Transcript Medical Evidence - Employees' Call for Real Change

WELCOME
AMERICAN FEDERATION OF
GOVERNMENT EMPLOYEES
A Veteran’s Guide to VA
Benefits
This guide is design to help you
understand the claims process and your
rights and responsibilities.
We would like to come to your community
and explain its contents and how you can
help to improve the claims processing.
So please volunteer to setup a town hall
meeting in your community.
COMPENSATION CLAIMS
VA disability compensation provides monthly benefits to
Veterans in recognition of the effects of disabilities,
diseases, or injuries incurred or aggravated during active
military service.
The program also provides monthly payments to
surviving spouses, dependent children, and dependent
parents in recognition of the economic loss caused by a
Veteran’s death during military service or, after
discharge from military service, as a result of a serviceconnected disability.
PENSION CLAIMS
VA helps Veterans and their families cope with financial
challenges by providing supplemental income through the
Veterans Pension and Survivors' Pension benefit programs.
Veterans Pension: Tax-free monetary benefit payable to
low-income wartime Veterans.
Survivors' Pension: Tax-free monetary benefit payable to a
low-income, un-remarried surviving spouse and/or
unmarried child(ren) of a deceased Veteran with wartime
service.
HOW TO FILE A CLAIM
E-BENEFITS https://www.ebenefits.va.gov/ebenefits-portal/ebenefits.portal
you may print and mail-in VA Form 21-526EZ, Application for Disability
Compensation and Related Compensation Benefits or call VA at 1-800-827-1000 to
have the form mailed to you.
http://www.vba.va.gov/pubs/forms/VBA-21526EZ-ARE.pdf
you may print and mail-in VA Form 21-527EZ, Application for Disability
Compensation and Related Compensation Benefits or call VA at 1-800-827-1000 to
have the form mailed to you.
http://www.vba.va.gov/pubs/forms/VBA-21527EZ-ARE.pdf
Dependency and Indemnity Compensation (DIC) VA Form 21-534EZ, Application
for DIC, Death Pension, and/or Accrued Benefits and mail it to your nearest VA
regional office. http://www.vba.va.gov/pubs/forms/VBA-21-534EZ-ARE.pdf
VISIT/CONTACT YOUR COUNTY VA OFC (CVAO)
VISIT/CONTACT A VETERAN SERVICE ORIGANATION PRESENTATIVE (VSO)
AL, DAV, VFW, PVA, ETC.
VA FORM 526b - Supplemental Claims
http://www.vba.va.gov/pubs/forms/VBA-21-526b-ARE.pdf
Fully Developed Claims (FDC)
http://benefits.va.gov/compensation/
The Fully Developed Claims (FDC) program is an
optional new initiative that offers Veterans, and
survivors faster decisions from VA on compensation,
pension, and survivor benefit claims.
Veterans and survivors simply submit all required
records and documentation at the time they make their
claim and certify that they have no further evidence. VA
can then review and process the claim more quickly.
TYPE OF COMPENSATION
CLAIMS
There are many types of claims for disability
compensation. For example, if you're filing a VA
claim for the very first time, you have an original
claim. A reopened claim means you have
newand material evidence and you want VA to
reconsider a claim it once denied. There are also
new claims, secondary claims, and special
claims.
Step 1 - Honorable Active Military Service
CFR 3.203
In order to be eligible for disability compensation benefits, you must have a
service-related disability and were discharged under other than
dishonorable conditions.
Acceptable documents to established veteran’s status are:
An original copy or carbon copy of the original separation document
a copy of the separation document certified by a clerk of court or
authorized VBA employee
A copy of the separation document certified by County Affairs
Officer or Service organization member who has been approved by
VA
Unacceptable documents to established veteran’s status are:
Notarized copies of separation documents
Zerox copies of separation documents that have not been properly
certified
The separation documents must contain the entry on active duty and
released from active duty dates, branch of service and characterization of
service
If documents are not available, the VA will assistance you in verifying your
service as long as you provide the your service dates, branch of service and
serial number if different from your SSN.
STEP 2 – Service Treatment Records (STR)
38 CFR 3.159
If you have the original copy of the STRS, VA will need it.
If you do not have the original VA will assist, you in obtaining it.
If you are an active member of a Reserve or National Guard Unit, VA will
need:

Your unit’s name and complete mailing address
STEP 3 – Medical Records
38 CFR 3.159
If you have been treated at a VA medical facility, tell VA the name of the
facility, dates of treatment, and the disability treated for and VA will get
these records.
If you have been treated at a Federal facility VA will assist you in getting
those records or you can send in the relevant treatment records.
If you have been treated by a private doctor/facility, you can send in the
relevant treatment records, or send a VA Form 21-4142, Authorization form
(a separate one for each doctor/facility) and the VA will assist you in
obtaining the records.
It is your responsibility to provide the VA with the necessary information to
obtain the medical records –
complete mailing address
dates of treatment
and disability treated for.
STEP 4 – Other Evidence
CFR 3.159
VA will assist you in obtaining other relevant evidence, such as service
records, employment info etc.
Reminder

It is your responsibility to provide the VA with the necessary information
to obtain the evidence
STEP 5 – Examinations
38 CFR 3.326 & 3.159
In claims for compensation a VA exam is not mandatory. The law requires
that certain requirements be meet.
VA will provide a medical examination or obtain a medical opinion based
upon a review of the evidence of record if VA determines it is necessary to
decide the claim. A medical examination or medical opinion is necessary if
the information and evidence of record does not contain sufficient
competent medical evidence to decide the claim, but:



Contains competent lay or medical evidence of a current diagnosed disability or
persistent or recurrent symptoms of disability;
Establishes that the veteran suffered an event, injury or disease in service, or
has a disease or symptoms of a disease listed in §3.309, §3.313, §3.316, and
§3.317 manifesting during an applicable presumptive period provided the
claimant has the required service or triggering event to qualify for that
presumption; and
Indicates that the claimed disability or symptoms may be associated with the
established event, injury, or disease in service or with another service-connected
disability.
DISABILITY PENSION 38 CFR 3.2,
PERIOD OF WAR
DID YOU SERVED DURING A PERIOD OF
WAR?

World War 4-6-1917 to 11-11-1918
 World War II
12-7-1941 to 12-31-1946

Korean Conflict6-27-1950 to 12-31-1955

Vietnam Era
2-28-1961 to 8-4-1964
(must have been physically in Vietnam)
8-5-1964 to 5-7-1975 (all others)

Gulf War 8-2-1990 to date to be prescribed
by Presidential proclamation or law
Pension Service Requirements
CFR 3.3
•
•
•
•
•
•
DO YOU MEET THE TIME IN SERVICE REQUIREMENT?
i) Served in the active military naval or air service for 90 days or more
during a period of war (38 U.S.C. 1521(j)); or
(ii) Served in the active military, naval or air service during a period of war
and was discharged or released from such service for a disability adjudged
service-connected without presumptive provisions of law, or at time of
discharge had such a service-connected disability, shown by official service
records, which in medical judgment would have justified a discharge for
disability (38 U.S.C. 1521(j)); or
(iii) Served in the active military naval or air service for a period of 90
consecutive days or more and such period began or ended during a period
of war (38 U.S.C. 1521(j)); or
(iv) Served in the active military, naval or air service for an aggregate of 90
days or more in two or more separate periods of service during more than
one period of war (38 U.S.C. 1521(j));
After originally enlisted in a regular compenent of the Armed Forces after
September 7, 1980 or entered on active duty after October 16, 1981 must
complete

i) Twenty-four months of continuous active duty or.

(ii) The full period for which a person was called or ordered to active
duty.
ANNUAL INCOME AND NET WORTH
REQUIREMENT FOR VETERANS
http://www.benefits.va.gov/pension/current_rates_veteran_pen.asp
If you are a veteran...
Your yearly
income must be
less than...
Without Spouse or Child
$12,652
With One Dependent
$16,569
Housebound Without Dependents
$15,462
Housebound With One Dependent
$19,380
A&A Without Dependents
$21,107
A&A With One Dependent
$25,022
ANNUAL INCOME AND NET WORTH
REQUIREMENT FOR SURVIVORS
http://www.benefits.va.gov/pension/current_rates_survivor_pen.asp
MAPR Without Dependent Child
To be deducted, medical expenses must
exceed 5% of MAPR or
MAPR With One Dependent Child
To be deducted, medical expenses must
exceed 5% of MAPR or
$8,485
$ 424
$11,107
$555
Housebound Without Dependents
$10,371
Housebound With One Dependent
$12,988
A&A Without Dependents
$13,563
A&A Without Dependents (SAW Veteran's
Surviving Spouse)
$14,113
A&A With One Dependent
$16,180
A&A With One Dependent (SAW Veteran's
Surviving Spouse)
$16,671
SBP/MIW Annuity Limitation
$8,485
Permanent and Total Disabled
DO YOU HAVE A Permanently & totally
disabled nonservice connected disability
not due to your own willful misconduct .
DO YOU MEET ONE OF THE
FOLLOWING CONDITION



65 years old or older
In a nursing home
Receiving disability social security
38 CFR 3.159 VCAA - Veterans Claims Assistance
Act
Requires VA to notify the you and your representative (if any), in writing of:
any information or evidence that is necessary to substantiate your claim,
including medical and lay evidence
the information or evidence you must submit, and
the information or evidence that VA will attempt to obtain on the your behalf.
Federal Records
38 CFR 3.159
The VA is responsible for assisting you in obtaining federal records:

Service records to include treatment records, VA medical records,
records in the custody of a federal agencies to include National Guard
records.
The VA will continue to pursue federal records until it is determine the
records do not exists or further efforts to obtain them would be futile.
VA will notify you if efforts fail and give you 10 days to provide the evidence
before deciding your claim.
However, remember you still have 12 months from the VCAA notification
date to send the records to the VA.
Non Federal Records
38 CFR 3.159
The VA is responsible for assisting you in obtaining private records.
It is limited to 30 days, initial request 15 days and 15 days follow-up.
VA is responsible for notifying you each time your private records are
requested.
It is still your responsibility to ensure VA gets these records prior to the 40
days.
If the records are not received within 30 days, VA can make a decision on
your claim. However, you still have 12 months from the date of VCAA
notification to submit the evidence.
38 CFR 3.303-6 Service Connection
Your disability must have occurred during or was aggravated by your
military service
You must have a current disability
There must be a nexus (link) between your current disability and your
military service
Example: If you broke your ankle in service, and now you are having
problems with your ankle then there is a possibility that it is related to your
service
or
If you broke your ankle prior to service, but it was aggravated by your
service then there is a possibility that it is related to your service.
38 CFR 3.156 New and material evidence
A claimant may reopen a finally adjudicated claim by submitting new and
material evidence.
Final adjudicated means that you have been notified of the decision and
12 months have past since notification.
New evidence means existing evidence not previously submitted to
agency decisionmakers.
Material evidence means existing evidence that, by itself or when
considered with previous evidence of record, relates to an unestablished
fact necessary to substantiate the claim.
New and material evidence can be neither cumulative nor redundant of
the evidence of record at the time of the last prior final denial of the claim
sought to be reopened, and must raise a reasonable possibility of
substantiating the claim. (Authority: 38 U.S.C. 501, 5103A(f), 5108)
38 CFR 3.307 Presumptive service connection
A chronic, tropical, prisoner of war related disease, or a disease associated
with exposure to certain herbicide agents listed in CFR 3.309 will be
considered to have been incurred in or aggravated by service under the
circumstances outlined in this section even though there is no evidence of
such disease during the period of service. No condition other than one listed
in §3.309(a) will be considered chronic.
38 CFR 3.309(a) Chronic diseases
The following diseases shall be granted service connection as a result of chronic diseases if all
provisions of law are meet and it is manifested to a compensable degree within one year of
service, except for Hansen’s disease and Tuberculosis which is 3 years and Multiple Sclerosis
which is 7 years following service in a period of war or following peacetime service on or after
January 1, 1947
Anemia, primary.
Arteriosclerosis.
Arthritis.
Atrophy, progressive muscular.
Brain hemorrhage.
Brain thrombosis.
Bronchiectasis.
Calculi of the kidney, bladder, or gallbladder.
Cardiovascular-renal disease, including hypertension. (This term applies to combination
involvement of the type of arteriosclerosis, nephritis, and organic heart disease, and since
hypertension is an early symptom long preceding the development of those diseases in their more
obvious forms, a disabling hypertension within the 1-year period will be given the same benefit of
service connection as any of the chronic diseases listed.) Cirrhosis of the liver.
Coccidioidomycosis.
Diabetes mellitus.
Encephalitis lethargica residuals.
Endocarditis. (This term covers all forms of valvular heart disease.) Endocrinopathies.
Epilepsies.
Hansen's disease (3 years).
Hodgkin's disease.
Leukemia.
Lupus erythematosus, systemic
Myasthenia gravis.
Myelitis.
38 CFR 3.309(a) Chronic diseases con’t
Myocarditis.
Nephritis.
Other organic diseases of the nervous system.
Osteitis deformans (Paget's disease).
Osteomalacia.
Palsy, bulbar.
Paralysis agitans.
Psychoses.
Purpura idiopathic, hemorrhagic.
Raynaud's disease.
Sarcoidosis.
Scleroderma.
Sclerosis, amyotrophic lateral.
Sclerosis, multiple (7 Years).
Syringomyelia.
Thromboangiitis obliterans (Buerger's disease).
Tuberculosis, active (3 Years).
(Tumors, malignant, or of the brain or spinal cord or peripheral nerves.
Ulcers, peptic (gastric or duodenal) (A proper diagnosis of gastric or duodenal ulcer
(peptic ulcer) is to be considered established if it represents a medically sound
interpretation of sufficient clinical findings warranting such diagnosis and provides an
adequate basis for a differential diagnosis from other conditions with like
symptomatology; in short, where the preponderance of evidence indicates gastric or
duodenal ulcer (peptic ulcer). Whenever possible, of course, laboratory findings
should be used in corroboration of the clinical data.
38 CFR 3.303(b) Tropical diseases
The following diseases shall be granted
service connection as a result of
tropical service if all provisions of law
are meet and it is manifested to
compensable degree within one year
following service in a period of war or
following peacetime service
Amebiasis.
Blackwater fever.
Cholera.
Dracontiasis.
Dysentery.
Filariasis.
Leishmaniasis, including kala-azar.
Loiasis.
Malaria.
Onchocerciasis.
Oroya fever.
Pinta.
Plague.
Schistosomiasis.
Yaws.
Yellow fever.
Resultant disorders or diseases
originating because of therapy
administered in connection with such
diseases or as a preventative thereof.
38 CFR 3.309(c) POW
WERE YOU A POW?

If a veteran is a former prisoner of war, the following diseases shall be service
connected if manifest to a degree of disability of 10 percent or more at any time
after discharge or release from active military, naval, or air service even though
there is no record of such disease during service, provided the rebuttable
presumption provisions of §3.307 are also satisfied.
DO YOU HAVE A DISEASE LISTED IN 309(C)

Psychosis.

Any of the anxiety states.

Dysthymic disorder (or depressive neurosis).

Organic residuals of frostbite, if it is determined that the veteran was interned in climatic
conditions consistent with the occurrence of frostbite.

Post-traumatic osteoarthritis.

Atherosclerotic heart disease or hypertensive vascular disease (including hypertensive heart
disease) and their complications (including myocardial infarction, congestive heart failure,
arrhythmia).

Stroke and its complications.

On or after October 10, 2008, Osteoporosis, if the Secretary determines that the veteran has
posttraumatic stress disorder (PTSD).
38 CFR 3.309(c) POW Con’t
Were you interned or detained for not less than 30 days?

The following diseases shall be service connected if manifest to a
degree of 10 percent or more at any time after discharge or release
from active military, naval, or air service even though there is no record
of such disease during service, provided the rebuttable presumption
provisions of §3.307 are also satisfied.
Avitaminosis.
Beriberi (including beriberi heart disease).
Chronic dysentery.
Helminthiasis.
Malnutrition (including optic atrophy associated with malnutrition).
Pellagra.
Any other nutritional deficiency.
Irritable bowel syndrome.
Peptic ulcer disease.
Peripheral neuropathy except where directly related to infectious causes.
Cirrhosis of the liver.
On or after September 28, 2009, Osteoporosis.
38 CFR 3.309(d) Radiation-Risk Activity
DID YOU PARTICIPATE IN A RADIATION RISK
ACTIVITY?
A) Onsite participation in a test involving the
atmospheric detonation of a nuclear device.
(B) The occupation of Hiroshima or Nagasaki,
Japan, by United States forces during the period
beginning on August 6, 1945, and ending on July 1,
1946.
(C) Internment as a prisoner of war in Japan(or
service on active duty in Japan immediately
following such internment) during World War II
which resulted in an opportunity for exposure to
ionizing radiation comparable to that of the United
States occupation forces in Hiroshima or Nagasaki,
Japan, during the period beginning on August 6,
1945, and ending on July 1, 1946.
DO YOU HAVE ANY DISEASE LISTED IN CFR
3.309(d)?

Leukemia (other than achronic lymphocytic
leukemia.

Cancer of the thyroid.

Cancer of the breast.

Cancer of the pharynx.

Cancer of the esophagus.

Cancer of the stomach.

Cancer of the small intestine.

Cancer of the pancreas.

Multiple myeloma.

Lymphomas (except Hodgkin’s disease).

Cancer of the bile ducts.

Cancer of the gall bladder.

Primary liver cancer (except if cirrhosis or
hepatitis B is indicated).

Cancer of the salivary gland.

Cancer of the urinary tract (urinary tract
means the kidneys, renal pelves, ureters,
urinary bladder, and urethra)

Bronchiolo-alveolar carcinoma.

Cancer of the bone.

Cancer of the brain.

Cancer of the colon.

Cancer of the lung.

Cancer of the ovary.
38 CFR 3.309(e) Agent Orange
Were you exposed to Agent Orange?
Exposure conceded by VA?

service in the RVN or its inland waterways, or

service in other locations if the conditions of service involved
duty or visitation in the RVN.

service along the DMZ in Korea, and was assigned to one of the
units recognized by VA between April 1968 and July 1969.

The National Archives and Records Administration (NARA) has
confirmed that the Navy destroyer USS Ingersoll (DD 652)
traveled into the inland waterways of RVN on October 24 and
25, 1965
Any exposure to herbicide agents during service in locations other
than the ones listed above must be established on a factual basis

How were you exposed?
provide the approximate dates, location, and nature of the
alleged exposure.
38 CFR 3.309(e) Agents Orange Con’t
Do you have a disease listed 3.309(e)
AL amyloidosis
Chloracne or other acneform disease consistent with chloracne
Type 2 diabetes (also known as Type II diabetes mellitus or adult-onset diabetes)
Hodgkin's disease
Ischemic heart disease (including, but not limited to, acute, subacute, and old myocardial infarction; atherosclerotic
cardiovascular disease including coronary artery disease (including coronary spasm) and coronary bypass
surgery; and stable, unstable and Prinzmetal's angina)
All chronic B-cell leukemias (including, but not limited to, hairy-cell leukemia and chronic lymphocytic leukemia)
Multiple myeloma
Non-Hodgkin's lymphoma
Parkinson's disease
Acute and subacute peripheral neuropathy
Porphyria cutanea tarda
Prostate cancer
Respiratory cancers (cancer of the lung, bronchus, larynx, or trachea)
Soft-tissue sarcoma (other than osteosarcoma, chondrosarcoma, Kaposi’s sarcoma, or mesothelioma)
The term soft-tissue sarcoma includes the following:
Adult fibrosarcoma; Dermatofibrosarcoma protuberans; Malignant fibrous histiocytoma; Liposarcoma;
Leiomyosarcoma; Epithelioid leiomyosarcoma (malignant leiomyoblastoma); Rhabdomyosarcoma;
Ectomesenchymoma; Angiosarcoma (hemangiosarcoma and lymphangiosarcoma); Proliferating (systemic)
angioendotheliomatosis; Malignant glomus tumor; Malignant hemangiopericytoma; Synovial sarcoma
(malignant synovioma); Malignant giant cell tumor of tendon sheath; Malignant schwannoma, including
malignant schwannoma with rhabdomyoblastic differentiation (malignant Triton tumor), glandular and
epithelioid malignant schwannomas; Malignant mesenchymoma; Malignant granular cell tumor;Alveolar soft
part sarcoma; Epithelioid sarcoma; Clear cell sarcoma of tendons and aponeuroses; Extraskeletal Ewing’s
sarcoma; Congenital and infantile fibrosarcoma; Malignant ganglioneuroma
38 CFR 3.814 AO Certain Children With Disabilities
Born Of Vietnam And Certain Korea Service Veterans
38 CFR 3.814 Monetary allowance under 38 U.S.C. chapter 18 for an individual
suffering from spina bifida whose biological father or mother is or was a
Vietnam veteran.
Under Public Law 106-419, VA identified the birth defects of children of women
Vietnam veterans that 1) are associated with Vietnam service; and 2) result in
permanent physical or mental disability. Birth defects not included in this benefit
program as those abnormalities that result from the following: 1) a familial disorder; 2)
a birth-related injury, 3) a fetal or neonatal infirmity with well-established causes. The
law defines the term "child" as an individual, regardless of age or marital status that is
the natural child of a woman Vietnam veteran, and was conceived after the veteran
first entered Vietnam. The legislation provides for health care services, vocational
training, and a monthly allowance for eligible children
TO APPLY COMPLETE VA FORM IS 21-0304 AND MAIL IT TO: VA Regional Office,
Veterans Service Center (339/21), Box 25126, Denver, CO 80225
All CLAIMS FOR THIS BENEFIT IS HANDLED BY BY THE DENVER RO.
38 CFR 3.304 Posttraumatic Stress Disorder
WHAT IS NEEDED FOR SERVICE CONNECTION?
Per 38 CFR 3.304(f), a finding of service connection for PTSD requires

credible supporting evidence that the claimed in-service stressor actually
occurred

medical evidence diagnosing the condition in accordance with 38 CFR 4.125,
and

a link, established by medical evidence, between current symptomatology and
the claimed in-service stressor.
Note: The lay testimony of a Veteran alone may, under certain circumstances,
establish the occurrence of an in-service stressor if the stressor is related to the
Veteran’s

PTSD is diagnosed in service, and the stressor is related to that service, or the
stressor is related to the Veteran’s
engagement in combat with the enemy
experience as a POW as defined by 38 CFR 3.1(y), or
fear of hostile military or terrorist activity, if a VA psychiatrist or psychologist,
or contract equivalent, confirms
 the claimed stressor is adequate to support a diagnosis of PTSD, and
 the Veteran’s symptoms are related to the claimed stressor.
Stressor Definitions
Engaging in combat with the enemy means personal participation in
events constituting an actual fight or encounter with a military foe or hostile
unit or instrumentality. It includes presence during such events either as a

combatant, or

service member performing duty in support of combatants, such as
providing medical care to the wounded
Fear of hostile military or terrorist activity means
the Veteran experienced, witnessed, or was confronted with an event or
circumstance that involved

actual or threatened death or serious injury, or

a threat to the physical integrity of the Veteran or others, and the
Veteran’s response to the event or circumstances involved a
psychological or psycho-physiological state of fear, helplessness, or
horror.
Examples of exposure to hostile military or terrorist activity include presence
at events involving

actual or potential improvised explosive devices (IEDs)

vehicle-imbedded explosive devices

incoming artillery, rocket, or mortar fires

small arms fire, including suspected sniper fires, or
38 CFR 3.304 Posttraumatic Stress Disorder
DO YOU HAVE A VERIFABLE STRESSOR?
If you have receive any of the combat decorations listed below, VA will presume that the you
engaged in combat with the enemy, unless there is clear and convincing evidence to the contrary:
Air Force Achievement Medal with “V” Device
Air Force Combat Action Medal

Air Force Commendation Medal with “V” Device

Air Force Cross

Air Medal with “V” Device

Army Commendation Medal with “V” Device

Bronze Star Medal with “V” Device

Combat Action Badge

Combat Action Ribbon (Note: Prior to February 1969, the Navy Achievement Medal with “V” Device was
awarded.)

Combat Aircrew Insignia

Combat Infantry/Infantryman Badge

Combat Medical Badge

Distinguished Flying Cross

Distinguished Service Cross

Joint Service Commendation Medal with “V” Device

Medal of Honor

Navy Commendation Medal with “V” Device

Navy Cross

Purple Heart, and/or

Silver Star.
Important: Receipt of one of the decorations cited above is not the only acceptable evidence of engagement in
combat.


Stressor Related to Fear of Hostile Military or Terrorist
Activity
Under 38 CFR 3.304(f)(3), a Veteran’s lay statement alone may establish the
occurrence of a stressor related to the fear of hostile military or terrorist activity if

evidence shows the Veteran served in an area of potential hostile military or
terrorist activity, and

a VA psychiatrist or psychologist (or contract equivalent)

accepts the Veteran’s statement as being adequate to support a diagnosis of
PTSD, and

relates the Veteran’s symptoms to the claimed stressor.
Notes:

The receipt of military awards such as, but not limited to, the Vietnam Service or
Campaign Medal, Kuwait Liberation Medal, Iraq Campaign Medal, and
Afghanistan Campaign Medal is generally considered evidence of service in an
area of potential hostile military or terrorist activity.

The receipt of military awards such as the National Defense Service Medal,
Armed Forces Service Medal, and Global War on Terrorism (GWOT) Service
Medal generally does not indicate service in locations that involve exposure to
hostile military or terrorist activity, because these are general medals that do not
denote service in a particular area or campaign. If the Veteran served in an area
of potential hostile military or terrorist activity, he/she would have received a
more specific medal for such service.
Stressor Corroboration Required
Examples of claimed stressors that must be
corroborated are




a plane crash caused by severe weather
a severe motor vehicle accident
witnessing the death, injury, or threat to the physical
being of another person caused by something other
than hostile military or terrorist activity, and
actual or threatened death or serious injury, or other
threat to one’s physical being, caused by something
other than hostile military or terrorist activity.
PTSD Personal Trauma
Personal trauma is an event of human design that
threatens or inflicts harm, Veterans claiming service
connection for disability due to in-service personal
trauma face unique problems documenting their claims.
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These incidents are often violent and may lead to the
development of PTSD.
Examples: Rape, physical assault, domestic battering,
robbery, mugging, stalking, and harassment.
Note: Service connection for PTSD based on in-service
personal trauma derives from the PTSD personal assault
regulation, 38 CFR 3.304(f)(5)
MST Incidents
DoD offers two reporting options for MST, restricted and unrestricted.
Restricted reporting allows a servicemember to file a report confidentially
without initiating the investigative process.
Following an MST incident, a servicemember may elect one of these
reporting options by completing DD Form 2910, Victim Reporting
Preference Statement.
The servicemember may also elect an optional sexual assault forensic
examination (SAFE), which is performed by a healthcare provider and is
documented on DD Form 2911, Forensic Medical Report: Sexual Assault
Examination.
Notes:
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DoD may have used other forms prior to the issuance of DD Form 2910. For
example, the Department of the Navy used the form NAVPERS 1752/1, Sexual
Assault Incident Data Collection Report.
In restricted reporting cases, DoD stores the evidence, including results from the
SAFE, for one year following the date of the victim’s report of sexual assault. If
the victim does not claim the evidence or elect an unrestricted report within one
year, DoD destroys it.
38 CFR 3.311 Ionizing Radiation
Were you exposed to Ionizing Radiation?
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atmospheric testing of nuclear weapons
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the occupation of Hiroshima or Nagasaki, Japan from September
1945
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other radiation-risk activities as claimed (I.E. X-RAY
TECHNICIAN, REACTOR PLANT ACTIVITIES, NUCLEAR
MEDICINE, RADIOGRAPHY, ETC)
Do You have a disease in CFR 3.311(b)(2) and disease first
manifested within the period specified in 38 CFR 3.311(b)(5)
Or
Do you have a disease not listed, but can cite or have competent
scientific or do you have medical evidence that the claimed
condition is a radiogenic disease
Medical or scientific EVIDENCE IS REQUIRED
38 CFR 3.311 Ionizing Radiation Con’t.
Do You have a disease in CFR 3.311(b)(2) and
disease first manifested within the period
specified in 38 CFR 3.311(b)(5)
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All forms of leukemia except chronic
lymphatic (lymphocytic) leukemia;
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Thyroid cancer;
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Breast cancer;
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Lung cancer;
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Bone cancer;
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Liver cancer;
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Skin cancer;
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Esophageal cancer;
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Stomach cancer;
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Bone cancer must become manifest within 30 years after
exposure;
Leukemia may become manifest at any time after exposure;
Posterior subcapsular cataracts must become manifest 6
months or more after exposure; and
Other diseases specified in paragraph (b)(2) of this section
must become manifest 5 years or more after exposure
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Colon cancer;
Pancreatic cancer;
Kidney cancer;
Urinary bladder cancer;
Salivary gland cancer;
Multiple myeloma;
Posterior subcapsular cataracts;
Non-malignant thyroid nodular disease;
Ovarian cancer;
Parathyroid adenoma;
Tumors of the brain and central
nervous system;
Cancer of the rectum;
Lymphomas other than Hodgkin’s
disease;
Prostate cancer; and
Any other cancer.
a disease not listed, but can cite or
have competent scientific or do you
have medical evidence that the claimed
condition is a radiogenic disease
38 CFR 3.316 Mustard Gas
a) Except as provided in paragraph (b) of this section, exposure to the specified
vesicant agents during active military service under the circumstances described
below together with the subsequent development of any of the indicated conditions is
sufficient to establish service connection for that condition:
(1) Full-body exposure to nitrogen or sulfur mustard during active
military service together with the subsequent development of chronic conjunctivitis,
keratitis, corneal opacities, scar formation, or the following cancers: Nasopharyngeal;
laryngeal; lung (except mesothelioma); or squamous cell carcinoma of the skin.
(2) Full-body exposure to nitrogen or sulfur mustard or Lewisite
during active military service together with the subsequent development of a chronic
form of laryngitis, bronchitis, emphysema, asthma or chronic obstructive pulmonary
disease.
(3) Full-body exposure to nitrogen mustard during active military
service together with the subsequent development of acute nonlymphocytic leukemia.
(b) Service connection will not be established under this section if the claimed
condition is due to the veteran’s own willful misconduct (See §3.301(c)) or there is
affirmative evidence that establishes a nonservice-related supervening condition or
event as the cause of the claimed condition (See §3.303).
38 CFR 3.317 Undiagnosed Illnesses.
ARE YOU EXPERIENCING ANY OR A COMBINATION OF THE FOLLOWING
CONDITIONS:
An undiagnosed illness;
The following medically unexplained chronic multisymptom illnesses that
are defined by a cluster of signs or symptoms:
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(1) Chronic fatigue syndrome;
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(2) Fibromyalgia;
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(3) Irritable bowel syndrome; or
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(4) a medically unexplained chronic multisymptom illness
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.
38 CFR 3.317 Undiagnosed illnesses Cont.
SIGNS OR SYMPTOMS WHICH MAY BE MANIFESTATIONS OF UNDIAGNOSED ILLNESS OR MEDICALLY
UNEXPLAINED CHRONIC MULTISYMPTOM ILLNESS INCLUDE, BUT ARE NOT LIMITED TO:
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(1) Fatigue
(2) Signs or symptoms involving skin
(3) Headache
(4) Muscle pain
(5) Joint pain
(6) Neurologic signs and 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.
DO YOU HAVE SOUTHWEST ASIA SERVICE ? The Southwest Asia theater of operations includes
the following locations and the airspace above them:
Iraq
Kuwait
Saudi Arabia
the neutral zone between Iraq and Saudi Arabia
United Arab Emirates
Bahrain
Qatar
Oman
the Gulf of Aden
the Gulf of Oman
the Persian Gulf
the Arabian Sea, and
the Red Sea.
38 CFR 3.318 ALS - Amyotrophic Lateral
Sclerosis
(a) Except as provided in paragraph (b) of this section,
the development of amyotrophic lateral sclerosis
manifested at any time after discharge or release from
active military, naval, or air service is sufficient to
establish service connection for that disease.
(b) Service connection will not be established under this
section:
(1) If there is affirmative evidence that amyotrophic lateral sclerosis
was not incurred during or aggravated by active military, naval, or
air service;
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(2) If there is affirmative evidence that amyotrophic lateral
sclerosis is due to the veteran’s own willful misconduct; or
(3) If the veteran did not have active, continuous service of 90
days or more. (Authority: 38 U.S.C. 501(a)(1))
ASBESTOS-RELATED DISEASES
M21-1MR PART IV
Many people with asbestos-related diseases have only recently come to medical attention because the latent
period varies from 10 to 45 or more years between the first exposure and development of a disease.
Note: The exposure may have been direct or indirect; the extent and duration of exposure is not a factor.
Inhalation of asbestos fibers can produce:
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fibrosis, the most commonly occurring of which is interstitial pulmonary fibrosis, or asbestosis
tumors
pleural effusions and fibrosis
pleural plaques
mesotheliomas of pleura and peritoneum
cancers of the
lung
bronchus
gastrointestinal tract
larynx
pharynx, and
urogenital system, except the prostate.
Specific effects of exposure to asbestos include
lung cancer that
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originates in the lung parenchyma rather than the bronchi, and
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eventually develops in about 50 percent of persons with asbestosis
gastrointestinal cancer that develops in 10 percent of persons with asbestosis
urogenital cancer that develops in 10 percent of persons with asbestosis, and
mesothelioma that develops in 17 percent of persons with asbestosis.
38 CFR 3.310 SECONDARY S/C
(a) General. Except as provided in §3.300(c), disability which is proximately due to or the result of
a service-connected disease or injury shall be service connected. When service connection is
thus established for a secondary condition, the secondary condition shall be considered a part of
the original condition.
(b) Aggravation of nonservice-connected disabilities. Any increase in severity of a nonserviceconnected disease or injury that is proximately due to or the result of a service-connected disease
or injury, and not due to the natural progress of the nonservice-connected disease, will be service
connected. However, VA will not concede that a nonservice-connected disease or injury was
aggravated by a service-connected disease or injury unless the baseline level of severity of the
nonservice-connected disease or injury is established by medical evidence created before the
onset of aggravation or by the earliest medical evidence created at any time between the onset of
aggravation and the receipt of medical evidence establishing the current level of severity of the
nonservice-connected disease or injury. The rating activity will determine the baseline and current
levels of severity under the Schedule for Rating Disabilities (38 CFR part 4) and determine the
extent of aggravation by deducting the baseline level of severity, as well as any increase in
severity due to the natural progress of the disease, from the current level. (Authority: 38 U.S.C.
1110 and 1131)
(c) Cardiovascular disease. Ischemic heart disease or other cardiovascular disease developing in
a veteran who has a 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, shall be held to
be the proximate result of the service-connected amputation or amputations. (Authority: 38 U.S.C.
501(a), 1110-1131)
INCREASE
Your service connected disability must get
worse.
38 CFR 4.29-30 Temporary 100%
Paragraph 29 - periods of hospitalization in excess of 21
days for medical treatment of an Service Connected
disability,
Paragraph 30 – Assign a temporary 100-percent
convalescent rating under 38 CFR 4.30 only following
regular hospital discharge or outpatient release,
regardless of the length of hospitalization, if treatment of
an Service Connected disability resulted in
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surgery necessitating at least one-month convalescence
surgery with severe postoperative residuals, or
immobilization of at least one major joint by cast without surgery,
including procedures performed at an outpatient clinic.
38 CFR 4.16 IU
a) To establish entitlement to compensation as if 100 percent disabled based on individual unemployability (IU), a
Veteran must be unable to secure or retain employment by reason of service-connected (SC) disability. The
Veteran must be unemployable in fact by reason of SC disability and either
meet the schedular requirements of 38 CFR 4.16,
4.16 - Total disability ratings for compensation based on unemployability of the individual.(a) Total disability ratings for compensation may
be assigned, where the schedular rating is less than total, when the disabled person is, in the judgment of the rating agency, unable to
secure or follow a substantially gainful occupation as a result of service-connected disabilities: Provided That, if there is only one such
disability, this disability shall be ratable at 60 percent or more, and that, if there are two or more disabilities, there shall be at least one
disability ratable at 40 percent or more, and sufficient additional disability to bring the combined rating to 70 percent or more. For the
above purpose of one 60 percent disability, or one 40 percent disability in combination, the following will be considered as one disability:
(1) Disabilities of one or both upper extremities, or of one or both lower extremities, including the bilateral factor, if applicable, (2)
disabilities resulting from common etiology or a single accident, (3) disabilities affecting a single body system, e.g. orthopedic, digestive,
respiratory, cardiovascular-renal, neuropsychiatric, (4) multiple injuries incurred in action, or (5) multiple disabilities incurred as a prisoner
of war. It is provided further that the existence or degree of nonservice-connected disabilities or previous unemployability status will be
disregarded where the percentages referred to in this paragraph for the service-connected disability or disabilities are met and in the
judgment of the rating agency such service-connected disabilities render the veteran unemployable. Marginal employment shall not be
considered substantially gainful employment. For purposes of this section, marginal employment generally shall be deemed to exist when
a veteran's earned annual income does not exceed the amount established by the U.S. Department of Commerce, Bureau of the Census,
as the poverty threshold for one person. Marginal employment may also be held to exist, on a facts found basis (includes but is not limited
to employment in a protected environment such as a family business or sheltered workshop), when earned annual income exceeds the
poverty threshold. Consideration shall be given in all claims to the nature of the employment and the reason for termination.
(Authority: 38 U.S.C. 501)
or
have an extra-schedular evaluation approved by the Compensation and Pension (C&P) Service (211B).
(b) It is the established policy of the Department of Veterans Affairs that all veterans who are unable to secure and follow a substantially
gainful occupation by reason of service-connected disabilities shall be rated totally disabled. Therefore, rating boards should submit to the
Director, Compensation and Pension Service, for extra-schedular consideration all cases of veterans who are unemployable by reason of
service-connected disabilities, but who fail to meet the percentage standards set forth in paragraph (a) of this section. The rating board
will include a full statement as to the veteran's service-connected disabilities, employment history, educational and vocational attainment
and all other factors having a bearing on the issue.
CFR 3.340 P&T - Permanent Total Ratings
(a) Total disability ratings —(1) General. Total disability will be considered to exist when there is present any impairment of mind or body which
is sufficient to render it impossible for the average person to follow a substantially gainful occupation. Total disability may or may not be
permanent. Total ratings will not be assigned, generally, for temporary exacerbations or acute infectious diseases except where
specifically prescribed by the schedule.
(2) Schedule for rating disabilities. Total ratings are authorized for any disability or combination of disabilities for which the Schedule for Rating
Disabilities prescribes a 100 percent evaluation or, with less disability, where the requirements of paragraph 16, page 5 of the rating
schedule are present or where, in pension cases, the requirements of paragraph 17, page 5 of the schedule are met.
(3) Ratings of total disability on history. In the case of disabilities which have undergone some recent improvement, a rating of total disability
may be made, provided:
(i) That the disability must in the past have been of sufficient severity to warrant a total disability rating;
(ii) That it must have required extended, continuous, or intermittent hospitalization, or have produced total industrial incapacity for at least 1
year, or be subject to recurring, severe, frequent, or prolonged exacerbations; and
(iii) That it must be the opinion of the rating agency that despite the recent improvement of the physical condition, the veteran will be unable to
effect an adjustment into a substantially gainful occupation. Due consideration will be given to the frequency and duration of totally
incapacitating exacerbations since incurrence of the original disease or injury, and to periods of hospitalization for treatment in
determining whether the average person could have reestablished himself or herself in a substantially gainful occupation.
(b) Permanent total disability. Permanence of total disability will be taken to exist when such impairment is reasonably certain to continue
throughout the life of the disabled person. The permanent loss or loss of use of both hands, or of both feet, or of one hand and one foot, or
of the sight of both eyes, or becoming permanently helpless or bedridden constitutes permanent total disability. Diseases and injuries of
long standing which are actually totally incapacitating will be regarded as permanently and totally disabling when the probability of
permanent improvement under treatment is remote. Permanent total disability ratings may not be granted as a result of any incapacity
from acute infectious disease, accident, or injury, unless there is present one of the recognized combinations or permanent loss of use of
extremities or sight, or the person is in the strict sense permanently helpless or bedridden, or when it is reasonably certain that a
subsidence of the acute or temporary symptoms will be followed by irreducible totality of disability by way of residuals. The age of the
disabled person may be considered in determining permanence.
(c) Insurance ratings. A rating of permanent and total disability for insurance purposes will have no effect on ratings for compensation or
pension.
CFR 3.381 Dental Claims
DENTAL TRAUMA (CLASS II(a)
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VETERANS HAVING A DENTAL CONDITION RESULTING FROM COMBAT WOUNDS OR SERVICE
TRAUMA MAY BE AUTHORIZED ANY REASONABLE NECESSARY TREATMENT FOR THE
CONDITION.
CLAIMS FOR TREATMENT ONLY IS HANDLED BY THE VA MEDICAL CENTER
38 CFR 3.361 1151 Claim
Benefits under 38 U.S.C. 1151(a) for additional disability or death due to hospital care, medical or surgical
treatment, examination, training and rehabilitation services, or compensated work therapy program.
(a) Claims subject to this section?(1) General. Except as provided in paragraph (2), this section applies to claims
received by VA on or after October 1, 1997. This includes original claims and claims to reopen or otherwise
readjudicate a previous claim for benefits under 38 U.S.C. 1151 or its predecessors. The effective date of benefits
is subject to the provisions of ? 3.400(i). For claims received by VA before October 1, 1997, see ? 3.358.
(2) Compensated Work Therapy. With respect to claims alleging disability or death due to compensated work
therapy, this section applies to claims that were pending before VA on November 1, 2000, or that were received by
VA after that date. The effective date of benefits is subject to the provisions of ?? 3.114(a) and 3.400(i), and shall
not be earlier than November 1, 2000.
(b) Determining whether a veteran has an additional disability. To determine whether a veteran has an additional
disability, VA compares the veteran's condition immediately before the beginning of the hospital care, medical or
surgical treatment, examination, training and rehabilitation services, or compensated work therapy (CWT) program
upon which the claim is based to the veteran's condition after such care, treatment, examination, services, or
program has stopped. VA considers each involved body part or system separately.
(c) Establishing the cause of additional disability or death. Claims based on additional disability or death due to
hospital care, medical or surgical treatment, or examination must meet the causation requirements of this
paragraph and paragraph (d)(1) or (d)(2) of this section. Claims based on additional disability or death due to
training and rehabilitation services or compensated work therapy program must meet the causation requirements
of paragraph (d)(3) of this section.
38 CFR 351 A&A and Housebound
(a)
General. This section sets forth criteria for determining whether:
(1) Increased pension is payable to a veteran by reason of need for aid and attendance or by reason of being
housebound.
(Authority: 38 U.S.C. 1521(d), (e))(2) Increased compensation is payable to a veteran by reason of the veteran's
spouse being in need of aid and attendance.
(Authority: 38 U.S.C. 1115(1)(E))(3) Increased dependency and indemnity compensation is payable to a surviving
spouse or parent by reason of being in need of aid and attendance.
(Authority: 38 U.S.C. 1311(c), 1315(h))(4) Increased dependency and indemnity compensation is payable to a
surviving spouse who is not in need of aid and attendance but is housebound.
(Authority: 38 U.S.C. 1311(d))(5) Increased pension is payable to a surviving spouse by reason of need for aid and
attendance, or if not in need of aid and attendance, by reason of being housebound.
(Authority: 38 U.S.C. 1541(d), (e))
(6) Increased death compensation is payable to a surviving spouse by reason of being in need of aid and
attendance.
(Authority: 38 U.S.C. 1122)
(b) Aid and attendance; need. Need for aid and attendance means helplessness or being so nearly helpless as to
require the regular aid and attendance of another person. The criteria set forth in paragraph (c) of this section will
be applied in determining whether such need exists.
38 CFR 351 A&A and Housebound Con’t
(c) aid and attendance; criteria. The veteran, spouse, surviving spouse or parent will be considered in need of regular aid and attendance if he or she:
(1) Is blind or so nearly blind as to have corrected visual acuity of 5/200 or less, in both eyes, or concentric contraction of the visual field to 5 degrees or
less; or
2) Is a patient in a nursing home because of mental or physical incapacity; or
(3) Establishes a factual need for aid and attendance under the criteria set forth in ? 3.352(a).
(Authority: 38 U.S.C. 1502(b))
(d) Housebound, or permanent and total plus 60 percent; disability pension. The rate of pension payable to a veteran who is entitled to pension under 38
U.S.C. 1521 and who is not in need of regular aid and attendance shall be as prescribed in 38 U.S.C. 1521(e) if, in addition to having a single permanent
disability rated 100 percent disabling under the Schedule for Rating Disabilities (not including ratings based upon unemployability under ? 4.17 of this
chapter) the veteran:
(1) Has additional disability or disabilities independently ratable at 60 percent or more, separate and distinct from the permanent disability rated as 100
percent disabling and involving different anatomical segments or bodily systems, or
(2) Is ?permanently housebound? by reason of disability or disabilities. This requirement is met when the veteran is substantially confined to his or her
dwelling and the immediate premises or, if institutionalized, to the ward or clinical area, and it is reasonably certain that the disability or disabilities and
resultant confinement will continue throughout his or her lifetime.
(Authority: 38 U.S.C. 1502(c), 1521(e))
(e) Housebound; dependency and indemnity compensation. The monthly rate of dependency and indemnity compensation payable to a surviving spouse who
does not qualify for increased dependency and indemnity compensation under 38 U.S.C. 1311(c) based on need for regular aid and attendance shall be
increased by the amount specified in 38 U.S.C. 1311(d) if the surviving spouse is permanently housebound by reason of disability. The ?permanently
housebound? requirement is met when the surviving spouse is substantially confined to his or her home (ward or clinical areas, if institutionalized) or
immediate premises by reason of disability or disabilities which it is reasonably certain will remain throughout the surviving spouse's lifetime.
(Authority: 38 U.S.C. 1311(d))
(f) Housebound; improved pension; death. The annual rate of death pension payable to a surviving spouse who does not qualify for an annual rate of
death pension payable under ? 3.23(a)(6) based on need for aid and attendance shall be as set forth in ? 3.23(a)(7) if the surviving spouse is
permanently housebound by reason of disability. The ?permanently housebound? requirement is met when the surviving spouse is substantially
confined to his or her home (ward or clinical areas, if institutionalized) or immediate premises by reason of disability or disabilities which it is reasonably
certain will remain throughout the surviving spouse's lifetime.
(Authority: 38 U.S.C. 1541(e))
3.350 SMC-Loss of Use
a) Ratings under 38 U.S.C. 1114(k). Special monthly compensation under 38 U.S.C.
1114(k) is payable for each anatomical loss or loss of use of one hand, one foot, both
buttocks, one or more creative organs, blindness of one eye having only light
perception, deafness of both ears, having absence of air and bone conduction,
complete organic aphonia with constant inability to communicate by speech or, in the
case of a woman veteran, loss of 25% or more of tissue from a single breast or both
breasts in combination (including loss by mastectomy or partial mastectomy), or
following receipt of radiation treatment of breast tissue. This special compensation is
payable in addition to the basic rate of compensation otherwise payable on the basis
of degree of disability, provided that the combined rate of compensation does not
exceed the monthly rate set forth in 38 U.S.C. 1114(l) when authorized in conjunction
with any of the provisions of 38 U.S.C. 1114 (a) through (j) or (s). When there is
entitlement under 38 U.S.C. 1114 (l) through (n) or an intermediate rate under (p)
such additional allowance is payable for each such anatomical loss or loss of use
existing in addition to the requirements for the basic rates, provided the total does not
exceed the monthly rate set forth in 38 U.S.C. 1114(o). The limitations on the
maximum compensation payable under this paragraph are independent of and do not
preclude payment of additional compensation for dependents under 38 U.S.C. 1115,
or the special allowance for aid and attendance provided by 38 U.S.C. 1114(r).
38 CFR 3.356 Helpless Child
(a) Basic determinations. A child must be shown to be permanently incapable
of self-support by reason of mental or physical defect at the date of attaining
the age of 18 years.
38 CFR 3.312 Cause of death
VA Form 21-534 (Initial Claim)
a) General. The death of a veteran will be considered as having been due to a service-connected disability
when the evidence establishes that such disability was either the principal or a contributory cause of
death. The issue involved will be determined by exercise of sound judgment, without recourse to
speculation, after a careful analysis has been made of all the facts and circumstances surrounding the
death of the veteran, including, particularly, autopsy reports.
(b) Principal cause of death. The service-connected disability will be considered as the principal
(primary) cause of death when such disability, singly or jointly with some other condition, was the
immediate or underlying cause of death or was etiologically related thereto.
(c) Contributory cause of death.
(1) Contributory cause of death is inherently one not related to the principal cause. In
determining whether the service-connected disability contributed to death, it must be shown that it
contributed substantially or materially; that it combined to cause death; that it aided or lent assistance to
the production of death. It is not sufficient to show that it casually shared in producing death, but rather it
must be shown that there was a causal connection.
(2) Generally, minor service-connected disabilities, particularly those of a static
nature or not materially affecting a vital organ, would not be held to have contributed to death primarily
due to unrelated disability. In the same category there would be included service-connected disease or
injuries of any evaluation (even though evaluated as 100 percent disabling) but of a quiescent or static
nature involving muscular or skeletal functions and not materially affecting other vital body functions.
(3) Service-connected diseases or injuries involving active processes affecting vital
organs should receive careful consideration as a contributory cause of death, the primary cause being
unrelated, from the viewpoint of whether there were resulting debilitating effects and general impairment
of health to an extent that would render the person materially less capable of resisting the effects of other
disease or injury primarily causing death. Where the service-connected condition affects vital organs as
distinguished from muscular or skeletal functions and is evaluated as 100 percent disabling, debilitation
may be assumed.
(4) There are primary causes of death which by their very nature are so overwhelming
that eventual death can be anticipated irrespective of coexisting conditions, but, even in such cases,
there is for consideration whether there may be a reasonable basis for holding that a service-connected
condition was of such severity as to have a material influence in accelerating death. In this situation,
however, it would not generally be reasonable to hold that a service-connected condition accelerated
death unless such condition affected a vital organ and was of itself of a progressive or debilitating nature.
38 CFR 3.2, 3.3, 3.12a DEATH PENSION
VA Form 21-534 (Initial)
ARE YOU A SPOUSE, CHILD UNDER 18, OR A CHILD OVER 18 AND ATTENDING SCHOOL
AND THE DECEASED VETERAN SERVED DURING A PERIOD OF WAR?
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World War II
12-7-1941 to 12-31-1946
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Korean Conflict 6-27-1950 to 12-31-1955
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Vietnam Era
2-28-1961 to 8-4-1964 (must have been physically in Vietnam
8-5-1964 to 5-7-1975
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Gulf War
8-2-1990 to date to be prescribed by Presidential proclamation or law
DID THE DECEASED VETERAN MEET THE TIME IN SERVICE REQUIREMENT?
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Served in the active military naval or air service for 90 days or more during a period of war (38 U.S.C.
1521(j)); or
Served in the active military, naval or air service during a period of war and was discharged or released from
such service for a disability adjudged service-connected without presumptive provisions of law, or at time of
discharge had such a service-connected disability, shown by official service records, which in medical
judgment would have justified a discharge for disability (38 U.S.C. 1521(j)); or
Served in the active military naval or air service for a period of 90 consecutive days or more and such period
began or ended during a period of war (38 U.S.C. 1521(j)); or
Served in the active military, naval or air service for an aggregate of 90 days or more in two or more
separate periods of service during more than one period of war (38 U.S.C. 1521(j));
After originally enlisted in a regular component of the Armed Forces after September 7, 1980 or entered on
active duty after October 16, 1981 must complete
Twenty-four months of continuous active duty or.
The full period for which a person was called or ordered to active duty.
YOU MUST MEET THE ANNUAL INCOME LIMITS AND NEW WORTH REQUIREMENTS?
ANCILLARY BENEFITS
Specially Adaptive Housing or
Special Home Adaptation
Grant
 VA Form 26-4555
Automobile and Adaptive
Equipment
 VA Form 21-4502