Part IV, Subpart ii, Chapter 2, Section ARating Action on Review Examination Results and Cancellations

has worsened so as to warrant a higher evaluation under schedular rating criteria

• consider the disability’s evaluation an issue raised on Department of Veterans Affairs (VA) initiative, and
• award entitlement to the appropriate increased evaluation from the date of the examination’s performance.

renders the Veteran unemployable

• consider the issue of entitlement to individual unemployability (IU) reasonably raised
• follow procedural instructions found in M21-1, Part VIII, Subpart iv, 3.B and C for reasonably raised claims of IU, and
• continue end product (EP) 310 until all issues are decided.

required hospitalization or observation at VA expense for a period in excess of 21 days

• consider entitlement to a temporary total rating a reasonably raised subordinate issue
• award entitlement to a temporary 100-percent evaluation under 38 CFR 4.29 for the duration of the hospitalization or treatment/observation period, and
• assign an appropriate schedular evaluation based on current examination results following discontinuance of the temporary 100-percent evaluation.

• the residual of a primary SC disease or disability whose diagnostic code criteria under 38 CFR Part 4
  • required re-examination, and
  • instruct that residuals be rated according to the body system involved, or
• one that 38 CFR Part 4 and/or other sources of official VA guidance identify as an accepted part of the underlying SC disability, such as
  • complications of systemic disease processes, including diabetes mellitus
  • scars associated with surgical interventions, or
  • peripheral nerve involvement associated with spinal pathology

award entitlement to service connection (SC) for the newly developed residual or secondary disability(ies), as well as any corresponding ancillary benefits, effective the date of the examination that resulted in discovery. Example: A Veteran SC for prostate cancer attends a review examination intended to assess that disability’s severity on January 1, 2016, at which time he is diagnosed with residual erectile dysfunction. Outcome: The rating activity will establish SC for erectile dysfunction and entitlement to special monthly compensation under 38 U.S.C. 1114(k) for loss of use of a creative organ effective January 1, 2016, the date of the review examination’s performance.

• affirmatively related to the primary SC disability as per the conclusions of a favorable medical opinion, but
• not considered an accepted part of the underlying SC disability, as discussed in the cell above

solicit a claim for benefits in accordance with M21-1, Part V, Subpart ii, 3.A.3.a. Example: A Veteran SC for lumbar spinal stenosis attends a review examination intended to assess that disability’s severity, at which time the VA examiner diagnoses right knee patellofemoral pain syndrome and provides a medical opinion that the latter is at least as likely as not related to the former. Outcome: The rating activity will

• evaluate the severity of the SC lumbar spinal stenosis based on the facts of the case, and
• solicit a claim for SC for right knee patellofemoral pain syndrome.

reflects total disability, either by reason of

• a 100-percent schedular evaluation, or
• entitlement to IU

awarding basic eligibility to Dependents’ Educational Assistance (DEA). References: For more information on

• ratings for DEA and permanent and total (P&T) disability, see M21-1, Part XIII, Subpart i, 1.A, and
• date of P&T disability upon cancellation or dismissal of review examination control, see M21-1, Part V, Subpart ii, 3.D.4.g.

does not reflect total disability

• confirming and continuing the existing evaluation of any disability for which review examination was originally scheduled, and
• identifying the disability(ies) as static, warranting no additional or future examination.