Schedule for Rating Disabilities; AL Amyloidosis (Primary Amyloidosis), 6466-6467 [2012-2883]
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6466
Federal Register / Vol. 77, No. 26 / Wednesday, February 8, 2012 / Rules and Regulations
Dated: January 26, 2012.
Gary Kassof,
Bridge Program Manager, First Coast Guard
District.
[FR Doc. 2012–2787 Filed 2–7–12; 8:45 am]
BILLING CODE 9110–04–P
DEPARTMENT OF VETERANS
AFFAIRS
38 CFR Part 4
RIN 2900–AN75
Schedule for Rating Disabilities; AL
Amyloidosis (Primary Amyloidosis)
Department of Veterans Affairs.
Final rule.
AGENCY:
ACTION:
The Department of Veterans
Affairs (VA) is amending its Schedule
for Rating Disabilities by updating the
schedule of ratings for the hemic and
lymphatic systems to include AL
amyloidosis. This regulatory action is
necessary to add AL amyloidosis as one
of the disease conditions and establish
criteria for disability evaluation to fully
implement the decision by the Secretary
of Veterans Affairs to grant presumptive
service connection based on herbicide
exposure for this disease. The intended
effects are to provide consistency in
disability ratings and to ease tracking of
AL amyloidosis for statistical analysis.
DATES: Effective Date: This final rule is
effective March 9, 2012.
Applicability Date: This final rule
applies to an application for benefits
that:
• Is received by VA on or after March
9, 2012;
• Was received by VA before March
9, 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 March 9,
2012;
• Was appealed to the Board before
March 9, 2012 but has not been decided
by the Board as of that date; or
• Is pending before VA on or after
March 9, 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:
Thomas J. Kniffen, Chief, Regulations
Staff (211D), Compensation Service,
Veterans Benefits Administration,
Department of Veterans Affairs, 810
Vermont Avenue NW., Washington, DC
20420, (202) 461–9700. (This is not a
toll-free number.)
SUPPLEMENTARY INFORMATION: On
October 22, 2010, VA published in the
Federal Register (75 FR 65279) a
pmangrum on DSK3VPTVN1PROD with RULES
SUMMARY:
VerDate Mar<15>2010
14:44 Feb 07, 2012
Jkt 226001
proposed rule that would add AL
amyloidosis to VA’s Schedule for Rating
Disabilities to update the schedule of
ratings for the hemic and lymphatic
systems, 38 CFR 4.117, by creating
diagnostic code 7717. The schedule
previously did not contain a diagnostic
code for AL amyloidosis. As an unlisted
condition, it has been rated by analogy
to non-Hodgkin’s lymphoma using the
‘‘built-up’’ diagnostic code 7799–7715.
However, AL amyloidosis requires a set
of evaluation criteria with a unique
diagnostic code, to serve as a basis for
disability rating, because the condition
is not part of the group of diseases
under the non-Hodgkin’s lymphoma
classification, but, rather, a disorder of
the bone marrow characterized by the
accumulation and deposition of
abnormal, insoluble proteins called light
chain amyloid proteins in any organ of
the body, interfering with the structure
and function of the organ. Additionally,
adding the diagnostic code would
establish criteria for disability
evaluation to fully implement the
decision by the Secretary of Veterans
Affairs to grant presumptive service
connection based on herbicide exposure
for this disease. A final rule regarding
that decision was published in the
Federal Register at 74 FR 21258, which
amended 38 CFR 3.309(e) by adding AL
amyloidosis to the list of diseases
associated with exposure to certain
herbicide agents. For these reasons, VA
proposed a regulation that would amend
VA’s Schedule of Rating Disabilities by
adding rating guidance and a diagnostic
code specifically for AL amyloidosis.
VA proposed diagnostic code 7717 for
AL amyloidosis because it was the first
available diagnostic code in the Hemic
and Lymphatic Systems listed in
§ 4.117. VA proposed to assign a 100
percent rating because the disease is
incurable and progressive, generally
causing death in a few years. Providing
a 100-percent evaluation in all cases
would obviate the need to repeatedly
reassess and reevaluate veterans with
AL amyloidosis over a short period of
time. Because of the poor prognosis, no
follow-up examination will be required
for re-evaluation of this disability rating.
VA also proposed to refer to AL
amyloidosis in diagnostic code 7717 as
‘‘primary amyloidosis,’’ which is
another common name for the same
disease. VA also proposed to amend 38
CFR Part 4, Appendices A, B, and C to
reflect the proposed addition of
diagnostic code 7717 for AL
amyloidosis to the rating schedule.
Comment in Response to Proposed Rule
A 60-day comment period ended
December 21, 2010, and we received
PO 00000
Frm 00004
Fmt 4700
Sfmt 4700
one comment from a member of the
general public. The comment expressed
support for the rule. We are not making
any changes in the final rule based on
this supportive comment.
As no further comments were
received, we thus are making no
changes to the proposed rule. 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.’’
E:\FR\FM\08FER1.SGM
08FER1
6467
Federal Register / Vol. 77, No. 26 / Wednesday, February 8, 2012 / Rules and Regulations
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).
Authority: 38 U.S.C. 1155, unless
otherwise noted.
Subpart B—Disability Ratings
§ 4.117
2. In § 4.117, add diagnostic code
7717, immediately following the note at
the end of diagnostic code 7716, to read
as follows:
■
§ 4.117 Schedule of ratings—hemic and
lymphatic systems.
Rating
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.
*
*
*
*
7717 AL amyloidosis (primary
amyloidosis) ..............................
List of Subjects in 38 CFR Part 4
3. In Appendix A to part 4, under Sec.
4.117, add diagnostic code 7717 in
numerical order (following diagnostic
code number 7716) to the table to read
as follows:
Appendix A to Part 4—Table of
Amendments and Effective Dates Since
1946
pmangrum on DSK3VPTVN1PROD with RULES
Dated: February 3, 2012.
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 is amended as
set forth below:
1. The authority citation for part 4
continues to read as follows:
■
Jkt 226001
*
*
*
*
*
7717
*
*
[FR Doc. 2012–2883 Filed 2–7–12; 8:45 am]
BILLING CODE 8320–01–P
ENVIRONMENTAL PROTECTION
AGENCY
[EPA–R04–OAR–2011–0084–201167(a);
FRL–9628–2]
Approval and Promulgation of
Implementation Plans; Alabama,
Georgia, and Tennessee: Chattanooga;
Particulate Matter 2002 Base Year
Emissions Inventory
Environmental Protection
Agency (EPA).
ACTION: Direct final rule.
AGENCY:
Sec.
Diagnostic
Code No.
*
4.117.
*
*
*
*
*
*
*
*
*
Added 3/9/2012.
*
*
*
*
*
4. In Appendix B to part 4 add
diagnostic code 7717 to the table in
numerical order (following the entry for
diagnostic code number 7716) and its
disability entry ‘‘AL amyloidosis
(primary amyloidosis)’’ to read as
follows:
■
Appendix B to Part 4—Numerical Index
of Disabilities
Diagnostic Code No.
Disability benefits, Pensions,
Veterans.
PART 4—SCHEDULE FOR RATING
DISABILITIES
100
■
7717
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 February 2, 2012, for
publication.
*
*
*
*
AL amyloidosis .................
40 CFR Part 52
Signing Authority
14:44 Feb 07, 2012
Diagnostic Code
No.
[Amended]
Regulatory Flexibility Act
VerDate Mar<15>2010
Appendix C to Part 4—Alphabetical
Index of Disabilities
THE HEMIC AND LYMPHATIC SYSTEMS
*
*
*
*
*
7717 .......................... AL amyloidosis (primary amyloidosis).
*
*
*
*
*
5. Appendix C to part 4 is amended
by adding in alphabetical order
(following ‘‘Agranulocytosis’’) a new
entry ‘‘AL amyloidosis’’ and its
diagnostic code number ‘‘7717’’ to read
as follows:
■
PO 00000
Frm 00005
Fmt 4700
Sfmt 4700
EPA is taking direct final
action to approve the fine particulate
matter (PM2.5) 2002 base year emissions
inventory portion of the State
Implementation Plan (SIP) revisions
submitted by the States of Alabama on
July 31, 2009, Georgia on October 27,
2009, and Tennessee on October 15,
2009. The emissions inventory is part of
the tri-state Chattanooga, AlabamaGeorgia-Tennessee, (hereafter referred to
as ‘‘the Chattanooga Area’’ or ‘‘Area’’),
PM2.5 attainment demonstrations that
were submitted for the 1997 annual
PM2.5 National Ambient Air Quality
Standards (NAAQS). This action is
being taken pursuant to section 110 of
the Clean Air Act (CAA).
DATES: This direct final rule is effective
April 9, 2012 without further notice,
unless EPA receives adverse comment
by March 9, 2012. If EPA receives such
comments, it will publish a timely
withdrawal of the direct final rule in the
Federal Register and inform the public
that the rule will not take effect.
ADDRESSES: Submit your comments,
identified by Docket ID No. EPA–R04–
OAR–2011–0084, by one of the
following methods:
1. www.regulations.gov: Follow the
on-line instructions for submitting
comments.
2. Email: benjamin.lynorae@epa.gov.
3. Fax: (404) 562–9019.
SUMMARY:
E:\FR\FM\08FER1.SGM
08FER1
]]>Agencies
[Federal Register Volume 77, Number 26 (Wednesday, February 8, 2012)]
[Rules and Regulations]
[Pages 6466-6467]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-2883]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
38 CFR Part 4
RIN 2900-AN75
Schedule for Rating Disabilities; AL Amyloidosis (Primary
Amyloidosis)
AGENCY: Department of Veterans Affairs.
ACTION: Final rule.
-----------------------------------------------------------------------
SUMMARY: The Department of Veterans Affairs (VA) is amending its
Schedule for Rating Disabilities by updating the schedule of ratings
for the hemic and lymphatic systems to include AL amyloidosis. This
regulatory action is necessary to add AL amyloidosis as one of the
disease conditions and establish criteria for disability evaluation to
fully implement the decision by the Secretary of Veterans Affairs to
grant presumptive service connection based on herbicide exposure for
this disease. The intended effects are to provide consistency in
disability ratings and to ease tracking of AL amyloidosis for
statistical analysis.
DATES: Effective Date: This final rule is effective March 9, 2012.
Applicability Date: This final rule applies to an application for
benefits that:
Is received by VA on or after March 9, 2012;
Was received by VA before March 9, 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
March 9, 2012;
Was appealed to the Board before March 9, 2012 but has not
been decided by the Board as of that date; or
Is pending before VA on or after March 9, 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: Thomas J. Kniffen, Chief, Regulations
Staff (211D), Compensation Service, Veterans Benefits Administration,
Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC
20420, (202) 461-9700. (This is not a toll-free number.)
SUPPLEMENTARY INFORMATION: On October 22, 2010, VA published in the
Federal Register (75 FR 65279) a proposed rule that would add AL
amyloidosis to VA's Schedule for Rating Disabilities to update the
schedule of ratings for the hemic and lymphatic systems, 38 CFR 4.117,
by creating diagnostic code 7717. The schedule previously did not
contain a diagnostic code for AL amyloidosis. As an unlisted condition,
it has been rated by analogy to non-Hodgkin's lymphoma using the
``built-up'' diagnostic code 7799-7715. However, AL amyloidosis
requires a set of evaluation criteria with a unique diagnostic code, to
serve as a basis for disability rating, because the condition is not
part of the group of diseases under the non-Hodgkin's lymphoma
classification, but, rather, a disorder of the bone marrow
characterized by the accumulation and deposition of abnormal, insoluble
proteins called light chain amyloid proteins in any organ of the body,
interfering with the structure and function of the organ. Additionally,
adding the diagnostic code would establish criteria for disability
evaluation to fully implement the decision by the Secretary of Veterans
Affairs to grant presumptive service connection based on herbicide
exposure for this disease. A final rule regarding that decision was
published in the Federal Register at 74 FR 21258, which amended 38 CFR
3.309(e) by adding AL amyloidosis to the list of diseases associated
with exposure to certain herbicide agents. For these reasons, VA
proposed a regulation that would amend VA's Schedule of Rating
Disabilities by adding rating guidance and a diagnostic code
specifically for AL amyloidosis.
VA proposed diagnostic code 7717 for AL amyloidosis because it was
the first available diagnostic code in the Hemic and Lymphatic Systems
listed in Sec. 4.117. VA proposed to assign a 100 percent rating
because the disease is incurable and progressive, generally causing
death in a few years. Providing a 100-percent evaluation in all cases
would obviate the need to repeatedly reassess and reevaluate veterans
with AL amyloidosis over a short period of time. Because of the poor
prognosis, no follow-up examination will be required for re-evaluation
of this disability rating. VA also proposed to refer to AL amyloidosis
in diagnostic code 7717 as ``primary amyloidosis,'' which is another
common name for the same disease. VA also proposed to amend 38 CFR Part
4, Appendices A, B, and C to reflect the proposed addition of
diagnostic code 7717 for AL amyloidosis to the rating schedule.
Comment in Response to Proposed Rule
A 60-day comment period ended December 21, 2010, and we received
one comment from a member of the general public. The comment expressed
support for the rule. We are not making any changes in the final rule
based on this supportive comment.
As no further comments were received, we thus are making no changes
to the proposed rule. 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.''
[[Page 6467]]
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 February 2, 2012, for publication.
List of Subjects in 38 CFR Part 4
Disability benefits, Pensions, Veterans.
Dated: February 3, 2012.
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 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
Sec. 4.117 [Amended]
0
2. In Sec. 4.117, add diagnostic code 7717, immediately following the
note at the end of diagnostic code 7716, to read as follows:
Sec. 4.117 Schedule of ratings--hemic and lymphatic systems.
------------------------------------------------------------------------
Rating
------------------------------------------------------------------------
* * * * *
7717 AL amyloidosis (primary amyloidosis).................... 100
------------------------------------------------------------------------
0
3. In Appendix A to part 4, under Sec. 4.117, add diagnostic code 7717
in numerical order (following diagnostic code number 7716) to the table
to read as follows:
Appendix A to Part 4--Table of Amendments and Effective Dates Since
1946
------------------------------------------------------------------------
Diagnostic
Sec. Code No.
------------------------------------------------------------------------
* * * * *
4.117....................
* * * * *
7717 Added 3/9/2012.
* * * * *
------------------------------------------------------------------------
0
4. In Appendix B to part 4 add diagnostic code 7717 to the table in
numerical order (following the entry for diagnostic code number 7716)
and its disability entry ``AL amyloidosis (primary amyloidosis)'' to
read as follows:
Appendix B to Part 4--Numerical Index of Disabilities
------------------------------------------------------------------------
Diagnostic Code No.
------------------------------------------------------------------------
THE HEMIC AND LYMPHATIC SYSTEMS
------------------------------------------------------------------------
* * * * *
7717...................................... AL amyloidosis (primary
amyloidosis).
* * * * *
------------------------------------------------------------------------
0
5. Appendix C to part 4 is amended by adding in alphabetical order
(following ``Agranulocytosis'') a new entry ``AL amyloidosis'' and its
diagnostic code number ``7717'' to read as follows:
Appendix C to Part 4--Alphabetical Index of Disabilities
------------------------------------------------------------------------
Diagnostic Code
No.
------------------------------------------------------------------------
* * * * *
AL amyloidosis........................................ 7717
* * * * *
------------------------------------------------------------------------
[FR Doc. 2012-2883 Filed 2-7-12; 8:45 am]
BILLING CODE 8320-01-P
