Overview
Congress has provided that VA can grant benefits for undiagnosed illnesses and chronic multisymptom illnesses related to service in the Gulf War. Certain specified medical conditions are also presumed to be related to Gulf War service. Under these provisions, the claimant does not need a medical opinion that states that there is a relationship between the illness or condition and any specific event in service. However, the claim will still need to be supported with adequate documentation of the veteran's post-service symptoms.
Statutory Law
The special provisions relating to Gulf War Illnesses are found in 38 U.S.C. § 1117 [available here] and 38 U.S.C. § 1118 [available here]. In particular:
- Section 1117:
- Subsection (a)(2) allows for benefits for "undiagnosed illnesses," "medically unexplained chronic multisymptom illness[es]," and any other condition that VA recognizes as related to Gulf War service.
- Subsection (g) lists thirteen "signs or symptoms that may be a manifestation of an undiagnosed illness or a chronic multisymptom illness."
- Section 1118:
- Subsections (b) and (c) describe how VA can add additional conditions to the list of those that are presumed to be related to Gulf War service.
There have been recent legislative hearings to address the ongoing scientific research into which conditions may be related to Gulf War service and what the causes of those conditions might be. Recent legislative hearings include:
- H. Hrg. 111-39 — The Implications of U.S. Department of Veterans Affairs' Limited Scope of Gulf War Illness Research, July 30, 2009 [link to House page for hearing]
- H. Hrg. 111-21 — Gulf War Illness Research: Is Enough Being Done, May 19, 2009 [download .pdf]
- S. Hrg. 110-314 — Oversight Hearing on Research and Treatment for Gulf War Illnesses, Sept. 25, 2007 [download .pdf]
- H. Hrg. 110-38 — Gulf War Exposures, July 26, 2007 [download .pdf]
Regulations
VA's primary regulations implementing the laws related to Gulf War Illnesses is 38 C.F.R. § 3.317 [available here]. In particular:
- Subsection 3.317(a)(2)(i)(B) recognizes chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome as chronic disabilities under the statute.
- Subsection 3.317(a)(2)(i)(C)(ii) defines "medically unexplained chronic multisymptom illness" as "a diagnosed illness without conclusive pathophysiology or etiology, that is characterized by overlapping symptoms and signs and has features such as fatigue, pain, disability out of proportion to physical findings, and inconsistent demonstration of laboratory abnormalities. Chronic multisymptom illnesses of partially understood etiology and pathophysiology will not be considered medically unexplained."
- Subsection 3.317(a)(4) generally requires at least a six-month history of symptoms in order for a condition to be recognized as chronic.
Federal Register Notices
When VA proposes or finalizes a regulation relating to Gulf War Illness conditions or when it withdraws such a proposed regulation — including the list of conditions that are presumed to be related to Gulf War service — it publishes a public notice in the Federal Register (which all government agencies use to announce proposed and final rule changes).
- Final Rules:
- Extension of Statutory Period for Compensation for Certain Disabilities Due to Undiagnosed Illnesses and Medically Unexplained Chronic Multi-Symptom Illnesses, 77 Fed. Reg. 63,225 (Oct. 16, 2012) [download .pdf]
- Proposed Rules:
- Presumptions of Service Connection for Persian Gulf Service. 75 Fed.Reg. 13,051 (Mar. 18, 2010) [download .pdf]
- Notices:
- Determinations Concerning Illnesses Discussed In National Academy of Sciences Reports on Gulf War and Health, Volumes 4 and 8, 76 Fed. Reg. 21,099 (Apr. 14, 2011) (stating no new conditions would be added on the basis of these reports) [download .pdf]
Selected Cases
A few cases relating to Gulf War illness claims:
- Federal Circuit:
- The Federal Circuit has not yet addressed any issues related to Gulf War Illness.
- CAVC:
- Tyrues v. Shinseki, 23 Vet. App. 166 (2009) (en banc) (addressing the procedural relationship between seeking benefits under 38 U.S.C. § 1117 and the general entitlement law) [download .pdf]
- Stankevich v. Nicholson, 19 Vet. App. 470 (2006) (addressing conflicting evidence regarding whether a condition is the result of an undiagnosed illness) [download .pdf]
- Gutierrez v. Principi, 19 Vet. App. 1 (2004) (addressing the relationship between undiagnosed condition and service) [download .pdf]
Law Review Articles
- James P. Terry, Gulf War Syndrome: Addressing Undiagnosed Illness from the First War with Iraq, 1 Veterans L. Rev. 167 (2009) [available here]
Selected Books and Reports
- Gulf War and Health: Volume 10: Update of Health Effects of Serving in the Gulf War, 2016 (2016). [download a free copy in .pdf]
- Chronic Multisymptom Illness in Gulf War Veterans: Case Definitions Reexamined (2014). Download a free .pdf copy from the NAP website.
- Institute of Medicine, Gulf War and Health: Updated Literature Review of Depleted Uranium (2008) [available as a free .pdf from the author]
- Institute of Medicine, Gulf War and Health: Vol. 5. Infectious Diseases (2007) [free .pdf summary available from the author]
- Institute of Medicine, Gulf War and Health: Vol. 4. Health Effects of Serving in the Gulf War (2006) [free .pdf summary available from the author]
- Institute of Medicine, Gulf War and Health: Vol. 3. Fuels, Combustion Products, and Propellants (2005) [free .pdf summary availabe from the author]
- Institute of Medicine, Gulf War and Health: Vol. 2. Insecticides and Solvents (2003) [free .pdf summary available from the author]