When you have a disability that you want to get compensated for, you apply for service-connected compensation benefits from the VA. We have looked at the process of getting service connected which involves: 1) a disability 2) an in-service injury, disease, or event, and 3) a nexus, or link between the two. This is known as direct service connection. This process can often be more challenging than one would hope because the VA can sometimes be reluctant to see a nexus or link between a disability and an in-service event. To help veterans get around this challenge of establishing a nexus to prove direct service connection, the VA has established a different way to get service connected, through presumption. Presumptive service connection means that there are certain conditions automatically presumed to be connected to service based on certain qualifications. There are different conditions for veterans serving in different locations that are presumed to be service connected, such as Camp Lejeune presumptions and Agent Orange presumptions. One example is the presumption for Gulf War veterans.
Veterans of the Persian Gulf War, Operation Desert Shield and Desert Storm, and Operation Enduring Freedom, Iraqi Freedom and New Dawn, can receive service connected compensation for mental and physical disabilities just like any other veteran can. But it was found that many Persian Gulf War veterans were suffering from multisymptom disabilities that were not yet fully understood by the medical profession. The terms usually used were “undiagnosed, or “chronic multisymptom” illness. This is because many of these veterans were likely exposed to biological or environmental hazards or to preventative medicine or vaccines whose effects are not yet well known and are still under scientific research. So Congress enacted a law that allows these veterans who suffer from a “qualifying chronic disability” to obtain service connection when their disability cannot be service-connected by other means.
There are three requirements for a veteran to establish entitlement to presumptive service connection. The veteran must:
- Be a Persian Gulf War veteran
- Suffer from a “qualifying chronic disability”, which is either:
- An undiagnosed illness,
- A medically unexplained chronic multisymptom illness, OR
- Any other illness deemed by law
- The particular qualifying chronic disability must have manifested:
- During active military service in the Southwest Asia area of operations OR
- To a degree of 10% at any time since the veteran’s return from active duty in Southwest Asia.
The veteran only needs to show that they meet these three criteria; they do not need to establish a nexus between their disease and service. And the veteran did not have to have sought medical treatment to meet the third element, only show that the disability began to manifest at 10% since returning from service. But you have to be careful because the VA may try to find that the qualifying chronic disability was caused by something after the veteran came back from service in Southwest Asia.
To be a Persian Gulf War veteran, the veteran had to have served on active military, naval, or air service in the Southwest Asia area of operations during the Persian Gulf War. This includes Iraq, Kuwait, Saudi Arabia, the neutral zone between Iraq and Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, Oman, the Gulf of Aden, the Gulf of Oman, the Persian Gulf, the Arabian Sea, the Red Sea, and the airspace above these locations. Veterans who served in Afghanistan also fall under these presumptions. The period of service must have included service in the area after August 1990 through the present.
A veteran has to have a qualifying chronic disability. This would mean either an undiagnosed illness, a medically unexplained chronic multi symptom illness, or a diagnosed illness deemed by law as warranting a presumption of service connection. Let’s first look at what undiagnosed illness means. An undiagnosed illness is usually described by manifestations that include fatigue, unexplained rashes or dermatological signs or symptoms, headache, muscle pain, joint pain, neurological signs and symptoms, signs or symptoms involving the upper or lower respiratory system, sleep disturbances, gastrointestinal signs or symptoms, cardiovascular signs or symptoms, abnormal weight loss, and menstrual disorders. Lay statements can be used to prove when the symptoms began, how long they have lasted, and how severe they are. The symptoms have to be chronic, meaning they have to have existed for 6 months or more from the earliest date that the symptoms manifested. If the symptoms exhibit in intermittent episodes of improving and worsening, it should still have been over a 6-month period. These symptoms also cannot be attributed to any other condition; it has to be due to an undiagnosed illness. This is one of the problems veterans often run into, when a doctor tries to diagnose their condition. If the symptoms can be attributed to a clinically diagnosed condition, they are no longer eligible for the presumption.
In part II we will take a closer look at the other requirements for establishing eligibility to presumptive service connection for Gulf War veterans.