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Title 38 laws on Chronic Fatigue, Fibromyalgia,
Irritable Bowel Syndrome (unexplained illnesses)



http://www.warms.vba.va.gov/regs/38CFR/BOOKB/PART3/S3_317.D

or,

http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?type=simple;c=ecfr;cc=ecfr;sid=89bb312d6d613680e34d4df4625d7f3b; region=DIV1;q1=gulf%20war;rgn=div8;view=text;idno=38;node=38%3A1.0.1.1

§ 3.317 Compensation for certain disabilities due to undiagnosed illnesses.

  • (a)(1) Except as provided in paragraph (c) of this section, VA will pay compensation in accordance with chapter 11 of title 38, United States Code, to a Persian Gulf veteran who exhibits objective indications of a qualifying chronic disability, provided that such disability:
  • (i) Became manifest either during active military, naval, or air service in the Southwest Asia theater of operations during the Persian Gulf War, or to a degree of 10 percent or more not later than December 31, 2006; and
  • (ii) By history, physical examination, and laboratory tests cannot be attributed to any known clinical diagnosis.
  • ((2)(i) For purposes of this section, a qualifying chronic disability means a chronic disability resulting from any of the following (or any combination of the following):
  • (A) An undiagnosed illness;
  • (B) The following medically unexplained chronic multisymptom illnesses that are defined by a cluster of signs or symptoms:
  • (1) Chronic fatigue syndrome;
  • (2) Fibromyalgia;
  • (3) Irritable bowel syndrome; or
  • (4) Any other illness that the Secretary determines meets the criteria in paragraph (a)(2)(ii) of this section for a medically unexplained chronic multisymptom illness; or
  • (C) Any diagnosed illness that the Secretary determines in regulations prescribed under 38 U.S.C. 1117(d) warrants a presumption of service-connection.
  • (ii) For purposes of this section, the term medically unexplained chronic multisymptom illness means a diagnosed illness without conclusive pathophysiology or etiology, that is characterized by overlapping symptoms and signs and has features such as fatigue, pain, disability out of proportion to physical findings, and inconsistent demonstration of laboratory abnormalities. Chronic multisymptom illnesses of partially understood etiology and pathophysiology will not be considered medically unexplained.
  • (3) For purposes of this section, “objective indications of chronic disability” include both “signs,” in the medical sense of objective evidence perceptible to an examining physician, and other, non-medical indicators that are capable of independent verification.
  • (4) For purposes of this section, disabilities that have existed for 6 months or more and disabilities that exhibit intermittent episodes of improvement and worsening over a 6-month period will be considered chronic. The 6-month period of chronicity will be measured from the earliest date on which the pertinent evidence establishes that the signs or symptoms of the disability first became manifest.
  • (5) A chronic disability resulting from an undiagnosed illness referred to in this section shall be rated using evaluation criteria from part 4 of this chapter for a disease or injury in which the functions affected, anatomical localization, or symptomatology are similar.
  • (6) A disability referred to in this section shall be considered service connected for purposes of all laws of the United States.
  • (b) For the purposes of paragraph (a)(1) of this section, signs or symptoms which may be manifestations of undiagnosed illness or medically unexplained chronic multisymptom illness include, but are not limited to:
  • (1) Fatigue
  • (2) Signs or symptoms involving skin
  • (3) Headache
  • (4) Muscle pain
  • (5) Joint pain
  • (6) Neurologic signs or symptoms
  • (7) Neuropsychological signs or symptoms
  • (8) Signs or symptoms involving the respiratory system (upper or lower)
  • (9) Sleep disturbances
  • (10) Gastrointestinal signs or symptoms
  • (11) Cardiovascular signs or symptoms
  • (12) Abnormal weight loss
  • (13) Menstrual disorders.
  • (c) Compensation shall not be paid under this section:
  • (1) If there is affirmative evidence that an undiagnosed illness was not incurred during active military, naval, or air service in the Southwest Asia theater of operations during the Persian Gulf War; or
  • (2) If there is affirmative evidence that an undiagnosed illness was caused by a supervening condition or event that occurred between the veteran's most recent departure from active duty in the Southwest Asia theater of operations during the Persian Gulf War and the onset of the illness; or
  • (3) If there is affirmative evidence that the illness is the result of the veteran's own willful misconduct or the abuse of alcohol or drugs.
  • (d) For purposes of this section:
  • (1) The term Persian Gulf veteran means a veteran who served on active military, naval, or air service in the Southwest Asia theater of operations during the Persian Gulf War.
  • (2) The Southwest Asia theater of operations includes Iraq, Kuwait, Saudi Arabia, the neutral zone between Iraq and Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, Oman, the Gulf of Aden, the Gulf of Oman, the Persian Gulf, the Arabian Sea, the Red Sea, and the airspace above these locations.

(Authority: 38 U.S.C. 1117)

[60 FR 6665, Feb. 3, 1995, as amended at 62 FR 23139, Apr. 29, 1997; 66 FR 56615, Nov. 9, 2001; 68 FR 34541, June 10, 2003]

http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?type=simple;c=ecfr;cc=ecfr;sid=89bb312d6d613680e34d4df4625d7f3b; region=DIV1;q1=gulf%20war;rgn=div8;view=text;idno=38;node=38%3A1.0.1.1

§ 4.88a Chronic fatigue syndrome.

  • (a) For VA purposes, the diagnosis of chronic fatigue syndrome requires:
  • (1) new onset of debilitating fatigue severe enough to reduce daily activity to less than 50 percent of the usual level for at least six months; and
  • (2) the exclusion, by history, physical examination, and laboratory tests, of all other clinical conditions that may produce similar symptoms; and
  • (3) six or more of the following:
  • (i) acute onset of the condition,
  • (ii) low grade fever,
  • (iii) nonexudative pharyngitis,
  • (iv) palpable or tender cervical or axillary lymph nodes,
  • (v) generalized muscle aches or weakness,
  • (vi) fatigue lasting 24 hours or longer after exercise,
  • (vii) headaches (of a type, severity, or pattern that is different from headaches in the pre-morbid state),
  • (viii) migratory joint pains,
  • (ix) neuropsychologic symptoms,
  • (x) sleep disturbance.
  • (b) [Reserved]

[59 FR 60902, Nov. 29, 1994]

6354 Chronic Fatigue Syndrome (CFS):

Debilitating fatigue, cognitive impairments (such as inability to concentrate, forgetfulness, confusion), or a combination of other signs and symptoms:.

Which are nearly constant and so severe as to restrict  routine daily activities almost completely and which may occasionally preclude self-care.........................................................................................100%

Which are nearly constant and restrict routine daily  activities to less than 50 percent of the pre-illness level, or; which wax and wane, resulting in periods of incapacitation of at least six weeks total duration per year...........................................................................................60%

Which are nearly constant and restrict routine daily  activities to 50 to 75 percent of the pre-illness level, or; which wax and wane, resulting in periods of incapacitation of at least four but less than six weeks total duration per year...........................................................................................40%

Which are nearly constant and restrict routine daily  activities by less than 25 percent of the pre-illness level, or; which wax and wane, resulting in periods of incapacitation of at least two but less than four weeks total duration per year...........................................................................................20%

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.................................

Note: For the purpose of evaluating this disability, the condition will be considered incapacitating only while it requires bed rest and treatment by a physician....................................................................................10%

 

5025 Fibromyalgia (fibrositis, primary fibromyalgia syndrome)

With widespread musculoskeletal pain and tender points, with or without associated fatigue, sleep disturbance, stiffness, paresthesias, headache, irritable bowel symptoms, depression, anxiety, or Raynaud's-like symptoms:

That are constant, or nearly so, and refractory to therapy.. 40

That are episodic, with exacerbations often precipitated by 20 environmental or emotional stress or by overexertion, but that are present more than one-third of the time........... That require continuous medication for control.................... 10

Note: Widespread pain means pain in both the left and right sides of the body, that is both above and below the waist, and that affects both the axial skeleton (i.e., cervical spine, anterior chest, thoracic spine, or low back) and the extremities.

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