Revised January 29, 2024
VIII.ii.1.D.1.aQualifying Service for Presumptive SC of Infectious Diseases Under 38 CFR 3.317
Qualifying service for the purpose of presumptive service connection (SC) for infectious diseases, means the Veteran served on active duty
- in the Southwest Asia theater of operations during the Gulf War, as defined in 38 CFR 3.317(e), or
- in Afghanistan on or after September 19, 2001.
Important: While some of the service locations overlap, qualifying service for the purposes of presumptive SC for infectious diseases is not equivalent to Persian Gulf Veteran service outlined in 38 U.S.C. 1117 for presumptive SC of undiagnosed illnesses and medically unexplained chronic multi-symptom illness (MUCMIs). Public Law 117-168 , Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act of 2022, did not change qualifying service or the other regulatory requirements for infectious diseases. References: For more information on
- qualifying service for presumptive SC of infectious diseases, see 38 CFR 3.317(c)(3)(ii), and
- definition of Persian Gulf war, see 38 CFR 3.2(i).
VIII.ii.1.D.1.bPresumptive SC for Infectious Diseases Under 38 CFR 3.317(c)
Effective September 29, 2010, presumptive SC is established under 38 CFR 3.317(c) for the specified infectious diseases if
- the Veteran had qualifying service as detailed in M21-1, Part VIII, Subpart ii, 1.D.1.a, and
- the disease becomes manifest to a compensable degree within the time limit specified in 38 CFR 3.317(c)(3)(i) and M21-1, Part VIII, Subpart ii, 1.A.2.c.
VIII.ii.1.D.1.cManifestation Period for Infectious Diseases Under 38 CFR 3.317
For each of the recognized presumptive infectious diseases, 38 CFR 3.317(c)(3)(i) prescribes a specific manifestation period as detailed in the table below.Note : The one-year time period specified in the table below means within one year from the date of separation from a qualifying period of service as specified in 38 CFR 3.317 (c)(3)(ii).
| Infectious Disease | Time Limit for Manifestation |
|---|---|
Brucellosis | one year |
Campylobacter jejuni | one year |
Coxiella burnetii (Q fever) | one year |
Malaria |
|
Mycobacterium tuberculosis | no time limit |
Nontyphoid Salmonella | one year |
Shigella | one year |
Visceral leishmaniasis | no time limit |
West Nile virus | one year |
References : For more information on
-
developing infectious disease claims, see M21-1, Part VIII, Subpart ii, 1.D.2, and
-
establishing onset of a presumptive disability during a required manifestation period, see M21-1, Part V, Subpart ii, 2.B.1.g.
VIII.ii.1.D.1.dConsidering Long-Term Health Effects Potentially Associated With Infectious Diseases
As specified in 38 CFR 3.317(d), if a Veteran who is presumed SC for a disease listed in column A of the table is diagnosed with a disease in column B within the time period specified in the table (if no time period is specified, at any time), the Department of Veterans Affairs (VA) will request a medical opinion as to whether it is at least as likely as not that the condition was caused by the Veteran having had the associated disease in column A. Note: This does not preclude a finding that other manifestations of disability or secondary conditions were caused by an infectious disease.
| Column A – Infectious Disease | Column B – Associated Condition(s) |
|---|---|
Brucellosis |
|
Campylobacter jejuni |
|
Coxiella burnetti (Q fever) |
|
Malaria |
|
Mycobacterium tuberculosis |
|
Nontyphoid Salmonella | reactive arthritis if manifest within three months of the infection |
Shigella |
|
Visceral leishmaniasis |
|
West Nile virus | variable physical, functional, or cognitive disability |
Reference : For more information on requesting medical opinions in claims for infectious diseases, see M21-1, Part VIII, Subpart ii, 1.D.2.c.
- Developing Claims for Infectious Disease Under 38 CFR 3.317
This topic contains information on developing claims of infectious disease under 38 CFR 3.317, including
- Section 5103 notice for infectious disease claims
- developing claims for infectious diseases, and
- requesting examinations in claims for infectious diseases.
Revised January 29, 2024
VIII.ii.1.D.2.aSection 5103 Notice for Infectious Disease Claims
It is unnecessary to issue Section 5103 notice when a Veteran files a new claim for SC for an infectious disease on a form that provides, or otherwise indicates the claimant received, the notice, such as VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits.References : For more information on
- circumstances under which it is necessary to issue Section 5103 notice, see
- requesting evidence from the claimant, see M21-1, Part III, Subpart i, 2.D, and
- clarifying contentions, see M21-1, Part III, Subpart i, 2.D.1.c.
VIII.ii.1.D.2.bDeveloping Claims for Infectious Diseases
In addition to the usual evidence-gathering procedures for claims, follow the procedures below when processing a claim for SC of an infectious disease under 38 CFR 3.317. — Step — Action 1 — Does the Veteran have qualifying service as defined in 38 CFR 3.317(c)(3)(ii) and as detailed in M21-1, Part VIII, Subpart ii, 1.D.1.a?
- If yes , go to next step.
- If no , send the claim for a decision.
2 — Is there credible lay or medical evidence of a qualifying infectious disease within the time limit, if applicable, specified in 38 CFR 3.317(c)(3)(i)?
- If yes , go to the next step.
- If no , send the claim for a decision.
3 — Is the Veteran claiming one of the long-term health effects listed in 38 CFR 3.317(d)(2) due to the infectious disease?
- If yes , go to the next step.
- If no , go to Step 5.
4 — Is there credible lay or medical evidence of the long-term health effect, and if applicable, within the time limit specified in 38 CFR 3.317(d)(2)?
- If yes ,
- request a medical opinion as outlined in M21-1, Part VIII, Subpart ii, 1.D.2.c, and
- go to the next step.
- If no , go to the next step.
5 — Request an examination for the infectious disease, if needed to decide the claim, following the guidance in M21-1, Part VIII, Subpart ii, 1.D.2.c. Reference : For more information on infectious diseases under 38 CFR 3.317 and potential long-term health effects, see M21-1, Part VIII, Subpart ii, 1.D.1.d.
VIII.ii.1.D.2.cRequesting Examinations in Claims for Infectious Diseases
Use the table below when an examination and/or medical opinion is needed to decide a claim for infectious disease under 38 CFR 3.317. — If the claim involves a(n) ... — Then ...
infectious disease listed in 38 CFR 3.317(c) | request the appropriate infectious diseases DBQ to evaluate current severity. Note: As presumptive SC applies to the infectious disease under 38 CFR 3.317, a medical opinion is not required. |
long-term health effect potentially associated with an infectious disease as noted in 38 CFR 3.317(d) | request a medical opinion as to whether it is at least as likely as not that the condition was caused by the Veteran having had the infectious disease. |
Important :
- Do not request a Gulf War general medical examination for infectious disease claims.
- The Acceptable Clinical Evidence (ACE) examination process may be used when processing these claims, when deemed appropriate.
Reference : For more information on ACE examinations, see M21-1, Part IV, Subpart i, 2.A.4.
3Rating Claims for Infectious Disease Under 38 CFR 3.317
Revised June 30, 2025
VIII.ii.1.D.3.aProper Coding for Infectious Disease Decisions Under 38 CFR 3.317
In order to properly identify and track infectious disease claims for which SC is awarded or denied under 38 CFR 3.317, regional offices must properly code the disabilities in the Veterans Benefits Management System - Ratings (VBMS-R) by assigning the
- _Gulf War Presumptive - Infectious Disease (3.317(c)) _special issue, and
- special issue basis specific to the infectious disease.
Reference : For more information on assigning a special issue in VBMS-R, see the VBMS-R User Guide.
End of Part VIII, Subpart ii, Chapter 1, Section D