Schedule for Rating Disabilities: The Cardiovascular System, 62095-62096 [2021-24419]

Download as PDF Federal Register / Vol. 86, No. 214 / Tuesday, November 9, 2021 / Rules and Regulations DEPARTMENT OF HOMELAND SECURITY Coast Guard 33 CFR Part 100 [Docket No. USCG–2021–0770] Special Local Regulation; Marine Events Within the Eleventh Coast Guard District-San Diego Fall Classic Dated: November 4, 2021. T.J. Barelli, Captain, U.S. Coast Guard, Captain of the Port San Diego. Coast Guard, Department of Homeland Security (DHS). ACTION: Notification of enforcement of regulation. AGENCY: [FR Doc. 2021–24515 Filed 11–8–21; 8:45 am] The Coast Guard will enforce the special local regulation on the waters of Mission Bay, San Diego, California, during the San Diego Fall Classic on November 14, 2021. This special local regulation is necessary to provide for the safety of the participants, crew, sponsor vessels of the rowing event, and general users of the waterway. During the enforcement period, persons and vessels are prohibited from entering into, transiting through, or anchoring within this regulated area unless authorized by the Captain of the Port, or his designated representative. SUMMARY: The regulations in 33 CFR 100.1101 for the location described in Table 1 to § 100.1101, Item No. 1, will be enforced from 5:30 a.m. until 12:30 p.m. on November 14, 2021. FOR FURTHER INFORMATION CONTACT: If you have questions about this notification of enforcement, call or email Lieutenant Commander John Santorum, Waterways Management, U.S. Coast Guard Sector, San Diego, CA; telephone (619) 278–7656, email MarineEventsSD@uscg.mil. SUPPLEMENTARY INFORMATION: The Coast Guard will enforce the special local regulations in 33 CFR 100.1101 for the location identified in Table 1 to § 100.1101, Item No. 1, from 5:30 a.m. through 12:30 p.m. on November 14, 2021 for the San Diego Fall Classic in Mission Bay, San Diego, CA. This action is being taken to provide for the safety of life on navigable waterways during the rowing event. Our regulation for recurring marine events in the San Diego Captain of the Port Zone, § 100.1101, Table 1 to § 100.1101, Item No. 1, specifies the location of the regulated area for the San Diego Fall Classic, which encompasses portions of Mission Bay. Under the provisions of § 100.1101, persons and vessels are prohibited from entering into, transiting through, or anchoring within this regulated area unless authorized by the jspears on DSK121TN23PROD with RULES1 DATES: VerDate Sep<11>2014 16:01 Nov 08, 2021 Jkt 256001 Captain of the Port, or his designated representative. The Coast Guard may be assisted by other Federal, State, or local law enforcement agencies in enforcing this regulation. In addition to this document in the Federal Register, the Coast Guard will provide the maritime community with advance notification of this enforcement period via the Local Notice to Mariners and marine information broadcasts. BILLING CODE 9110–04–P DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 4 RIN 2900–AQ67 Schedule for Rating Disabilities: The Cardiovascular System Department of Veterans Affairs. Final rule; correction. AGENCY: ACTION: On September 30, 2021, the Department of Veterans Affairs (VA) published in the Federal Register a final rule that amended the portion of the VA Schedule for Rating Disabilities (‘‘VASRD’’ or ‘‘rating schedule’’) that addresses the cardiovascular system. This correction addresses the instructions for evaluating peripheral arterial disease in the published final rule and corrects another minor technical error. DATES: This correction is effective November 14, 2021. FOR FURTHER INFORMATION CONTACT: Gary Reynolds, M.D., VASRD Program Management Office (210), 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 telephone number.) SUPPLEMENTARY INFORMATION: VA is correcting its final rule, ‘‘RIN 2900– AQ67, Schedule for Rating Disabilities: The Cardiovascular System’’, that was published on September 30, 2021, in the Federal Register at 86 FR 54089. The error is with new Note (2) for diagnostic code (DC) 7114 peripheral arterial disease which fails to identify which of the four tests are necessary before an evaluation can be assigned. In the proposed rule, VA identified two major shortcomings in the rating criteria for DC 7114 that were addressed by creating SUMMARY: PO 00000 Frm 00015 Fmt 4700 Sfmt 4700 62095 evaluation criteria that use the ankle/ brachial index (ABI), ankle pressure (AP), toe pressure (TP) and transcutaneous oximetry (TcPO2) to describe four different levels of impairment. See 84 FR 37594, 37599 (Aug. 1, 2019). New Note (2) instructed raters to select the highest impairment value of ABI, AP, TP, or TcPO2 for evaluation when rating a condition under DC 7114. Upon further consideration, we believe the note could be misconstrued as requiring medical examiners to conduct all four tests. This is inconsistent with our intent, which was to provide examiners with multiple options in the event that ABI was unreliable due to non-compressible arteries. To address this issue, we are correcting new Note (2) to read, ‘‘If AP, TP, and TcPO2 testing are not of record, evaluate based on ABI unless the examiner states that an AP, TP, or TcPO2 test is needed in a particular case because ABI does not sufficiently reflect the severity of the veteran’s peripheral arterial disease. In all other cases, evaluate based on the test that provides the highest impairment value.’’ This correction serves two purposes: (1) It reflects VA’s intent that although ABI should be the primary testing by which conditions should be rated under DC 7114, raters should request AP, TP, or TcPO2 testing when the record reflects that an examiner believes ABI testing does not sufficiently reflect a veteran’s level of impairment, and (2) when multiple tests are of record, it allows the rater to select the test result that would grant the veteran the highest evaluation. Additionally, VA is fixing a technical error with the section heading for 38 CFR 4.100 to ensure that it is applicable to all diagnostic codes that could use the general rating formula for diseases of the heart in its evaluation criteria, such as DCs 7009 and 7110. Correction In FR Rule Doc. No. 2021–19998, published September 30, 2021, at 86 FR 54089, make the following corrections: § 4.100 [Corrected] 1. On page 54093, at the top of the third column, remove the section heading ‘‘§ 4.100 Application of the evaluation criteria for diagnostic codes 7000–7007, 7011, and 7015–7020.’’ and add in its place ‘‘§ 4.100 Application of the general rating formula for diseases of the heart.’’ ■ 2. On page 54095, in § 4.104, correct Note (2) in the entry for diagnostic code 7114 ‘‘Peripheral arterial disease’’ to read as follows: ■ E:\FR\FM\09NOR1.SGM 09NOR1 62096 Federal Register / Vol. 86, No. 214 / Tuesday, November 9, 2021 / Rules and Regulations § 4.104 Schedule of ratings— cardiovascular system. * * * * * DISEASES OF THE HEART Rating 7114 * * Peripheral arterial disease: * * * * * * * * * * Note (2): If AP, TP, and TcPO2 testing are not of record, evaluate based on ABI unless the examiner states that an AP, TP, or TcPO2 test is needed in a particular case because ABI does not sufficiently reflect the severity of the veteran’s peripheral arterial disease. In all other cases, evaluate based on the test that provides the highest impairment value. * * * Jeffrey M. Martin, Assistant Director, Office of Regulation Policy & Management, Office of the Secretary, Department of Veterans Affairs. [FR Doc. 2021–24419 Filed 11–8–21; 8:45 am] BILLING CODE 8320–01–P ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA–R10–OAR–2020–0648; FRL–8787–02– R10] Air Plan Approval; AK; Eagle River Second 10-Year PM10 Limited Maintenance Plan Environmental Protection Agency (EPA). ACTION: Final rule. AGENCY: The Environmental Protection Agency (EPA) is approving the Eagle River, Alaska (AK) limited maintenance plan (LMP) submitted on November 10, 2020, by the Alaska Department of Environmental Conservation (ADEC or ‘‘the State’’). This plan addresses the second 10-year maintenance period after redesignation for particulate matter with an aerodynamic diameter less than or equal to a nominal 10 micrometers (PM10). The plan relies upon control measures contained in the first 10-year maintenance plan and the determination that the Eagle River area currently monitors PM10 levels well below the PM10 National Ambient Air Quality Standard (NAAQS or ‘‘the standard’’). The EPA is approving Alaska’s LMP as meeting Clean Air Act (CAA) requirements. DATES: This final rule is effective December 9, 2021. ADDRESSES: The EPA has established a docket for this action under Docket ID No. EPA–R10–OAR–2020–0648. All documents in the docket are listed on jspears on DSK121TN23PROD with RULES1 SUMMARY: VerDate Sep<11>2014 16:01 Nov 08, 2021 Jkt 256001 * * the https://www.regulations.gov website. Although listed in the index, some information is not publicly available, e.g., Confidential Business Information or other information the disclosure of which is restricted by statute. Certain other material, such as copyrighted material, is not placed on the internet and will be publicly available only in hard copy form. Publicly available docket materials are available at https:// www.regulations.gov, or please contact the person listed in the FOR FURTHER INFORMATION CONTACT section for additional availability information. FOR FURTHER INFORMATION CONTACT: Christi Duboiski, EPA Region 10, 1200 Sixth Avenue (Suite 155), Seattle, WA 98101, at (360) 753–9081, or duboiski.christi@epa.gov. SUPPLEMENTARY INFORMATION: Throughout this document wherever ‘‘we’’ or ‘‘our’’ is used, it refers to the EPA. I. Background On November 10, 2020, ADEC submitted to the EPA for approval a second 10-year PM10 LMP for Eagle River. The SIP revision, State effective November 7, 2020, fulfills the second 10-year planning requirement of CAA section 175A(b) to ensure PM10 NAAQS compliance through 2033. The Eagle River area has been meeting the PM10 standard for multiple years and was redesignated to attainment on March 8, 2013 with an approved 10-year PM10 maintenance plan. The area currently monitors PM10 levels well below the PM10 NAAQS. We proposed to approve the Eagle River second 10-year LMP on September 2, 2021 (86 FR 49278). The reasons for our approval are included in that proposal and will not be restated here. The public comment period for our proposed action closed on October 4, PO 00000 Frm 00016 Fmt 4700 Sfmt 4700 * * * * 2021. We received no public comments. Therefore, we are finalizing our action as proposed. II. Final Action In this final action, the EPA is approving Alaska’s second 10-year LMP for Eagle River submitted on November 10, 2020, as satisfying the requirements of section 175A of the CAA. III. Statutory and Executive Order Reviews Under the CAA, the Administrator is required to approve a SIP submission that complies with the provisions of the CAA and applicable Federal regulations. 42 U.S.C. 7410(k); 40 CFR 52.02(a). Thus, in reviewing SIP submissions, the EPA’s role is to approve state choices, provided that they meet the criteria of the CAA. Accordingly, this action merely approves State law as meeting Federal requirements and does not impose additional requirements beyond those imposed by State law. For that reason, this action: • Is not a ‘‘significant regulatory action’’ subject to review by the Office of Management and Budget under Executive Orders 12866 (58 FR 51735, October 4, 1993) and 13563 (76 FR 3821, January 21, 2011); • Does not impose an information collection burden under the provisions of the Paperwork Reduction Act (44 U.S.C. 3501 et seq.); • Is certified as not having a significant economic impact on a substantial number of small entities under the Regulatory Flexibility Act (5 U.S.C. 601 et seq.); • Does not contain any unfunded mandate or significantly or uniquely affect small governments, as described in the Unfunded Mandates Reform Act of 1995 (Pub. L. 104–4); • Does not have federalism implications as specified in Executive E:\FR\FM\09NOR1.SGM 09NOR1

Agencies

[Federal Register Volume 86, Number 214 (Tuesday, November 9, 2021)]
[Rules and Regulations]
[Pages 62095-62096]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-24419]


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DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 4

RIN 2900-AQ67


Schedule for Rating Disabilities: The Cardiovascular System

AGENCY: Department of Veterans Affairs.

ACTION: Final rule; correction.

-----------------------------------------------------------------------

SUMMARY: On September 30, 2021, the Department of Veterans Affairs (VA) 
published in the Federal Register a final rule that amended the portion 
of the VA Schedule for Rating Disabilities (``VASRD'' or ``rating 
schedule'') that addresses the cardiovascular system. This correction 
addresses the instructions for evaluating peripheral arterial disease 
in the published final rule and corrects another minor technical error.

DATES: This correction is effective November 14, 2021.

FOR FURTHER INFORMATION CONTACT:  Gary Reynolds, M.D., VASRD Program 
Management Office (210), 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 
telephone number.)

SUPPLEMENTARY INFORMATION: VA is correcting its final rule, ``RIN 2900-
AQ67, Schedule for Rating Disabilities: The Cardiovascular System'', 
that was published on September 30, 2021, in the Federal Register at 86 
FR 54089. The error is with new Note (2) for diagnostic code (DC) 7114 
peripheral arterial disease which fails to identify which of the four 
tests are necessary before an evaluation can be assigned. In the 
proposed rule, VA identified two major shortcomings in the rating 
criteria for DC 7114 that were addressed by creating evaluation 
criteria that use the ankle/brachial index (ABI), ankle pressure (AP), 
toe pressure (TP) and transcutaneous oximetry 
(TcPO2) to describe four different levels of 
impairment. See 84 FR 37594, 37599 (Aug. 1, 2019). New Note (2) 
instructed raters to select the highest impairment value of ABI, AP, 
TP, or TcPO2 for evaluation when rating a 
condition under DC 7114. Upon further consideration, we believe the 
note could be misconstrued as requiring medical examiners to conduct 
all four tests. This is inconsistent with our intent, which was to 
provide examiners with multiple options in the event that ABI was 
unreliable due to non-compressible arteries. To address this issue, we 
are correcting new Note (2) to read, ``If AP, TP, and 
TcPO2 testing are not of record, evaluate based 
on ABI unless the examiner states that an AP, TP, or 
TcPO2 test is needed in a particular case because 
ABI does not sufficiently reflect the severity of the veteran's 
peripheral arterial disease. In all other cases, evaluate based on the 
test that provides the highest impairment value.'' This correction 
serves two purposes: (1) It reflects VA's intent that although ABI 
should be the primary testing by which conditions should be rated under 
DC 7114, raters should request AP, TP, or TcPO2 
testing when the record reflects that an examiner believes ABI testing 
does not sufficiently reflect a veteran's level of impairment, and (2) 
when multiple tests are of record, it allows the rater to select the 
test result that would grant the veteran the highest evaluation.
    Additionally, VA is fixing a technical error with the section 
heading for 38 CFR 4.100 to ensure that it is applicable to all 
diagnostic codes that could use the general rating formula for diseases 
of the heart in its evaluation criteria, such as DCs 7009 and 7110.

Correction

    In FR Rule Doc. No. 2021-19998, published September 30, 2021, at 86 
FR 54089, make the following corrections:


Sec.  4.100  [Corrected]

0
1. On page 54093, at the top of the third column, remove the section 
heading ``Sec.  4.100 Application of the evaluation criteria for 
diagnostic codes 7000-7007, 7011, and 7015-7020.'' and add in its place 
``Sec.  4.100 Application of the general rating formula for diseases of 
the heart.''

0
2. On page 54095, in Sec.  4.104, correct Note (2) in the entry for 
diagnostic code 7114 ``Peripheral arterial disease'' to read as 
follows:

[[Page 62096]]

Sec.  4.104  Schedule of ratings--cardiovascular system.

* * * * *

                          Diseases of the Heart
------------------------------------------------------------------------
                                                              Rating
------------------------------------------------------------------------
 
                              * * * * * * *
7114 Peripheral arterial disease:
 
                              * * * * * * *
Note (2): If AP, TP, and TcPO2 testing are not of
 record, evaluate based on ABI unless the examiner
 states that an AP, TP, or TcPO2 test is needed in a
 particular case because ABI does not sufficiently
 reflect the severity of the veteran's peripheral
 arterial disease. In all other cases, evaluate based on
 the test that provides the highest impairment value....
 
                              * * * * * * *
------------------------------------------------------------------------


Jeffrey M. Martin,
Assistant Director, Office of Regulation Policy & Management, Office of 
the Secretary, Department of Veterans Affairs.
[FR Doc. 2021-24419 Filed 11-8-21; 8:45 am]
BILLING CODE 8320-01-P
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