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ME/CFS- Gulf. Service connection without presumption

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We are currently in the process of applying. In the three steps we have perfect for 1 and 3 but struggling with the service connect. 

We have the diagnosis moderate/severe with many doctors over many years, almost textbook. We have a timeline And progression that clearly points to something happening during the summer/fall of 2002. I’ve been declining/progressing for over a decade until the point if severity. I had to leave my full time job in the summer of 2018. 

 The issue, and my question, is that in reading anything on ME/CFS or Gulf the VA tends to go on presumption of being in the gulf but medical research shows that there are much stronger theories that does not involve the gulf and we can’t pin down one exact event for the cause.

 Any research or advice would be greatly appreciated. I am currently 30% for a permanent foot injury. 

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The presumptives are a slightly different than regular service-connection. In brief, regular service connection requires an event/injury in service (or existing SC disability), current diagnosis, and medical nexus. Presumptives relax the medical nexus so long as you can prove you were in theater and some other minor requirements (duration six months+, 10% disabling, etc...).

If you can prove it beyond that, then that's great! But the presumption is there for CFS and medically undiagnosed illness. The idea is if you merely meet the criteria, you should be covered.


I'm not sure if this answers your question, but I hope it helps. Also, don't forget, you should consider secondary SC on top of those.

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Woods and Woods ( lawyers for vets) have some good info here on this condition-myalgic encephalomyelitis:


However if you are not a GWV, their could be some inservice nexus, such as in this article by MAYO clinic:

"The cause of chronic fatigue syndrome is unknown, although there are many theories — ranging from viral infections to psychological stress. Some experts believe chronic fatigue syndrome might be triggered by a combination of factors."


They consider this to be just like CFS.

Did you have a severe viral infection during "summer/fall of 2002"?

Do yu have a complete copy of your inservice SMRs and 201 ( Personnel) file?

The CDC has more info here on this condition:




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All around great advice above, also keep in mind that any in service symptoms notes in your medical progress reports can also help with direct service connection.

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You got some good advice and directions to information so far from others. What I didn't see anywhere in your email was anything that said for sure if you were or were not a Gulf War Veteran. That makes a big difference. If you are a GWV, then the presumptive conditions apply and it's an entirely different ball game. If you're not a GWV, then you have to prove direct service connection and it's a more difficult path.

There are a ton of great websites to get information from, but I'd recommend looking at Cort Johnson's Health Rising site for some non-biased information that will keep you up to date on what's happening in the community. You will also find links to other sites there. https://www.healthrising.org

Good luck and let me know if you need some more specific information.

Dr. Dave

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