Schedule for Rating Disabilities; Evaluation of Amyotrophic Lateral Sclerosis, 78823-78824 [2011-32531]
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Federal Register / Vol. 76, No. 244 / Tuesday, December 20, 2011 / Rules and Regulations
Charleston by telephone at (843) 740–
7050, or a designated representative via
VHF radio on channel 16, to request
authorization. If authorization to enter,
transit through, anchor in, or remain
within the regulated area is granted by
the Captain of the Port Charleston or a
designated representative, all persons
and vessels receiving such authorization
must comply with the instructions of
the Captain of the Port Charleston or a
designated representative.
(3) The Coast Guard will provide
notice of the regulated area by Local
Notice to Mariners, Broadcast Notice to
Mariners, and on-scene designated
representatives.
(d) Effective Date. This rule is
effective from 5:30 p.m. until 6:50 p.m.
on December 31, 2011.
Dated: December 9, 2011.
M.F. White,
Captain, U.S. Coast Guard, Captain of the
Port Charleston.
[FR Doc. 2011–32485 Filed 12–19–11; 8:45 am]
BILLING CODE 9110–04–P
DEPARTMENT OF VETERANS
AFFAIRS
38 CFR Part 4
RIN 2900–AN60
Schedule for Rating Disabilities;
Evaluation of Amyotrophic Lateral
Sclerosis
Department of Veterans Affairs.
Final rule.
AGENCY:
ACTION:
The Department of Veterans
Affairs (VA) is amending its Schedule
for Rating Disabilities by revising the
disability evaluation criterion provided
for amyotrophic lateral sclerosis (ALS)
to provide an evaluation of 100 percent
for any veteran with service-connected
ALS. This change is necessary to
adequately compensate veterans who
suffer from this progressive, untreatable,
and fatal disease. This change is
intended to provide a total disability
rating for any veteran with serviceconnected ALS.
DATES: Effective Date: This final rule is
effective January 19, 2012.
Applicability Date: This final rule
applies to an application for benefits
that:
• Is received by VA on or after
January 19, 2012;
• Was received by VA before January
19, 2012 but has not been decided by a
VA regional office as of that date;
• Is appealed to the Board of
Veterans’ Appeals on or after January
19, 2012;
pmangrum on DSK3VPTVN1PROD with RULES
SUMMARY:
VerDate Mar<15>2010
15:31 Dec 19, 2011
Jkt 226001
• Was appealed to the Board before
January 19, 2012 but has not been
decided by the Board as of that date; or
• Is pending before VA on or after
January 19, 2012 because the Court of
Appeals for Veterans Claims vacated a
Board decision on the application and
remanded it for readjudication.
FOR FURTHER INFORMATION CONTACT:
Nancy A. Copeland, Consultant,
Regulations Staff (211D), Compensation
and Pension Service, Veterans Benefits
Administration, Department of Veterans
Affairs, 810 Vermont Avenue NW.,
Washington, DC 20420, (202) 461–9428.
(This is not a toll-free number.)
SUPPLEMENTARY INFORMATION: On June
23, 2010, VA published in the Federal
Register (75 FR 35711) a proposed rule
that would revise the evaluation
criterion for amyotrophic lateral
sclerosis (ALS) in the VA Schedule for
Rating Disabilities (diagnostic code 8017
in 38 CFR 4.124a, the schedule of
ratings for neurological conditions and
convulsive disorders). The schedule
previously provided a minimum
evaluation of 30 percent for ALS;
however, we determined that providing
a 100-percent evaluation in all cases
would obviate the need to reassess and
reevaluate veterans with ALS repeatedly
over a short period of time, as the
condition worsens and inevitably and
relentlessly progresses to total
disability, and we proposed to increase
the minimum evaluation for ALS to
100 percent.
Comments in Response to Proposed
Rule
A 30-day comment period ended July
23, 2010, and we received comments
from 17 individual members of the
general public and 1 from the
Amyotrophic Lateral Sclerosis
Association. The comments from the
general public included 5 from veterans
who have ALS, 3 from family members
of veterans who have ALS or who died
from ALS, and 1 from an individual
raising claim-specific issues. Fifteen of
the individual commenters expressed
support for the rule. Two of the 15 said
they support the rule ‘‘wholeheartedly,’’
and others used expressions such as ‘‘it
is imperative’’ and ‘‘it is absolutely
vital.’’ We are not making any changes
to the final rule based on these
supportive comments.
In addition, the Amyotrophic Lateral
Sclerosis (ALS) Association strongly
endorsed the proposed rule. It stated
that the establishment of an evaluation
of 100 percent for ALS in all cases, plus
the note under the evaluation criterion
that recommends consideration of
special monthly compensation (SMC)
PO 00000
Frm 00019
Fmt 4700
Sfmt 4700
78823
(an additional monthly amount of
compensation that may be paid to
veterans with certain serious
disabilities) will help ensure that
veterans with ALS are compensated
appropriately. The ALS Association
recommended that VA adopt special
processing procedures to expedite ALS
claims; however, VA has already
established procedures for handling
hardship cases involving seriously
disabled veterans. Therefore, we are not
making any changes to the final rule
based on this comment.
One commenter said that he would
like to see the 100-percent rating for this
disease given to all veterans, whether or
not they are service-connected.
However, under current law, 38 U.S.C.
1110 and 1131, VA’s authority is limited
to providing compensation to veterans
with service-connected disabilities.
Therefore, as VA is prohibited from
taking the action the commenter
requests, we are not making any changes
to the final rule based on this comment.
One commenter expressed the belief
that revision of the VA rating schedule
in the proposed rulemaking would be
‘‘arbitrary,’’ arguing that ALS was being
evaluated differently from other
neurological disorders. The comment
expressed the belief that the proposed
rule would ‘‘rate multiple disabilities as
a single disability’’ when a possibility of
entitlement to SMC exists, and that the
proposed rule would ‘‘produce
decisions which result in payment at a
rate lower than the veteran is entitled to
now.’’
VA appreciates this comment;
however, this rule does not change the
procedure for evaluating serviceconnected disabilities. It only prescribes
a higher minimum disability rating for
ALS. VA remains required to provide an
evaluation for all service-connected
disabilities, regardless of whether a
veteran already has received a 100percent disability rating for one.
Therefore, all veterans will continue to
receive thorough evaluations for all
service-connected disabilities and
disorders. All veterans who would be
eligible for SMC or ancillary benefits
before the promulgation of this
regulation will remain so.
As the proposed rule explained, ALS
is a rapidly progressing disease, and
establishment of a 100-percent
evaluation for ALS will not adversely
affect how ALS is evaluated for rating
purposes. Although a veteran may
receive compensation at the 100-percent
rate based either on a 100-percent
evaluation specifically for ALS or on a
combined evaluation for ALS and other
service-connected conditions, on either
basis VA may consider the veteran for
E:\FR\FM\20DER1.SGM
20DER1
78824
Federal Register / Vol. 76, No. 244 / Tuesday, December 20, 2011 / Rules and Regulations
varying levels of SMC, which is an
amount of compensation in addition to
amounts payable for service-connected
disability, including disabilities rated
100-percent disabling, where applicable.
Indeed, as amended, 38 CFR 4.124a
includes a note to the rater: ‘‘Consider
the need for special monthly
compensation.’’ Furthermore, because
this rule does not alter VA’s procedures
regarding evaluation of all disabilities
and disorders, any ancillary benefits to
which a veteran may be entitled will be
preserved. We thus make no changes to
the regulation based on this comment.
One general public commenter raised
claim-specific issues that are unrelated
to this rulemaking. We thus are making
no changes to the proposed rule based
on this comment.
Therefore, based on the rationale set
forth in the proposed rule and this
document, we are adopting the
provisions of the proposed rule as a
final rule with no changes.
pmangrum on DSK3VPTVN1PROD with RULES
Unfunded Mandates
The Unfunded Mandates Reform Act
of‘1995 requires, at 2 U.S.C. 1532, that
agencies prepare an assessment of
anticipated costs and benefits before
issuing any rule that may result in an
expenditure by State, local, and tribal
governments, in the aggregate, or by the
private sector, of $100 million or more
(adjusted annually for inflation) in any
given year. This rule will have no such
effect on State, local, and tribal
governments, or on the private sector.
Executive Orders 12866 and 13563
Executive Orders 12866 and 13563
direct agencies to assess the costs and
benefits of available regulatory
alternatives and, when regulation is
necessary, to select regulatory
approaches that maximize net benefits
(including potential economic,
environmental, public health and safety
effects, and other advantages;
distributive impacts; and equity).
Executive Order 13563 (Improving
Regulation and Regulatory Review)
emphasizes the importance of
quantifying both costs and benefits,
reducing costs, harmonizing rules, and
promoting flexibility. Executive Order
12866 (Regulatory Planning and
Review) defines a ‘‘significant
regulatory action,’’ which requires
review by the Office of Management and
Budget (OMB), as ‘‘any regulatory action
that is likely to result in a rule that may:
(1) Have an annual effect on the
economy of $100 million or more or
adversely affect in a material way the
economy, a sector of the economy,
productivity, competition, jobs, the
environment, public health or safety, or
VerDate Mar<15>2010
15:31 Dec 19, 2011
Jkt 226001
State, local, or tribal governments or
communities; (2) Create a serious
inconsistency or otherwise interfere
with an action taken or planned by
another agency; (3) Materially alter the
budgetary impact of entitlements,
grants, user fees, or loan programs or the
rights and obligations of recipients
thereof; or (4) Raise novel legal or policy
issues arising out of legal mandates, the
President’s priorities, or the principles
set forth in this Executive Order.’’
The economic, interagency,
budgetary, legal, and policy
implications of this regulatory action
have been examined and it has been
determined not to be a significant
regulatory action under Executive Order
12866.
Paperwork Reduction Act
This document contains no provisions
constituting a collection of information
under the Paperwork Reduction Act of
1995 (44 U.S.C. 3501–3521).
Dated: December 15, 2011.
Robert C. McFetridge,
Director of Regulation Policy and
Management, Office of the General Counsel,
Department of Veterans Affairs.
For the reasons set out in the
preamble, 38 CFR part 4, subpart B, is
amended as set forth below:
PART 4—SCHEDULE FOR RATING
DISABILITIES
1. The authority citation for part 4
continues to read as follows:
■
Authority: 38 U.S.C. 1155, unless
otherwise noted.
Subpart B—Disability Ratings
2. In § 4.124a, revise diagnostic code
8017 to read as follows:
■
§ 4.124a Schedule of ratings—neurological
conditions and convulsive disorders.
*
*
*
*
*
Rating
Regulatory Flexibility Act
The Secretary hereby certifies that
this final rule will not have a significant
economic impact on a substantial
number of small entities as they are
defined in the Regulatory Flexibility
Act, 5 U.S.C. 601–612. The rule could
affect only VA beneficiaries and will not
directly affect small entities. Therefore,
pursuant to 5 U.S.C. 605(b), this rule is
exempt from the initial and final
regulatory flexibility analyses
requirements of sections 603 and 604.
Catalog of Federal Domestic Assistance
The Catalog of Federal Domestic
Assistance program numbers and titles
for this rule are as follows: 64.109,
Veterans Compensation for ServiceConnected Disability; and 64.110,
Veterans Dependency and Indemnity
Compensation for Service-Connected
Death.
Signing Authority
The Secretary of Veterans Affairs, or
designee, approved this document and
authorized the undersigned to sign and
submit the document to the Office of the
Federal Register for publication
electronically as an official document of
the Department of Veterans Affairs. John
R. Gingrich, Chief of Staff, Department
of Veterans Affairs, approved this
document on October 7, 2011, for
publication.
List of Subjects in 38 CFR Part 4
Disability benefits, Pensions,
Veterans.
PO 00000
Frm 00020
Fmt 4700
Sfmt 4700
*
*
*
*
8017 Amyotrophic lateral sclerosis
*
100
Note: Consider the need for special
monthly compensation.
*
*
*
*
*
[FR Doc. 2011–32531 Filed 12–19–11; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
38 CFR Part 17
RIN 2900–AO28
Copayments for Medications in 2012
Department of Veterans Affairs.
Interim final rule.
AGENCY:
ACTION:
The Department of Veterans
Affairs (VA) amends its medical
regulations concerning the copayment
required for certain medications. Under
current regulations, beginning on
January 1, 2012, the copayment amount
must be increased based on the
prescription drug component of the
Medical Consumer Price Index, and the
maximum annual copayment amount
must be increased when the copayment
is increased. A prior action ‘‘froze’’ the
copayment amount for veterans in VA’s
health care system enrollment priority
categories 2 through 6 and allowed for
increased copayments, as required by
the current regulation, only for veterans
in priority categories 7 and 8. This
document freezes copayments at the
SUMMARY:
E:\FR\FM\20DER1.SGM
20DER1
Agencies
[Federal Register Volume 76, Number 244 (Tuesday, December 20, 2011)]
[Rules and Regulations]
[Pages 78823-78824]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-32531]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
38 CFR Part 4
RIN 2900-AN60
Schedule for Rating Disabilities; Evaluation of Amyotrophic
Lateral Sclerosis
AGENCY: Department of Veterans Affairs.
ACTION: Final rule.
-----------------------------------------------------------------------
SUMMARY: The Department of Veterans Affairs (VA) is amending its
Schedule for Rating Disabilities by revising the disability evaluation
criterion provided for amyotrophic lateral sclerosis (ALS) to provide
an evaluation of 100 percent for any veteran with service-connected
ALS. This change is necessary to adequately compensate veterans who
suffer from this progressive, untreatable, and fatal disease. This
change is intended to provide a total disability rating for any veteran
with service-connected ALS.
DATES: Effective Date: This final rule is effective January 19, 2012.
Applicability Date: This final rule applies to an application for
benefits that:
Is received by VA on or after January 19, 2012;
Was received by VA before January 19, 2012 but has not
been decided by a VA regional office as of that date;
Is appealed to the Board of Veterans' Appeals on or after
January 19, 2012;
Was appealed to the Board before January 19, 2012 but has
not been decided by the Board as of that date; or
Is pending before VA on or after January 19, 2012 because
the Court of Appeals for Veterans Claims vacated a Board decision on
the application and remanded it for readjudication.
FOR FURTHER INFORMATION CONTACT: Nancy A. Copeland, Consultant,
Regulations Staff (211D), Compensation and Pension Service, Veterans
Benefits Administration, Department of Veterans Affairs, 810 Vermont
Avenue NW., Washington, DC 20420, (202) 461-9428. (This is not a toll-
free number.)
SUPPLEMENTARY INFORMATION: On June 23, 2010, VA published in the
Federal Register (75 FR 35711) a proposed rule that would revise the
evaluation criterion for amyotrophic lateral sclerosis (ALS) in the VA
Schedule for Rating Disabilities (diagnostic code 8017 in 38 CFR
4.124a, the schedule of ratings for neurological conditions and
convulsive disorders). The schedule previously provided a minimum
evaluation of 30 percent for ALS; however, we determined that providing
a 100-percent evaluation in all cases would obviate the need to
reassess and reevaluate veterans with ALS repeatedly over a short
period of time, as the condition worsens and inevitably and
relentlessly progresses to total disability, and we proposed to
increase the minimum evaluation for ALS to 100 percent.
Comments in Response to Proposed Rule
A 30-day comment period ended July 23, 2010, and we received
comments from 17 individual members of the general public and 1 from
the Amyotrophic Lateral Sclerosis Association. The comments from the
general public included 5 from veterans who have ALS, 3 from family
members of veterans who have ALS or who died from ALS, and 1 from an
individual raising claim-specific issues. Fifteen of the individual
commenters expressed support for the rule. Two of the 15 said they
support the rule ``wholeheartedly,'' and others used expressions such
as ``it is imperative'' and ``it is absolutely vital.'' We are not
making any changes to the final rule based on these supportive
comments.
In addition, the Amyotrophic Lateral Sclerosis (ALS) Association
strongly endorsed the proposed rule. It stated that the establishment
of an evaluation of 100 percent for ALS in all cases, plus the note
under the evaluation criterion that recommends consideration of special
monthly compensation (SMC) (an additional monthly amount of
compensation that may be paid to veterans with certain serious
disabilities) will help ensure that veterans with ALS are compensated
appropriately. The ALS Association recommended that VA adopt special
processing procedures to expedite ALS claims; however, VA has already
established procedures for handling hardship cases involving seriously
disabled veterans. Therefore, we are not making any changes to the
final rule based on this comment.
One commenter said that he would like to see the 100-percent rating
for this disease given to all veterans, whether or not they are
service-connected. However, under current law, 38 U.S.C. 1110 and 1131,
VA's authority is limited to providing compensation to veterans with
service-connected disabilities. Therefore, as VA is prohibited from
taking the action the commenter requests, we are not making any changes
to the final rule based on this comment.
One commenter expressed the belief that revision of the VA rating
schedule in the proposed rulemaking would be ``arbitrary,'' arguing
that ALS was being evaluated differently from other neurological
disorders. The comment expressed the belief that the proposed rule
would ``rate multiple disabilities as a single disability'' when a
possibility of entitlement to SMC exists, and that the proposed rule
would ``produce decisions which result in payment at a rate lower than
the veteran is entitled to now.''
VA appreciates this comment; however, this rule does not change the
procedure for evaluating service-connected disabilities. It only
prescribes a higher minimum disability rating for ALS. VA remains
required to provide an evaluation for all service-connected
disabilities, regardless of whether a veteran already has received a
100-percent disability rating for one. Therefore, all veterans will
continue to receive thorough evaluations for all service-connected
disabilities and disorders. All veterans who would be eligible for SMC
or ancillary benefits before the promulgation of this regulation will
remain so.
As the proposed rule explained, ALS is a rapidly progressing
disease, and establishment of a 100-percent evaluation for ALS will not
adversely affect how ALS is evaluated for rating purposes. Although a
veteran may receive compensation at the 100-percent rate based either
on a 100-percent evaluation specifically for ALS or on a combined
evaluation for ALS and other service-connected conditions, on either
basis VA may consider the veteran for
[[Page 78824]]
varying levels of SMC, which is an amount of compensation in addition
to amounts payable for service-connected disability, including
disabilities rated 100-percent disabling, where applicable. Indeed, as
amended, 38 CFR 4.124a includes a note to the rater: ``Consider the
need for special monthly compensation.'' Furthermore, because this rule
does not alter VA's procedures regarding evaluation of all disabilities
and disorders, any ancillary benefits to which a veteran may be
entitled will be preserved. We thus make no changes to the regulation
based on this comment.
One general public commenter raised claim-specific issues that are
unrelated to this rulemaking. We thus are making no changes to the
proposed rule based on this comment.
Therefore, based on the rationale set forth in the proposed rule
and this document, we are adopting the provisions of the proposed rule
as a final rule with no changes.
Unfunded Mandates
The Unfunded Mandates Reform Act of`1995 requires, at 2 U.S.C.
1532, that agencies prepare an assessment of anticipated costs and
benefits before issuing any rule that may result in an expenditure by
State, local, and tribal governments, in the aggregate, or by the
private sector, of $100 million or more (adjusted annually for
inflation) in any given year. This rule will have no such effect on
State, local, and tribal governments, or on the private sector.
Executive Orders 12866 and 13563
Executive Orders 12866 and 13563 direct agencies to assess the
costs and benefits of available regulatory alternatives and, when
regulation is necessary, to select regulatory approaches that maximize
net benefits (including potential economic, environmental, public
health and safety effects, and other advantages; distributive impacts;
and equity). Executive Order 13563 (Improving Regulation and Regulatory
Review) emphasizes the importance of quantifying both costs and
benefits, reducing costs, harmonizing rules, and promoting flexibility.
Executive Order 12866 (Regulatory Planning and Review) defines a
``significant regulatory action,'' which requires review by the Office
of Management and Budget (OMB), as ``any regulatory action that is
likely to result in a rule that may: (1) Have an annual effect on the
economy of $100 million or more or adversely affect in a material way
the economy, a sector of the economy, productivity, competition, jobs,
the environment, public health or safety, or State, local, or tribal
governments or communities; (2) Create a serious inconsistency or
otherwise interfere with an action taken or planned by another agency;
(3) Materially alter the budgetary impact of entitlements, grants, user
fees, or loan programs or the rights and obligations of recipients
thereof; or (4) Raise novel legal or policy issues arising out of legal
mandates, the President's priorities, or the principles set forth in
this Executive Order.''
The economic, interagency, budgetary, legal, and policy
implications of this regulatory action have been examined and it has
been determined not to be a significant regulatory action under
Executive Order 12866.
Paperwork Reduction Act
This document contains no provisions constituting a collection of
information under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-
3521).
Regulatory Flexibility Act
The Secretary hereby certifies that this final rule will not have a
significant economic impact on a substantial number of small entities
as they are defined in the Regulatory Flexibility Act, 5 U.S.C. 601-
612. The rule could affect only VA beneficiaries and will not directly
affect small entities. Therefore, pursuant to 5 U.S.C. 605(b), this
rule is exempt from the initial and final regulatory flexibility
analyses requirements of sections 603 and 604.
Catalog of Federal Domestic Assistance
The Catalog of Federal Domestic Assistance program numbers and
titles for this rule are as follows: 64.109, Veterans Compensation for
Service-Connected Disability; and 64.110, Veterans Dependency and
Indemnity Compensation for Service-Connected Death.
Signing Authority
The Secretary of Veterans Affairs, or designee, approved this
document and authorized the undersigned to sign and submit the document
to the Office of the Federal Register for publication electronically as
an official document of the Department of Veterans Affairs. John R.
Gingrich, Chief of Staff, Department of Veterans Affairs, approved this
document on October 7, 2011, for publication.
List of Subjects in 38 CFR Part 4
Disability benefits, Pensions, Veterans.
Dated: December 15, 2011.
Robert C. McFetridge,
Director of Regulation Policy and Management, Office of the General
Counsel, Department of Veterans Affairs.
For the reasons set out in the preamble, 38 CFR part 4, subpart B,
is amended as set forth below:
PART 4--SCHEDULE FOR RATING DISABILITIES
0
1. The authority citation for part 4 continues to read as follows:
Authority: 38 U.S.C. 1155, unless otherwise noted.
Subpart B--Disability Ratings
0
2. In Sec. 4.124a, revise diagnostic code 8017 to read as follows:
Sec. 4.124a Schedule of ratings--neurological conditions and
convulsive disorders.
* * * * *
------------------------------------------------------------------------
Rating
------------------------------------------------------------------------
* * * * *
8017 Amyotrophic lateral sclerosis........................... 100
------------------------------------------------------------------------
Note: Consider the need for special monthly compensation.
* * * * *
[FR Doc. 2011-32531 Filed 12-19-11; 8:45 am]
BILLING CODE 8320-01-P