In previous posts, my colleagues and I have written about Gulf War Syndrome, and the requirements for Gulf War Veterans to be entitled to service connection for medical conditions that have developed as a result of service in the Gulf War.
The purpose of this post, is to take it a step further and to discuss in more detail, one of the medical conditions that the VA generally concedes is caused by service in the Persian Gulf War. Specifically, we’re going to discuss Irritable Bowel Syndrome, more commonly known as “IBS.” In later posts, we’ll discuss some of the other Gulf War conditions in more detail.
The VA’s regulation for Gulf War Veterans: 38 C.F.R § 3.317
38 C.F.R § 3.317 provides, in part, that Gulf War Veterans are generally entitled to service connection for “medically unexplained chronic multisymptom illness.” The definition of chronic multisymptom illness, as stated in the regulation, specifically includes IBS.
When the VA Gets It Wrong
Recently, I’ve worked on cases where veterans have served in the Gulf War, AND have been diagnosed with IBS; yet, the VA has denied their claims for service connection. You may be wondering, how can the VA do this, and deny a claim for a condition that should be presumptively service-connected? Unfortunately, the answer to this question can sometimes be murky. However, most people who practice VA law, know that these denials happen more often than they should.
In the cases I’ve seen, these claims have been denied for reasons that are blatantly in error, and/or are contrary to the law. For example, the VA has denied these claims, stating that there is no evidence that a “specific event or exposure” happened during service in the Gulf War, which would have caused the IBS. Or, the VA has said that the veteran doesn’t have a diagnosis of IBS in the first place, even though the VA’s own doctors and specialists have specifically diagnosed and written this condition in the veteran’s medical records. These are two of the most common errors I’ve seen.
In the above examples, the VA is wrong to deny these claims, because the law does not require veterans to prove that a specific event or exposure happened in the Gulf War. So long as the veteran, (1) served in the Southwest Asia theater of operations, (2) has been diagnosed with IBS, (3) has IBS that has manifested to a degree of 10% or more prior to December 31, 2016 and (4) has IBS that is not due to a supervening event or due to willful misconduct; then service connection should be granted. These rules seem simple enough, yet, time and time again, the VA fumbles the ball.
The lesson here, is that if you are a veteran who has served in the Southwest Asia theater of operations during the Persian Gulf War, and if you have been suffering from chronic GI symptoms, and/or you have been diagnosed with IBS or another functional GI disorder, don’t let the VA deny your claim, without a second review. Even if the rating decision seems correct to you, please have a qualified person to carefully review the rating decision, in order to determine if an appeal is in order. It is sad, but true, that the VA often misapplies and/or misstates the law.
Obtaining an Appropriate Disability Rating
Once service connection is granted, that is not the end of the analysis. The next step is determining what the proper rating should be. In this regard, the VA looks at several symptoms, to determine how the IBS will be rated.
According to the VA, if the IBS symptoms are “mild,” with only occasional episodes of abdominal distress, then the veteran will only receive a 0% rating for this condition. In other words, no compensation is due to a veteran for only mild symptoms. If the symptoms are “moderate,” with frequent episodes of bowel disturbance and abdominal distress, then the VA will give a 10% rating. Finally, if the symptoms are “severe,” with more or less constant abdominal distress, AND diarrhea or alternating diarrhea and constipation, then the VA will give a 30% rating.
Therefore, it is important to keep track of the frequency and severity of the symptoms, and for veterans to thoroughly discuss these issues with their doctors, so that there is a paper trail. There’s nothing worse than carrying on the fight for service connection, only to later receive a 0% rating, because there is no documentation to verify how bad the symptoms really are.
The VA will state that 30% is the highest schedular rating possible for IBS. However, this is another area that may be the subject of an appeal. If your IBS is very severe and causes symptoms that are not fully contemplated in the rating schedule, or, if the IBS prevents you from working, then other, higher levels of compensation may need to be explored.