VA Issues Proposed Rules Regarding Ratings for Neurological and Convulsive Conditions — Comments Due Jan. 13, 2025 (by Jennifer R. Morrell, Delaware Law School)

VA issued proposed rules this fall regarding the part of the Schedule for Rating Disabilities that pertains to neurological conditions and convulsive disorders. Comments are due January 13, 2025.

According to VA, the proposed changes are intended to incorporate medical advancements, update terminology, and improve the clarity of evaluation criteria. However, the proposed rule changes are based, at least in part, upon a nearly 18-year-old report from the Institute of Medicine.

Some of the changes are long overdue, such as removing the term “neuritis” from the rating schedule. Neuritis, VA explains, is an obsolete term that should be replaced by “neuropathy.”

VA proposes the inclusion of informational language to explain how disabilities from various neurological conditions are evaluated. For sensory impairment, VA proposes simplifying the evaluation criteria to either incomplete sensory deprivation or complete sensory deprivation. VA proposes updating diagnostic code 8004 to Parkinson’s Disease (from Paralysis Agitans) and adding an additional diagnostic code (8026) for Parkinson’s Plus or Secondary Parkinsonism Syndromes to reflect variations in symptoms amongst veterans and to allow for tracking of these diseases within the population.

For the diagnostic code for convulsive tic (8103), VA proposes changing the name to “hemifacial spasm,” to “provide a much more explicit indication as to the condition to be evaluated,” which is a “facial nerve disorder.” However, convulsive tic is the diagnostic code frequently used by analogy to rate Tourette syndrome, as it lacks a distinct code. This proposed change makes it all the more necessary for VA to create a separate diagnostic code for Tourette syndrome, because Tourette syndrome, in moderate and severe cases, extends far beyond simple facial tics, including such symptoms as hand movements that lead to finger deformity, various vocal tics (clicking, cursing/inappropriate speech, etc.), shoulder shrugging, limb jerking, jumping, and touching objects and/or people.

For the full proposed rule, see here. Comments are due Jan. 13, 2025.