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Improving the Presumptive Disability Decision-Making Process for Veterans
Appendix F
Tables: Summary of Presumptive Disability Decision-Making Legislative History
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TABLE F-1 Summary of PDDM Legislative History (by Date)
Date
Legislation or Regulation
Presumptive Disease
Etiology of Disease
Location/Date of Service
Presumptive Period
Additional Information
August 9, 1921
Veterans’ Bureau. Public Law 67-47. 1921. 67th Cong., 1st Sess. Ch. 57, Sec. 18, 42 Stat. 147, 153
Chronic Diseases:
Neuropsychiatric disease [later called psychoses]
Tuberculosis, pulmonary (active) [March 4, 1923 Act expanded the presumption to include all forms of active tuberculosis]
Disease contracted during active military service
On or after April 6, 1917
Within 2 years after separation from active military or naval service
Or Discharged or resigned active service on or before November 11, 1918
Characteristic manifestations of the disease to 10 percent or more
November 12, 1921
Internal Memorandum implementing Veterans’ Bureau Regulation No. 11
Chronic Constitutional Diseases:
Anemia (primary)
Arteriosclerosis
Beriberi
Diabetes insipidus
Diabetes mellitus
Endocrinopathies
Gout
Hemochromatosis
Hemoglobinuria (paroxysmal)
Hemophilia
Hodgkin’s disease
Leukemia (all types)
Ochronosis
Pellagra
Polycythemia (erythremia)
Purpura
Rickets
Scurvy
Chronic constitutional disease contracted during active military service
Within 1 year after the date of separation from service
November 12, 1921, stated connection to active military service
December 2, 1921
Office Memorandum No. 36
And Constitutional diseases were defined on December 2, 1921
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Legislation or Regulation
Presumptive Disease
Etiology of Disease
Location/Date of Service
Presumptive Period
Additional Information
June 7, 1924
World War Veterans’ Act, 1924. Public Law 68-242. 68th Cong., 1st Sess. Title II. Compensation and Treatment. Ch. 320 Sec. 200, 43 Stat. 607, 615
Chronic Diseases:
Dysentery (amebic) (tropical disease added as chronic disease)
Encephalitis lethargica
Neuropsychiatric disease
Paralysis agitans
Tuberculous (active)
Disease contracted during active military or naval service
Between April 6, 1917, and July 2, 1921
By January 1, 1925
Or Discharged or resigned prior to July 2, 1921
Characteristic manifestations of the disease to 10 percent or more
Or Discharged or resigned on or before November 11, 1918, or on or after July 2, 1921
1925
Veterans’ Bureau Schedule for Rating Disabilities (based upon the WW Veterans Act, 1924)
Constitutional Diseases:
Arthritis (deformans and chronic)
Carcinoma, sarcoma, and other tumors
Cardiovascular-renal disease, including hypertension
Endocarditis, chronic
Leprosy (tropical disease added as a chronic disease)
Myocarditis, chronic
Nephritis, chronic forms
(was not carried forward,
cholecystitis, chronic, proceeding to gall-stone formation
Disease contracted during military or naval services in the World War I
During World War I
Characteristic manifestation within 1 year from date of separation from active service
Or If medical evidence affirmatively establishes conclusive service connection after 1 year of separation
Amends list of constitutional diseases
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Location/Date of Service
Presumptive Period
Additional Information
nephrolithiasis
valvulitis, chronic)
November 2, 1928
Veterans’ Bureau Schedule of Disability Ratings, Extension 6
Ulcers (gastric or duodenal)
Manifest within 6 months from discharge from military service and shown present within 1 year after discharge
Establishes service connection for ulcers
April 12, 1933
Executive Order 6089. Instruction No. 2, Implementing Vet. Reg. No. 1. April 12, 1933
Chronic Diseases
Epilepsies
Organic diseases of the nervous system
Tuberculosis: Manifest to a degree of 10 percent within 1 year of discharge; second-year diagnoses presumptive if at 6 months for minimal cases, 9 months for moderately advanced cases, and 12 months for far advanced cases
Amends list of chronic diseases and presumption of tuberculosis Carried forward prior presumptions of chronic diseases except rickets, obesity, acidosis, beriberi, chronic cholecystitis, diabetes insipidus, gout, hemophilia, hemochromatosis, hemoglobinuria, nephrolithiasis, ochronosis, pellagra, purpura, scurvy, polycythemia (erythremia), and chronic valvulitis
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Additional Information
August 14, 1935
Executive Order 6089. Instruction No. 2-A, Implementing Vet. Reg. No. 1. August 14, 1935
Chronic Diseases:
Osteitis deformans (Paget’s disease)
Amends list of chronic diseases
December 28, 1945
VA Circular No. 8, section I
Tropical Diseases:
Malaria
Disease contracted during active
Within 1 year after separation of active service military service
January 3, 1947
Disability ratings for malaria and chronic diseases characteristically tropical in origin. Veterans Administration Technical Bulletin 8-6. Washington, DC: VA
Tropical Diseases:
Dysentery (amebic, bacillary)
Filariasis (Bancroft’s type)
Leishmaniasis (including kala-azar)
Malaria
Schistosomiasis
Trypanosomiasis
Yaws
Disease contracted during wartime service
Service in the tropics or a place having a high incidence of the disease under consideration
Within 1 year after separation of active wartime service
Relapses of malaria (after the 1 year separation) need others, under oath to establish frequency of relapse over a period of time relating back to the 1-year period following discharge
June 24, 1948
Act of June 24, 1948. Public Law 80-748. 80th Cong., 2d Sess. Ch. 612, Sec. 1, 62 Stat. 581
Chronic Diseases:
Anemia (primary)
Arteriosclerosis
Arthritis
Bronchiectasis
Calculi of the kidney, bladder, or gall bladder
Cardiovascular-renal disease (hypertension, myocarditis, Buerger’s disease, Raynaud’s disease)
Disease contracted during active service
At least 6 months of service and honorably discharged Within 1 year after separation from active service or at a time when standard and accepted treatises indicate that the incubation period
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Additional Information
Cirrhosis of the liver
Coccidioidomycosis
Diabetes mellitus
Encephalitis lethargica residuals
Endocarditis
Endocrinopathies
Epilepsies
Hodgkin’s disease
Leukemia (nephritis)
Organic diseases of the nervous system (tumors of the brain, cord, peripheral nerves)
Osteitis (deformans)
Osteomalacia
Peptic ulcers (gastric or duodenal)
Scleroderma
Tuberculosis (active)
Tumors (malignant)
thereof commenced during active service
Tropical Diseases:
Black water fever
Cholera
Dracontiasis
Dysentery
Filariasis
Leishmaniasis
Leprosy
Loiasis
Malaria
Onchocerciasis
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Additional Information
Oroya fever
Pinta
Plague
Schistosomiasis
Yaws
Yellow fever
February 9, 1949
Pensions, bonuses, and veterans’ relief. Part 3: Veterans’ claims; miscellaneous amendments. Federal Register 14(26):568-578. Former 39 CFR Sec. 3.80; Sec. 3.86(a), 3.95
Chronic Diseases:
Anemia (primary)
Arteriosclerosis
Arthritis
Atrophy, progressive muscular
Brain hemorrhage
Brain thrombosis
Bronchiectasis
Calculi of the kidney, bladder, or gall bladder
Cardiovascular-renal disease (hypertension)
Cirrhosis of the liver
Coccidioidomycosis
Diabetes mellitus
Encephalitis lethargica residuals
Endocarditis
Endocrinopathies
Epilepsies
Hodgkin’s disease
Leprosy
Leukemia (nephritis)
Myasthenia gravis
Myelitis
Myocarditis
Disease contracted during military service
Wartime service prior to January 1, 1947, to July 25, 1947
Within 1 year after separation from active wartime service
Factual Basis: Established by medical evidence, competent lay evidence, or both
Tropical Diseases: Service in the tropics or a place having a high incidence of the disease under consideration
Within 1 year after the date prior to which a disability must have been incurred
Pulmonary Tuberculosis: Specific assumptions for diagnosis in second year after service
Chronic Disease: Manifestations sufficient to identify the disease entity and sufficient observations to establish chronicity at the time
Ulcer (peptic): Within 6 months from date of active service or within 6 months of July 25, 1947; or if more than 6 months, then evidence of continuity of characteristic symptoms during the first 6 months after termination of active service
Tropical Disease: When shown to exist at a time when standard and accepted treatises indicate that the
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Additional Information
Nephritis
Organic diseases of the nervous system
Osteitis (deformans)
Osteomalacia
Palsy, bulbar
Paralysis agitans
Peptic ulcers (gastric or duodenal)
Psychoses
Raynaud’s disease
Scleroderma
Sclerosis (amyotrophic lateral, multiple)
Syringomyelia
Thromboangiitis Obliterans (Buerger’s disease)
Tuberculosis (active)
Tumors (malignant) of the brain or spinal cord or peripheral nerves
incubation period of the diseases commenced during active service
Characteristic manifestations of the disease to 10 percent or more, except pulmonary tuberculosis
Tropical Diseases:
Black water fever
Cholera
Dracontiasis
Dysentery
Filariasis
Leishmaniasis
Leprosy
Loiasis
Malaria
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Onchocerciasis
Oroya fever
Pinta
Plague
Schistosomiasis
Yaws
Yellow fever
October 12, 1949
Pensions, bonuses, and veterans’ relief. Part 3: Veterans’ claims; miscellaneous amendments. Federal Register 14(197):6174-6180. Former 38 CFR Sec. 3.86(a)
Chronic Diseases: Pupura idiopathic (hemorrhagic)
Military service
Amends list of chronic diseases
August 31, 1950
Pensions, bonuses, and veterans’ relief. Part 3: Veterans’ claims; miscellaneous amendments. Federal Register 15(169):5902-5910. Former 38 CFR
Chronic Disease: Sarcoidosis
Disease contracted during military service
See Veterans Regulation 1 (38 USC Ch. 12)
See Veterans Regulation 1 (38 USC Ch. 12)
Added to list of chronic and tropical diseases
Tropical Disease: Amebiasis
June 17, 1957
Veterans’ Benefits Act of 1957. Public Law 85-56. Sec. 301. 85th
Chronic and Tropical Diseases: Same diseases as above three entries (1949 and 1950
Disease contracted during active military, naval, or air service
Veteran who engaged in combat with the enemy in active service with
Tropical Diseases: Serves 6 months or more and contracts
Summarizes previous rules and legislation and amends
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Cong., 1st Sess. Sec. 301(3 and 4). 71 Stat. 83, 95
entries)
a military, naval, or air organization of the U. S. during a period of war, campaign, or expedition
tropical or disease because of therapy in connection with tropical disease
dates/location of service and presumption
Within 1 year after separation from active service or when standard and accepted treatises indicate incubation period
Period of service after November 11, 1918, and before July 2, 1921, if served after April 5, 1917, and before November 12, 1918
Psychosis: WWII or Korean service within 2 years after discharge or release and before July 26, 1949 (WWII) or February 1, 1957 (Korean)
Period after December 31, 1946, and before July 26, 1947, if period began before January 1, 1947
February 24, 1961
Disease subject to presumptive service connection. Federal Register 26(36):1581-1582
Chronic and Tropical Diseases: Same as June 17, 1957
Disease contracted during active military, naval, or air service
Lays out criteria for presumption wartime service connection for chronic or tropical disease
Factual Basis: May be established by medical evidence,
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competent lay evidence or both
August 12, 1970
Public Law 91-376. Sec. 3. 91st Cong., 2d Sess., 1970. Sec 3. 84 Stat. 787, 788
Former Prisoner of War Associated Diseases:
Avitaminosis
Beriberi (including beriberi heart disease)
Chronic dysentery
Helminthiasis
Malnutrition (including optic atrophy associated with malnutrition)
Other nutritional deficiency
Pellagra
Psychosis
Active military, naval, or air service and was held prisoner of war
Held by Imperial Japanese Government or the German Government during World War II, Government of North Korea during the Korean conflict, or the Government of North Vietnam, or the Viet Cong during the Vietnam era
Detained or interned for not less than 6 months
Service connection presumption for former prisoners of war
Characteristic manifestations of the disease (except psychosis) to 10 percent or more after service
Psychosis: Characteristic manifestations of the disease to 10 percent or more within 2 years after separati on from service
December 1, 1970
Pensions, bonuses, and veterans’ relief. Part 3: Adjudication. Subpart A: Pension, compensation, and dependency and indemnity compensation. Federal Register 35(232):18280
Diseases Associated with Former Prisoners of War
Active service
Service of 90 daysor more during a war period on or after January 31, 1955
Chronic Diseases: Manifest to a degree of 10 percent or more within 1 year for Hansen’s disease (leprosy) and tuberculosis within 3 years; multiple sclerosis within 7 years from date of separation from
Chronic and Tropical Diseases
Former Prisons of War: Held by an enemy government or its agents during WWII, Korean conflict, or the Vietnam era, suffered from dietary deficiencies,
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Date
Etiology of Disease
Location/Date of Service
Presumptive Period
Additional Information
Neurologic signs or symptoms
Neuropsychological signs or symptoms
Signs or symptoms involving skin
Signs or symptoms involving the respiratory system (upper or lower)
Sleep disturbances
the Arabian Sea, the Red Sea, and the airspace above these locations
active service in the Southwest Asia theater of operations during the Persian Gulf War
Compensation for certain undiagnosed illnesses. Final rule. Federal Register 60(23):6660-6666. 38 CFR Part 3
February 3, 1995
Final rule for undiagnosed illnesses during service in the Persian Gulf War
Compensation for certain undiagnosed illnesses. Interim rule with request for comments. Federal Register 62(82):23138-23139. 38 CFR Part 3
April 29, 1997
Persian Gulf War service
Interim rule extending the period of disease to manifest from “two years after the date on which the veteran last performed active military, naval, or air service in the Southwest Asia theater of operations during the Persian Gulf War” to “December 31, 2001”
Interim rule to expand the period within diseases must manifest
Compensation for certain
March 6, 1998
Extend the presumptive
Final rule for extending the
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undiagnosed illnesses. Final rule. Federal Register 63(44):11122-11123. 38 CFR Part 3
period (to December 31, 2001) in such a manner that no Persian Gulf veterans with qualifying disabilities would be denied compensation (no specific dates)
presumptive period for Persian Gulf veterans
Chronic multisymptom illness: chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome
Veterans Education and Benefits Expansion Act of 2001. Public Law 107-103. 107th Cong., 1st Sess.
December 27, 2001
Military service Vietnam Veteran active service
Persian Gulf Exposure: Active duty in the Armed Forces in the Southwest Asia theater of operations during the Persian Gulf War
Persian Gulf Exposure Additional Diseases: “On September 30, 2011”
Extension of presumptive period for respiratory cancers and additional diseases associated with herbicide exposure and Persian Gulf exposure
Persian Gulf Exposure: Persian Gulf War service active military, naval, or air service
Amended list of diseases associated with military service, Persian Gulf War
Extension of the presumptive period for compensation for Gulf War veterans’ undiagnosed illnesses. Interim
November 9, 2001
Persian Gulf War active military, naval, or air service
Veteran who served on active duty in the Southwest Asia theater during the Persian Gulf War
Undiagnosed illness manifest to a degree of 10 percent or more through December 31, 2006
Extension of presumptive period for compensation for Gulf War veteran’s undiagnosed illnesses
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final rule with request for comments. Federal Register 66(218):56614-56615. 38 CFR Part 3
Extension of the presumptive period for compensation for Gulf War veterans’ undiagnosed illnesses. Final rule. Federal Register 67(249):78979-78980. 38 CFR Part 3
December 27, 2002
Southwest Asia theater of operations during the Persian Gulf War
Through December 31, 2006
Extends the period within which disabilities must become manifest for entitlement for compensation
Compensation and pension provisions of the Veterans Education and Benefits Expansion Act of 2001. Final Rule. Federal Register 68(111):34539-34543. 38 CFR Parts 3 and 13
June 10, 2003
Amends what a “qualifying chronic disability” includes
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Extension of the presumptive period for compensation for Gulf War veterans. Interim final rule. Federal Register 7(242):75669-75672. 38 CFR Part 3
December 18, 2006
Southwest Asia theater of operations during the Persian Gulf War
Through December 31, 2011
Extends the period within which disabilities must become manifest for entitlement for compensation
38 USC § 1117
Approved February 27, 2006
Active duty in the Armed Forces during the Persian Gulf War
Southwest Asia theater during the Persian Gulf War
Medical or scientific evidence and historical treatment of manifestation periods that have been established
38 USC § 1118
Approved February 27, 2006
Association with exposure to a biological, chemical, or other toxic agent, environmental or wartime hazard, or preventive medicine or vaccine
Service in the Armed Forces in the Southwest Asia theater of operations during the Persian Gulf War
Within a period (if any) that is prescribed in a regulation
38 CFR 3.317
Southwest Asia theater during the Persian Gulf War
Manifest either during active military, naval, or air service or to a degree of 10 percent or more
Chronic disabilities for a period of 6 months or more or intermittent episodes of improvement and
Southwest Asia theater includes
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Iraq, Kuwait, Saudi Arabia, neutral zone between Iraq and Saudi Arabia, Bahrain, Qatar, United Arab Emirates, Oman, Gulf of Aden, Gulf of Oman, Persian Gulf, Arabian Sea, Red Sea, and air space above these locations
not later than December 31, 2006
worsening over a 6-month period
Language for the National Academy of Sciences report for presumption of service connection for illnesses associated with service in the Persian Gulf War
Persian Gulf War Veterans Act of 1998. Public Law 105-277. 105th Cong., 2d Sess., Sec. 1601, 1602, 1603
October 21, 1998
Establishes service connection for illnesses associated with the Persian Gulf War
Veteran who served on active duty in the Southwest Asia theater during the Persian Gulf War
Diseases having an association with exposure to a biological, chemical, or other toxic agent, environmental or wartime hazard, or preventive medicine or vaccine
Diseases Associated with Radiation-Risk Activity
Cancer of the bone
Cancer of the brain
Diseases specific to radiation-exposed veterans.
August 8, 2001
Radiation-risk activity
Total of at least 250 days before February 1, 1992
Amends list of diseases associated with radiation-risk
Ionizing radiation
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Additional Information
Cancer of the colon
Cancer of the lung
Cancer of the ovary
Proposed rule. Federal Register 66(153):41483-41485. 38 CFR Part 3
Military service
(Paducah, KY; Portsmouth, OH; K25 at Oak Ridge, TN)
activities and date/location of service
Diseases specific to radiation-exposed veterans. Final rule. Federal Register 67(17):3612-3616. 38 CFR Part 3
January 25, 2002
Radiation-risk activity Definition: Participation in a test involving atmospheric detonation of a nuclear device; occupation of Hiroshima or Nagasaki, Japan (August 6, 1945, to July 1, 1946); or internment as a prisoner of war in Japan or service on active duty in Japan following such internment during WWII with opportunity for exposure to ionizing radiation
Service before January 1, 1974 (Amchitka Island, AL) and performance of duty related to Long Shot, Milrow, or Cannikin underground nuclear tests
Amends definition of radiation-risk activity
Veterans Benefits Improvement Act of 2004.Public Law 108-454. 108th Cong., 2d Sess., Sec. 306. 118 Stat. 3598
December 10, 2004
Radiation-risk activity
Amended “radiation-risk activity” to include service in a capacity if performed as an employee of the DOE would qualify inclusion as a
Ionizing
Military service
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member of the Special Exposure Cohort
Diseases or Death NOT Associated with Military Service
Disease attributable to use of tobacco products
Claims based on the effects of tobacco products. Final rule. Federal Register 66(67):18195-18198. 38 CFR Part 3
April 6, 2001
Active military, naval, or air service
Veterans’ use of tobacco products are NOT considered to be service connected
Miscellaneous
Definitions:
Veteran
Spanish-American War
World War I
World War II
Korean conflict
Armed Forces
Veteran of any war
Service-connected
Non-service-connected
Active duty
Active duty for training
Inactive duty training
Active military, naval, or air service
Former prisoner of war
Reserve
Vietnam era
Persian Gulf war
38 USC § 101
Approved February 27, 2006
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Death
38 USC § 108
Approved February 27, 2006
7-year absence
Secretary has authority to prescribe rules and regulations to carry out laws administered by the VA
38 USC § 501
Approved February 27, 2006
Entitlement to compensation for disability resulting from diseases contracted in line of duty in the active military, naval, or air service, during a period of war
38 USC § 1110
Approved February 27, 2006
Presumption of sound condition at the time of examination, acceptance, and enrollment into service
38 USC § 1111
Approved February 27, 2006
Aggravation to a preexisting injury or disease
38 USC § 1153
Approved February 27, 2006
Increase in disability during active military, naval, or air service, unless the increase is due to the natural progress of the disease
Veteran’s service requirements for non-service-connected disability
38 USC § 1521
Approved February 27, 2006
Active military, naval, or air service
Service requirements:
90 days or more during a period of war
Period of war
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and was discharged or released for a service-connected disability
90 consecutive days or more and began or ended during a period of war
Aggregate of 90 days or more in two or more separate periods of service during more than one period of war
Guidelines for establishing presumptions of service connection for former prisoners of war
38 CFR 1.18
Former prisoners of war
May give a minimum duration of detention or internment for application of the presumption
Secretary may establish a presumption of service connection for a disease when there is at least limited/suggestive evidence that an increased risk of such disease is associated with
Defines “evidence”
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service involving detention or internment as a prisoner of war and an association between the two is biologically plausible
Secondary condition established as service connection of the original condition
Cardiovascular disease for service-connected amputation
38 CFR 3.310
Service-connected amputation of one lower extremity at or above the knee or service-connected amputations of both lower extremities at or above the ankles
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