Gulf War and PACT Act Presumptive Conditions: Detailed Descriptions, Symptoms, and Rating Criteria Gulf War Presumptive Conditions

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Veterans looking to file a claim under the PACT Act should be aware of a key deadline to maximize their benefits. The PACT Act, signed into law in August 2022, expands VA benefits and healthcare for veterans exposed to toxic substances such as burn pits, Agent Orange, and other hazardous materials. To be eligible for backdated benefits to August 10, 2022, veterans must file their claims or submit an intent to file by August 14, 2024. Meeting this deadline ensures that veterans receive retroactive compensation for their service-related health conditions, acknowledging the time since the enactment of the PACT Act​ (Veterans Affairs)​​ (Consumer Advice)​.

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It is important to note that while the PACT Act itself will remain in effect beyond this date, the opportunity for back pay extending to August 2022 will no longer be available for claims filed after August 14, 2024. Therefore, veterans are encouraged to file their claims as soon as possible to take full advantage of the benefits owed to them. Filing promptly secures these backdated benefits and expedites access to the comprehensive healthcare and compensation provided under the PACT Act for conditions presumed to be related to toxic exposures during military service​.

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1. Chronic Fatigue Syndrome (CFS)

   • Description: A debilitating disorder characterized by extreme fatigue that cannot be explained by any underlying medical condition. The fatigue worsens with physical or mental activity but does not improve with rest.

   • Symptoms: Severe tiredness lasting more than 24 hours after physical or mental exertion, unrefreshing sleep, memory problems, muscle pain, headaches, and sore throat.

   • Rating Criteria:

     • 10%: Symptoms which wax and wane but result in periods of incapacitation of at least one but less than two weeks total duration per year, or symptoms controlled by continuous medication.

     • 20%: Symptoms resulting in periods of incapacitation of at least two but less than four weeks total duration per year.

     • 40%: Symptoms resulting in periods of incapacitation of at least four but less than six weeks total duration per year.

     • 60%: Symptoms resulting in periods of incapacitation of at least six but less than eight weeks total duration per year.

     • 100%: Symptoms resulting in periods of incapacitation of at least eight weeks total duration per year.

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1. Fibromyalgia

   • Description: A condition characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory, and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way the brain and spinal cord process painful and nonpainful signals.

   • Symptoms: Widespread pain, fatigue, cognitive difficulties (often referred to as "fibro fog"), irritable bowel syndrome, and depression.

   • Rating Criteria:

     • 10%: Symptoms require continuous medication for control.

     • 20%: Symptoms that are episodic with exacerbations often enough to produce moderate impairment.

     • 40%: Symptoms that are constant, or nearly so, and refractory to therapy.

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1. Functional Gastrointestinal Disorders (e.g., IBS)

   • Description: Disorders where the gastrointestinal tract behaves abnormally, causing symptoms without any structural or biochemical abnormalities. IBS is one of the most common.

   • Symptoms: Chronic or recurrent abdominal pain, bloating, and changes in bowel habits such as diarrhea or constipation.

   • Rating Criteria:

     • 10%: Mild with occasional episodes of abdominal distress.

     • 30%: Moderate with frequent episodes of bowel disturbance with abdominal distress.

     • 60%: Severe with diarrhea, or alternating diarrhea and constipation, with more or less constant abdominal distress.

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1. Undiagnosed Illnesses

   • Description: Conditions that present a variety of signs and symptoms that cannot be attributed to any known clinical diagnosis. These are often referred to as "Gulf War Syndrome".

   • Symptoms: Fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, and memory problems.

   • Rating Criteria: Evaluated based on the severity and impact of the individual symptoms on the veteran's ability to function.

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1. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

   • Description: A severe, long-term illness that affects many body systems, making it hard to do usual activities. ME/CFS is more than being tired; it can severely impact a person's quality of life.

   • Symptoms: Severe fatigue, sleep problems, pain, and difficulties with concentration and memory.

   • Rating Criteria: Same as Chronic Fatigue Syndrome (see above).

 

 

PACT Act Presumptive Conditions

 

• Asthma

  • Description: A chronic condition that affects the airways in the lungs, causing them to become inflamed and narrow, making it difficult to breathe.

  • Symptoms: Wheezing, shortness of breath, chest tightness, and coughing, especially at night or early morning.

  • Rating Criteria:

    • 10%: FEV-1 of 71- to 80-percent predicted, or FEV-1/FVC of 71 to 80 percent, or intermittent inhalational or oral bronchodilator therapy.

    • 30%: FEV-1 of 56- to 70-percent predicted, or FEV-1/FVC of 56 to 70 percent, or daily inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication.

    • 60%: FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; at least monthly visits to a physician for required care of exacerbations, or; intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids.

    • 100%: FEV-1 less than 40-percent predicted, or; FEV-1/FVC less than 40 percent, or; more than one attack per week with episodes of respiratory failure, or; requires daily use of systemic (oral or parenteral) high dose corticosteroids or immuno-suppressive medications.

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• Chronic Bronchitis

  • Description: A form of chronic obstructive pulmonary disease (COPD) characterized by chronic inflammation of the bronchi, leading to coughing and mucus production.

  • Symptoms: Persistent cough, mucus production, shortness of breath, wheezing, and chest discomfort.

  • Rating Criteria:

    • 10%: FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; DLCO (SB) 66- to 80-percent predicted.

    • 30%: FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; DLCO (SB) 56- to 65-percent predicted.

    • 60%: FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; DLCO (SB) 40- to 55-percent predicted, or; maximum oxygen consumption of 15 to 20 ml/kg/min (with cardiorespiratory limit).

    • 100%: FEV-1 less than 40-percent predicted, or; FEV-1/FVC less than 40 percent, or; DLCO (SB) less than 40-percent predicted, or; maximum exercise capacity less than 15 ml/kg/min oxygen consumption (with cardiac or respiratory limitation), or; cor pulmonale (right heart failure), or; right ventricular hypertrophy, or; pulmonary hypertension (shown by Echo or cardiac catheterization), or; episode(s) of acute respiratory failure, or; requires outpatient oxygen therapy.

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• Chronic Obstructive Pulmonary Disease (COPD)

  • Description: A group of progressive lung diseases, including emphysema and chronic bronchitis, that cause breathing difficulties.

  • Symptoms: Shortness of breath, wheezing, chest tightness, chronic cough, and frequent respiratory infections.

  • Rating Criteria:

    • 10%: FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; DLCO (SB) 66- to 80-percent predicted.

    • 30%: FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; DLCO (SB) 56- to 65-percent predicted.

    • 60%: FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; DLCO (SB) 40- to 55-percent predicted, or; maximum oxygen consumption of 15 to 20 ml/kg/min (with cardiorespiratory limit).

    • 100%: FEV-1 less than 40-percent predicted, or; FEV-1/FVC less than 40 percent, or; DLCO (SB) less than 40-percent predicted, or; maximum exercise capacity less than 15 ml/kg/min oxygen consumption (with cardiac or respiratory limitation), or; cor pulmonale (right heart failure), or; right ventricular hypertrophy, or; pulmonary hypertension (shown by Echo or cardiac catheterization), or; episode(s) of acute respiratory failure, or; requires outpatient oxygen therapy.

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• Chronic Rhinitis

  • Description: Inflammation of the nasal mucous membrane, often causing nasal congestion, runny nose, and sneezing.

  • Symptoms: Nasal congestion, runny nose, sneezing, itching, and postnasal drip.

  • Rating Criteria:

    • 10%: With polyps, or without polyps but with greater than 50-percent obstruction of nasal passage on both sides or complete obstruction on one side.

    • 30%: With polyps.

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• Chronic Sinusitis

  • Description: Long-term inflammation of the sinuses, often resulting in blocked sinuses and pain.

  • Symptoms: Facial pain/pressure, nasal congestion, nasal discharge, loss of smell, and cough.

  • Rating Criteria:

    • 10%: One or two incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; three to six non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting.

    • 30%: Three or more incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; more than six non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting.

    • 50%: Following radical surgery with chronic osteomyelitis, or; near constant sinusitis characterized by headaches, pain and tenderness of affected sinus, and purulent discharge or crusting after repeated surgeries.

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• Constrictive Bronchiolitis

  • Description: A rare, but serious condition characterized by the narrowing of the smallest airways in the lungs due to inflammation and scarring.

  • Symptoms: Shortness of breath, cough, and wheezing.

  • Rating Criteria: Evaluated based on the severity and impact of the individual symptoms on the veteran's ability to function, similar to other respiratory conditions.

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• Emphysema

  • Description: A type of COPD involving damage to the air sacs (alveoli) in the lungs, leading to difficulty breathing.

  • Symptoms: Shortness of breath, chronic cough, and reduced exercise capacity.

  • Rating Criteria: Same as Chronic Obstructive Pulmonary Disease (see above).

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• Interstitial Lung Disease

  • Description: A group of lung diseases affecting the interstitium (the tissue and space around the air sacs of the lungs), causing scarring and lung stiffness.

  • Symptoms: Shortness of breath, dry cough, and fatigue.

  • Rating Criteria: Evaluated based on the severity and impact of the individual symptoms on the veteran's ability to function, similar to other respiratory conditions.

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• Pleuritis

  • Description: Inflammation of the tissues that line the lungs and chest cavity (pleura), causing sharp chest pain that worsens during breathing.

  • Symptoms: Sharp chest pain, shortness of breath, and cough.

  • Rating Criteria:

    • 10%: With exacerbations that are infrequent and not incapacitating.

    • 30%: With frequent and severe exacerbations.

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• Pulmonary Fibrosis

  • Description: A lung disease that occurs when lung tissue becomes damaged and scarred, leading to serious breathing problems.

  • Symptoms: Shortness of breath, dry cough, fatigue, and unexplained weight loss.

  • Rating Criteria: Evaluated based on the severity and impact of the individual symptoms on the veteran's ability to function, similar to other respiratory conditions.

 

 

Cancers Caused by Exposure:

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1. Brain Cancer

   • Description: A malignant tumor in the brain that can affect brain function.

   • Symptoms: Headaches, seizures, vision problems, cognitive difficulties, and changes in personality.

   • Rating Criteria:

     • 100%: Active malignancy or within six months of cessation of treatment. Residuals are rated based on specific symptoms and disabilities caused by the tumor or its treatment.

2. Gastrointestinal Cancer

   • Description: Cancer that occurs in the gastrointestinal tract, including the stomach, intestines, and other digestive organs.

   • Symptoms: Abdominal pain, weight loss, loss of appetite, nausea, and vomiting.

   • Rating Criteria:

     • 100%: Active malignancy or within six months of cessation of treatment. Residuals are rated based on specific symptoms and disabilities caused by the tumor or its treatment.

3. Glioblastoma

   • Description: A fast-growing and aggressive brain tumor.

   • Symptoms: Severe headaches, seizures, nausea, vomiting, and cognitive difficulties.

   • Rating Criteria:

     • 100%: Active malignancy or within six months of cessation of treatment. Residuals are rated based on specific symptoms and disabilities caused by the tumor or its treatment.

4. Head Cancer

   • Description: Malignant tumors located in the head region, which can affect various structures like the mouth, throat, and sinuses.

   • Symptoms: Persistent headaches, facial pain, difficulty swallowing, and changes in voice.

   • Rating Criteria:

     • 100%: Active malignancy or within six months of cessation of treatment. Residuals are rated based on specific symptoms and disabilities caused by the tumor or its treatment.

5. Kidney Cancer

   • Description: Cancer that starts in the kidneys, the organs that filter waste from the blood to make urine.

   • Symptoms: Blood in urine, persistent pain in the back or side, unexplained weight loss, and fatigue.

   • Rating Criteria:

     • 100%: Active malignancy or within six months of cessation of treatment. Residuals are rated based on specific symptoms and disabilities caused by the tumor or its treatment.

6. Lymphatic Cancer

   • Description: Cancer that affects the lymphatic system, which is part of the body's germ-fighting network.

   • Symptoms: Swollen lymph nodes, fatigue, fever, and weight loss.

   • Rating Criteria:

     • 100%: Active malignancy or within six months of cessation of treatment. Residuals are rated based on specific symptoms and disabilities caused by the tumor or its treatment.

7. Lymphoma

   • Description: Cancer of the lymphatic system, including Hodgkin's and non-Hodgkin's lymphoma.

   • Symptoms: Swollen lymph nodes, fever, night sweats, and weight loss.

   • Rating Criteria:

     • 100%: Active malignancy or within six months of cessation of treatment. Residuals are rated based on specific symptoms and disabilities caused by the tumor or its treatment.

8. Melanoma

   • Description: A type of skin cancer that develops from the pigment-producing cells known as melanocytes.

   • Symptoms: Changes in existing moles, the appearance of new pigmented or unusual-looking growths on the skin.

   • Rating Criteria:

     • 100%: Active malignancy or within six months of cessation of treatment. Residuals are rated based on specific symptoms and disabilities caused by the tumor or its treatment.

9. Neck Cancer

   • Description: Malignant tumors that occur in the neck region, affecting structures such as the thyroid, larynx, and pharynx.

   • Symptoms: Swelling or lumps in the neck, difficulty swallowing, and persistent pain.

   • Rating Criteria:

     • 100%: Active malignancy or within six months of cessation of treatment. Residuals are rated based on specific symptoms and disabilities caused by the tumor or its treatment.

10. Pancreatic Cancer

    • Description: Cancer that begins in the tissues of the pancreas, an organ that lies behind the lower part of the stomach.

    • Symptoms: Abdominal pain, weight loss, jaundice, and loss of appetite.

    • Rating Criteria:

      • 100%: Active malignancy or within six months of cessation of treatment. Residuals are rated based on specific symptoms and disabilities caused by the tumor or its treatment.

11. Reproductive Cancer

    • Description: Cancer that affects the reproductive organs, including prostate, testicular, ovarian, and uterine cancers.

    • Symptoms: Varies by specific type, but may include pelvic pain, abnormal bleeding, lumps, and urinary symptoms.

    • Rating Criteria:

      • 100%: Active malignancy or within six months of cessation of treatment. Residuals are rated based on specific symptoms and disabilities caused by the tumor or its treatment.

12. Respiratory Cancer

    • Description: Cancer that affects the respiratory system, including the lungs, trachea, and bronchus.

    • Symptoms: Persistent cough, chest pain, shortness of breath, and coughing up blood.

    • Rating Criteria:

      • 100%: Active malignancy or within six months of cessation of treatment. Residuals are rated based on specific symptoms and disabilities caused by the tumor or its treatment.

13. Sarcoma

    • Description: A type of cancer that originates in the bones and soft tissues, including fat, muscles, blood vessels, and fibrous tissues.

    • Symptoms: Painful swelling or lumps, limited range of motion, and fatigue.

    • Rating Criteria:

      • 100%: Active malignancy or within six months of cessation of treatment. Residuals are rated based on specific symptoms and disabilities caused by the tumor or its treatment.

14. Urinary Cancer

    • Description: Cancer that affects the urinary system, including bladder, ureter, and kidney cancers.

    • Symptoms: Blood in urine, frequent urination, pain during urination, and back pain.

    • Rating Criteria:

      • 100%: Active malignancy or within six months of cessation of treatment. Residuals are rated based on specific symptoms and disabilities caused by the tumor or its treatment.

 

Other Conditions:

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• Chronic Fatigue Syndrome

  • Description: A debilitating disorder characterized by extreme fatigue that cannot be explained by any underlying medical condition. The fatigue worsens with physical or mental activity but does not improve with rest.

  • Symptoms: Severe tiredness lasting more than 24 hours after physical or mental exertion, unrefreshing sleep, memory problems, muscle pain, headaches, and sore throat.

  • Rating Criteria: Same as Chronic Fatigue Syndrome under Gulf War Presumptive Conditions (see above).

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• Fibromyalgia

  • Description: A condition characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory, and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way the brain and spinal cord process painful and nonpainful signals.

  • Symptoms: Widespread pain, fatigue, cognitive difficulties (often referred to as "fibro fog"), irritable bowel syndrome, and depression.

  • Rating Criteria: Same as Fibromyalgia under Gulf War Presumptive Conditions (see above).

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• Parkinson’s Disease

  • Description: A progressive disorder of the nervous system that affects movement, causing symptoms to develop gradually.

  • Symptoms: Tremors, stiffness, slow movement, and balance problems.

  • Rating Criteria:

    • 30%: Minimum rating for Parkinson's disease.

    • 40%: If there is bradykinesia or hypokinesia with moderate impairment of bodily functions.

    • 60%: If there is severe impairment of bodily functions.

    • 100%: When there is complete loss of bodily function requiring assistance.

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• Multiple Sclerosis (MS)

  • Description: A disease in which the immune system eats away at the protective covering of nerves, disrupting the flow of information within the brain, and between the brain and body.

  • Symptoms: Numbness or weakness in limbs, electric-shock sensations, tremor, lack of coordination, and vision problems.

  • Rating Criteria:

    • 30%: Mild symptoms or impairment of motor or sensory function.

    • 60%: Moderate symptoms with more pronounced functional impairments.

    • 100%: Severe symptoms with significant impairment of bodily functions requiring assistance.

 

This detailed list provides an overview of the conditions, their symptoms, and the VA's rating criteria based on the Schedule for Rating Disabilities. Each veteran's situation is unique, and it's important to consult with a healthcare provider and a VA representative to ensure proper evaluation and rating.