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8000
§ 4.124a Schedule of ratings—neurological conditions and convulsive disorders.

Encephalitis lethargica residuals

Residual neurological deficits from encephalitis lethargica (sleeping sickness)

What the rating means

VA rates chronic epidemic encephalitis under diagnostic code 8000. During an active febrile episode of the disease, the rating is 100%. Once the active phase has resolved, VA rates the residual effects left behind rather than the disease itself. The minimum rating for residuals is 10%.

Because the regulation does not set out specific percentage levels for each type of residual symptom under this code, VA rates the residuals by analogy to the conditions they most closely resemble. Cognitive and behavioral effects — such as problems with memory, attention, judgment, orientation, communication, social interaction, motor activity, visual spatial orientation, subjective symptoms, and neurobehavioral effects — are evaluated using a detailed table that assigns levels from 0 to 3, or a "Total" level, within each symptom category. The overall disability rating is then drawn from a combination of those levels. Cranial nerve and peripheral nerve involvement, if present, are rated separately under their own schedules and, when bilateral, are combined without applying the bilateral factor for cranial nerves, or with the bilateral factor for peripheral nerves.

Evidence that helps

To show the active febrile phase, medical records documenting fever, hospitalization, and the treating provider's diagnosis during that period would be relevant.

For residuals, the evidence that matters depends on which symptoms you have. For cognitive effects — memory loss, poor attention, impaired judgment, disorientation, or communication difficulties — neuropsychological test results showing objective impairment carry weight, as do records describing the degree to which those impairments affect daily functioning. For neurobehavioral effects such as irritability, impulsivity, or verbal aggression, treatment notes and statements from people who observe you at home or work can reflect how often those effects interfere with workplace or social interaction.

For subjective symptoms like headaches, dizziness, or fatigue, medical records that describe frequency and severity, as well as your own statements explaining how those symptoms affect your ability to work or manage daily tasks, can help show which level of the rating criteria applies. Motor activity and visual spatial problems would be supported by examination findings and descriptions of specific limitations in daily activities.

Secondary conditions

Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.