INSIGHTi
VA Now Processing Gulf War Veterans’
Disability Claims for New Respiratory
Presumptive Conditions
August 16, 2021
Background
On August 2, 2021, the Department of Veterans Affairs (VA) announced it wil begin processing disability
claims for asthma, rhinitis, and sinusitis on a presumptive basis due to presumed exposure to particulate
matter (such as burn pit emissions) during servicemembers’ deployment to Southwest Asia and certain
other countries. This update in presumptive conditions comes after VA Secretary Denis McDonough
informed Congress on June 16, 2021, that he has “recommended initiation of rulemaking to establish a
presumption of service connection for respiratory conditions related to exposure to particulate matter and
other airborne hazards, which may conclude [sic] such conditions as asthma, rhinitis, and sinusitis for
Gulf War Veterans. This decision was based on the first iteration of a newly formed internal VA process to
review scientific evidence relating to exposures.” Less than two months later, on August 5, 2021, VA
began to adjudicate veterans’ claims for the aforementioned conditions.
Veterans and Conditions Covered
VA published an interim final rule on August 5, 2021, amending its adjudication regulations to establish
presumptive service connection for specific respiratory conditions due to a servicemember’s exposure to
particulate matter. VA’s decision resulted from internal procedures outlined in VA Directive 0215 to
review the evidence and analysis of scientific reports including those from the National Academies of
Science (NAS). VA reviewed the following reports:
 National Research Council’s 2010 Review of the Department of Defense Enhanced
Particulate Matter Surveillance Program Report;
 Institute of Medicine’s 2011 report on Long-Term Consequences of Exposure to Burn Pits
in Iraq and Afghanistan; and
 NAS’s 2020 report on Respiratory Health Effects of Airborne Hazards Exposures in the
Southwest Asia Theater of Military Operations.
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In addition, VA conducted further analysis of VA respiratory claims data for veterans who deployed to
Southwest Asia compared to a similar group of veterans with respiratory claims who had never deployed.
Based upon VA’s review of scientific evidence and analysis of its own data, VA decided to grant
presumptions, including them in Title 38, Section 3.320, of the Code of Federal Regulations, “Claims
Based on Exposure to Particulate Matter.” Table 1 summarizes the eligibility requirements for the
veterans as wel as the health conditions included in the new regulation. Those veterans with any health
condition(s) mentioned in Table 1, and manifested to a degree of 10% or more within 10 years after
separation from active military service, shal be presumed to have such health conditions incurred or
aggravated in service, even if there is no evidence of such disease during service.
Table 1. Eligibility Requirements and Health Conditions
Ef ective August 5, 2021
Location of Service
Time Period
Health Conditions
Southwest Asia Theater of Operationsa During Persian Gulf Warb
 Asthma
 Rhinitis
Afghanistan
On or after September 19, 2001,
during the Persian Gulf War
 Sinusitis, to include Rhinosinusitis
(Any one of these conditions must
On or after September 19, 2001,
Syria
have manifested itself within 10 years
during the Persian Gulf War
of separation from active military
On or after September 19, 2001,
service.)
Djibouti
during the Persian Gulf War
On or after September 19, 2001,
Uzbekistan
during the Persian Gulf War
Source: 38 C.F.R. §3.320 and Department of Veterans Affairs, “Presumptive Service Connection for Respiratory
Conditions Due to Exposure to Particulate Matter,” 86 Federal Register 42724, 42732, August 5, 2021.
Notes:
a. As defined by 38 C.F.R. §3.317(e)(2): Iraq, Kuwait, Saudi Arabia, the 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 the
airspace above these locations.
b. As defined by 38 C.F.R. §3.2(i): August 2, 1990, through date to be prescribed by presidential proclamation or law.
Adjudicating Claims
According to the interim final rule, the effective date for VA to apply the provisions for the new
presumptions based on specific military service is August 5, 2021. This date wil apply for claims in two
situations:
1. Claims received by VA on or after August 5, 2021; and
2. Claims pending before VA or before the U.S. Court of Appeals for Veterans Claims or
U.S. Court of Appeals for the Federal Circuit on August 5, 2021.
VA updated three sections of its M21-1 Adjudication Procedures Manual providing guidance on
processing claims to reflect the new presumptions. Part VIII.i .2.A provides general information on
granting presumptive service connection for disabilities resulting from exposure to “fine, particulate
matter under 38 U.S.C. §3.320.” Part VIII.i .2.B and Part VIII.i .2.C provide guidance for identifying
claims for these presumptions and how to rate, award, or deny claims for service connection, respectively.
VA announced that no action is required for veterans with pending claims for one or more of these new
presumptions, because VA is automatical y reviewing these claims and wil send the veteran a decision

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notice upon completion of the review. For veterans and their survivors who are in various stages of the
claims process and believe they are now eligible for benefits, VA announced:
 Veterans who disagree with the initial decision on service connection of these three
conditions are able to request a new claim review. Veterans should complete VA Form 20-
0995 for a supplemental claim and submit it to the VA processing center or regional
office listed on the initial decision form.
 Veterans who are filing an initial claim can do so by completing VA Form 21-526EZ and
mailing it to the VA claims intake center at the address listed on the form. Veterans are
also able to submit a claim electronical y through the Fully Developed Claim system.
For additional information on the presumptive conditions of asthma, rhinitis, and sinusitis and the claims
process, see VA’s Airborne Hazards and Burn Pit Exposures or VA’s Exposure to Specific Environmental
Hazards webpages. Congressional offices with specific constituent questions can contact VA’s Office of
Congressional and Legislative Affairs.

Author Information

Heather M. Salazar

Analyst in Veterans Policy




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