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VA Issues Final Rule on 'Presumptive' Illnesses

 |  By John Commins  
   September 30, 2010

A final regulation from the Veterans Administration makes receiving healthcare and disability compensation for diseases it easier for veterans who served in the Gulf War, Iraq, and Afghanistan. The rule adds nine infectious disease "presumptives" associated with military service.

"This is part of historic changes in how VA considers Gulf War Veterans' illnesses," says Secretary of Veterans Affairs Eric K. Shinseki. "By setting up scientifically based presumptions of service connection, we give these deserving veterans a simple way to obtain the medical and compensation benefits they earned in service to our country."

The final regulation—published Wednesday in the Federal Register—establishes presumptions of service connection for nine specific infectious diseases associated with military service in Southwest Asia beginning on or after the start of the first Gulf War on Aug. 2, 1990, through the conflict in Iraq and on or after Sept. 19, 2001, in Afghanistan.

The regulation reflects an association between service in Southwest Asia or Afghanistan and nine diseases and includes information about the long-term health effects potentially associated with these diseases: Brucellosis, Campylobacter jejuni, Coxiella Burnetii (Q fever), Malaria, Mycobacterium tuberculosis, Nontyphoid Salmonella, Shigella, Visceral leishmaniasis and West Nile virus.

With the final rule, a veteran will only have to show service in Southwest Asia or Afghanistan and that he or she had one of the nine diseases within a certain time after service and has a current disability as a result of that disease, subject to certain time limits for seven of the diseases. Most of these diseases would be diagnosed within one year of return from service, though some conditions may become apparent later than that.

For non-presumptive conditions, a veteran is required to provide medical evidence to establish an actual connection between military service in Southwest Asia or Afghanistan and a specific disease. The decision to add these "presumptives" was made after reviewing a 2006 report from the National Academy of Sciences Institute of Medicine that looked at the long-term health effects of diseases affecting to Gulf War veterans. The VA included Afghanistan veterans because NAS found that the nine diseases are also prevalent in that country.

The 1998 Persian Gulf War Veterans Act requires the VA to review NAS reports that study possibly links between illnesses and exposure to toxic agents by veterans who served in the Persian Gulf War.

In a separate development, Shinseki, and former VA Secretary Anthony Principi, MD, told the Senate Veterans Affairs Committee this month that they still stand behind their decisions to add diabetes, prostate cancer, heart disease, Parkinson's disease, and leukemia to the those conditions that VA officials can "presume" to be caused by Agent Orange exposure among Vietnam War veterans. With associated cases and costs quickly rising, the Senate is panel is reviewing the landmark 1991 Agent Orange regulation that has set the tone in terms of how disability claims are handled in regard to the herbicide and defoliant widely used during the Vietnam War. By granting a "presumption," the VA creates a way to bypass the standard process for filing disability claims.

See also:

VA to Improve Access to Health Benefits Info

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.

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