### Section H. Claims for Service Connection for Other Diseases and Disabilities

#### Overview

+------------+---------------------------------------------------------+
| #          | > This section contains the following topics:           |
| #### In th |                                                         |
| is Section |                                                         |
+------------+---------------------------------------------------------+

  ------------ ---------------------------------------------- ------------
  Topic        Topic Name                                     See Page

  26           Developing Claims for Service Connection for   1-H-2
               Positive Tuberculin Reactions                  

  27           Developing Claims for Service Connection for   1-H-4
               Chronic or Tropical Diseases                   

  28           Developing Claims for Service Connection for   1-H-7
               Disabilities Resulting From Exposure to        
               Herbicides Containing 2, 3, 7, 8               
               Tetrachlorodibenzo-P-Dioxin (TCDD) During      
               Service in the Republic of Vietnam (RVN)       

  29           Developing Claims for Service Connection for   1-H-12
               Asbestos-Related Diseases                      

  30           Developing Claims for Service Connection for   1-H-14
               Acquired Immune Deficiency Syndrome (AIDS)     
  ------------ ---------------------------------------------- ------------

#### 26. Developing Claims for Service Connection for Positive Tuberculin Reactions

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on developing claims  |
| troduction | > for service connection for positive tuberculin        |
|            | > reactions. It includes information on the             |
|            |                                                         |
|            | -   action to take on a claim for service connection    |
|            |     for a                                               |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   positive tuberculin reaction only, or               |
|            |                                                         |
|            | -   positive tuberculin reaction and other              |
|            |     disabilities, and                                   |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   the reporting responsibilities of the Department of |
|            |     Veterans Affairs (VA) outpatient clinics and VA     |
|            |     medical centers (VAMCs).                            |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > September 5, 2008                                     |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### a    | > If *VA* *Form* *21-526*, *Veteran's Application for   |
| . Action t | > Compensation and/or Pension,* is received claiming    |
| o Take on  | > *only* a positive tuberculin reaction, refer the      |
| a Claim fo | > claim to the rating activity for a determination as   |
| r Service  | > to whether or not a disability is present.            |
| Connection | >                                                       |
|  for a Pos | > ***Reference***: For more information on claims for   |
| itive Tube | > service connection for a positive tuberculin          |
| rculin Rea | > reaction, see [M21-1MR, Part III, Subpart v,          |
| ction Only | > 7.A.10](../pt03_sp05_ch07_secA.xml#III.v.7.A.10).     |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > If *VA Form 21-526* indicates that a positive         |
|  b. Action | > tuberculin reaction is claimed together with other    |
|  to Take o | > disabilities                                          |
| n a Claim  |                                                         |
| for Servic | -   complete any appropriate development required for   |
| e Connecti |     the other disabilities, and                         |
| on for a P |                                                         |
| ositive Tu | -   refer the file to the rating activity for rating of |
| berculin R |     all the claimed disabilities.                       |
| eaction an |                                                         |
| d Other Di |                                                         |
| sabilities |                                                         |
+------------+---------------------------------------------------------+

Continued on next page

26\. Developing Claims for Service Connection for Positive Tuberculin
Reactions, Continued

+------------+---------------------------------------------------------+
| ##### c. R | > As provided in [M21-1MR, Part III, Subpart v,         |
| eporting R | > 7.A.10](../pt03_sp05_ch07_secA.xml#III.v.7.A.10), a   |
| esponsibil | > Department of Veterans Affairs (VA) outpatient clinic |
| ities of V | > or VA medical center (VAMC) will furnish a report of  |
| A Outpatie | > the follow-up examination made at the expiration of   |
| nt Clinics | > the 12-month period of chemotherapy for discharged    |
|  and Medic | > personnel who have had a tuberculin test conversion   |
| al Centers | > from negative to positive during service.             |
|            | >                                                       |
|            | > Refer the file to the rating activity if a VA         |
|            | > outpatient clinic or VAMC report or any other         |
|            | > evidence indicates the presence of tuberculous        |
|            | > disease.                                              |
|            | >                                                       |
|            | > The rating activity will consider establishing        |
|            | > service connection by way of presumption under [38    |
|            | > CFR                                                   |
|            | > 3.307](http://                                        |
|            | www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_307.DOC) |
|            | > and [M21-1MR, Part IV, Subpart ii,                    |
|            | > 1.H.27.d](../pt04_sp02_ch01_secH.xml#IV.ii.1.H.27.d). |
+------------+---------------------------------------------------------+

#### 27. Developing Claims for Service Connection for Chronic or Tropical Diseases

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on developing claims  |
| troduction | > for service connection for chronic or tropical        |
|            | > diseases. It includes information on                  |
|            |                                                         |
|            | -   the definition of a ***chronic*** ***disease***     |
|            |                                                         |
|            | -   establishing whether a disease is chronic           |
|            |                                                         |
|            | -   considering                                         |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   service connection for a chronic or tropical        |
|            |     disease, and                                        |
|            |                                                         |
|            | -   presumptive service connection                      |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   the locations of lists of chronic and tropical      |
|            |     diseases, and                                       |
|            |                                                         |
|            | -   the action to take if a disease was                 |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   treated in service, or                              |
|            |                                                         |
|            | -   not treated in service.                             |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > December 13, 2005                                     |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > A ***chronic*** ***disease*** is a disease            |
| a. Definit |                                                         |
| ion: Chron | -   of prolonged duration, producing incapacitating     |
| ic Disease |     symptoms of varying degree                          |
|            |                                                         |
|            | -   that may undergo remission, and                     |
|            |                                                         |
|            | -   that is seldom entirely cured with all residuals of |
|            |     damage being completely eradicated.                 |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### b. E | > If a diagnosis is prefaced with the word "chronic,"   |
| stablishin | > that does *not* necessarily establish the disease as  |
| g Whether  | > chronic.                                              |
| a Disease  | >                                                       |
| Is Chronic | > ***Important***: Whether a disease is chronic is a    |
|            | > matter for a factual determination dependent on the   |
|            | > nature of the disease and its manifestations. Some    |
|            | > diseases are inherently chronic, such as multiple     |
|            | > sclerosis, while others, such as bronchitis, may be   |
|            | > either acute or chronic.                              |
+------------+---------------------------------------------------------+

Continued on next page

27\. Developing Claims for Service Connection for Chronic or Tropical
Diseases, Continued

+------------+---------------------------------------------------------+
| ###        | > When deciding any claim for service connection for a  |
| ## c. Cons | > chronic or tropical disease, it is also necessary to  |
| idering Se | > consider                                              |
| rvice Conn |                                                         |
| ection for | -   service connection based on manifestation of the    |
|  a Chronic |     claimed disease during service, and                 |
|  or Tropic |                                                         |
| al Disease | -   service connection based on a presumption that the  |
|            |     disease, which was first manifested following       |
|            |     discharge from service, is nevertheless related to  |
|            |     service.                                            |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #          | > Once a substantially complete claim is of record, the |
| #### d. Co | > following conditions apply:                           |
| nsidering  |                                                         |
| Presumptiv | -   the possibility of entitlement to presumptive       |
| e Service  |     service connection exists when the veteran alleges  |
| Connection |     inception within the limiting periods contained in  |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   [38 U.S.C.                                          |
|            |     1112](http://straylight.law.cornell.edu/            |
|            | uscode/html/uscode38/usc_sec_38_00001112----000-.html), |
|            |     or                                                  |
|            |                                                         |
|            | -   [38 U.S.C.                                          |
|            |     1133](http://straylight.law.cornell.edu/            |
|            | uscode/html/uscode38/usc_sec_38_00001133----000-.html), |
|            |     when appropriate                                    |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   the veteran does not need to establish that the     |
|            |     disease in question was definitely diagnosed within |
|            |     the presumptive period, and                         |
|            |                                                         |
|            | -   the evidence should show that manifestations of the |
|            |     condition, disabling to the degree of at least 10   |
|            |     percent, became apparent prior to the expiration of |
|            |     the presumptive period shown in [38 CFR             |
|            |     3.307](http://w                                     |
|            | ww.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_307.DOC). |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### e. L | > The conditions listed in                              |
| ocations o |                                                         |
| f Lists of | -   [38 U.S.C.                                          |
|  Chronic a |     1101(3)](http://straylight.law.cornell.edu          |
| nd Tropica | /uscode/html/uscode38/usc_sec_38_00001101----000-.html) |
| l Diseases |     and [38 CFR                                         |
|            |     3.309(a)](http://                                   |
|            | www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_309.DOC) |
|            |     are chronic diseases, and                           |
|            |                                                         |
|            | -   [38 U.S.C.                                          |
|            |     1101(4)](http://straylight.law.cornell.edu          |
|            | /uscode/html/uscode38/usc_sec_38_00001101----000-.html) |
|            |     and [38 CFR                                         |
|            |     3.309(b)](http://                                   |
|            | www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_309.DOC) |
|            |     are tropical diseases.                              |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##         | > If service records show the veteran was treated for a |
| ### f. Act | > chronic or tropical disease, refer the case to the    |
| ion to Tak | > rating activity.                                      |
| e if a Con |                                                         |
| dition Was |                                                         |
|  Treated i |                                                         |
| n Service  |                                                         |
+------------+---------------------------------------------------------+

Continued on next page

27\. Developing Claims for Service Connection for Chronic or Tropical
Diseases, Continued

+------------+---------------------------------------------------------+
| ####       | > Even though certain chronic and tropical diseases     |
| # g. Actio | > were not treated during service, service connection   |
| n to Take  | > may still be established on a presumptive basis under |
| If a Disea | > the provisions of                                     |
| se Was Not |                                                         |
|  Treated i | -   [38 U.S.C.                                          |
| n Service  |     1112](http://straylight.law.cornell.edu             |
|            | /uscode/html/uscode38/usc_sec_38_00001112----000-.html) |
|            |                                                         |
|            | -   [38 U.S.C.                                          |
|            |     1133](http://straylight.law.cornell.edu/            |
|            | uscode/html/uscode38/usc_sec_38_00001133----000-.html), |
|            |     or                                                  |
|            |                                                         |
|            | -   [38 U.S.C.                                          |
|            |     1137](http://straylight.law.cornell.edu/            |
|            | uscode/html/uscode38/usc_sec_38_00001137----000-.html). |
|            |                                                         |
|            | > ***Reference***: For information on the diseases for  |
|            | > which service connection may be established on a      |
|            | > presumptive basis and the service requirements that   |
|            | > must be met, see [38 CFR                              |
|            | > 3.307](http://w                                       |
|            | ww.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_307.DOC). |
+------------+---------------------------------------------------------+

#### 28. Developing Claims for Service Connection for Disabilities Resulting From Exposure to Herbicides Containing 2, 3, 7, 8 Tetrachlorodibenzo-P-Dioxin (TCDD) During Service in the Republic of Vietnam (RVN)

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on developing claims  |
| troduction | > for service connection for disabilities resulting     |
|            | > from exposure to 2, 3, 7, 8                           |
|            | > Tetrachlorodibenzo-P-Dioxin (TCDD) during service in  |
|            | > the Republic of Vietnam (RVN). It includes            |
|            | > information on                                        |
|            |                                                         |
|            | -   the definition of ***service in the RVN***          |
|            |                                                         |
|            | -   the time period during which exposure may be        |
|            |     presumed                                            |
|            |                                                         |
|            | -   considering                                         |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   qualifying length of service, and                   |
|            |                                                         |
|            | -   proof of service in the RVN                         |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   the diseases for which service connection may be    |
|            |     presumed under the Agent Orange Act of 1991         |
|            |                                                         |
|            | -   initial correspondence with the veteran             |
|            |                                                         |
|            | -   the action to take when no disability is claimed,   |
|            |     and                                                 |
|            |                                                         |
|            | -   considering claims for birth defects.               |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > September 5, 2008                                     |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### a.   | > For the purposes of establishing service connection   |
| Definition | > under [38 CFR                                         |
| : Service  | > 3.307(a)(6)](http://                                  |
| in the RVN | www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_307.DOC) |
|            | > and [38 CFR                                           |
|            | > 3.309(e)](http://w                                    |
|            | ww.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_309.DOC), |
|            | > ***service in the Republic of Vietnam*** (RVN) means  |
|            |                                                         |
|            | -   service in the RVN or its inland waterways, or      |
|            |                                                         |
|            | -   service in other locations if the conditions of     |
|            |     service involved duty or visitation in the RVN.     |
|            |                                                         |
|            | > ***References***: For                                 |
|            |                                                         |
|            | -   more information on the definition of service in    |
|            |     the RVN, see [VAOPGCPREC                            |
|            |     27-97](http://www1.va.gov/ogc/docs/Prc27-97.doc)    |
|            |                                                         |
|            | -   information on exposure to herbicides along the     |
|            |     demilitarized zone in Korea, see [M21-1MR, Part IV, |
|            |     Subpart ii,                                         |
|            |                                                         |
|            |   2.C.10.l](../pt04_sp02_ch02_secC.xml#IV.ii.2.C.10.l). |
+------------+---------------------------------------------------------+

Continued on next page

*28. Developing Claims for Service Connection for Disabilities Resulting
From Exposure to Herbicides Containing 2, 3, 7, 8
Tetrachlorodibenzo-P-Dioxin (TCDD) During Service in the Republic of
Vietnam (RVN), Continued*

+------------+---------------------------------------------------------+
| ##### b.   | > *Public Law (PL) 104-275* ([38 U.S.C.                 |
|  Time Peri | > 1116](http://straylight.law.cornell.edu/              |
| od During  | uscode/html/uscode38/usc_sec_38_00001116----000-.html)) |
| Which Expo | > provides that effective January 1, 1997, the time     |
| sure May B | > period during which exposure to herbicides in the RVN |
| e Presumed | > may be presumed is January 9, 1962, to May 7, 1975.   |
|            | >                                                       |
|            | > ***Notes***:                                          |
|            |                                                         |
|            | -   Qualifying skin conditions *must* have become       |
|            |     manifest to a degree of 10 percent or more within   |
|            |     one year of the last date of service within the     |
|            |     RVN.                                                |
|            |                                                         |
|            | -   2, 3, 7, 8 Tetrachlorodibenzo-P-Dioxin (TCDD) is a  |
|            |     herbicide commonly referred to as "Agent Orange."   |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### c. C | > There is no requirement for a specified length of     |
| onsidering | > service, duty, or visitation in the RVN under [38 CFR |
|  Qualifyin | > 3.313](http://w                                       |
| g Length o | ww.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_313.DOC). |
| f Service  | >                                                       |
|            | > ***Rationale***: Even a few hours in the RVN during   |
|            | > the Vietnam era may be sufficient to establish        |
|            | > service connection for subsequently developed         |
|            | > diseases based on a presumption of exposure to        |
|            | > herbicides.                                           |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### d.   | > If the claimant alleges service in the RVN, review    |
| Considerin | > the *DD Form 214, Certificate of Release or Discharge |
| g Proof of | > from Active Duty,* or other evidence in the claims    |
|  Service i | > folder to confirm such service.                       |
| n the RVN  | >                                                       |
|            | > If necessary                                          |
|            |                                                         |
|            | -   submit a request for verification through PIES,     |
|            |     using request code O34, and                         |
|            |                                                         |
|            | -   ask the claimant to submit evidence, including      |
|            |     "buddy statements," to confirm service in Vietnam.  |
|            |                                                         |
|            | > ***Important***: A claim may not be denied solely     |
|            | > because service in the RVN cannot be verified         |
|            |                                                         |
|            | -   until the end of the initial 30-day and 30-day      |
|            |     follow-up response periods, and/or                  |
|            |                                                         |
|            | -   (in cases where Federal records are needed to       |
|            |     verify service in the RVN) until the requested      |
|            |     Federal records are received or a formal response   |
|            |     is received that the records are unavailable.       |
|            |                                                         |
|            | > ***Reference***: For information on verifying service |
|            | > on a ship in the waters offshore of the RVN, see      |
|            | > [M21-1MR, Part III, Subpart iii,                      |
|            | >                                                       |
|            | 2.E.33.c](../pt03_sp03_ch02_secE.xml#III.iii.2.E.33.c). |
+------------+---------------------------------------------------------+

Continued on next page

28\. Developing Claims for Service Connection for Disabilities Resulting
From Exposure to Herbicides Containing 2, 3, 7, 8
Tetrachlorodibenzo-P-Dioxin (TCDD) During Service in the Republic of
Vietnam (RVN), Continued

+------------+---------------------------------------------------------+
| ##### e    | > The Agent Orange Act of 1991, *PL 102-4*, established |
| . Diseases | > a presumption of service connection for veterans with |
|  for Which | > service in the RVN during the Vietnam era who         |
|  Service C | > subsequently develop, to a degree of 10 percent or    |
| onnection  | > more                                                  |
| May Be Pre |                                                         |
| sumed Unde | -   Hodgkin's disease                                   |
| r the Agen |                                                         |
| t Orange A | -   multiple myeloma                                    |
| ct of 1991 |                                                         |
|            | -   non-Hodgkin's lymphoma (NHL)                        |
|            |                                                         |
|            | -   acute and subacute peripheral neuropathy            |
|            |                                                         |
|            | -   porphyria cutanea tarda                             |
|            |                                                         |
|            | -   prostate cancer                                     |
|            |                                                         |
|            | -   respiratory cancers, such as cancers of the         |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   lung                                                |
|            |                                                         |
|            | -   bronchus                                            |
|            |                                                         |
|            | -   larynx, or                                          |
|            |                                                         |
|            | -   trachea                                             |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   soft-tissue sarcoma                                 |
|            |                                                         |
|            | -   chloracne or other acneiform disease consistent     |
|            |     with chloracne                                      |
|            |                                                         |
|            | -   type 2 diabetes mellitus, and                       |
|            |                                                         |
|            | -   chronic lymphocytic leukemia.                       |
|            |                                                         |
|            | > ***Note***: Under [38 CFR                             |
|            | > 3.313](http://w                                       |
|            | ww.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_313.DOC), |
|            | > a regulation not based on exposure to herbicides,     |
|            | > service in the RVN, in its inland waterways, or in    |
|            | > the waters offshore, together with the development of |
|            | > NHL after service, is sufficient to establish service |
|            | > connection. NHL does *not* have to be at least 10     |
|            | > percent disabling. Entitlement under [38 CFR          |
|            | > 3.313](http://w                                       |
|            | ww.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_313.DOC), |
|            | > *unlike entitlement under [38 CFR                     |
|            | > 3.307(a)(6)](http://ww                                |
|            | w.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_307.DOC),* |
|            | > does not require service on land in the RVN or in its |
|            | > inland waterways.                                     |
+------------+---------------------------------------------------------+

Continued on next page

28\. Developing Claims for Service Connection for Disabilities Resulting
From Exposure to Herbicides Containing 2, 3, 7, 8
Tetrachlorodibenzo-P-Dioxin (TCDD) During Service in the Republic of
Vietnam (RVN), Continued

+------------+---------------------------------------------------------+
| ##### f.   | > When initially corresponding with a veteran claiming  |
|  Initial C | > disability resulting from exposure to herbicides      |
| orresponde | > while in the RVN                                      |
| nce With t |                                                         |
| he Veteran | -   inform the veteran of the availability of hospital  |
|            |     examinations and treatment, or                      |
|            |                                                         |
|            | -   if the veteran has already had the herbicide        |
|            |     examination or been treated for herbicide exposure, |
|            |     request that the veteran submit                     |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   a copy of the examination or treatment report, or   |
|            |                                                         |
|            | -   the name of the VA facility performing the          |
|            |     examination or treatment so that the regional       |
|            |     office (RO) may obtain a copy of the report.        |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ###        | > A claim is not substantially complete if a veteran    |
| ## g. Acti | > alleges exposure to herbicides during service, but    |
| on to Take | > does not claim service connection for a specific      |
|  When No D | > disability. In cases such as this                     |
| isability  |                                                         |
| Is Claimed | -   inform the veteran that he/she *must* identify a    |
|            |     specific disability, since exposure in and of       |
|            |     itself is not a disability, and                     |
|            |                                                         |
|            | -   ask the veteran to identify the disability(ies)     |
|            |     that resulted from exposure to herbicides during    |
|            |     service.                                            |
|            |                                                         |
|            | > ***Important***:                                      |
|            |                                                         |
|            | -   Do not                                              |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   process the claim as a denial, or                   |
|            |                                                         |
|            | -   establish end product (EP) control for the          |
|            |     incomplete claim.                                   |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   Whenever possible, telephone the veteran to obtain  |
|            |     the information needed to substantiate the claim.   |
|            |                                                         |
|            | > ***Reference***: For more information on what         |
|            | > constitutes a substantially complete application, see |
|            |                                                         |
|            | -   [38 CFR                                             |
|            |     3.159(a)(3)](http://w                               |
|            | ww.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_159.DOC), |
|            |     and                                                 |
|            |                                                         |
|            | -   [M21-1MR, Part I,                                   |
|            |     1.B.3.a](../pt01_ch01_secB.xml#I.1.B.3.a).          |
+------------+---------------------------------------------------------+

Continued on next page

28\. Developing Claims for Service Connection for Disabilities Resulting
From Exposure to Herbicides Containing 2, 3, 7, 8
Tetrachlorodibenzo-P-Dioxin (TCDD) During Service in the Republic of
Vietnam (RVN), Continued

+------------+---------------------------------------------------------+
| ###        | > Claims for                                            |
| ## h. Cons |                                                         |
| idering Cl | -   benefits for a child suffering from spina bifida    |
| aims for B |     and other birth defects are discussed in [M21-1MR,  |
| enefits Ba |     Part                                                |
| sed on Bir |     VI](http://                                         |
| th Defects | vbaw.vba.va.gov/bl/21/M21-1MR/m21-1mr_main.htm#part-6), |
|            |     and                                                 |
|            |                                                         |
|            | -   additional benefits for female Vietnam veterans due |
|            |     to certain birth defects of a natural child have    |
|            |     been authorized under *PL 106-419*.                 |
|            |                                                         |
|            | > ***Important***: The law limits the birth defects for |
|            | > which VA may pay benefits. Deny claims for            |
|            | > compensation for the following on the basis that it   |
|            | > is not authorized by law:                             |
|            |                                                         |
|            | -   birth defects resulting from a familial disorder    |
|            |                                                         |
|            | -   a birth-related injury, or                          |
|            |                                                         |
|            | -   a fetal or neonatal infirmity, with                 |
|            |     well-established, unrelated causes.                 |
|            |                                                         |
|            | > ***Reference***: For more information on claims for   |
|            | > benefits for birth defects from children of Vietnam   |
|            | > veterans, see                                         |
|            |                                                         |
|            | -   [M21-1MR, Part                                      |
|            |     VI](http:/                                          |
|            | /vbaw.vba.va.gov/bl/21/M21-1MR/m21-1mr_main.htm#part-6) |
|            |                                                         |
|            | -   [38 CFR                                             |
|            |     3.814](http://                                      |
|            | www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_814.DOC) |
|            |                                                         |
|            | -   [38 CFR                                             |
|            |     3.815](http:                                        |
|            | //vbaw.vba.va.gov/bl/21/publicat/Regs/Part3/3_815.htm), |
|            |     and                                                 |
|            |                                                         |
|            | -   [38 U.S.C. Chapter                                  |
|            |     18](http://straylight.law.cornell.ed                |
|            | u/uscode/html/uscode38/usc_sup_01_38_10_II_20_18.html). |
+------------+---------------------------------------------------------+

#### 29. Developing Claims for Service Connection for Asbestos-Related Diseases

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on developing claims  |
| troduction | > for service connection for asbestos-related diseases, |
|            | > including information on                              |
|            |                                                         |
|            | -   considering the latent period and type of asbestos  |
|            |     exposure                                            |
|            |                                                         |
|            | -   the responsibilities of the rating activity, and    |
|            |                                                         |
|            | -   the action to take when no disability is claimed.   |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > September 29, 2006                                    |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### a.   | > Many people with asbestos-related diseases have only  |
|  Consideri | > recently come to medical attention because the latent |
| ng the Lat | > period varies from 10 to 45 or more years between the |
| ent Period | > first exposure and development of a disease.          |
|  and Type  | >                                                       |
| of Asbesto | > ***Note***: The exposure may have been direct or      |
| s Exposure | > indirect; the extent and duration of exposure is not  |
|            | > a factor.                                             |
|            | >                                                       |
|            | > ***Reference***: For more information on              |
|            | > asbestos-related diseases, see [M21-1MR, IV, Subpart  |
|            | > ii, 2.C.9](../pt04_sp02_ch02_secC.xml#IV.ii.2.C.9).   |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### b.   | > The rating activity is responsible for                |
|  Responsib |                                                         |
| ilities of | -   determining whether or not the evidence of record   |
|  the Ratin |     confirms the veteran was exposed to asbestos during |
| g Activity |     service, and                                        |
|            |                                                         |
|            | -   ensuring that development is accomplished to        |
|            |     determine whether the veteran was exposed to        |
|            |     asbestos (as a result of his/her occupation, for    |
|            |     example) before or after service.                   |
+------------+---------------------------------------------------------+

Continued on next page

29\. Developing Claims for Service Connection for Asbestos-Related
Diseases, Continued

+------------+---------------------------------------------------------+
| ###        | > A claim is not substantially complete if a veteran    |
| ## c. Acti | > alleges exposure to asbestos during service, but does |
| on to Take | > not claim service connection for a specific           |
|  When No D | > disability. In cases such as this                     |
| isability  |                                                         |
| Is Claimed | -   inform the veteran that exposure, in and of itself, |
|            |     is not a disability, and                            |
|            |                                                         |
|            | -   ask the veteran to identify the disability(ies)     |
|            |     that resulted from exposure to asbestos during      |
|            |     service.                                            |
|            |                                                         |
|            | > ***Important***:                                      |
|            |                                                         |
|            | -   Do not                                              |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   process the claim as a denial, or                   |
|            |                                                         |
|            | -   establish end product (EP) control for the          |
|            |     incomplete claim.                                   |
|            |                                                         |
|            | ```{=html}                                              |
|            | <!-- -->                                                |
|            | ```                                                     |
|            | -   Whenever possible, telephone the veteran to obtain  |
|            |     the information needed to substantiate the claim.   |
|            |                                                         |
|            | > ***Reference***: For more information on what         |
|            | > constitutes a substantially complete application, see |
|            |                                                         |
|            | -   [38 CFR                                             |
|            |     3.159(a)(3)](http://w                               |
|            | ww.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_159.DOC), |
|            |     and                                                 |
|            |                                                         |
|            | -   [M21-1MR, Part I,                                   |
|            |     1.B.3.a](../pt01_ch01_secB.xml#I.1.B.3.a).          |
+------------+---------------------------------------------------------+

#### 30. Developing Claims for Service Connection for Acquired Immune Deficiency Syndrome (AIDS)

+------------+---------------------------------------------------------+
| ##### In   | > This topic contains information on developing claims  |
| troduction | > for service connection for acquired immune deficiency |
|            | > syndrome (AIDS***)***. It includes information on     |
|            |                                                         |
|            | -   the definition of ***AIDS***                        |
|            |                                                         |
|            | -   the causative agent of AIDS                         |
|            |                                                         |
|            | -   the tests available to verify AIDS                  |
|            |                                                         |
|            | -   obtaining medical records, and                      |
|            |                                                         |
|            | -   when to send the claim to the rating activity.      |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### C    | > September 5, 2008                                     |
| hange Date |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| #####      | > ***Acquired immune deficiency syndrome (AIDS)*** is   |
|  a. Defini | > defined by the Centers for Disease Control (CDC) as   |
| tion: AIDS | > "a disease at least moderately predictive of a defect |
|            | > in cell-mediated immunity occurring in a person with  |
|            | > no known cause for diminished resistance to that      |
|            | > disease."                                             |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##         | > AIDS is caused by the human immunodeficiency virus    |
| ### b. Cau | > (HIV).                                                |
| sative Age |                                                         |
| nt of AIDS |                                                         |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ##### c.   | > The most commonly used lab test for AIDS is the HIV   |
| Tests Avai | > antibody test.                                        |
| lable to V | >                                                       |
| erify AIDS | > The following two HIV antibody tests are available:   |
|            |                                                         |
|            | -   the screening enzyme-linked immunosorbent assay     |
|            |     (ELISA) test, and                                   |
|            |                                                         |
|            | -   the confirmatory Western Blot test.                 |
+------------+---------------------------------------------------------+

Continued on next page

30\. Developing Claims for Service Connection for Acquired Immune
Deficiency Syndrome (AIDS), Continued

+------------+---------------------------------------------------------+
| ####       | > Request                                               |
| # d. Obtai |                                                         |
| ning Medic | -   service treatment records (STRs) if they are not in |
| al Records |     the claims folder, and                              |
|            |                                                         |
|            | -   records of treatment from a VAMC or VA outpatient   |
|            |     clinic, if the veteran indicates that he/she        |
|            |     received treatment at one of these facilities.      |
|            |                                                         |
|            | > Send the veteran *VA Form 21-4142*, *Authorization    |
|            | > and Consent to Release Information to the Department  |
|            | > of Veterans Affairs(VA,)* if he/she                   |
|            |                                                         |
|            | -   reports treatment by a private hospital or          |
|            |     physician, but                                      |
|            |                                                         |
|            | -   does not furnish the treatment records.             |
+------------+---------------------------------------------------------+

+------------+---------------------------------------------------------+
| ####       | > If a substantially complete claim exists, send the    |
| # e. When  | > claim to the rating activity.                         |
| to Send th | >                                                       |
| e Claim to | > ***Reference***: For information on what constitutes  |
|  the Ratin | > a substantially complete claim, see                   |
| g Activity |                                                         |
|            | -   [M21-1MR, Part I,                                   |
|            |     1.B.3.a](../pt01_ch01_secB.xml#I.1.B.3.a), and      |
|            |                                                         |
|            | -   [38 CFR                                             |
|            |     3.159(a)(3)](http://w                               |
|            | ww.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_159.DOC). |
+------------+---------------------------------------------------------+