TL;DR — Quick Summary
- Who qualifies: Veterans who served in Southwest Asia, Afghanistan, or surrounding regions from August 2, 1990 to present
- No time limit: Conditions can manifest at any time after separation (PACT Act removed deadline)
- No minimum rating: Conditions no longer need to rate 10% for presumption
- File specific conditions: Do NOT file for "Gulf War Syndrome" — file for your specific diagnosis
- Key conditions: Chronic fatigue syndrome, fibromyalgia, IBS/functional GI disorders, and undiagnosed illnesses
Eligibility Requirements
Important Clarification
The term "Gulf Veterans" refers to anyone who served in the region from August 2, 1990 to present — NOT only those who served during the first Gulf War of 1990-1991!
Covered Locations (August 2, 1990 – Present)
You qualify for Gulf War presumptives if you served in any of these locations:
Southwest Asia Theater of Operations
* Airspace NOT included for these locations
Conditions (Any Time After Separation)
Key Changes from the PACT Act
- No time limit: Conditions can appear at any point after service
- No minimum rating: 10% threshold removed for presumptive connection
- Condition must be chronic (ill for at least 6 months) to establish chronicity
Medically Unexplained Chronic Multi-symptom Illness (MUCMI)
| Condition | Examples |
|---|---|
| Chronic Fatigue Syndrome | — |
| Fibromyalgia | — |
| Functional Gastrointestinal Disorders* | Functional abdominal pain, bloating, constipation, indigestion, difficulty swallowing, vomiting, IBS |
*Does NOT include structural GI diseases like GERD. See M21 VIII.ii.1.A.1.h.
Signs/Symptoms of Undiagnosed Illness
These conditions are presumptive ONLY IF a medical examiner opines that your condition is either an undiagnosable illness OR a diagnosable but medically unexplained chronic multi-symptom illness of UNKNOWN etiology:
- Abnormal weight loss
- Cardiovascular signs or symptoms
- Fatigue
- Gastrointestinal signs or symptoms
- Headache
- Joint pain / Muscle pain
- Menstrual disorders
- Neurological signs or symptoms
- Neuropsychological signs or symptoms / Sleep disturbances
- Skin conditions
- Respiratory system (upper or lower)
Important
Failure to do proper medical diagnostic testing BEFORE a C&P Examination does NOT make a condition undiagnosable!
Conditions (Within One Year of Separation)
The following infectious diseases must manifest within one year of separation:
- Brucellosis
- Campylobacter jejuni
- Coxiella burnetii (Q fever)
- Malaria
- Nontyphoid salmonella
- Shigella
- West Nile virus
Common Secondary Conditions
Note: Secondary service-connection is NOT presumptive but may be granted with proper nexus.
| Primary Disease | Common Secondaries |
|---|---|
| Brucellosis | Arthritis, cardiovascular/nervous/respiratory infections, chronic meningitis, deafness, episcleritis, fatigue, Guillain-Barré syndrome, hepatic abnormalities, myelitis-radiculoneuritis, spondylitis, uveitis |
| Campylobacter jejuni | Guillain-Barré syndrome (within 2 months), Reactive arthritis (within 3 months), Uveitis (within 1 month) |
| Coxiella burnetii (Q fever) | Chronic hepatitis, endocarditis, osteomyelitis, post-Q-fever chronic fatigue syndrome, vascular infection |
| Malaria | Demyelinating polyneuropathy, Guillain-Barré syndrome, hematologic manifestations (anemia, splenic rupture), neurologic disease, neuropsychiatric disease, retinal hemorrhage |
| Nontyphoid Salmonella | Reactive arthritis (within 3 months) |
| Shigella | Hemolytic-uremic syndrome (within 1 month), Reactive arthritis (within 3 months) |
| West Nile virus | Variable physical, functional, or cognitive disability |
Conditions (Lifetime Presumption)
The following conditions can manifest at ANY point after separation with no time limit:
Common Secondary Conditions
| Primary Disease | Common Secondaries |
|---|---|
| Mycobacterium tuberculosis | Active tuberculosis, long-term adverse health outcomes due to irreversible tissue damage |
| Visceral leishmaniasis | Delayed presentation of acute clinical syndrome, post-kala-azar dermal leishmaniasis (within 2 years), reactivation with future immunosuppression |