**§3.317 Compensation for certain disabilities due to undiagnosed
illnesses.**

\(a\) (1) Except as provided in paragraph (c) of this section, VA will
pay compensation in accordance with chapter 11 of title 38, United
States Code, to a Persian Gulf veteran who exhibits objective
indications of a qualifying chronic disability, provided that such
disability:

\(i\) Became manifest either during active military, naval, or air
service in the Southwest Asia theater of operations during the Persian
Gulf War, or to a degree of 10 percent or more not later than December
31, 2011; and

\(ii\) By history, physical examination, and laboratory tests cannot be
attributed to any known clinical diagnosis.

\(2\) (i) For purposes of this section, a *qualifying chronic
disability* means a chronic disability resulting from any of the
following (or any combination of the following):

\(A\) An undiagnosed illness;

\(B\) The following medically unexplained chronic multisymptom illnesses
that are defined by a cluster of signs or symptoms:

> (*1*) Chronic fatigue syndrome;
>
> (*2*) Fibromyalgia;
>
> (*3*) Irritable bowel syndrome; or
>
> (*4*) Any other illness that the Secretary determines meets the
> criteria in paragraph (a)(2)(ii) of this section for a medically
> unexplained chronic multisymptom illness; or

\(C\) Any diagnosed illness that the Secretary determines in regulations
prescribed under 38 U.S.C. 1117(d) warrants a presumption of
service-connection.

\(ii\) For purposes of this section, the term *medically unexplained
chronic multisymptom illness* means 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.

\(3\) For purposes of this section, "objective indications of chronic
disability" include both "signs," in the medical sense of objective
evidence perceptible to an examining physician, and other, non-medical
indicators that are capable of independent verification.

\(4\) For purposes of this section, disabilities that have existed for 6
months or more and disabilities that exhibit intermittent episodes of
improvement and worsening over a 6-month period will be considered
chronic. The 6-month period of chronicity will be measured from the
earliest date on which the pertinent evidence establishes that the signs
or symptoms of the disability first became manifest.

\(5\) A chronic disability resulting from an undiagnosed illness
referred to in this section shall be rated using evaluation criteria
from part 4 of this chapter for a disease or injury in which the
functions affected, anatomical localization, or symptomatology are
similar.

\(6\) A disability referred to in this section shall be considered
service connected for purposes of all laws of the United States.

\(b\) For the purposes of paragraph (a)(1) of this section, signs or
symptoms which may be manifestations of undiagnosed illness or medically
unexplained chronic multisymptom illness include, but are not limited
to:

\(1\) Fatigue

\(2\) Signs or symptoms involving skin

\(3\) Headache

\(4\) Muscle pain

\(5\) Joint pain

\(6\) Neurologic signs and symptoms

\(7\) Neuropsychological signs or symptoms

\(8\) Signs or symptoms involving the respiratory system (upper or
lower)

\(9\) Sleep disturbances

\(10\) Gastrointestinal signs or symptoms

\(11\) Cardiovascular signs or symptoms

\(12\) Abnormal weight loss

\(13\) Menstrual disorders.

\(c\) Compensation shall not be paid under this section:

\(1\) If there is affirmative evidence that an undiagnosed illness was
not incurred during active military, naval, or air service in the
Southwest Asia theater of operations during the Persian Gulf War; or

\(2\) If there is affirmative evidence that an undiagnosed illness was
caused by a supervening condition or event that occurred between the
veteran's most recent departure from active duty in the Southwest Asia
theater of operations during the Persian Gulf War and the onset of the
illness; or

\(3\) If there is affirmative evidence that the illness is the result of
the veteran's own willful misconduct or the abuse of alcohol or drugs.

\(d\) For purposes of this section:

\(1\) The term *Persian Gulf veteran* means a veteran who served on
active military, naval, or air service in the Southwest Asia theater of
operations during the Persian Gulf War.

\(2\) The Southwest Asia theater of operations 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. (Authority: 38 U.S.C. 1117)

\[60 FR 6665, Feb. 3, 1995, as amended at 62 FR 23139, Apr. 29, 1997; 63
FR 11122, Mar. 6, 1998; 66 FR 56615, Nov. 9, 2001; 67 FR 78979, Dec. 27,
2002; 68 FR 34541, June 10, 2003; 71 FR 75672, Dec. 18, 2006; 72 FR
68507, Dec. 5, 2007\]

**Supplement *Highlights* references**: 14(5), 29(1), 48(2), 57(1),
74(3), 75(1), 77(1).