Contents
- Introduction
- Rating Tables and Charts
- Weight Loss
- Steps to Determine Weight Loss
- Other Impairment - Oral Cavity and Salivary Glands
- Other Impairment - Esophagus
- Other Impairment - Stomach and Duodenum
- Other Impairment - Gastric Surgery
- Other Impairment - Small Bowel, Large Bowel, Rectum and Anus
- Other Impairment - Liver and Gallbladder
- Other Impairment - Pancreas
- Other Impairment - Miscellaneous Gastrointestinal
- Tables, Steps and Charts
- Table 14.1 Other Impairment - Oral Cavity and Salivary Glands
- Steps to Determine Gastrointestinal Oral Cavity and Salivary Glands Assessment
- Table 14.2 Other Impairment - Esophagus
- Steps to Determine Gastrointestinal Esophagus Assessment
- Table 14.3 Other Impairment - Stomach and Duodenum
- Table 14.4 Other Impairment - Gastric Surgery
- Steps to Determine Gastrointestinal Stomach and Duodenum Assessment
- Table 14.5 Other Impairment - Small Bowel, Large Bowel, Rectum and Anus
- Steps to Determine Gastrointestinal Small Bowel, Large Bowel, Rectum and Anus Assessment
- Table 14.6 Other Impairment - Liver and Gallbladder
- Steps to Determine Gastrointestinal Liver and Gallbladder Assessment
- Table 14.7 Other Impairment - Pancreas
- Steps to Determine Gastrointestinal Pancreas Assessment
- Table 14.8 Other Impairment - Gastrointestinal Miscellaneous
- Steps to Determine Miscellaneous Gastrointestinal Assessment
- Reference Chart 1 Weights by Sex, Height, and Body Build
- Reference Chart 2 BMI Chart
Introduction
This chapter provides criteria for assessing permanent impairment from entitled conditions of the gastrointestinal tract and the accessory organs of digestion (liver, gallbladder and pancreas). This chapter is also used to rate abdominal wall hernias, inguinal hernias, pilonidal sinus disease and obesity.
A rating is not given from this chapter for the conditions listed below. Each bullet indicates the appropriate chapter to be used.
- Impairment from dysphagia due to a neurological condition is rated within Chapter 20, Neurological Impairment.
- Impairment from diabetes mellitus is rated within Chapter 15, Endocrine and Metabolic Impairment.
No additional rating will be given from Chapter 22, Skin Impairment as a result of skin manifestations due to ostomies.
Impairment from malignant gastrointestinal conditions is rated within Chapter 18, Malignant Impairment. Follow the steps contained within the Malignant Impairment chapter.
Rating Tables and Charts
This chapter contains eight "Other Impairment" tables which may be used to rate entitled gastrointestinal conditions. Two reference charts are also included within this chapter. The first notes ideal weights by sex, height, and body build. The second is a body mass index chart.
The tables within this chapter give specific impairment ratings based largely on the presence of symptoms; however, most tables also contain applicable functional loss criteria (e.g. weight loss).
The tables within this chapter are:
Table | Loss of Function | Other Impairment |
---|---|---|
Table 14.1 | Other Impairment - Oral Cavity and Salivary Glands | This table is used to rate impairment of the oral cavity and salivary glands. |
Table 14.2 | Other Impairment - Esophagus | This table is used to rate impairment of the esophagus. |
Table 14.3 | Other Impairment - Stomach and Duodenum | This table is used to rate impairment of the stomach and duodenum. |
Table 14.4 | Other Impairment - Gastric Surgery | This table is used to rate impairment from past gastric surgery. |
Table 14.5 | Other Impairment - Small Bowel, Large Bowel, Rectum and Anus | This table is used to rate impairment of the small bowel, large bowel, rectum and anus. |
Table 14.6 | Other Impairment - Liver and Gallbladder | This table is used to rate impairment of the liver and gallbladder. |
Table 14.7 | Other Impairment - Pancreas | This table is used to rate impairment of the pancreas. |
Table 14.8 | Other Impairment - Miscellaneous Gastrointestinal | This table is used to rate impairment from miscellaneous gastrointestinal conditions. |
Chart 1 | Chart 1 - Weights by Sex, Height, and Body Build | This chart provides ideal weights by sex, height and body build. |
Chart 2 | Chart 2 - Body Mass Index (BMI) Chart | This is a body mass index chart. |
Weight Loss
Weight loss is an important indicator of gastrointestinal disease severity. Weight loss criteria is contained within each applicable table.
Any weight loss must be caused by the entitled condition. For VAC purposes "a loss of weight" is defined as a significant involuntary weight reduction with the inability to regain weight, despite optimal therapy.
To determine impairment resulting from gastrointestinal conditions, the pre-morbid weight (weight before the beginning or worsening of the entitled gastrointestinal condition) is measured against any deviation or weight loss.
Steps to Determine Weight Loss:
- Step 1: Determine pre-morbid weight
Pre-morbid weight may be determined from medical history or previous health records.
Where pre-morbid weight is absent, to approximate pre-morbid weight, refer to either:
Chart 1 - Weights by Sex, Height, and Body Build, or Chart 2 - the Body Mass Index (BMI) Chart and related Instructions.
- Step 2: Determine the weight at the time of the assessment.
- Step 3: Determine the weight loss by subtracting the assessment weight (Step 2) from the pre-morbid weight (Step 1) and express in terms of a percentage.
Where the weight in Step Two is equal to or greater than the pre-morbid weight, no rating based on involuntary weight loss can be given.
Where the weight in Step Two is less than the pre-morbid weight, express the difference as a percentage of the pre-morbid weight.
weight loss (pre-morbid weight - assessment weight) / pre-morbid weight X 100% = %
- Step 4: Apply the weight loss percentages to the applicable table.
Other Impairment - Oral Cavity and Salivary Glands
Table 14.1 is used to rate impairment of the oral cavity and salivary glands. Only one rating may be selected for each entitled condition. If more than one rating is applicable for an entitled condition, the ratings are compared and the highest selected.
When entitled oral cavity and salivary gland conditions result in permanent impairment of other organ systems, a consequential entitlement decision is required. If awarded, the resulting impairment of that organ system(s) will be rated using the applicable body system specific table(s).
If non-entitled conditions or conditions rated within another chapter/table of the Table of Disabilities are contributing to the overall impairment, then the Partially Contributing Table (PCT) must be applied to arrive at the rating which is due to the entitled condition(s) rated within this table.
Other Impairment - Esophagus
Table 14.2 is used to rate impairment of the esophagus. Only one rating may be selected. If more than one rating is applicable, the ratings are compared and the highest selected.
If more than one condition of the esophagus is to be rated from Table 14.2, the conditions are bracketed for assessment purposes.
When entitled conditions of the esophagus result in permanent impairment of other organ systems, a consequential entitlement decision is required. If awarded, the resulting impairment of that organ system(s) will be rated using the applicable body system specific table(s).
If non-entitled conditions or conditions rated within another chapter/table of the Table of Disabilities are contributing to the overall impairment, then the Partially Contributing Table (PCT) must be applied to arrive at the rating which is due to the entitled condition(s) rated within this table.
Other Impairment - Stomach and Duodenum
Table 14.3 is used to rate impairment of the stomach and duodenum. Only one rating may be selected. If more than one rating is applicable, the ratings are compared and the highest selected.
If more than one condition of the stomach and duodenum is to be rated from Table 14.3, the conditions are bracketed for assessment purposes.
If a Member/Veteran/Client has had gastric surgery, a rating(s) may be applicable from Table 14.4 and/or Table 14.5. Any applicable rating(s) from Table 14.4 and/or Table 14.5 must be added to the rating from this table.
When entitled stomach and duodenum conditions result in permanent impairment of other organ systems, a consequential entitlement decision is required. If awarded, the resulting impairment of that organ system(s) will be rated using the applicable body system specific table(s).
If non-entitled conditions or conditions rated within another chapter/table of the Table of Disabilities are contributing to the overall impairment, then the Partially Contributing Table (PCT) must be applied to arrive at the rating which is due to the entitled condition(s) rated within this table.
Other Impairment - Gastric Surgery
Table 14.4 is used to rate impairment from past gastric surgery. Only one rating may be selected for each condition. If more than one rating is applicable for a condition, the ratings are compared and the highest selected.
Note: Postvagotomy syndrome is rated within Table 14.5 - Other Impairment - Small Bowel, Large Bowel, Rectum and Anus.
Any applicable rating(s) from this table or Table 14.5 must be added to the impairment rating(s) from Table 14.3.
When entitled gastric conditions which require surgery result in permanent impairment of other organ systems, a consequential entitlement decision is required. If awarded, the resulting impairment of that organ system(s) will be rated using the applicable body system specific table(s).
If non-entitled conditions or conditions rated within another chapter/table of the Table of Disabilities are contributing to the overall impairment, then the Partially Contributing Table (PCT) must be applied to arrive at the rating which is due to the entitled condition(s) rated within this table.
Other Impairment - Small Bowel, Large Bowel, Rectum and Anus
Table 14.5 is used to rate impairment for each entitled condition of the small bowel, large bowel, rectum and anus. Only one rating may be selected for an entitled condition. If more than one rating is applicable, the ratings are compared and the highest selected.
For VAC purposes, bowel disorders include irritable bowel syndrome, diverticulosis, diverticulitis, chronic constipation, chronic diarrhea and postvagotomy syndrome.
Inflammatory bowel disease (IBD) ratings obtained from Table 14.5 include all intestinal manifestations of IBD as well as aphthous stomatitis, anemia and constitutional signs and symptoms such as nausea, fever and fatigue.
When entitled small bowel, large bowel, rectum and anus conditions result in permanent impairment of other organ systems, a consequential entitlement decision is required. If awarded, the resulting impairment of that organ system(s) will be rated using the applicable body system specific table(s).
If non-entitled conditions or conditions rated within another chapter/table of the Table of Disabilities are contributing to the overall impairment, then the Partially Contributing Table (PCT) must be applied to arrive at the rating which is due to the entitled condition(s) rated within this table.
Other Impairment - Liver and Gallbladder
Table 14.6 is used to rate impairment of the liver and gallbladder. Two ratings may be selected from Table 14.6, one rating for liver disease and one rating for gallbladder disease. If more than one rating is applicable for the liver, the ratings are compared and the highest selected. If more than one rating is applicable for the gallbladder, the ratings are compared and the highest selected.
If more than one condition of the liver is to be rated, the conditions are bracketed for assessment purposes.
If more than one condition of the gallbladder is to be rated, the conditions are bracketed for assessment purposes.
When entitled liver or gallbladder disease results in permanent impairment of other organ systems, a consequential entitlement decision is required. If awarded, the resulting impairment of that organ system(s) will be rated using the applicable body system specific table(s).
If non-entitled conditions or conditions rated within another chapter/table of the Table of Disabilities are contributing to the overall impairment, then the Partially Contributing Table (PCT) must be applied to arrive at the rating which is due to the entitled condition(s) rated within this table.
Other Impairment - Pancreas
Table 14.7 is used to rate impairment of the pancreas. Only one rating may be selected. If more than one rating is applicable, the ratings are compared and the highest selected.
If more than one condition of the pancreas is to be rated from Table 14.7, the conditions are bracketed for assessment purposes.
When entitled conditions of the pancreas result in diabetes mellitus, a consequential entitlement decision is required. If awarded, the resulting impairment is rated within Chapter 15, Endocrine and Metabolic Impairment.
If non-entitled conditions or conditions rated within another chapter/table of the Table of Disabilities are contributing to the overall impairment, then the Partially Contributing Table (PCT) must be applied to arrive at the rating which is due to the entitled condition(s) rated within this table.
Other Impairment - Miscellaneous Gastrointestinal
Table 14.8 is used to rate impairment of miscellaneous gastrointestinal conditions. Only one rating may be selected for each entitled condition. If more than one rating is applicable for an entitled condition, the ratings are compared and the highest selected.
For VAC purposes morbid obesity is defined as a Body Mass Index (BMI) greater than or equal to 40. Morbid obesity is rated within this table only when it is an entitled condition.
When entitled miscellaneous gastrointestinal conditions result in permanent impairment of other organ systems, a consequential entitlement decision is required. If awarded, the resulting impairment of that organ system(s) will be rated using the applicable body system specific table(s).
If non-entitled conditions or conditions rated within another chapter/table of the Table of Disabilities are contributing to the overall impairment, then the Partially Contributing Table (PCT) must be applied to arrive at the rating which is due to the entitled condition(s) rated within this table.
Table 14.1 - Other Impairment - Oral Cavity and Salivary Glands
Only one rating may be given for each entitled condition from Table 14.1. If more than one rating is applicable for an entitled condition, the ratings are compared and the highest selected.
Each bullet (•) represents one criterion. In order for a rating to be established for Table 14.1, only one criterion must be met at a level of impairment for that rating to be selected.
Rating | Criteria |
---|---|
Nil |
Conditions of the oral cavity and salivary glands:
Ingestion:
Maintenance of Nutrition:
|
Two |
Conditions of the oral cavity and salivary glands:
Maintenance of Nutrition:
|
Four |
Conditions of the oral cavity and salivary glands:
Ingestion:
|
Nine |
Maintenance of Nutrition:
|
Thirteen |
Ingestion:
Maintenance of Nutrition:
|
Eighteen |
Maintenance of Nutrition:
|
Twenty-six |
Maintenance of Nutrition:
|
Thirty-four |
Maintenance of Nutrition:
|
Forty-three |
Maintenance of Nutrition:
|
Sixty-one |
Maintenance of Nutrition:
|
Steps to Determine Gastrointestinal Oral Cavity and Salivary Glands Assessment
- Step 1: Determine the rating from Table 14.1 (Other Impairment - Oral Cavity and Salivary Glands).
- Step 2: Does the Partially Contributing Table apply? If yes, then apply to rating at Step 1.
- Step 3: Determine the Quality of Life rating.
- Step 4: Add the ratings at Step 2 and Step 3.
- Step 5: If partial entitlement exists, apply to the rating at Step 4.
This is the Disability Assessment
Note: If a condition of the oral cavity and the salivary glands both require a rating, the steps are repeated.
Table 14.2 - Other Impairment - Esophagus
Only one rating may be given from Table 14.2. If more than one rating is applicable, the ratings are compared and the highest selected.
Each bullet (•) represents one criterion. In order for a rating to be established for Table 14.2, only one criterion must be met at a level of impairment for that rating to be selected.
Rating | Criteria |
---|---|
Nil |
Conditions of the esophagus:
Ingestion:
Maintenance of Nutrition:
|
Two |
Conditions of the esophagus:
Maintenance of Nutrition:
|
Four |
Conditions of the esophagus:
Ingestion:
|
Nine |
Maintenance of Nutrition:
|
Thirteen |
Conditions of the esophagus:
Ingestion:
Maintenance of Nutrition:
|
Eighteen |
Conditions of the esophagus:
Maintenance of Nutrition:
|
Twenty-six |
Ingestion:
Maintenance of Nutrition:
|
Thirty-four |
Ingestion:
Maintenance of Nutrition:
|
Forty-three |
Maintenance of Nutrition:
|
Sixty-one |
Maintenance of Nutrition:
|
Steps to Determine Gastrointestinal Esophagus Assessment
- Step 1: Determine the rating from Table 14.2 (Other Impairment - Esophagus).
- Step 2: Does the Partially Contributing Table apply? If yes, then apply to rating at Step 1.
- Step 3: Determine the Quality of Life rating.
- Step 4: Add the ratings at Step 2 and Step 3.
- Step 5: If partial entitlement exists, apply to the rating at Step 4.
This is the Disability Assessment
Table 14.3 - Other Impairment - Stomach and Duodenum
Only one rating may be given from Table 14.3. If more than one rating is applicable, the ratings are compared and the highest selected.
Each bullet (•) represents one criterion. In order for a rating to be established for Table 14.3, only one criterion must be met at a level of impairment for that rating to be selected.
Rating | Criteria |
---|---|
Nil |
Conditions of the stomach and duodenum:
Maintenance of Nutrition:
|
Two |
Conditions of the stomach and duodenum:
Maintenance of Nutrition:
|
Four |
Conditions of the stomach and duodenum:
|
Nine |
Conditions of the stomach and duodenum:
|
Thirteen |
Conditions of the stomach and duodenum:
Maintenance of Nutrition:
|
Eighteen |
Maintenance of Nutrition:
|
Twenty-one |
Conditions of the stomach and duodenum:
|
Twenty-six |
Maintenance of Nutrition:
|
Thirty-four |
Maintenance of Nutrition:
|
Forty-three |
Maintenance of Nutrition:
|
Sixty-one |
Maintenance of Nutrition:
|
Table 14.4 - Other Impairment - Gastric Surgery
Only one rating may be given for each entitled condition from Table 14.4. If more than one rating is applicable for a condition, the ratings are compared and the highest selected.
Each bullet (•) represents one criterion. In order for a rating to be established for Table 14.4, only one criterion must be met at a level of impairment for that rating to be selected.
Rating | Criteria |
---|---|
Nil |
|
Four |
|
Nine |
|
Thirteen |
|
Note: Postvagotomy syndrome is rated within Table 14.5.
Steps to Determine Gastrointestinal Stomach and Duodenum Assessment
- Step 1: Determine the rating from Table 14.3 (Other Impairment - Stomach and Duodenum).
- Step 2: Does the Partially Contributing Table apply? If yes, then apply to rating at Step 1.
- Step 3: Determine the rating(s) from Table 14.4 (Other Impairment - Gastric Surgery) (if applicable).
Note: A rating may also be applicable for signs and symptoms of postvagotomy syndrome from the bowel disorder section of Table 14.5 (Other Impairment - Small bowel, Large bowel, Rectum and Anus). If so, applicable ratings from Table 14.4and Table 14.5 are added.
- Step 4: Does the Partially Contributing Table apply? If yes, then apply to rating at Step 3.
- Step 5: Add the ratings at Step 2 and Step 4.
- Step 6: Determine the Quality of Life rating.
- Step 7: Add the ratings at Step 5 and Step 6.
- Step 8: If partial entitlement exists, apply to the rating at Step 7.
This is the Disability Assessment
Table 14.5 - Other Impairment - Small Bowel, Large Bowel, Rectum and Anus
Only one rating may be given for each entitled condition from Table 14.5. If more than one rating is applicable for an entitled condition, the ratings are compared and the highest selected.
Each bullet (•) represents one criterion. In order for a rating to be established for Table 14.5, only one criterion must be met at a level of impairment for that rating to be selected.
Rating | Criteria |
---|---|
Nil |
Conditions of the rectum and anus:
Bowel Disorder:
Maintenance of Nutrition:
Excretion:
|
Two |
Conditions of the rectum and anus:
Bowel disorder:
Maintenance of Nutrition:
|
Four |
Conditions of the small bowel, large bowel, rectum and anus:
Bowel disorder:
Inflammatory bowel disease:
Maintenance of Nutrition:
Excretion:
|
Nine |
Conditions of the small bowel, large bowel, rectum and anus:
Bowel disorder:
Inflammatory bowel disease:
Excretion:
|
Thirteen |
Conditions of the rectum and anus:
Bowel disorder:
Inflammatory bowel disease:
Maintenance of Nutrition:
Excretion:
|
Eighteen |
Maintenance of Nutrition:
|
Twenty-six |
Inflammatory bowel disease:
Maintenance of Nutrition: Involuntary weight loss of 15 - 19%; or Excretion:
|
Thirty-four |
Maintenance of Nutrition:
Excretion:
|
Forty-three |
Inflammatory bowel disease:
Maintenance of Nutrition:
|
Sixty-one |
Maintenance of Nutrition:
|
Eighty-one |
Inflammatory bowel disease:
|
Inflammatory bowel disease associated with enterocutaneous fistula(e) are rated on individual merits.
Steps to Determine Gastrointestinal Small Bowel, Large Bowel, Rectum and Anus Assessment
- Step 1: Determine the rating from Table 14.5 (Other Impairment - Small Bowel and Large Bowel, Rectum and Anus).
- Step 2: Does the Partially Contributing Table apply? If yes, then apply to rating at Step 1.
- Step 3: Determine the Quality of Life rating.
- Step 4: Add the ratings at Step 2 and Step 3.
- Step 5: If partial entitlement exists, apply to the rating at Step 4.
This is the Disability Assessment
Note: If more than one entitled condition requires a rating, the steps must be repeated.
Table 14.6 - Other Impairment - Liver and Gallbladder
Two ratings may be selected from Table 14.6, one rating for liver disease and one rating for gallbladder disease. If more than one rating is applicable for the liver, the ratings are compared and the highest selected. If more than one rating is applicable for the gallbladder, the ratings are compared and the highest selected.
Each bullet (•) represents one criterion. In order for a rating to be established for Table 14.6, only one criterion must be met at a level of impairment for that rating to be selected.
Rating | Criteria |
---|---|
Nil |
Conditions of the liver and gallbladder:
Maintenance of Nutrition:
|
Two |
Maintenance of Nutrition:
|
Four |
Conditions of the liver and gallbladder:
Maintenance of Nutrition:
|
Nine |
Conditions of the liver and gallbladder:
|
Thirteen |
Maintenance of Nutrition:
|
Eighteen |
Conditions of the liver and gallbladder:
|
Twenty-six |
Conditions of the liver and gallbladder:
Maintenance of Nutrition:
|
Thirty-four |
Conditions of the liver and gallbladder:
Maintenance of Nutrition:
|
Forty-three |
Conditions of the liver and gallbladder:
Maintenance of Nutrition:
|
Sixty-one |
Conditions of the liver and gallbladder:
Maintenance of Nutrition: Involuntary weight loss greater than 30%. |
Eighty-one |
Conditions of the liver and gallbladder:
|
Steps to Determine Gastrointestinal Liver and Gallbladder Assessment
- Step 1: Determine the rating from Table 14.6 (Other Impairment - Liver and Gallbladder).
- Step 2: Does the Partially Contributing Table apply? If yes, then apply to rating at Step 1.
- Step 3: Determine the Quality of Life rating.
- Step 4: Add the ratings at Step 2 and Step 3.
- Step 5: If partial entitlement exists, apply to the rating at Step 4.
This is the Disability Assessment
Note: If both a liver and gallbladder condition require a rating, the steps must be repeated.
Table 14.7 - Other Impairment - Pancreas
Only one rating may be given from Table 14.7. If more than one rating is applicable, the ratings are compared and the highest selected.
Each bullet (•) represents one criterion. In order for a rating to be established for Table 14.7, only one criterion must be met at a level of impairment for that rating to be selected.
Rating | Criteria |
---|---|
Nil |
Conditions of the pancreas:
Maintenance of Nutrition:
|
One |
Conditions of the pancreas:
|
Two |
Maintenance of Nutrition:
|
Four |
Maintenance of Nutrition:
|
Nine |
Conditions of the pancreas:
|
Thirteen |
Conditions of the pancreas:
Maintenance of Nutrition:
|
Eighteen |
Conditions of the pancreas:
|
Twenty-six |
Maintenance of Nutrition:
|
Thirty-four |
Maintenance of Nutrition:
|
Forty-three |
Maintenance of Nutrition:
|
Sixty-one |
Maintenance of Nutrition:
|
* Pancreatic pseudocyst requiring surgical decompression will be rated on individual merits.
Steps to Determine Gastrointestinal Pancreas Assessment
- Step 1: Determine the rating from Table 14.7 (Other Impairment - Pancreas).
- Step 2: Does the Partially Contributing Table apply? If yes, then apply to rating at Step 1.
- Step 3: Determine the Quality of Life rating.
- Step 4: Add the ratings at Step 2 and Step 3.
- Step 5: If partial entitlement exists, apply to the rating at Step 4.
This is the Disability Assessment
Table 14.8 - Other Impairment - Gastrointestinal Miscellaneous
Only one rating may be given for each entitled condition from Table 14.8. If more than one rating is applicable for an entitled condition, the ratings are compared and the highest selected.
Each bullet (•) represents one criterion. In order for a rating to be established for Table 14.8, only one criterion must be met at a level of impairment for that rating to be selected.
Rating | Criteria |
---|---|
Nil |
• Abdominal wall hernia: asymptomatic, no pain or discomfort; or • Abdominal wall hernia: operated with no symptoms, well healed; or • Inguinal hernia: operated with no symptoms, well healed; or • Pilonidal sinus disease: asymptomatic; or • Pilonidal sinus disease: operated with no symptoms, well healed. |
Two |
• Abdominal wall hernia: resulting in slight visible protrusion only with increased abdominal pressure, occasional mild discomfort; or • Inguinal hernia: with slight visible protrusion only with increased abdominal pressure, occasional mild discomfort; or • Abdominal wall hernia: operated with ongoing discomfort, well healed scar but scar may be tender; or • Inguinal hernia: operated with ongoing discomfort, well healed scar but scar may be tender. |
Three |
• Abdominal wall hernia: resulting in visible protrusion, manually reducible, frequent discomfort which precludes heavy lifting but is able to carry out normal daily activities; or • Inguinal hernia: resulting in visible protrusion, manually reducible, frequent discomfort which precludes heavy lifting but is able to carry out normal daily activities. |
Four |
• Pilonidal sinus disease: recurrent disease with intermittent symptoms despite surgery; or • Morbid obesity: Body Mass Index (BMI) greater than or equal to 40. |
Nine |
• Abdominal wall hernia: resulting in large visible protrusion, irreducible and irreparable, persistent discomfort, limits normal activities; or • Inguinal hernia: large in size, not readily reducible and irreparable, persistent discomfort, limits normal activities; or • Pilonidal sinus disease: with chronic drainage despite surgery. |
Steps to Determine Miscellaneous Gastrointestinal Assessment
- Step 1: Determine the rating from Table 14.8 (Other Impairment - Miscellaneous - Gastrointestinal).
- Step 2: Does the Partially Contributing Table apply? If yes, then apply to rating at Step 1.
- Step 3: Determine the Quality of Life rating.
- Step 4: Add the ratings at Step 2 and Step 3.
- Step 5: If partial entitlement exists, apply to the rating at Step 4.
This is the Disability Assessment
Note: If more than one entitled condition requires a rating, the steps must be repeated.
Reference Chart 1 - Weights by Sex, Height, and Body Build
Indoor clothing weighing 2.3 kg [5 lb] for men and 1.4 kg [3 lb] for women; and shoes with 2.5 cm [1 in] heels.
Men
Height in (cm) | Weight lb (kg) | ||
---|---|---|---|
Small Frame | Medium Frame | Large Frame | |
62 (157) | 128-134 (58.0-60.7) | 131-141 (59.2-63.9) | 138-150 (62.5-67.8) |
63 (160) | 130-136 (59.0-61.7) | 133-143 (60.3-64.9) | 140-153 (63.5-69.4) |
64 (163) | 132-138 (60.0-62.7) | 135-145 (61.3-66.0) | 142-156 (64.5-71.1) |
65 (165) | 134-140 (60.8-63.5) | 137-148 (62.1-67.0) | 144-160 (65.3-72.5) |
66 (168) | 136-142 (61.8-64.6) | 139-151 (63.2-68.7) | 146-164 (66.4-74.7) |
67 (170) | 138-145 (62.5-65.7) | 142-154 (64.3-69.8) | 149-168 (67.5-76.1) |
68 (173) | 140-148 (63.6-67.3) | 145-157 (65.9-71.4) | 152-172 (69.1-78.2) |
69 (175) | 142-151 (64.3-68.3) | 148-160 (66.9-72.4) | 155-176 (70.1-79.6) |
70 (178) | 144-154 (65.4-70.0) | 151-163 (68.6-74.0) | 158-180 (71.8-81.8) |
71 (180) | 146-157 (66.1-71.0) | 154-166 (69.7-75.1) | 161-184 (72.8-83.3) |
72 (183) | 149-160 (67.7-72.7) | 157-170 (71.3-77.2) | 164-188 (74.5-85.4) |
73 (185) | 152-164 (68.7-74.1) | 160-174 (72.4-78.6) | 168-192 (75.9-86.8) |
74 (188) | 155-168 (70.3-76.2) | 164-178 (74.4-80.7) | 172-197 (78.0-89.4) |
75 (190) | 158-172 (71.4-77.6) | 167-182 (75.4-82.2) | 176-202 (79.4-91.2) |
76 (193) | 162-176 (73.5-79.8) | 171-187 (77.6-84.8) | 181-207 (82.1-93.9) |
Women
Height in (cm) | Weight lb (kg) | ||
---|---|---|---|
Small Frame | Medium Frame | Large Frame | |
58 (147) | 102-111 (46.2-50.2) | 109-121 (49.3-54.7) | 118-131 (53.3-59.3) |
59 (150) | 103-113 (46.7-51.3) | 111-123 (50.3-55.9) | 120-134 (54.4-60.9) |
60 (152) | 104-115 (47.1-52.1) | 113-126 (51.1-57.0) | 122-137 (55.2-61.9) |
61 (155) | 106-118 (48.1-53.6) | 115-129 (52.2-58.6) | 125-140 (56.8-63.6) |
62 (157) | 108-121 (48.8-54.6) | 118-132 (53.2-59.6) | 128-143 (57.8-64.6) |
63 (160) | 111-124 (50.3-56.2) | 121-135 (54.9-61.2) | 131-147 (59.4-66.7) |
64 (163) | 114-127 (51.9-57.8) | 124-138 (56.4-62.8) | 134-151 (61.0-68.8) |
65 (165) | 117-130 (53.0-58.9) | 127-141 (57.5-63.9) | 137-155 (62.0-70.2) |
66 (168) | 120-133 (54.6-60.5) | 130-144 (59.2-65.5) | 140-159 (63.7-72.4) |
67 (170) | 123-136 (55.7-61.6) | 133-147 (60.2-66.6) | 143-163 (64.8-73.8) |
68 (173) | 126-139 (57.3-63.2) | 136-150 (61.8-68.2) | 146-167 (66.4-75.9) |
69 (175) | 129-142 (58.3-64.2) | 139-153 (62.8-69.2) | 149-170 (67.4-76.9) |
70 (178) | 132-145 (60.0-65.9) | 142-156 (64.5-70.9) | 152-173 (69.0-78.6) |
71 (180) | 135-148 (61.0-66.9) | 145-159 (65.6-71.9) | 155-176 (70.1-79.6) |
72 (183) | 138-151 (62.6-68.4) | 148-162 (67.0-73.4) | 158-179 (71.6-81.2) |
Chart 2 - BMI Chart
Instructions for Use of BMI Chart
To estimate pre-morbid weight, locate the point on the chart where height and the midpoint of Zone B intersect and follow the horizontal line to determine the estimated weight. Read the number on the dashed line closest to this point.
For example, if you are 173 cm tall and you have a BMI of approximately 22 at the midpoint of Zone B, your estimated weight would be 66 kg.
You can calculate your BMI using this formula: BMI = weight(kg)/height(m2).
- Zone A = Underweight
- Zone B = Normal
- Zone C = Overweight
- Zone D = Obesity