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5 Questions about Presumptions for Gulf War and Undiagnosed Illnesses

December 20, 2019

The Veterans who served
during Operation Desert Storm, Desert Shield, and which have
continued up to the present, includes countries such as Iraq
where most of the fighting happened and Kuwait
and also Saudi Arabia and some of the other surrounding countries. A Veteran who has served in
the Gulf War is entitled to a presumption of service
connection for any undiagnosed illness. In addition to undiagnosed
illnesses, Veterans who have a medically unexplained chronic
multi-symptom illness such as irritable bowel
syndrome, fibromyalgia, chronic fatigue syndrome, and
other functional GI disorders. Based on an Institute of
Medicine report, we made presumptive nine
infectious diseases which were found to be associated with service not only in the Gulf,
but also in Afghanistan. The other presumptions
are not available for those who served
in Afghanistan. A Veteran who did serve in
Afghanistan and had one of those conditions would need to provide
evidence that they either had it in service or it was due to some
exposure while they were on active duty there. Service connection
generally requires three distinct components. One, there has to be
evidence of a disability. There has to be evidence
of something in service, either an injury, a disease,
or an exposure of some kind. Then there has to be what is
called a medical nexus or a link between the current
disability and what happened in the service. The presumption eliminates
the need for the nexus. It’s presumed that it resulted
from their service. An undiagnosed illness is one
that, regardless and despite of all the testing that can be
done, no diagnosis can be made. The undiagnosed illness
may appear in any of the body systems, so it can be in
the respiratory system, the cardiovascular system,
neurological system. When we either get a report from
a Veteran’s private provider or in response to a request
for a VA examination from a VHA clinician, we expect
that, if after all the testing is done the examiner cannot make
a diagnosis, that they will put in their report that this Veteran has an undiagnosed illness of
whatever body system is involved. What I hope to let you know or
to impart to you today is that when you file a claim for an
undiagnosed illness, please be sure that you have
an undiagnosed illness. If you have a diagnosed illness
such as sleep apnea, such as bronchitis, such as sinusitis,
those are diagnosed conditions. In order for those to be
service-connected, you will have to provide evidence that you
either had this disability initially while you were on
active duty or you aggravated a preexisting disability or it
is related to something that happened in service,
an exposure, perhaps, in those countries. An undiagnosed illness is one
where an examiner, whether it be a private provider
or a VHA examiner, after doing all tests
that are indicated, cannot provide a diagnosis. Those are presumptive,
but please remember, if it is diagnosed,
it’s not presumptive.

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