We have previously written on how the VA has implemented new rules on Gulf War syndrome seemingly rewriting the rules in favor of veterans. However there are still many potential pitfalls for the complicated rules relating to gulf war syndrome. The rules apply to Gulf War veterans who have served in either the first Persian Gulf War, as well as the more recent Operations Enduring Freedom and Iraqi Freedom. There are two types of problems that allow gulf war veterans to be compensated the first is:
1. undiagnosed illnesses
2. “chronic multisymptom illnesses” (only medically unexplained illnesses)
3. diagnosed illnesses (presumptively service connected)
VA examiners are unfortunately quick to label or shoehorn vague symptoms into a diagnosed illness that can be related to a known cause and therefore the VA would not need to compensate the Veteran. There are some techniques that could be helpful for counteracting this VA strategy. The veteran could 1. state that the problem cannot be related to any particular diagnosis (usually by expert medical opinion) 2. Also with an expert medical opinion state that the claimed diagnosis is really a chronic multisymptom illness (the examples here were previously explained and would include fibromyalgia, chronic fatigue symdrome, or irritable bowel syndrome) 3. Lastly, there is the option to argue for direct service connection. This last option would likely be difficult since it would require fairly convincing evidence that it is as likely as not that the chemicals or toxins that one were exposed to caused any given illness.
Certain illnesses will not be regarded as medically unexplained and for a gastrointestinal problem has to be a “functional” as opposed to a “structural” problem. The difference is an issue like Crohn’s disease or acid reflux (GERD) are thought to be structural as opposed to functional. 76 Fed. Reg. 41,696 (July 15, 2011). There could be many other problems that are considered medically unexplained but the rule does specifically mention problems that would not be considered as such including diabetes.