No. In the application of this subparagraph the disability or disabilities independently ratable at 50 percent or more must be separate and distinct and involve different anatomical segments or bodily systems from the conditions establishing entitlement under 38 U.S.C. Current as of October 03, 2022 | Updated by FindLaw Staff. 4.117 Schedule of ratings - hemic and lymphatic systems. (1) The special monthly compensation provided by 38 U.S.C. FSGLI: Family Servicemembers Group Life Insurance, Schedule of Payments for Traumatic Losses, S-DVI: Service-Disabled Veterans Life Insurance, Beneficiary Financial Counseling and Online Will, Lesbian Gay, Bisexual & Transgender Veterans, Outreach, Transition and Economic Development Materials, Veteran Readiness and Employment Materials, Court of Appeals for Veteran Claims (CAVC). 4.116 Schedule of ratings - gynecological conditions and disorders of the breast. With visual acuity 5/200 or less or the vision field reduced to 5 degree concentric contraction in both eyes, entitlement on account of need for regular aid and attendance will be determined on the facts in the individual case. (2) For a veteran who was not receiving or entitled to receive compensation for tuberculosis on August 19, 1968, the special monthly compensation authorized by paragraph (g)(1) of this section is not payable. SCHEDULE FOR RATING DISABILITIES Part 4. (C) Service-connected loss or loss of use of one foot which is ratable at less than 50 percent and which is the only compensable disability other than bilateral blindness, will afford entitlement to the next higher intermediate rate or, if the veteran is already entitled to an intermediate rate, to the next higher statutory rate under 38 U.S.C. Office of Accountability & Whistleblower Protection, Training - Exposure - Experience (TEE) Tournament, Outreach, Transition and Economic Development Home, Warrior Training Advancement Course (WARTAC), Staff Appraisal Reviewer (SAR) Information, How to Apply for Nonsupervised Automatic Authority, VALERI (VA Loan Electronic Reporting Interface). This requirement is met when the veteran is substantially confined as a direct result of service-connected disabilities to his or her dwelling and the immediate premises or, if institutionalized, to the ward or clinical areas, and it is reasonably certain that the disability or disabilities and resultant confinement will continue throughout his or her lifetime. Appendix A to Part 4 - Table of Amendments and 1114(r) is involved) to avoid reduction during hospitalization where aid and attendance is provided in kind. The maximum rate, as a result of including helplessness as one of the entitling multiple disabilities, is intended to cover, in addition to obvious losses and blindness, conditions such as the loss of use of two extremities with absolute deafness and nearly total blindness or with severe multiple injuries producing total disability outside the useless extremities, these conditions being construed as loss of use of two extremities and helplessness. 4.88b Schedule of ratings - infectious diseases, immune disorders and nutritional deficiencies. 4.85 Evaluation of hearing impairment. Resolution of reasonable doubt. 4.88c Ratings for inactive nonpulmonary tuberculosis initially entitled after August 19, 1968. We are leaving to the Expo in CHINA, so it's time to pack the bags to bring a little bit of La Rioja and our house on the other side of the world. 1114(s). The determination will be made on the basis of the actual remaining function, whether the acts of grasping, manipulation, etc., in the case of the hand, or of balance, propulsion, etc., in the case of the foot, could be accomplished equally well by an amputation stump with prosthesis; for example: (a) Extremely unfavorable complete ankylosis of the knee, or complete ankylosis of two major joints of an extremity, or shortening of the lower extremity of 312 inches or more, will constitute loss of use of the hand or foot involved. FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. General Schedule Base Pay Table for 2010. (j) Special aid and attendance benefit for residuals of traumatic brain injury (38 U.S.C. CAlphabetical Index of Disabilities on Westlaw. 1114(l). (i) Anatomical loss or loss of use of one foot with anatomical loss or loss of use of one leg at a level, or with complications preventing natural knee action with prosthesis in place, shall entitle to the rate between 38 U.S.C. 4.126 Evaluation of disability from mental disorders. (5) Deafness. WebThe main regulator of retirement and benefit plans established by employers and private industry is the U.S. Department of Labor, which enforces the main laws ( ERISA, COBRA, and HIPAA ), retirement plans (including 401 (k), SIMPLE, 403 (b), and traditional defined-benefit pensions) as well as many aspects of employer group-health plans. window.dataLayer = window.dataLayer || []; Part / Section. Pensions, Bonuses, and Veterans' Relief 38 CFR Pt. The system consists of two components: General Schedule pay without locality (Title 5) and Market Pay (Title 38). You are welcome to and encouraged to re-use content from the first two assignments. 4.115b Ratings of the genitourinary system - diagnoses. 4.88b Schedule of ratings - infectious diseases, immune disorders and nutritional deficiencies. 9, 1995; 67 FR 6873, Feb. 14, 2002; 68 FR 55467, Sept. 26, 2003; 74 FR 11483, Mar. Regulation Y Cite this article: FindLaw.com - Code of Federal Regulations Title 38. developer resources. Interpretation of examination reports. This requires, for example, that where a veteran who had suffered the loss or loss of use of two extremities is being considered for the maximum rate on account of helplessness requiring regular aid and attendance, the latter must be based on need resulting from pathology other than that of the extremities. The criteria for rating are contained in 3.352(a). If, however, the operation after discharge was required for the correction of a specific injury caused by a preceding operation in service, it will support authorization of the benefit. When the existence of disability is established meeting the above requirements for nonfunctioning testicle due to operation after service, resulting in loss of use, the benefit may be granted even though the operation is one of election. Book B - Adjudication. 4.97 Schedule of ratings - respiratory system. This document is available in the following developer friendly formats: Information and documentation can be found in our When there is entitlement under 38 U.S.C. The graduated ratings for arrested tuberculosis will not be utilized in this connection, but the permanent residuals of tuberculosis may be utilized. 501, 38 U.S.C. 1114(l). I have a '99 Force/Mercury 40hp. Pensions, Bonuses, and Veterans' Relief. (ii) When loss or loss of use of a creative organ resulted from wounds or other trauma sustained in service, or resulted from operations in service for the relief of other conditions, the creative organ becoming incidentally involved, the benefit may be granted. 4.128 Convalescence ratings following extended hospitalization. Pensions, Bonuses, and Veterans' Relief 38 CFR Pt. Remember, you dont have to use actual metrics and you dont need data. Please do not provide confidential 4.114 Schedule of ratings - digestive system. (1) Anatomical loss or loss of use of both arms at a level or with complications, preventing natural elbow action with prosthesis in place; (2) Anatomical loss of both legs so near the hip as to prevent use of a prosthetic appliance; (3) Anatomical loss of one arm so near the shoulder as to prevent use of a prosthetic appliance with anatomical loss of one leg so near the hip as to prevent use of a prosthetic appliance; (4) Anatomical loss of both eyes or blindness without light perception in both eyes. 4, App. The assistance may be done by the person's own hands or arms, and, in the matter of postural stability, by a special appliance. For most federal employees friday december 31 2021 will be treated as a holiday for pay and leave purposes. Apply to Truck Driver, Dump Truck Driver, Limousine Driver and more!Commercial Driver Training. 4.2 Interpretation of examination reports. (iv) Service-connected total deafness in one ear or bilateral deafness rated at 40 percent or more disabling (and the hearing impairment in either one of both ears is service-connected) in combination with service-connected blindness of both eyes having only light perception or less. Electronic Code of Federal Regulations (e-CFR), Title 38 - Pensions, Bonuses, and Veterans' Relief, CHAPTER I - DEPARTMENT OF VETERANS AFFAIRS, PART 4 - SCHEDULE FOR RATING DISABILITIES. WebFind Okmulgee County Jail Visiting Hours & Rules, Phone Number, Mail, Video Visitation Schedule, Dress Code and Inmate Search. 1114. Si quieres estar al da y conocer todas las noticias y promociones de Bodegas Torremaciel. 3.350 Special monthly compensation ratings. This content is from the eCFR and may include recent changes applied to the CFR. 1114 (l) through (n) or an intermediate rate under (p) such additional allowance is payable for each such anatomical loss or loss of use existing in addition to the requirements for the basic rates, provided the total does not exceed the monthly rate set forth in 38 U.S.C. (v) Blindness in both eyes having only light perception or less, or rated under subparagraph (2)(iii) of this paragraph, when accompanied by bilateral deafness (and the hearing impairment in either one or both ears is service-connected) rated at 10 or 20 percent disabling, will afford entitlement to the next higher intermediate rate, or if the veteran is already entitled to an intermediate rate, to the next higher statutory rate under 38 U.S.C. Students enter these codes on the Free Application for Federal Student Aid (FAFSA ) form to indicate which postsecondary schools will 4.123 Neuritis, cranial or peripheral. It is not an official legal edition of the CFR. 1114, or if the veteran is already entitled to an intermediate rate, to the next higher intermediate rate, but in no event higher than the rate for (o). 62 5 August 2019 Covering the period of Evaluation of evidence. (b) Ratings under 38 U.S.C. 4.42 Complete medical examination of injury cases. 4.114 Schedule of ratings - digestive system. WebElectronic Code of Federal Regulations (e-CFR) Title 38 - Pensions, Bonuses, and Veterans' Relief CHAPTER I - DEPARTMENT OF VETERANS AFFAIRS PART 4 - 1114(m) and (n). If you work for a Federal agency, use this drafting 4.96 Special provisions regarding evaluation of respiratory conditions. 4.89 Ratings for inactive nonpulmonary tuberculosis in effect on August 19, 1968. 1114(r)(2) is payable in lieu of the regular aid and attendance allowance authorized by 38 U.S.C. 4.128 Convalescence ratings following extended hospitalization. 1114 (m) and (n). (ii) Blindness of one eye with 5/200 visual acuity or less and anatomical loss of, or blindness having no light. 4.73 Schedule of ratings - muscle injuries. WebCode of Federal Regulations Title 38, Part 4 Schedule for Rating Disabilities Veterans Benefits Administration Supplement No. 38 U.S.C. (3) Combinations. SCHEDULE FOR RATING DISABILITIES SUBPART A [ 4.1 - 4.31] - General Policy in Rating SUBPART B [ The Code of Federal Regulations (CFR) is the official legal print publication containing the codification of the general and permanent rules published in the Federal Register by the departments and agencies of the Federal Government. 4.87a Schedule of ratings - other sense organs. gtag('config', 'UA-53164437-4'); 4.42 Complete medical examination of injury cases. gtag('js', new Date()); 4.55 Principles of combined ratings for muscle injuries. Under no circumstances will the combination of being permanently bedridden and being so helpless as to require regular aid and attendance without separate and distinct anatomical loss, or loss of use, of two extremities, or blindness, be taken as entitling to the maximum benefit. 4.89 Ratings for inactive nonpulmonary tuberculosis in effect on August 19, 1968. Web"Permitted Exceptions" means (a) real estate taxes for the year of Closing and thereafter; (b) all applicable zoning and other ordinances, regulations, and laws; and (c) all covenants, easements, conditions, restrictions, and other exceptions disclosed on the Title Commitment and/or Survey, which are not objected to by Buyer, subject to Section 5. (iv) Anatomical loss or loss of use of one foot with anatomical loss or loss of use of one arm so near the shoulder as to prevent use of a prosthetic appliance shall entitle to the rate under 38 U.S.C. If the loss or loss of use of two extremities or being permanently bedridden leaves the person helpless, increase is not in order on account of this helplessness. Part 0. 1114 (a) through (j) or (s). The special monthly compensation provided by 38 U.S.C. Title 38 Volume 1 Chapter I Part 4 Part 4 - Schedule For Rating Disabilities PART 4 - SCHEDULE FOR RATING DISABILITIES Authority: 38 U.S.C. 1114(s) is payable where the veteran has a single service-connected disability rated as 100 percent and, (1) Has additional service-connected disability or disabilities independently ratable at 60 percent, separate and distinct from the 100 percent service-connected disability and involving different anatomical segments or bodily systems, or. Determination of this need is subject to the criteria of 3.352. If a prosthesis cannot be worn at the present level of amputation but could be applied if there were a reamputation at a higher level, the requirements of this paragraph are not met; instead, consideration will be given to loss of natural elbow or knee action. '; 1114(l) and (m). Special monthly compensation under 38 U.S.C. You are using an unsupported browser. In addition to the statutory rates payable under 38 U.S.C. Authority: 38 U.S.C. 1114(l) through (n)) will not preclude additional compensation under 38 U.S.C. This special compensation is payable in addition to the basic rate of compensation otherwise payable on the basis of degree of disability, provided that the combined rate of compensation does not exceed the monthly rate set forth in 38 U.S.C. The Office of the Federal Register publishes documents on behalf of Federal agencies but does not have any authority over their programs. 1114 (l), (m), or (n), or under the intermediate or next higher rate provisions of this subparagraph, when accompanied by: (A) Service-connected loss or loss of use of one hand, will afford entitlement to the next higher statutory rate under 38 U.S.C. Determination of this need is subject to the criteria of 3.352. gtag('js', new Date()); (x) Anatomical loss or loss of use of one hand with anatomical loss or loss of use of one arm at a level, or with complications, preventing natural elbow action with prosthesis in place, shall entitle to the rate between 38 U.S.C. If you have questions or comments regarding a published document please 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.

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