VA to establish an additional requirement for a showing of fault. and 38 CFR PL 104-204 3.358 Vs. 38 amended the causation standard for claims under to include a Section 422 CFR 3.361 fault element. Prior to October 1, 1997, a showing of VA fault or failure to exercise reasonable skill and care is not an element of establishing causation for entitlement to benefits. Statutory language imposed the requirement of a causal connection only between the injury or aggravation of an injury and hospitalization, medical or surgical treatment, or the pursuit of a course of vocational rehabilitation. This standard of causation is discussed in . On or after October 1, 1997, an additional fault element was added under , requiring that the evidence show that additional disability or death was caused by either an event not reasonably foreseeable, or carelessness, negligence, lack of proper skill, error in judgment, or similar instance of fault. For more information on the revision of causation to include the Reference: addition of the fault requirement, see , 1 Vet. App. 584 (1991), 513 U.S. 115(1994) and PL 104-204 Section 422, . r. Definition of changed the term to PL 104-204 Section 422 hospitalization hospital care Hospitalization effective October 1, 1997. under 38 CFR 3.358 Vs. as included in , is not restricted to activities specifically Hospitalization, Hospital Care related to care and treatment but encompasses the entire process of Under 38 CFR maintaining or lodging a patient during the period of hospitalization. 3.361 as included in , encompasses, at a minimum, services unique Hospital care, to the hospitalization of patients. Whether there was hospital care for the purpose of depends on a variety of factors, including the nature of services degree of VA control over patient freedom mental and physical condition of patients, and foreseeability of potential harm. For more information on the definition of and distinction between Reference: hospitalization and hospital care, see , and M21-1, Part IV, Subpart ii, 2.G.1.d. 2. Considering Specific Instances of Causation and Fault Under 38 U.S.C. 1151
and 38 CFR 3.358 Vs. 38 CFR 3.361 VA to establish an additional requirement for a showing of fault. PL 104-204 Section 422 amended the causation standard for claims under to include a fault element. Prior to October 1, 1997, a showing of VA fault or failure to exercise reasonable skill and care is not an element of establishing causation for entitlement to benefits. Statutory language imposed the requirement of a causal connection only between the injury or aggravation of an injury and hospitalization, medical or surgical treatment, or the pursuit of a course of vocational rehabilitation. This standard of causation is discussed in . On or after October 1, 1997, an additional fault element was added under , requiring that the evidence show that additional disability or death was caused by either an event not reasonably foreseeable, or carelessness, negligence, lack of proper skill, error in judgment, or similar instance of fault. Reference: For more information on the revision of causation to include the addition of the fault requirement, see , 1 Vet. App. 584 (1991), 513 U.S. 115(1994) PL 104-204 Section 422, and . r. Definition of Hospitalization under 38 CFR 3.358 Vs. Hospital Care Under 38 CFR 3.361 PL 104-204 Section 422 changed the term hospitalization to hospital care effective October 1, 1997. Hospitalization, as included in , is not restricted to activities specifically related to care and treatment but encompasses the entire process of maintaining or lodging a patient during the period of hospitalization. Hospital care, as included in , encompasses, at a minimum, services unique to the hospitalization of patients. Whether there was hospital care for the purpose of depends on a variety of factors, including the nature of services degree of VA control over patient freedom mental and physical condition of patients, and foreseeability of potential harm. Reference: For more information on the definition of and distinction between hospitalization and hospital care, see , and M21-1, Part IV, Subpart ii, 2.G.1.d. 2. Considering Specific Instances of Causation and Fault Under 38 U.S.C. 1151