# Presentation: 031156

## Chronology of VBA Responses to the Gulf War
Bradley Flohr
Assistant Director for Policy, Compensation and Pension Service
September 25, 2008

- Bradley Flohr
- Assistant Director for Policy, Compensation and Pension Service
- September 25, 2008

## Briefing Objectives

- Explain VA statutes and regulations for benefits based on service in the Gulf War
- Explain VBA’s actions in response to Congress and Gulf War veterans

## Statutes and Regulations

- PL 103-446 – VBIA of 1994
- Authorized compensation for undiagnosed illnesses
- 38 CFR 3.317 – February 1995
- Implemented the statute, including a 2-year presumptive period following GW service

## Chronology of Actions

- August 1990 - Modifier added to control mechanism for claims from GW vets based on environmental hazards endemic to GW theater
- July 1991 – VBA published instructions to field stations for reporting claims based on exposure to environmental hazards
- To identify patterns of claims sharing common environmental factor
- December 1992 – claims centralized to the Louisville RO

## Chronology (cont.)

- December 1993 – 83 claims had been granted based on environmental hazards out of 1676 decided.  Biggest reason for denial was a large number of claims based on exposure only
- October 1994 – claims redistributed to 3 additional ROs – Phoenix, Nashville and Philadelphia
- November 1994 – PL 103-446
- February 1995 – GW claims based on undiagnosed illnesses centralized to the four RO processing sites – a readjudication of previously denied claims was directed for possible entitlement under PL 103-446

## Chronology (cont.)

- 1995-1996 – Five quality reviews of rating decisions conducted by C&P Service
- February 1995 – Instructions to ROs for implementing PL 103-446 included a requirement to readjudicate all prior denied claims
- March to May 1996 – separate reviews of cases being tracked were conducted
- July 1996 through 1997 – a review of approximately 10,000 cases conducted
- March 1997 – President approved a request by Secretary Brown to extend eligibility period for undiagnosed illnesses from 2 years post service to December 31, 2001.

## Chronology (cont.)

- April 1997 - Section 3.317 amended to extend presumptive date to December 31, 2001
- Readjudication project expanded to include denials on the basis of net meeting the prior 2-year presumptive period; additional 4,000 cases added to readjudication list
- GW claims redistributed to all ROs – concerns about training for employees were raised
- May 1997 – 2-hour satellite broadcast conducted for all ROs regarding GW issues

## Chronology (cont.)

- June 1997 – in depth training session for representatives of all offices; subsequent workshops conducted for all offices
- June 1997 – Rapid Response Team formed and weekly GW conference calls initiated with ROs
- July 1997 – each RO required to submit monthly report of a review of GW ratings to C&P Service
- October 1997 – Study of national sample of GW cases conducted
- February 1998 – guidelines for medical examinations of GW veterans transmitted to ROs and VAMCs
- February 1998 – VA contracted with NAS for reviews of exposure to environmental hazards and the subsequent development of disease.

- April 1998 – Study of 101 Gulf War cases completed – 23% grant rate for undiagnosed illnesses
- June 1998 – conference calls reduced to monthly until April 1999, when discontinued
- End of 1998 – readjudication completed
- September 2001 – VBA conducted a review of 800 denied claims based on undiagnosed illnesses
- December 2001 – The Secretary made a decision to service connect vets of the GW who develop ALS
- PL 107-103 – Veterans Education and Benefits Expansion Act of 2001 signed into law

## Chronology (cont.)

- March 2003 – Based on PL 107-103, VA added chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome as presumptive diseases based on GW service.
- October 2006 – GW and Health, Volume 5 (infectious diseases) released
- January 2008 – Secretary informed Congress of intent to create 9 new presumptions (brucellosis, campylobacter jejuni, Q fever, malaria, mycobacterium tuberculosis, nontyphoid salmonella, shigella, visceral leishmaniasis, West Nile fever).