b. Provisions of the GW Veterans’ Act of 1998 The “Persian Gulf War Veterans’ Act of 1998,” PL 105-277, authorized VA to compensate GW Veterans for diagnosed or undiagnosed disabilities that are determined by VA regulation to warrant a presumption of service connection (SC) based on a positive association with exposure to one of the following as a result of GW service a toxic agent an environmental or wartime hazard, or a preventive medication or vaccine. Note: This PL added . c. Provisions of the Veterans Education and Benefits Expansion Act of 2001 The “Veterans Education and Benefits Expansion Act of 2001,” PL 107-103, expanded the definition of “qualifying chronic disability” under to include, effective March 1, 2002, not only a disability resulting from an undiagnosed illness but also a medically unexplained chronic illness (MUCMI)that is defined by a cluster of signs and symptoms, and any diagnosed illness that is determined by VA regulation to warrant presumption of SC. Reference: For more information on MUCMIs, see M21-1, Part IV, Subpart ii, 2.D.1.i. d. Provisions of 38 CFR 3.317 implements by defining certain key terms and providing for presumptive SC for undiagnosed illness or MUCMIs, and a list of infectious diseases. e. Definition: Qualifying Veteran Under 38 CFR 3.317 A qualifying Veteran, under , is a Veteran who served on active military, naval, or air service in the Southwest Asia theater of operations during the GW period. Per , the GW period extends from August 2, 1990, through a date yet to be determined by law or Presidential proclamation. Reference: For a definition of the Southwest Asia theater of operations, see , and M21-1, Part IV, Subpart ii, 2.D.1.f.
fundamentally different body systems that may clearly warrant separate consideration. If SC for several symptoms or is denied for the same reason, consider such symptoms and signs as a single issue. Assign one hyphenated diagnostic code (DC) on the codesheet to each issue that is separately considered, whether SC is awarded or denied. b. Information Required to Decide the Issue of SC for a Chronic Qualifying Disability The following information is required to determine whether SC for a chronic qualifying disability is in order: when the disability arose whether the disability was severe enough to warrant the award of a compensable evaluation at any time during the presumptive period, unless manifested while in the Southwest Asia theater, and whether the disability chronically persisted for at least six months. Reference: For more information on development requirements for claims based on service in Southwest Asia, see M21-1, Part IV, Subpart ii, 1.E. c. Role of the Veteran’s Testimony in Establishing Signs or Symptoms When considering disabilities the provisions of , a Veteran’s lay statement describing his or her own symptoms of a qualifying disability takes on a greater importance than when considering other claims under direct SC principles. as indicated in M21-1, Part IV, Subpart ii, 1.E.2.a, the threshold for ordering an examination based on claims under is low, as the claimant’s statement alone, describing symptoms, may be sufficient to trigger an examination. Second, lay evidence describing symptoms unsupported by clinical findings is sufficient to establish SC under as long as there is medical evidence showing that “no medical diagnosis” is present. Important: The Federal Circuit, in , 766 F.3d 1939 (Fed. Cir. 2014) held that “neck pain,” that was unsupported by physical examination findings or laboratory tests, may establish an undiagnosed illness that causes a qualifying chronic disability. This demonstrates the importance of the Veteran’s testimony, which is essentially all that is needed for the examiner to characterize the symptoms as an “undiagnosed illness” and for SC to be granted, if all other SC requirements are otherwise met. References: For more information on requesting examinations in GW claims, see M21-1, Part III, Subpart iv, 3.A, and