Qualifying Gulf War veterans receive presumptive service connection if they suffer from “a qualifying chronic disability” and the particular chronic disability manifested during active military service in the Southwest Asia Theater of operations or to a degree of 10% anytime since the veteran’s return from active duty in Southwest Asia. A “qualifying chronic disability” can be any of the following (or a combination of the following):
- An undiagnosed illness.
- A medically unexplained chronic multisymptom illness
- A diagnosed illness that the Secretary determines warrants a presumption of service connection.
Today, we will look at the third qualifying chronic disability: infectious diseases. Congress has directed the VA to determine whether any illness warrants a presumption of service connection “by reason of having a positive association with exposure to a biological, chemical, or other toxic agent, environmental or wartime hazard, or preventative medicine or vaccine know or presumed to be associated with service” during the Persian Gulf War. Veterans with active service in Afghanistan on or after September 19, 2001 (Operation Enduring Freedom vets) are entitled to presumptive service connection for the recognized infectious diseases even though they never served in Southwest Asia.
The VA currently recognizes 9 infectious diseases that warrant presumptive service connection. The infectious disease must manifest to a degree of 10% within one year from separation from service. However, there are two diseases which will be presumptively service-connected unless proven otherwise, no matter how long they take to manifest. These two diseases are mycobacterium tuberculosis and visceral leishmaniasis.
Keep in mind that The VA Gulf War Veterans Illnesses Task Force continues to research possible causes of illness in Gulf War veterans, so the above list may be added to in the future. In addition to the Task Force, the VA, The National Academy of Sciences, The National Institutes of Health and numerous other medical researchers are also researching the health of Persian Gulf War veterans.
The table below lists the 9 recognized infectious diseases along with the symptoms of each disease.
| DISEASE | SYMPTOMS |
| Brucellosis | A bacterial disease with symptoms such as profuse sweating and joint and muscle pain. The illness may be chronic and persist for years. |
| Campylobacter Jejuni | A disease with symptoms such as abdominal pain, diarrhea, and fever. |
| Coxielle Burnetii (Q fever) | A bacterial disease with symptoms such as fever, severe headache, and gastrointestinal problems such as nausea and diarrhea. In chronic cases, the illness may cause inflammation of the heart. |
| Malaria | An infectious disease caused by a parasite transmitted by mosquitoes. Symptoms include chills, fever, and sweats. |
| Mycobacterium Tuberculosis | An illness that primarily affects the lungs and causes symptoms such as chest pain, persistent cough (sometimes bloody), weight loss, and fever. |
| Nontyphoid Salmonella | A condition characterized by symptoms such as nausea, vomiting and diarrhea. |
| Visceral Leishmaniasis | A parasitic disease characterized by symptoms such as fever, weight loss, enlargement of the spleen and liver, and anemia. The condition may be fatal if left untreated. |
| West Nile Virus | A disease spread by mosquitoes characterized by symptoms such as fever, headache, and muscle pain or weakness, nausea, and vomiting. Symptoms may range from mild to severe. |
Additionally, each of the nine infectious diseases that receive presumptive service connection may cause long-term health effects that may potentially be eligible to receive secondary service connection. The table below lists the 9 recognized infectious diseases along with long-term health effects associated with each disease.
| DISEASE | HEALTH EFFECTS |
| Brucellosis | Arthritis; cardiovascular, nervous, and respiratory system infections; chronic meningitis and meningoencephalitis; deafness; episcleritis; fatigue, inattention, amnesia, and depression; Guillain-Barre syndrome; hepatic abnormalities (including granulomatous hepatitis); mulifocal choroiditis; myelitis-radiculoneuritis; nummular keratitis; papilledema; optic neuritis; orchioepididymitis and infections of the genitourinary system; sensorineural hearing loss; spondylitis; uveitis. |
| Campylobacter Jejuni | Guillian-Barre syndrome (if maniftested within 2 months of the infection); reactive arthritis (if manifested within 3 months of the infection); uveitis (if manifested within 1 month of the infection). |
| Coxiella Burnetii (Q fever) | Chronic hepatitis; endocarditis; osteomyelitis; post Q-fever chronic fatigue syndrome; vascular infection. |
| Malaria | Demyelinating polyneuropathy; Guillan-Barr syndrome; hematologic manifestations (i.e. anemia); immune-complex glomerulonephritis; neurologic disease, neuropsychiatric disease, or both; ophthalmologic manifestations (particularly retinal hemorrhage and scarring); plasmodium falciparum; plasmodium malariae; plasmodium ovale; plasmodium vivax; renal disease (especially nephrotic syndrome). |
| Mycobacterium Tuberculosis | Active tuberculosis; long-term adverse health outcomes due to irreversible tissue damage from severe forms of pulmonary and extra pulmonary tuberculosis and active tuberculosis. |
| Nontyphoid Salmonella | Reactive arthritis (if manifested within 3 months of the infection). |
| Shigella | Hemolytic-uremic syndrome (if manifested within 1 month of the infection); reactive arthritis (if manifested within 1 month of the infection). |
| Visceral Leishmaniasis | Delayed presentation of the acute clinical syndrome; post-kala-azar dermal leishmaniasis (if manifested within 2 years of the infection); reactivation of visceral leishmaniasis in the context of immunosuppression |
| West Nile Virus | Variable physical, functional, or cognitive disability. |
If a veteran is service-connected for one of the nine infectious diseases and is diagnosed with one of the potentially related conditions listed in the table above within the time period specified, VA regulations say that the “VA will request a medical opinion as to whether it is at least as likely as not that the condition was caused by the veteran having had the service-connected infectious disease.” In other words, the VA is required to provide a medical nexus opinion in cases where the veteran has a diagnosis of one of the long-term health effects associated with the recognized infectious diseases.
Again, many of these infectious diseases can lead to other health issues down the road. It is important to get service-connection for an infectious disease as soon as you can, even if it doesn’t bother you much today. You don’t know when secondary health issues will follow, or how mad they might get.
