neurological conditions and convulsive disorders

8000 Encephalitis, epidemic, chronic: As active febrile disease — 100 percent. Rate residuals, minimum — 10 percent. Brain, new growth of:

8002 Malignant — 100 percent. Note: The rating in code 8002 will be continued for 2 years following cessation of surgical, chemotherapeutic or other treatment modality. At this point, if the residuals have stabilized, the rating will be made on neurological residuals according to symptomatology. Minimum rating — 30 percent.

8003 Benign, minimum — 60 percent. Rate residuals, minimum — 10 percent.

8004 Paralysis agitans: Minimum rating — 30 percent.

8005 Bulbar palsy — 100 percent.

8007 Brain, vessels, embolism of.

8008 Brain, vessels, thrombosis of.

8009 Brain, vessels, hemorrhage from: Rate the vascular conditions under Codes 8007 through 8009, for 6 months — 100 percent. Rate residuals, thereafter, minimum — 10 percent.

8010 Myelitis: Minimum rating — 10 percent.

8011 Poliomyelitis, anterior: As active febrile disease — 100 percent. Rate residuals, minimum — 10 percent.

8012 Hematomyelia: For 6 months — 100 percent. Rate residuals, minimum — 10 percent.

8013 Syphilis, cerebrospinal.

8014 Syphilis, meningovascular.

8015 Tabes dorsalis. Note: Rate upon the severity of convulsions, paralysis, visual impairment or psychotic involvement, etc.

8017 Amyotrophic lateral sclerosis — 100 percent. Note: Consider the need for special monthly compensation.

8018 Multiple sclerosis: Minimum rating — 30 percent.

8019 Meningitis, cerebrospinal, epidemic: As active febrile disease — 100 percent. Rate residuals, minimum — 10 percent.

8020 Brain, abscess of: As active disease — 100 percent. Rate residuals, minimum — 10 percent. Spinal cord, new growths of:

8021 Malignant — 100 percent. Note: The rating in code 8021 will be continued for 2 years following cessation of surgical, chemotherapeutic or other treatment modality. At this point, if the residuals have stabilized, the rating will be made on neurological residuals according to symptomatology. Minimum rating — 30 percent.

8022 Benign, minimum rating — 60 percent. Rate residuals, minimum — 10 percent.

8023 Progressive muscular atrophy: Minimum rating — 30 percent.

8024 Syringomyelia: Minimum rating — 30 percent.

8025 Myasthenia gravis: Minimum rating — 30 percent. Note: It is required for the minimum ratings for residuals under diagnostic codes 8000-8025, that there be ascertainable residuals. Determinations as to the presence of residuals not capable of objective verification, i.e., headaches, dizziness, fatigability, must be approached on the basis of the diagnosis recorded; subjective residuals will be accepted when consistent with the disease and not more likely attributable to other disease or no disease. It is of exceptional importance that when ratings in excess of the prescribed minimum ratings are assigned, the diagnostic codes utilized as bases of evaluation be cited, in addition to the codes identifying the diagnoses.

8045 Residuals of traumatic brain injury (TBI): There are three main areas of dysfunction that may result from TBI and have profound effects on functioning: cognitive (which is common in varying degrees after TBI), emotional/behavioral, and physical. Each of these areas of dysfunction may require evaluation. Cognitive impairment is defined as decreased memory, concentration, attention, and executive functions of the brain. Executive functions are goal setting, speed of information processing, planning, organizing, prioritizing, self-monitoring, problem solving, judgment, decision making, spontaneity, and flexibility in changing actions when they are not productive. Not all of these brain functions may be affected in a given individual with cognitive impairment, and some functions may be affected more severely than others. In a given individual, symptoms may fluctuate in severity from day to day. Evaluate cognitive impairment under the table titled “Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified.” Subjective symptoms may be the only residual of TBI or may be associated with cognitive impairment or other areas of dysfunction. Evaluate subjective symptoms that are residuals of TBI, whether or not they are part of cognitive impairment, under the subjective symptoms facet in the table titled “Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified.” However, separately evaluate any residual with a distinct diagnosis that may be evaluated under another diagnostic code, such as migraine headache or Meniere's disease, even if that diagnosis is based on subjective symptoms, rather than under the “Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified” table Evaluate emotional/behavioral dysfunction under § 4.130 (Schedule of ratings—mental disorders) when there is a diagnosis of a mental disorder. When there is no diagnosis of a mental disorder, evaluate emotional/behavioral symptoms under the criteria in the table titled “Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified.” Evaluate physical (including neurological) dysfunction based on the following list, under an appropriate diagnostic code: Motor and sensory dysfunction, including pain, of the extremities and face; visual impairment; hearing loss and tinnitus; loss of sense of smell and taste; seizures; gait, coordination, and balance problems; speech and other communication difficulties, including aphasia and related disorders, and dysarthria; neurogenic bladder; neurogenic bowel; cranial nerve dysfunctions; autonomic nerve dysfunctions; and endocrine dysfunctions. The preceding list of types of physical dysfunction does not encompass all possible residuals of TBI. For residuals not listed here that are reported on an examination, evaluate under the most appropriate diagnostic code. Evaluate each condition separately, as long as the same signs and symptoms are not used to support more than one evaluation, and combine under § 4.25 the evaluations for each separately rated condition. The evaluation assigned based on the “Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified” table will be considered the evaluation for a single condition for purposes of combining with other disability evaluations Consider the need for special monthly compensation for such problems as loss of use of an extremity, certain sensory impairments, erectile dysfunction, the need for aid and attendance (including for protection from hazards or dangers incident to the daily environment due to cognitive impairment), being housebound, etc Evaluation of Cognitive Impairment and Subjective Symptoms The table titled “Evaluation of Cognitive Impairment and Other Residuals of TBI Not Otherwise Classified” contains 10 important facets of TBI related to cognitive impairment and subjective symptoms. It provides criteria for levels of impairment for each facet, as appropriate, ranging from 0 to 3, and a 5th level, the highest level of impairment, labeled “total.” However, not every facet has every level of severity. The Consciousness facet, for example, does not provide for an impairment level other than “total,” since any level of impaired consciousness would be totally disabling. Assign a 100-percent evaluation if “total” is the level of evaluation for one or more facets. If no facet is evaluated as “total,” assign the overall percentage evaluation based on the level of the highest facet as follows: 0 = 0 percent; 1 = 10 percent; 2 = 40 percent; and 3 = 70 percent. For example, assign a 70 percent evaluation if 3 is the highest level of evaluation for any facet. Note (1): There may be an overlap of manifestations of conditions evaluated under the table titled “Evaluation Of Cognitive Impairment And Other Residuals Of TBI Not Otherwise Classified” with manifestations of a comorbid mental or neurologic or other physical disorder that can be separately evaluated under another diagnostic code. In such cases, do not assign more than one evaluation based on the same manifestations. If the manifestations of two or more conditions cannot be clearly separated, assign a single evaluation under whichever set of diagnostic criteria allows the better assessment of overall impaired functioning due to both conditions. However, if the manifestations are clearly separable, assign a separate evaluation for each condition. Note (2): Symptoms listed as examples at certain evaluation levels in the table are only examples and are not symptoms that must be present in order to assign a particular evaluation. Note (3): “Instrumental activities of daily living” refers to activities other than self-care that are needed for independent living, such as meal preparation, doing housework and other chores, shopping, traveling, doing laundry, being responsible for one's own medications, and using a telephone. These activities are distinguished from “Activities of daily living,” which refers to basic self-care and includes bathing or showering, dressing, eating, getting in or out of bed or a chair, and using the toilet. Note (4): The terms “mild,” “moderate,” and “severe” TBI, which may appear in medical records, refer to a classification of TBI made at, or close to, the time of injury rather than to the current level of functioning. This classification does not affect the rating assigned under diagnostic code 8045. Note (5): A veteran whose residuals of TBI are rated under a version of § 4.124a, diagnostic code 8045, in effect before October 23, 2008 may request review under diagnostic code 8045, irrespective of whether his or her disability has worsened since the last review. VA will review that veteran's disability rating to determine whether the veteran may be entitled to a higher disability rating under diagnostic code 8045. A request for review pursuant to this note will be treated as a claim for an increased rating for purposes of determining the effective date of an increased rating awarded as a result of such review; however, in no case will the award be effective before October 23, 2008. For the purposes of determining the effective date of an increased rating awarded as a result of such review, VA will apply 38 CFR 3.114, if applicable.

8046 Cerebral arteriosclerosis: Purely neurological disabilities, such as hemiplegia, cranial nerve paralysis, etc., due to cerebral arteriosclerosis will be rated under the diagnostic codes dealing with such specific disabilities, with citation of a hyphenated diagnostic code (e.g., 8046-8207). Purely subjective complaints such as headache, dizziness, tinnitus, insomnia and irritability, recognized as symptomatic of a properly diagnosed cerebral arteriosclerosis, will be rated 10 percent and no more under diagnostic code 9305. This 10 percent rating will not be combined with any other rating for a disability due to cerebral or generalized arteriosclerosis. Ratings in excess of 10 percent for cerebral arteriosclerosis under diagnostic code 9305 are not assignable in the absence of a diagnosis of multi-infarct dementia with cerebral arteriosclerosis. Note: The ratings under code 8046 apply only when the diagnosis of cerebral arteriosclerosis is substantiated by the entire clinical picture and not solely on findings of retinal arteriosclerosis.

8100 Migraine: With very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability — 50 percent. With characteristic prostrating attacks occurring on an average once a month over last several months — 30 percent. With characteristic prostrating attacks averaging one in 2 months over last several months — 10 percent. With less frequent attacks — 0 percent.

8103 Tic, convulsive: Severe — 30 percent. Moderate — 10 percent. Mild — 0 percent. Note: Depending upon frequency, severity, muscle groups involved.

8104 Paramyoclonus multiplex (convulsive state, myoclonic type): Rate as tic; convulsive; severe cases — 60 percent.

8105 Chorea, Sydenham's: Pronounced, progressive grave types — 100 percent. Severe — 80 percent. Moderately severe — 50 percent. Moderate — 30 percent. Mild — 10 percent. Note: Consider rheumatic etiology and complications.

8106 Chorea, Huntington's. Rate as Sydenham's chorea. This, though a familial disease, has its onset in late adult life, and is considered a ratable disability.

8107 Athetosis, acquired. Rate as chorea.

8108 Narcolepsy. Rate as for epilepsy, petit mal.

8205 Paralysis of: Complete — 50 percent. Incomplete, severe — 30 percent. Incomplete, moderate — 10 percent. Note: Dependent upon relative degree of sensory manifestation or motor loss.

8207 Paralysis of: Complete — 30 percent. Incomplete, severe — 20 percent. Incomplete, moderate — 10 percent. Note: Dependent upon relative loss of innervation of facial muscles.

8209 Paralysis of: Complete — 30 percent. Incomplete, severe — 20 percent. Incomplete, moderate — 10 percent. Note: Dependent upon relative loss of ordinary sensation in mucous membrane of the pharynx, fauces, and tonsils.

8210 Paralysis of: Complete — 50 percent. Incomplete, severe — 30 percent. Incomplete, moderate — 10 percent. Note : Dependent upon extent of sensory and motor loss to organs of voice, respiration, pharynx, stomach and heart.

8211 Paralysis of: Complete — 30 percent. Incomplete, severe — 20 percent. Incomplete, moderate — 10 percent. Note: Dependent upon loss of motor function of sternomastoid and trapezius muscles.

8212 Paralysis of: Complete — 50 percent. Incomplete, severe — 30 percent. Incomplete, moderate — 10 percent. Note: Dependent upon loss of motor function of tongue.

8305 Neuritis.

8307 Neuritis.

8309 Neuritis.

8310 Neuritis.

8311 Neuritis.

8312 Neuritis.

8405 Neuralgia. Note: Tic douloureux may be rated in accordance with severity, up to complete paralysis. Seventh (facial) cranial nerve

8407 Neuralgia. Ninth (glossopharyngeal) cranial nerve

8409 Neuralgia. Tenth (pneumogastric, vagus) cranial nerve

8410 Neuralgia. Eleventh (spinal accessory, external branch) cranial nerve.

8411 Neuralgia. Twelfth (hypoglossal) cranial nerve.

8412 Neuralgia.

8510 Paralysis of: Complete; all shoulder and elbow movements lost or severely affected, hand and wrist movements not affected — 60 percent. Incomplete: Severe — 40 percent. Moderate — 30 percent. Mild — 20 percent.

8511 Paralysis of: Complete; adduction, abduction and rotation of arm, flexion of elbow, and extension of wrist lost or severely affected — 60 percent. Incomplete: Severe — 40 percent. Moderate — 30 percent. Mild — 20 percent.

8512 Paralysis of: Complete; all intrinsic muscles of hand, and some or all of flexors of wrist and fingers, paralyzed (substantial loss of use of hand) — 60 percent. Incomplete: Severe — 40 percent. Moderate — 30 percent. Mild — 20 percent.

8513 Paralysis of: Complete — 80 percent. Incomplete: Severe — 60 percent. Moderate — 30 percent. Mild — 20 percent.

8514 Paralysis of: Complete; drop of hand and fingers, wrist and fingers perpetually flexed, the thumb adducted falling within the line of the outer border of the index finger; can not extend hand at wrist, extend proximal phalanges of fingers, extend thumb, or make lateral movement of wrist; supination of hand, extension and flexion of elbow weakened, the loss of synergic motion of extensors impairs the hand grip seriously; total paralysis of the triceps occurs only as the greatest rarity — 60 percent. Incomplete: Severe — 40 percent. Moderate — 20 percent. Mild — 20 percent.

8515 Paralysis of: Complete; the hand inclined to the ulnar side, the index and middle fingers more extended than normally, considerable atrophy of the muscles of the thenar eminence, the thumb in the plane of the hand (ape hand); pronation incomplete and defective, absence of flexion of index finger and feeble flexion of middle finger, cannot make a fist, index and middle fingers remain extended; cannot flex distal phalanx of thumb, defective opposition and abduction of the thumb, at right angles to palm; flexion of wrist weakened; pain with trophic disturbances — 60 percent. Incomplete: Severe — 40 percent. Moderate — 20 percent. Mild — 10 percent.

8516 Paralysis of: Complete; the “griffin claw” deformity, due to flexor contraction of ring and little fingers, atrophy very marked in dorsal interspace and thenar and hypothenar eminences; loss of extension of ring and little fingers cannot spread the fingers (or reverse), cannot adduct the thumb; flexion of wrist weakened — 50 percent. Incomplete: Severe — 30 percent. Moderate — 20 percent. Mild — 10 percent.

8517 Paralysis of: Complete; weakness but not loss of flexion of elbow and supination of forearm — 20 percent. Incomplete: Severe — 20 percent. Moderate — 10 percent. Mild — 0 percent.

8518 Paralysis of: Complete; abduction of arm is impossible, outward rotation is weakened; muscles supplied are deltoid and teres minor — 40 percent. Incomplete: Severe — 20 percent. Moderate — 10 percent. Mild — 0 percent.

8519 Paralysis of: Complete; inability to raise arm above shoulder level, winged scapula deformity — 20 percent. Incomplete: Severe — 20 percent. Moderate — 10 percent. Mild — 0 percent. Note: Not to be combined with lost motion above shoulder level.

8520 Paralysis of: Complete; the foot dangles and drops, no active movement possible of muscles below the knee, flexion of knee weakened or (very rarely) lost — 80 percent. Incomplete: Severe, with marked muscular atrophy — 60 percent. Moderately severe — 40 percent. Moderate — 20 percent. Mild — 10 percent.

8521 Paralysis of: Complete; foot drop and slight droop of first phalanges of all toes, cannot dorsiflex the foot, extension (dorsal flexion) of proximal phalanges of toes lost; abduction of foot lost, adduction weakened; anesthesia covers entire dorsum of foot and toes — 40 percent. Incomplete: Severe — 30 percent. Moderate — 20 percent. Mild — 10 percent.

8522 Paralysis of: Complete; eversion of foot weakened — 30 percent. Incomplete: Severe — 20 percent. Moderate — 10 percent. Mild — 0 percent.

8523 Paralysis of: Complete; dorsal flexion of foot lost — 30 percent. Incomplete: Severe — 20 percent. Moderate — 10 percent. Mild — 0 percent.

8524 Paralysis of: Complete; plantar flexion lost, frank adduction of foot impossible, flexion and separation of toes abolished; no muscle in sole can move; in lesions of the nerve high in popliteal fossa, plantar flexion of foot is lost — 40 percent. Incomplete: Severe — 30 percent. Moderate — 20 percent. Mild — 10 percent.

8525 Paralysis of: Complete; paralysis of all muscles of sole of foot, frequently with painful paralysis of a causalgic nature; toes cannot be flexed; adduction is weakened; plantar flexion is impaired — 30 percent. Incomplete: Severe — 20 percent. Moderate — 10 percent. Mild — 10 percent.

8526 Paralysis of: Complete; paralysis of quadriceps extensor muscles — 40 percent. Incomplete: Severe — 30 percent. Moderate — 20 percent. Mild — 10 percent.

8527 Paralysis of: Severe to complete — 10 percent. Mild to moderate — 0 percent.

8528 Paralysis of: Severe to complete — 10 percent. Mild or moderate — 0 percent.

8529 Paralysis of: Severe to complete — 10 percent. Mild or moderate — 0 percent.

8530 Paralysis of: Severe to complete — 10 percent. Mild or moderate — 0 percent.

8540 Soft-tissue sarcoma (of neurogenic origin) — 100 percent. Note: The 100 percent rating will be continued for 6 months following the cessation of surgical, X-ray, antineoplastic chemotherapy or other therapeutic procedure. At this point, if there has been no local recurrence or metastases, the rating will be made on residuals.

8610 Neuritis.

8611 Neuritis.

8612 Neuritis.

8613 Neuritis.

8614 Neuritis.

8615 Neuritis.

8616 Neuritis.

8617 Neuritis.

8618 Neuritis.

8619 Neuritis.

8620 Neuritis.

8621 Neuritis.

8622 Neuritis.

8623 Neuritis.

8624 Neuritis.

8625 Neuritis.

8626 Neuritis.

8627 Neuritis.

8628 Neuritis.

8629 Neuritis.

8630 Neuritis.

8710 Neuralgia. Middle radicular group

8711 Neuralgia. Lower radicular group

8712 Neuralgia. All radicular groups

8713 Neuralgia. The musculospiral nerve (radial nerve)

8714 Neuralgia. Note: Lesions involving only “dissociation of extensor communis digitorum” and “paralysis below the extensor communis digitorum,” will not exceed the moderate rating under code 8514. The median nerve

8715 Neuralgia. The ulnar nerve

8716 Neuralgia. Musculocutaneous nerve

8717 Neuralgia. Circumflex nerve

8718 Neuralgia. Long thoracic nerve

8719 Neuralgia. Note: Combined nerve injuries should be rated by reference to the major involvement, or if sufficient in extent, consider radicular group ratings.

8720 Neuralgia. External popliteal nerve (common peroneal)

8721 Neuralgia. Musculocutaneous nerve (superficial peroneal)

8722 Neuralgia. Anterior tibial nerve (deep peroneal)

8723 Neuralgia. Internal popliteal nerve (tibial)

8724 Neuralgia. Posterior tibial nerve

8725 Neuralgia. Anterior crural nerve (femoral)

8726 Neuralgia. Internal saphenous nerve

8727 Neuralgia. Obturator nerve

8728 Neuralgia. External cutaneous nerve of thigh

8729 Neuralgia. Ilio-inguinal nerve

8730 Neuralgia.

8910 Epilepsy, grand mal. Rate under the general rating formula for major seizures.

8911 Epilepsy, petit mal. Rate under the general rating formula for minor seizures. Note (1): A major seizure is characterized by the generalized tonic-clonic convulsion with unconsciousness. Note (2): A minor seizure consists of a brief interruption in consciousness or conscious control associated with staring or rhythmic blinking of the eyes or nodding of the head (“pure” petit mal), or sudden jerking movements of the arms, trunk, or head (myoclonic type) or sudden loss of postural control (akinetic type).

8912 Epilepsy, Jacksonian and focal motor or sensory.

General Rating Formula for Major and Minor Epileptic Seizures: Averaging at least 1 major seizure per month over the last year — 100 percent. Averaging at least 1 major seizure in 3 months over the last year; or more than 10 minor seizures weekly — 80 percent. Averaging at least 1 major seizure in 4 months over the last year; or 9-10 minor seizures per week — 60 percent. At least 1 major seizure in the last 6 months or 2 in the last year; or averaging at least 5 to 8 minor seizures weekly — 40 percent. At least 1 major seizure in the last 2 years; or at least 2 minor seizures in the last 6 months — 20 percent. A confirmed diagnosis of epilepsy with a history of seizures — 10 percent. Note (1): When continuous medication is shown necessary for the control of epilepsy, the minimum evaluation will be 10 percent. This rating will not be combined with any other rating for epilepsy. Note (2): In the presence of major and minor seizures, rate the predominating type. Note (3): There will be no distinction between diurnal and nocturnal major seizures.

8913 Epilepsy, diencephalic. Rate as minor seizures, except in the presence of major and minor seizures, rate the predominating type.

General Rating Formula for Major and Minor Epileptic Seizures: Averaging at least 1 major seizure per month over the last year — 100 percent. Averaging at least 1 major seizure in 3 months over the last year; or more than 10 minor seizures weekly — 80 percent. Averaging at least 1 major seizure in 4 months over the last year; or 9-10 minor seizures per week — 60 percent. At least 1 major seizure in the last 6 months or 2 in the last year; or averaging at least 5 to 8 minor seizures weekly — 40 percent. At least 1 major seizure in the last 2 years; or at least 2 minor seizures in the last 6 months — 20 percent. A confirmed diagnosis of epilepsy with a history of seizures — 10 percent. Note (1): When continuous medication is shown necessary for the control of epilepsy, the minimum evaluation will be 10 percent. This rating will not be combined with any other rating for epilepsy. Note (2): In the presence of major and minor seizures, rate the predominating type. Note (3): There will be no distinction between diurnal and nocturnal major seizures.

8914 Epilepsy, psychomotor. Major seizures: Psychomotor seizures will be rated as major seizures under the general rating formula when characterized by automatic states and/or generalized convulsions with unconsciousness. Minor seizures: Psychomotor seizures will be rated as minor seizures under the general rating formula when characterized by brief transient episodes of random motor movements, hallucinations, perceptual illusions, abnormalities of thinking, memory or mood, or autonomic disturbances. Mental Disorders in Epilepsies: A nonpsychotic organic brain syndrome will be rated separately under the appropriate diagnostic code (e.g., 9304 or 9326). In the absence of a diagnosis of non-psychotic organic psychiatric disturbance (psychotic, psychoneurotic or personality disorder) if diagnosed and shown to be secondary to or directly associated with epilepsy will be rated separately. The psychotic or psychroneurotic disorder will be rated under the appropriate diagnostic code. The personality disorder will be rated as a dementia (e.g., diagnostic code 9304 or 9326). Epilepsy and Unemployability: (1) Rating specialists must bear in mind that the epileptic, although his or her seizures are controlled, may find employment and rehabilitation difficult of attainment due to employer reluctance to the hiring of the epileptic. (2) Where a case is encountered with a definite history of unemployment, full and complete development should be undertaken to ascertain whether the epilepsy is the determining factor in his or her inability to obtain employment. (3) The assent of the claimant should first be obtained for permission to conduct this economic and social survey. The purpose of this survey is to secure all the relevant facts and data necessary to permit of a true judgment as to the reason for his or her unemployment and should include information as to: (a) Education; (b) Occupations prior and subsequent to service; (c) Places of employment and reasons for termination; (d) Wages received; (e) Number of seizures. (4) Upon completion of this survey and current examination, the case should have rating board consideration. Where in the judgment of the rating board the veteran's unemployability is due to epilepsy and jurisdiction is not vested in that body by reason of schedular evaluations, the case should be submitted to the Compensation Service or the Director, Pension and Fiduciary Service.

General Rating Formula for Major and Minor Epileptic Seizures: Averaging at least 1 major seizure per month over the last year — 100 percent. Averaging at least 1 major seizure in 3 months over the last year; or more than 10 minor seizures weekly — 80 percent. Averaging at least 1 major seizure in 4 months over the last year; or 9-10 minor seizures per week — 60 percent. At least 1 major seizure in the last 6 months or 2 in the last year; or averaging at least 5 to 8 minor seizures weekly — 40 percent. At least 1 major seizure in the last 2 years; or at least 2 minor seizures in the last 6 months — 20 percent. A confirmed diagnosis of epilepsy with a history of seizures — 10 percent. Note (1): When continuous medication is shown necessary for the control of epilepsy, the minimum evaluation will be 10 percent. This rating will not be combined with any other rating for epilepsy. Note (2): In the presence of major and minor seizures, rate the predominating type. Note (3): There will be no distinction between diurnal and nocturnal major seizures.