21st Century System for Evaluating Veterans' Disability Benefits recommends improvements in the medical evaluation and rating of veterans for the benefits provided by the Department of Veterans Affairs (VA) to compensate for illnesses or injuries incurred in or aggravated by military service. Compensation is a monthly cash benefit based on a rating schedule that determines the degree of disability on a scale of 0 to 100. Although a disability rating may also entitle a veteran to ancillary services, such as vocational rehabilitation and employment services, the rating schedule is out of date medically and contains ambiguous criteria and obsolete conditions and language. The current rating schedule emphasizes impairment and limitations or loss of specific body structures and functions which may not predict disability well. 21st Century System for Evaluating Veterans' Disability Benefits recommends that this schedule could be revised to include modern concepts of disability including work disability, nonwork disability, and quality of life. In addition to the need for an updated rating schedule, this book highlights the need for the Department of Veterans' Affairs to devote additional resources to systematic analysis of how well it is providing services or how much the lives of veterans are being improved, as well as the need for a program of research oriented toward understanding and improving the effectiveness of its benefits programs. Table of Contents Front Matter Summary 1 Introduction 2 Veterans with Disabilities in the 21st Century 3 Impairment, Disability, and Quality of Life 4 The Rating Schedule 5 The Medical Examination and Disability Rating Process 6 Medical Criteria for Ancillary Benefits 7 Individual Unemployability 8 Other Diagnostic Classification Systems and Rating Schedules 9 Service Connection on Aggravation and Secondary Bases 10 Conclusion: Into the 21st Century A Biographical Sketches of Committee Members, Consultants, and Staff B Committee Charge C The Relationship Between Impairments and Earnings Losses in Multicondition Studies D The Role of Medical Personnel in Selected Disability Benefit Programs E Diagram: Assessing Impairment and Functional Disability