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Medically Unexplained Chronic Multisymptom Illnesses
A prominent condition affecting Gulf War Veterans is a cluster of medically unexplained chronic symptoms that can include fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, and memory problems.
VA does not use the term “Gulf War Syndrome” when referring to “medically unexplained chronic multisymptom illnesses” reported by Gulf War Veterans. Symptoms vary widely and therefore, do not meet the definition of a syndrome.
A syndrome is a group of symptoms that usually occur together and characterize a certain disease or abnormal condition. That is why VA uses the term “medically unexplained chronic multisymptom illnesses” instead of “Gulf War Syndrome.”
Gulf War Veterans who meet the criteria below do not need to prove a connection between their military service and medically unexplained chronic multisymptom illnesses in order to receive VA disability compensation. VA presumes certain chronic, unexplained symptoms existing for 6 months or more are related to Gulf War service without regard to cause. These "presumptive" illnesses must have appeared during active duty in the Southwest Asia theater of military operations or by
December 31, 2016, and be at least 10 percent disabling.
These illnesses include:
Chronic fatigue syndrome, a condition of long-term and severe fatigue that is not relieved by rest and is not directly caused by other conditions.
Fibromyalgia, a condition characterized by widespread muscle pain. Other symptoms may include insomnia, morning stiffness, headache, and memory problems.
Functional gastrointestinal disorders, a group of conditions marked by chronic or recurrent symptoms related to any part of the gastrointestinal tract. Functional condition refers to an abnormal function of an organ, without a structural alteration in the tissues.
Examples include irritable bowel syndrome (IBS), functional dyspepsia, and functional abdominal pain syndrome.
Undiagnosed illnesses with symptoms that may include but are not limited to: abnormal weight loss, fatigue, cardiovascular disease, muscle and joint pain, headache, menstrual disorders, neurological and psychological problems, skin conditions, respiratory disorders, and sleep disturbances.
VA’s final rule specifying that functional gastrointestinal disorders are covered as presumptive illnesses took effect on August 15, 2011.
Parkinson's Disease - A progressive disorder of the nervous system that affects muscle movement
Peripheral Neuropathy, Early-Onset - A nervous system condition that causes numbness,
tingling, and motor weakness. Under VA's rating regulations, it must be
at least 10 percent disabling within one year of herbicide exposure.
Porphyria Cutanea Tarda - A disorder characterized by liver dysfunction and by thinning and
blistering of the skin in sun-exposed areas. Under VA's rating regulations,
it must be at least 10 percent disabling within one year of exposure to herbicides.
Prostate Cancer - Cancer of the prostate; one of the most common cancers among men
Respiratory Cancers (includes lung cancer) Cancers of the lung, larynx, trachea, and bronchus
Soft Tissue Sarcomas (other than osteosarcoma, chondrosarcoma, Kaposi's sarcoma,
or mesothelioma) A group of different types of cancers in body tissues
such as muscle, fat, blood and lymph vessels, and connective tissues
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Veterans' Diseases Associated with Agent Orange
VA assumes that certain diseases can be related to a Veteran's qualifying military service. We call these "presumptive diseases."
VA has recognized certain cancers and other health problems as presumptive diseases associated with exposure to Agent Orange or other herbicides during military service.
Veterans and their survivors may be eligible for benefits for these diseases.
A "condition", in the language of the VA, is any disease, illness or injury that occurs during active duty military service. To be service connected and eligible for a disability compensation rating, the condition must be caused or contributed to by an event that
occurred during service. If the condition existed prior to service, it must be shown to have been aggravated (made worse) by military service.
To achieve a disability compensation rating, the veteran must prove that he or she had appropriate military service, that an event that caused the claimed condition occurred and that a medically diagnosed condition that is disabling exists today.
The regulations that govern presumptive conditions only eliminate the requirement to prove that an event caused the condition. For example, a Vietnam veteran does not have to prove that agent orange caused the diabetes he has today. It is presumed that he was exposed to agent orange and also that agent orange is at the root of the diabetes.
While agent orange and the Vietnam veteran are the best known of all presumptive conditions and ratings, atomic veterans, certain Korean veterans and other veterans may also be eligible for presumptive ratings of certain conditions.
The regulations are complex. Some veterans who have a Vietnam Service Medal aren't eligible for presumptive ratings because they didn't set their boots on the soil of the country of Vietnam. Many Korean veterans don't realize that they may be eligible for service connections due to exposure to the herbicide agent orange.
If you believe that you may be eligible for any presumptive condition and rating, the best way to find out is to file a VA disability claim. The process of adjudication is the only sure way to know.
38 CFR 3.309 - Disease subject to presumptive service connection.
§ 3.309 Disease subject to presumptive service connection.
(a) Chronic diseases. The following diseases shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under § 3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of § 3.307 are also satisfied.
DISABILITY COMPENSATION “PRESUMPTIVE” DISABILITY BENEFITS
Disabilities determined by VA to be related to your military service can lead to monthly non-taxable compensation, enrollment in the VA health care system, a 10-point hiring preference for federal employment and other important benefits. Ask your VA representative or Veterans Service Organization representative about Disability Compensation, Pension, Health Care, Caregiver Program, Career Services, Educational Assistance, Home Loan Guaranty, Insurance and/or Dependents and Survivors’ Benefits.
A Brief History of Presumptive Disability Decisions for Veterans
Presumptions have played an important role in both the conceptual basis for service connection and the actual administration of the Department of Veterans Affairs (VA) compensation program. Presumptions are used to bridge gaps in scientific and medical knowledge, as well as to resolve complex policy questions and simplify determinations of service connection for VA (VA, 1993a). This chapter offers a brief history of the presumptive disability decisions established for veterans since 1921. It is not intended as a comprehensive or exhaustive account of all presumptive decisions; rather, it provides background on presumptions—it explains how they operate, why they are used, and their role in making disability compensation available to veterans. The chapter focuses on presumptions for health outcomes rather than administrative presumptions. For a comprehensive review of presumptive decisions, the reader is referred to Analysis of Presumptions of Service Connection (VA, 1993a), Presumptions of Service Connection (Zeglin, 2006), VA Disability Compensation Program: Legislative History (Economic Systems Inc., 2004a), and VA Disability Compensation Program: Literature Review (Economic Systems Inc., 2004b).
Gulf War Presumptions Gulf War Service
For VA benefit purposes, Gulf War service is active military duty in any of the following areas in the Southwest Asia theater of military operations any time during the first Gulf War starting August 2, 1990 through the current conflict in Iraq.
This includes Veterans who served in Operation Iraqi Freedom (2003-2010) and Operation New Dawn (2010 and continuing).
Iraq, Kuwait, Saudi Arabia, The neutral zone between Iraq and Saudi Arabia, Bahrain, Qatar, The United Arab Emirates, Oman, Gulf of Aden, Gulf of Oman, Waters of the Persian Gulf, the Arabian Sea, and the Red Sea & the airspace above these locations.
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WHAT IS “PRESUMPTIVE” SERVICE CONNECTION?
VA presumes that specific disabilities diagnosed in certain veterans were caused by their military service. VA does this because of the unique circumstances of their military service. If one of these conditions is diagnosed in a Veteran in one of these groups, VA presumes that the circumstances of his/her service caused the condition, and disability compensation can be awarded.
Hodgkin's Disease - A malignant lymphoma (cancer) characterized by progressive enlargement
of the lymph nodes, liver, and spleen, and by progressive anemia
Ischemic Heart Disease - A disease characterized by a reduced supply of
blood to the heart, that leads to chest pain
Multiple Myeloma - A cancer of plasma cells, a type of white blood cell in bone marrow
Non-Hodgkin's Lymphoma - A group of cancers that affect the lymph glands and other lymphatic tissue
AL Amyloidosis - A rare disease caused when an abnormal protein, amyloid, enters tissues or organs
Chronic B-cell Leukemias - A type of cancer which affects white blood cells
Chloracne (or similar acneform disease) A skin condition that occurs soon after exposure
to chemicals and looks like common forms of acne seen in teenagers. Under VA's rating
regulations, it must be at least 10 percent disabling within one year of exposure to herbicides.
Diabetes Mellitus Type 2 A disease characterized by high blood sugar levels
resulting from the body’s inability to respond properly to the hormone insulin
Disability - When the initial decision finds no "nexus"
What is the "nexus" and why is it important?
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