A Proposed Rule by the Veterans Affairs Department on 02/05/2019 (US format - UK format 05/02/2019)

Source: U.S. Federal Register

Vol. 84, #24, p 1678-1690

Date: February 5, 2019

URL:
https://www.federalregister.gov/doc...immune-disorders-and-nutritional-deficiencies

https://www.govinfo.gov/content/pkg/FR-2019-02-05/pdf/2019-00636.pdf

[A Proposed Rule by the Veterans Affairs Department]

Schedule for Rating Disabilities: Infectious Diseases, Immune Disorders, and Nutritional Deficiencies
----------------------------------------------------------

AGENCY:

Department of Veterans Affairs.

ACTION:

Proposed rule.

SUMMARY:

The Department of Veterans Affairs (VA) proposes to amend the section of the VA Schedule for Rating Disabilities (VASRD or Rating Schedule) that addresses infectious diseases and immune disorders. The purpose of these changes is to incorporate medical advances since the last revision, update medical terminology, and clarify evaluation criteria. The proposed rule considers comments from experts and the public during a forum held from January 31 to February 1, 2011, on revising this section of the VASRD.

DATES:

Comments must be received by VA on or before April 8, 2019.

ADDRESSES:

Written comments may be submitted through www.regulations.gov; by mail or hand-delivery to Director, Regulation Policy and Management (00REG), Department of Veterans Affairs, 810 Vermont Ave. NW, Room 1063B, Washington, DC 20420; or by fax to (202) 273-9026. (This is not a toll free number.) Comments should indicate that they are submitted in response to 'RIN 2900-AQ43-Schedule for Rating Disabilities: Infectious Diseases, Immune Disorders, and Nutritional Deficiencies.' Copies of comments received will be available for public inspection in the Office of Regulation Policy and Management, Room 1063B, between the hours of 8 a.m. and 4:30 p.m., Monday through Friday (except holidays). Please call (202) 461-4902 for an appointment. (This is not a toll free number.) In addition, during the comment period, comments may be viewed online through the Federal Docket Management System (FDMS) at

www.Regulations.gov.

FOR FURTHER INFORMATION CONTACT:

Ioulia Vvedenskaya, M.D., M.B.A., Medical Officer, Part 4 VASRD Regulations Staff (211C), Compensation Service, Veterans Benefits Administration, Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420, (202) 461-9700. (This is not a toll-free telephone number.)

 

this is not good, they plan to remove ME

@JaimeS

eta: I, and I imagine a lot of others, would rather see CFS removed

 

It's odd that they want the SEID name but the Fukuda criteria? Surely that's a mistake?

 

I did not experience significant fatigue until years into. Or, well, I did but it was ordinary fatigue, the kind that is easy to brush off and has nothing to do with the flu-like heavy crushing "fatigue" of flu-like symptoms.

We can't even have the most basic definitions right. Not sure if this is genuine progress.

 

So SEID but actually Fukuda?

This is the Fukuda criteria.

 

"We have fully updated and modernized our criteria to [checks clipboard] the 1990s criteria."

"Additionally, we have chosen to call it by a completely different name."

Ok?

 

I've been asked to reduce the size of the entry, but you should be able to read it all at the link, although unfortunately not edited for ME as the entry was.

 

https://s4me.info/threads/usa-nchs-cdc-proposal-for-icd-10-cm-adding-seid.5929/page-9#post-143598

 

Latest release of SNOMED CT US Edition posted:

The March 01, 2019 release of SNOMED CT US Edition was posted today on the SNOMED CT browser platform.

I can confirm that no new SNOMED CT Concept code or Synonym term under an existing SNOMED CT Concept code for either "Systemic exertion intolerance disease" or "SEID - Systemic exertion intolerance disease" has been added to the US Edition's March release.

The US Edition posts a release twice yearly. The next release for the US Edition will be the September 01, 2019 release.

The US release can be accessed from this page - click on the blue button for "Go browsing United States edition 2019-03-01" https://browser.ihtsdotools.org/

 

Are they dreaming?

 

You rarely even see a "licensed physician" there anymore in primary care. They have figured out it is cheaper to use PAs and treating pharmacists (forgot the exact name). Since it is a federal facility, they can make up whatever exceptions they choose. Even the civilian contracted opticians in my state are allowed to operate on federal property without a license, but a license is required by the state for operation of an optical business.

Source: I was a licensed optician before I became to ill to work and filled in at the VA. Found out the guy who runs the dispensary is unlicensed and was told that is how it works.

 

has this shift already started in the States?
spotted it on one of the slides at the OMF conference (June 8th)






eta:
taken from this tweet

 

The outcome (if any) of the proposals under discussion at the September 2018 ICD-10-CM Coordination and Maintenance Committee for potentially adding SEID to ICD-10-CM isn't known yet.

Whose slide presentation is in your image?

 

The FY 2020 release for ICD-10-CM is scheduled to be posted at some point this month.

 

If SEID has not been included in the FY 2020 release of ICD-10-CM, then one of the following applies:

a) no decision was made by NCHS Director on the proposals presented at the September 2018 meeting and the topic has been left hanging;

or

b) no decision was made by NCHS Director on the proposals presented at the September 2018 meeting and proposals are intended to be re-presented for further discussion, potentially with proposed amendments, at the September 2019 meeting or at some future C & M Committee meeting.

or

c) the proposals presented at the September 2018 and the comments received during the public review period were considered by the NCHS Director and the proposals were not approved.


The next meeting of the NCHS/CDC C & M Committee will be September 10-11, 2019.


Edited to insert c).

 

A few clinical guidance providers initially used the name "CFS/SEID" when the IOM report came out but have since changed to ME/CFS. The VA recently used the name "SEID/CFS" in a rule change they were proposing (which also proposed using Fukuda) but I will be surprised if its accepted. And it appears that a few doctors have used the term "SEID" in medical records

At this point, CDC, NIH, and many/most US medical ed providers use the term ME/CFS while some (e.g. Mayo) still use CFS.

 

See also thread:

USA - NCHS/CDC Proposal for ICD-10-CM - adding SEID

https://s4me.info/threads/usa-nchs-cdc-proposal-for-icd-10-cm-adding-seid.5929/

 

Ditto

 

I was stuck in the VA system for 2 decades bc I did not have private insurance. I was told everything from conversion disorder to flat out faking. My primary was the ONLY doc that believed me, but prescribing bedrest is not something that is done and we all know that. VA doesn't indicate bed rest for much of anything, including recovery from hernia surgery when my hub had that. No doc in the VA system will even acknowledge that I have ME/CFS/SEID or whatever their flavor of the day is. A neuro told me I have a disease that "has not been discovered yet"

 

With extreme prejudice. As in: this was a massive mistake that needs to be rectified and steps should be taken to assure something like this never happens again.

It will take some time because of liabilities but it has to happen. It was a massive blunder of disastrous impact, one that added nothing but confusion for health care providers and harm to sufferers.