38 C.F.R. § 4.68
Amputation rule
The combined rating for disabilities of an extremity shall not exceed the rating for the amputation at the elective level, were amputation to be performed. For example, the combined evaluations for disabilities below the knee shall not exceed the 40 percent evaluation, diagnostic code 5165. This 40 percent rating may be further combined with evaluation for disabilities above the knee but not to exceed the above the knee amputation elective level. Painful neuroma of a stump after amputation shall be assigned the evaluation for the elective site of reamputation.
Notes of Decisions
Cited in 13
cases, 1992–2020 · leading case: Moyer v. Derwinski, 2 Vet. App. 289 (Vet. App. 1992).
Moyer v. Derwinski, 2 Vet. App. 289 (Vet. App. 1992). “38 C.F.R. § 4.68 . The BVA concluded, however, that the combined rating did not warrant an 80% disability, the maximum allowable under 38 C.”
Seals v. Brown, 8 Vet. App. 291 (Vet. App. 1995). “The BVA appeared to indicate that the issue of a higher rating for the light ankle is moot because the veteran already has a combined rating of 40% for the right foot (including the 20% rating for osteo-myelitis), and because the rating cannot be higher due to the “amputation…”
Hrvatin v. Principi, 3 Vet. App. 426 (Vet. App. 1992). “Under the amputation rule, contained in 38 C.F.R. § 4.68 (1991), “[t]he combined rating for disabilities of an extremity shall not exceed the rating for the amputation at the elective level, were amputation to be performed.”
08-23 090 (Board of Vet. App. 2017). “38 C.F.R. § 4.68 . In this case, the Amputation Rule precludes a rating in excess of 40 percent for any pathology involving the ankle.”
08-04 749 (Board of Vet. App. 2017). “38 C.F.R. § 4.68 (2016). Thus, the highest evaluation that may be assigned under the amputation rule, for the knee, is 60 percent.”
09-30 895 (Board of Vet. App. 2017). “38 C.F.R. § 4.68 . Amputation of the thigh is rated 60 percent disabling.”
14-18 262 (Board of Vet. App. 2016). “38 C.F.R. § 4.68 (2015). Thus, the highest evaluation that may be assigned under the amputation rule, for the knee, is 60 percent.”
12-21 239 (Board of Vet. App. 2018). “See 38 C.F.R. § 4.68 , the combined rating for disabilities of an extremity shall not exceed the rating for the amputation at the elective level, were amputation to be performed.”
08-36 778 (Board of Vet. App. 2018). “Diagnostic Code 7804 also directs the rater to see 38 C.F.R. § 4.68 (amputation rule). 38 C.”
191121-44744 (Board of Vet. App. 2020). “38 C.F.R. § 4.68 (Amputation rule). For a higher rating to be assigned, the evidence needs to show that the Veteran’s left thumb was amputated with metacarpal resection.”
13-03 789 (Board of Vet. App. 2015). “38 C.F.R. § 4.68 (2014). In both initial rating claims and normal increased rating claims, the Board must discuss whether "staged ratings" are warranted, and if not, why not.”
12-20 070 (Board of Vet. App. 2015). “The Board notes that consideration of entitlement to a higher rating is subject to 38 C.F.R. § 4.68 (i.e., the amputation rule) (the combined rating for disabilities of an extremity shall not exceed the rating for amputation of the extremity at the elective level, were…”
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