Guaranteed Loanmaking, 50802 [2017-23912]
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Federal Register / Vol. 82, No. 211 / Thursday, November 2, 2017 / Rules and Regulations
Section 301.75–15 issued under Sec. 204,
Title II, Public Law 106–113, 113 Stat.
1501A–293; sections 301.75–15 and 301.75–
16 issued under Sec. 203, Title II, Public Law
106–224, 114 Stat. 400 (7 U.S.C. 1421 note).
Done in Washington, DC, this 30th day of
October 2017.
Michael C. Gregoire,
Acting Administrator, Animal and Plant
Health Inspection Service.
[FR Doc. 2017–23897 Filed 11–1–17; 8:45 am]
BILLING CODE 3410–34–P
DEPARTMENT OF AGRICULTURE
Rural Business-Cooperative Service
Rural Utilities Service
7 CFR Part 4279
Guaranteed Loanmaking
CFR Correction
In Title 7 of the Code of Federal
Regulations, Part 2000 to End, revised as
of January 1, 2017, on page 749,
§ 4279.162 is added to read as follows:
§ 4279.162 Strategic economic and
community development.
Applicants with projects that support
the implementation of strategic
economic development and community
development plans are encouraged to
review and consider 7 CFR part 1980,
subpart K, which contains provisions
for providing priority to projects that
support the implementation of strategic
economic development and community
development plans on a Multijurisdictional basis.
[81 FR 10457, Mar. 1, 2016]
[FR Doc. 2017–23912 Filed 11–1–17; 8:45 am]
BILLING CODE 1301–00–D
DEPARTMENT OF VETERANS
AFFAIRS
38 CFR Part 4
RIN 2900–AO44
Schedule for Rating Disabilities; The
Endocrine System
Department of Veterans Affairs.
Final rule.
AGENCY:
ACTION:
This document amends the
Department of Veterans Affairs (VA)
Schedule for Rating Disabilities
(VASRD) by revising the portion of the
Schedule that addresses endocrine
conditions and disorders of the
endocrine system. The effect of this
action is to ensure that the VASRD uses
current medical terminology and to
nlaroche on DSK9F9SC42PROD with RULES
SUMMARY:
VerDate Sep<11>2014
14:56 Nov 01, 2017
Jkt 244001
provide detailed and updated criteria
for evaluation of endocrine disorders.
DATES: This rule is effective on
December 10, 2017.
FOR FURTHER INFORMATION CONTACT:
Ioulia Vvedenskaya, Medical Officer,
Part 4 VASRD Regulations Staff (211C),
Compensation Service, Veterans
Benefits Administration, Department of
Veterans Affairs, 810 Vermont Avenue
NW., Washington, DC 20420,
Ioulia.Vvedenskaya@va.gov, (202) 461–
9700 (this is not a toll-free telephone
number).
SUPPLEMENTARY INFORMATION: VA
published a proposed rule in the
Federal Register at 80 FR 39011 on July
8, 2015, to amend the portion of the
VASRD dealing with endocrine
disorders. VA provided a 60-day public
comment period, and interested persons
were invited to submit written
comments, suggestions, or objections on
or before September 8, 2015. VA
received comments from four
individuals. In addition, VA received a
comment from a veterans service
organization. Unless otherwise
indicated below, VA adopts the changes
set forth in the proposed rule.
Public Comments
One commenter asked whether VA
would recognize polycystic ovarian
syndrome (PCOS) under the VA rating
schedule. VA has a mechanism in place
to address PCOS under 38 CFR 4.116.
Specifically, the rating schedule for
Gynecological Conditions and Disorders
of the Breast addresses various ovarian
conditions under Diagnostic Code (DC)
7615, ‘‘Ovary, disease, injury, or
adhesions of’’ and allows VA to rate
based on whether symptoms are
controlled by or require continuous
treatment. In exceptional cases where
the schedular evaluation is inadequate,
38 CFR 3.321 allows for extraschedular
evaluation. Therefore, VA makes no
changes based on this comment.
Two commenters proposed additional
modifications to DC 7913, ‘‘Diabetes
mellitus.’’ One commenter suggested
adding a note to address the issue of
regulation of activities. Another
commenter suggested not changing the
insulin requirements within DC 7913
without considering the other
requirements in the DC such as
regulation of activities. The same
commenter suggested removing the
insulin requirement for a 20-percent
rating and the regulation of activities
requirement at all disability ratings
under the DC. The commenter stated
that the functional impairment caused
by required use of insulin is greater than
impairment caused by ingestion of oral
PO 00000
Frm 00002
Fmt 4700
Sfmt 4700
medication to control diabetes. As
stated in the proposed rule, VA is not
proposing any change to the evaluation
criteria for DC 7913 at this time other
than requiring ‘‘one or more daily
injection’’ of insulin for a 20-, 40- or 60percent rating and instead intends to
establish a work group to specifically
address this condition. Therefore, these
comments are beyond the scope of this
rulemaking. However, VA will take
these comments into consideration in
connection with a possible future
rulemaking.
One commenter suggested changing
the terminology for a 100-percent rating
under DC 7903, ‘‘Hypothyroidism’’ from
‘‘myxedema’’ to ‘‘myxedema coma or
crisis’’ because myxedema can be
present without causing the requisite
level of symptoms for a 100-percent
rating. Myxedema is a term used to
denote severe hypothyroidism, and
myxedema coma or myxedema crisis is
a medical emergency and represents a
specific rare life-threatening clinical
condition. Because the clinical picture
of myxedema appears in the most
extreme cases of hypothyroidism, we
believe that this manifestation of the
disability warrants a 100-percent rating
(See Greenspan’s Basic & Clinical
Endocrinology (D.G. Gardner et al. eds.,
9th ed. 2011) available at https://
accessmedicine.mhmedical.com/
content.aspx?bookid=380&
sectionid=39744047#8401831).
Therefore, VA makes no changes based
on this comment.
The same commenter proposed that
VA retain a 10-percent minimum
evaluation in the DCs for endocrine
disabilities because of the need for
continuous medication to control the
symptoms of these disabilities. VA
disagrees. In the absence of symptoms,
medical management of chronic
endocrine disorders does not present a
significant lifestyle adjustment, and it
does not result in impairment of earning
capacity (see 38 U.S.C. 1155). Therefore,
VA makes no changes based on this
comment.
The same commenter noted a
typographical error in the text of
proposed DC 7911. The word
‘‘adrenocortical’’ was misspelled as
‘‘adrenalcortical.’’ VA has changed the
spelling of the term based on this
comment.
One commenter was supportive of the
overall changes and additions to this
section of the VASRD, such as
additional DCs, clarification of notes on
residuals affecting other body systems,
instructions to rate some residuals
separately, accounting for additional
symptoms, and formation of a new work
group for diabetes mellitus. The
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]]>Agencies
[Federal Register Volume 82, Number 211 (Thursday, November 2, 2017)]
[Rules and Regulations]
[Page 50802]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-23912]
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DEPARTMENT OF AGRICULTURE
Rural Business-Cooperative Service
Rural Utilities Service
7 CFR Part 4279
Guaranteed Loanmaking
CFR Correction
In Title 7 of the Code of Federal Regulations, Part 2000 to End,
revised as of January 1, 2017, on page 749, Sec. 4279.162 is added to
read as follows:
Sec. 4279.162 Strategic economic and community development.
Applicants with projects that support the implementation of
strategic economic development and community development plans are
encouraged to review and consider 7 CFR part 1980, subpart K, which
contains provisions for providing priority to projects that support the
implementation of strategic economic development and community
development plans on a Multi-jurisdictional basis.
[81 FR 10457, Mar. 1, 2016]
[FR Doc. 2017-23912 Filed 11-1-17; 8:45 am]
BILLING CODE 1301-00-D
