Section H - Claims for Service Connection for Other Diseases and Disabilities - Updated 12/16/11

Subpart II - Compensation
Chapter 1 - Development

Overview


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In this Section
This section contains the following topics:   ''' '''
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26.   Developing Claims for Service Connection for Positive Tuberculin Reactions
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Introduction
This topic contains information on developing claims for service connection for positive tuberculin reactions, including the
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 ·      action to take when a positive tuberculin reaction only is claimed

 ·      action to take when a positive tuberculin reaction and other disabilities are claimed, and

 ·      reporting responsibilities of the Department of Veterans Affairs (VA) outpatient clinics and VA medical centers (VAMCs). 
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Change Date
September 5, 2008 {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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a.   Action to Take When a Positive Tuberculin Reaction Only Is Claimed
If VA Form 21-526, Veteran’s Application for Compensation and/or Pension, is received claiming only a positive tuberculin reaction, refer the claim to the rating activity for a determination as to whether or not a disability is present.
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<p class="MsoBlockText">

<p class="MsoBlockText">Reference:   For more information on claims for service connection for a positive tuberculin reaction, see M21-1MR, Part III, Subpart v, 7.A.10. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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b. When a Positive Tuberculin Reaction and Other Disabilities Are Claimed
<p class="MsoBlockText">If VA Form 21-526 indicates that a positive tuberculin reaction is claimed together with other disabilities
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      complete any appropriate development required for the other disabilities, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      refer the file to the rating activity for rating of all the claimed disabilities. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 26. Developing Claims for Service Connection for Positive Tuberculin Reactions, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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c.   Reporting Responsibilities of VA Outpatient Clinics and Medical Centers
<p class="MsoBlockText">As provided in M21-1MR, Part III, Subpart v, 7.A.10, a Department of Veterans Affairs (VA) outpatient clinic or VA medical center (VAMC) will furnish a report of the follow-up examination made at the expiration of the 12-month period of chemotherapy for discharged personnel who have had a tuberculin test conversion from negative to positive during service.
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<p class="MsoBlockText">

<p class="MsoBlockText">Refer the file to the rating activity if a VA outpatient clinic or VAMC report or any other evidence indicates the presence of tuberculous disease.

<p class="MsoBlockText">

<p class="MsoBlockText">The rating activity will consider establishing service connection by way of presumption under 38 CFR 3.307 and M21-1MR, Part IV, Subpart ii, 1.H.27.d. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt"> '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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27.   Developing Claims for Service Connection for Chronic or Tropical Diseases
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Introduction
<p class="MsoBlockText">This topic contains information on developing claims for service connection for chronic or tropical diseases, including
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the definition of a chronic disease

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      establishing whether a disease is chronic

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      considering

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     service connection for a chronic or tropical disease, and

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     presumptive service connection

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the locations of lists of chronic and tropical diseases, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the action to take if a disease was

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     treated in service, or

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     not treated in service. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
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Change Date
<p class="MsoBlockText">December 13, 2005 {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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a.   Definition:   Chronic Disease
<p class="MsoBlockText">A chronic disease is a disease
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      of prolonged duration, producing incapacitating symptoms of varying degree

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      that may undergo remission, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      that is seldom entirely cured with all residuals of damage being completely eradicated. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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b.   Establishing Whether a Disease Is Chronic
<p class="MsoBlockText">If a diagnosis is prefaced with the word “chronic,” that does not necessarily establish the disease as chronic.
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<p class="MsoBlockText">

<p class="MsoBlockText">Important:   Whether a disease is chronic is a matter for a factual determination dependent on the nature of the disease and its manifestations. Some diseases are inherently chronic, such as multiple sclerosis, while others, such as bronchitis, may be either acute or chronic. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 27. Developing Claims for Service Connection for Chronic or Tropical Diseases, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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c.   Considering Service Connection for a Chronic or Tropical Disease
<p class="MsoBlockText">When deciding any claim for service connection for a chronic or tropical disease, it is also necessary to consider
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      service connection based on manifestation of the claimed disease during service, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      service connection based on a presumption that the disease, which was first manifested following discharge from service, is nevertheless related to service. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
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d.   Considering Presumptive Service Connection
<p class="MsoBlockText">Once a substantially complete claim is of record, the following conditions apply:
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the possibility of entitlement to presumptive service connection exists when the Veteran alleges inception within the limiting periods contained in

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     38 U.S.C. 1112, or

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     38 U.S.C. 1133, when appropriate

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the Veteran does not need to establish that the disease in question was definitely diagnosed within the presumptive period, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the evidence should show that manifestations of the condition, disabling to the degree of at least 10 percent, became apparent prior to the expiration of the presumptive period shown in 38 CFR 3.307. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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e.   Locations of Lists of Chronic and Tropical Diseases
<p class="MsoBlockText">The conditions listed in
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      38 U.S.C. 1101(3) and 38 CFR 3.309(a) are chronic diseases, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      38 U.S.C. 1101(4) and 38 CFR 3.309(b) are tropical diseases. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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f.   Action to Take if a Condition Was Treated in Service
<p class="MsoBlockText">If service records show the Veteran was treated for a chronic or tropical disease, refer the case to the rating activity. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 27. Developing Claims for Service Connection for Chronic or Tropical Diseases, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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g.   Action to Take If a Disease Was Not Treated in Service
<p class="MsoBlockText">Even though certain chronic and tropical diseases were not treated during service, service connection may still be established on a presumptive basis under the provisions of
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      38 U.S.C. 1112

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      38 U.S.C. 1133, or

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      38 U.S.C. 1137.

<p class="MsoBlockText">

<p class="MsoBlockText">Reference:   For information on the diseases for which service connection may be established on a presumptive basis and the service requirements that must be met, see 38 CFR 3.307. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt"> '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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28.   Developing Claims Based on Herbicide Exposure in the Republic of Vietnam (RVN)
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Introduction
<p class="MsoBlockText">This topic contains information on developing claims based on service in the Republic of Vietnam (RVN), including
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the definition of service in the RVN

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the time period during which herbicide exposure may be presumed

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      considering

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     qualifying length of service in the RVN, and

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     proof of service in the RVN

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the diseases for which service connection may be presumed under the Agent Orange Act of 1991

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      initial correspondence with the Veteran in herbicide exposure claims

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the action to take when the Veteran alleges herbicide exposure but does not claim a disability

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      developing claims based on service aboard ships offshore the RVN

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      requesting verification of service aboard ships offshore the RVN or on inland waterways from the

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     National Personnel Records Center, or

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     U.S. Army and Joint Services Records Research Center (JSRRC)

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      requesting verification of naval aviation service in the RVN, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      considering claims for benefits based on birth defects. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
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Change Date
<p class="MsoBlockText">December 16, 2011 <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 28. Developing Claims Based on Herbicide Exposure in the Republic of Vietnam (RVN), Continued {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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a.   Definition:   Service in the RVN
<p class="MsoBlockText"> For the purposes of establishing service connection under 38 CFR 3.307(a)(6) and 38 CFR 3 .309(e), service in the Republic of Vietnam  (RVN)  means
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      service in the RVN or its inland waterways, or

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      service in other locations if the conditions of service involved duty or visitation in the RVN.

<p class="MsoBlockText">

<p class="MsoBlockText">References:   For

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      more information on the definition of service in the RVN, see VAOPGCPREC 27-97

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      information on exposure to herbicides during service

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     aboard ships that operated offshore the RVN, see M21-1MR, Part IV, Subpart ii, 1.H.28.h

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     along the demilitarized zone in Korea, see M21-1MR, Part IV, Subpart ii, 2.C.10.o, and

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     in Thailand, see M21-1MR, Part IV, Subpart ii, 2.C.10.p. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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b.   Time Period During Which Exposure May Be Presumed
<p class="MsoBlockText">Public Law (PL) 104-275 (38 U.S.C. 1116) provides that effective January 1, 1997, the time period during which exposure to herbicides in the RVN may be presumed is January 9, 1962, to May 7, 1975.
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<p class="MsoBlockText">

<p class="MsoBlockText">Notes:

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      Qualifying skin conditions must have become manifest to a degree of 10 percent or more within one year of the last date of service within the RVN.

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      2, 3, 7, 8 Tetrachlorodibenzo-P-Dioxin (TCDD) is a herbicide commonly referred to as “Agent Orange.” {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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c.   Considering Qualifying Length of Service
<p class="MsoBlockText">There is no requirement for a specified length of service, duty, or visitation in the RVN under 38 CFR 3.307(a)(6)(iii).
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<p class="MsoBlockText">

<p class="MsoBlockText">Rationale:   Even a few hours in the RVN during the Vietnam era may be sufficient to establish service connection for subsequently developed diseases based on a presumption of exposure to herbicides. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 28. Developing Claims Based on Herbicide Exposure in the Republic of Vietnam (RVN), Continued {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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d.   Considering Proof of Service in the RVN
<p class="MsoBlockText">If the claimant alleges service in the RVN, review the DD Form 214, Certificate of Release or Discharge from Active Duty, or other evidence in the claims folder to confirm such service.
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<p class="MsoBlockText">

<p class="MsoBlockText">If necessary

<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      submit a request for verification through PIES, using request code O34,   and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      ask the claimant to submit evidence, including “buddy statements,” to confirm service in Vietnam.

<p class="MsoBlockText">

<p class="MsoBlockText">Exception:   Use PIES O39 request code to verify service if the Veteran claims temporary duty (TDY) to the RVN during the early period of the Southeast Asian conflict, January 9, 1962, to August 5, 1964.

<p class="MsoBlockText">

<p class="MsoBlockText">Note:   Award of the Armed Forces Expeditionary Medal may indicate TDY in the RVN before 1965.

<p class="MsoBlockText">

<p class="MsoBlockText">Important:   A claim may not be denied solely because service in the RVN cannot be verified

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      until the end of the initial 30-day and 30-day follow-up response periods, and/or

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      (in cases where Federal records are needed to verify service in the RVN) until the requested Federal records are received or a formal response is received that the records are unavailable.

<p class="MsoBlockText">

<p class="MsoBlockText">Reference:   For information on verifying service on a ship in the waters offshore of the RVN, see M21-1MR, Part IV, Subpart ii, 1.H.28.i. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 28. Developing Claims Based on Herbicide Exposure in the Republic of Vietnam (RVN), Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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e.   Diseases for Which Service Connection   May Be Presumed Under the Agent Orange Act of 1991
<p class="MsoBlockText">The Agent Orange Act of 1991, PL 102-4, established a presumption of service connection for Veterans with service in the RVN during the Vietnam era who subsequently develop, to a degree of 10 percent or more
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      Hodgkin’s disease

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      multiple myeloma

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      non-Hodgkin’s lymphoma (NHL)

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      acute and subacute peripheral neuropathy

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      porphyria cutanea tarda

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      prostate cancer

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      respiratory cancers, such as cancers of the

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     lung

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     bronchus

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     larynx, or

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     trachea

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      soft-tissue sarcoma

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      chloracne or other acneiform disease consistent with chloracne

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      type 2 diabetes mellitus

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      chronic lymphocytic leukemia

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      AL amyloidosis

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      ischemic heart disease

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      chronic B-cell leukemia, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      Parkinson’s disease.

<p class="MsoBlockText">

<p class="MsoBlockText">Notes:

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      Presumptive service connection based on herbicide exposure is provided for the above-listed diseases at 38 CFR 3.307(a)(6) and 38 CFR 3.309(e).

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      Presumptive service connection for NHL is also provided at 38 CFR 3.313, which is not based on herbicide exposure. Unlike entitlement under 38 CFR 3.307(a)(6) and 38 CFR 3.309(e), entitlement under 38 CFR 3.313

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -       is based solely on service in the RVN, including naval service in the offshore “blue water” of the RVN, and

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     does not require that NHL manifest itself to a degree of 10 percent or more after service.

<p class="MsoBlockText">

<p class="MsoBlockText">Reference:   For more information on entitlement to service connection for NHL under 38 CFR 3.313, see M21-1MR, Part IV, Subpart ii, 2.C.10.t and u. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 28. Developing Claims Based on Herbicide Exposure in the Republic of Vietnam (RVN), Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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f.   Initial Correspondence With the Veteran in Herbicide Exposure Claims
<p class="MsoBlockText">When initially corresponding with a Veteran claiming disability resulting from exposure to herbicides while in the RVN
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      inform the Veteran of the availability of hospital examinations and treatment, or

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      if the Veteran has already had the herbicide examination or been treated for herbicide exposure, request that the Veteran submit

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     a copy of the examination or treatment report, or

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     the name of the VA facility performing the examination or treatment so that the regional office (RO) may obtain a copy of the report. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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g.   Action to Take When the Veteran Alleges Herbicide Exposure but Does Not Claim a Disability
<p class="MsoBlockText">A claim is not substantially complete if a Veteran alleges exposure to herbicides during service, but does not claim service connection for a specific disability. In cases such as this
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      inform the Veteran that he/she must identify a specific disability, since exposure in and of itself is not a disability, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      ask the Veteran to identify the disability(ies) that resulted from exposure to herbicides during service.

<p class="MsoBlockText">

<p class="MsoBlockText">Important:

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      Do not

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     process the claim as a denial, or

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     establish end product (EP) control for the incomplete claim.

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      Whenever possible, telephone the Veteran to obtain the information needed to substantiate the claim.

<p class="MsoBlockText">

<p class="MsoBlockText">Reference:   For more information on what constitutes a substantially complete application, see

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      38 CFR 3.159(a)(3), and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      M21-1MR, Part I, 1.B.3.a. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
 * }

<p class="MapTitleContinued"> 28. Developing Claims Based on Herbicide Exposure in the Republic of Vietnam (RVN), Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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h.   Developing Claims Based on Service Aboard Ships Offshore the RVN
<p class="MsoBlockText">When a Veteran alleges exposure to herbicides during service aboard a Navy or Coast Guard ship that operated on the offshore waters of the RVN, develop for
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      evidence that shows the ship

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     docked to the shores or piers of the RVN

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     operated temporarily on the RVN inland waterways, or

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     operated on close coastal waters for extended periods, with evidence that

<p class="BulletText3" style="mso-list:l14 level1 lfo7"> §   crew members went ashore, or

<p class="BulletText3" style="mso-list:l14 level1 lfo7"> §   smaller vessels from the ship went ashore regularly with supplies or personnel

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      evidence that places the Veteran onboard the ship at the time the ship docked to the shore or pier or operated in inland waterways or on close coastal waters for extended periods, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the Veteran’s statement as to whether he/she went ashore when the ship docked or operated on close coastal waters for extended periods, if the evidence shows the ship docked to the shore or pier or that crew members were sent ashore when the ship operated on close coastal waters.

<p class="MsoBlockText">

<p class="MsoBlockText">Important:   In all cases where a Veteran claims exposure to herbicides during service aboard a ship in offshore waters, place a copy of the U.S. Army and Joint Services Records Research Center’s (JSRRC’s) memorandum shown in M21-1MR, Part IV, Subpart ii, 2.C.10.l in the Veteran’s claim folder. This document will

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      substitute for individual inquiries to the Compensation Service’s Agent Orange mailbox and to the JSRRC, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      establish that the JSRRC has no evidence to support a claim of herbicide exposure during shipboard service.

<p class="MsoBlockText">

<p class="MsoBlockText">Reference:   For more information on ships that docked to the shore of the RVN,   traveled on inland waterways, or operated on close coastal waters for extended periods, see the following page on the Compensation Service Intranet website:   http://vbaw.vba.va.gov/bl/21/rating/VENavyShip.htm. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
 * }

<p class="MapTitleContinued"> 28. Developing Claims Based on Herbicide Exposure in the Republic of Vietnam (RVN), Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

<p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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i.   Requesting Verification of Service on Ships Offshore of the RVN or on Inland Waterways From NPRC
<p class="MsoBlockText">If a Veteran claims service connection for a disability related to exposure to herbicide agents, and alleges service on a ship in the waters offshore of the RVN or on the inland waterways, submit a PIES request to the National Personnel Records Center (NPRC) for verification of this fact, using request code O19 or O34.
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<p class="MsoBlockText">

<p class="MsoBlockText">Once a response is received, review the available records for evidence that the

<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      ship on which the Veteran served was in the waters off the RVN, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      Veteran’s service involved duty or visitation on land.

<p class="MsoBlockText">

<p class="MsoBlockText">Important:   Accept the claimant’s statement that he/she went ashore from that ship as evidence of presumptive exposure to herbicides if there is evidence that the

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      claimant’s ship

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     docked to the shore of the RVN, or

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     sent crew members ashore while operating on close coastal waters for extended periods, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the claimant was stationed aboard the ship at that time. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
 * }

<p class="MapTitleContinued"> 28. Developing Claims Based on Herbicide Exposure in the Republic of Vietnam (RVN), Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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j.   Requesting Verification of Service on Ships Offshore RVN or on Inland Waterways From JSRRC
<p class="MsoBlockText">If the Veteran has identified a 60-day* time frame for docking or inland waterway travel, but cannot produce the necessary evidence, and the service department has been unable to provide verification that the veteran went ashore or traveled on inland waterways, request verification from the U.S. Army and Joint Services Records Research Center (JSRRC) through the PIES/Defense Personnel Records Image Retrieval System (DPRIS) interface, using request code O43.
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<p class="MsoBlockText">

<p class="MsoBlockText">The request must include the following information:

<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the name and hull number of the ship, such as USS Galveston (CLG 3), and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the dates during which the ship

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     was docked to the shore of the RVN, or

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     traveled on the inland waterways.

<p class="MsoBlockText">

<p class="MsoBlockText">Notes:

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      Code O43 generates a request for ship histories and deck logs for Navy veterans. If verification is required for a veteran from another branch of service who served aboard a Navy ship, mail that request to JSRRC at the address listed in M21-1MR, Part III, Subpart iii, 2.K.76.t.

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      *The time frame for the inquiry submitted to JSRRC

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     must be limited to a cumulative period of 60 days, but

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     may include different date ranges, as long as the cumulative number of days does not exceed 60. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
 * }

<p class="MapTitleContinued"> 28. Developing Claims Based on Herbicide Exposure in the Republic of Vietnam (RVN), Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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k.   Verifying   Naval Aviation Service in the RVN
<p class="MsoBlockText">When a Veteran claims herbicide exposure during naval aviation service in the RVN, and initial development does not provide evidence to support in-country duty or visitation, send a
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      PIES O18 request to NPRC for the Veteran’s complete military records, and/or

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      DPRIS O43 request for unit research to JSRRC.

<p class="MsoBlockText">

<p class="MsoBlockText">Notes:

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      To reduce processing time, claims processors may wish to consult the U.S. Navy web site Dictionary of American Naval Aviation Squadrons, which contains the histories of all attack squadrons (“VA” prefix) and strike fighter squadrons (“VFA” prefix). These histories describe unit locations, including RVN in-country locations.

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      Concede exposure to herbicides on a presumptive basis if the

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     Veteran’s unit history shows RVN in-country service, consistent with the Veteran’s dates of assignment to that unit, and

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     Veteran provides a lay statement of personal in-country service. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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l.   Considering Claims for Benefits Based on Birth Defects
<p class="MsoBlockText">Claims for
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      benefits for a child suffering from spina bifida and other birth defects are discussed in M21-1MR, Part VI, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      additional benefits for female Vietnam Veterans due to certain birth defects of a natural child have been authorized under PL 106-419.

<p class="MsoBlockText">

<p class="MsoBlockText">Important:   The law limits the birth defects for which VA may pay benefits. Deny claims for compensation for the following on the basis that it is not authorized by law:

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      birth defects resulting from a familial disorder

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      a birth-related injury, or

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      a fetal or neonatal infirmity, with well-established, unrelated causes.

<p class="MsoBlockText">

<p class="MsoBlockText">Reference:   For more information on claims for benefits for birth defects from children of Vietnam Veterans, see

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·        M21-1MR, Part VI

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      38 CFR 3.814

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      38 CFR 3.815, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      38 U.S.C. Chapter 18. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt"> '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
 * }

29.   Developing Claims for Service Connection for Asbestos-Related Diseases
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Introduction
<p class="MsoBlockText">This topic contains information on developing claims for service connection for asbestos-related diseases, including
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      considering the latent period and type of asbestos exposure

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the responsibilities of the rating activity, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the action to take when no disability is claimed. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
 * }

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Change Date
<p class="MsoBlockText">July 20, 2009 {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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a.   Considering the Latent Period and Type of Asbestos Exposure
<p class="MsoBlockText">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.
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<p class="MsoBlockText">

<p class="MsoBlockText">Note:   The exposure may have been direct or indirect; the extent and duration of exposure is not a factor.

<p class="MsoBlockText">

<p class="MsoBlockText">Reference:   For more information on asbestos-related diseases, see M21-1MR, IV, Subpart ii, 2.C.9. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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b.   Responsibilities of the Rating Activity
<p class="MsoBlockText">The rating activity is responsible for
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      determining whether or not the evidence of record confirms the Veteran was exposed to asbestos during service, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      ensuring that development is accomplished to determine whether the Veteran was exposed to asbestos (as a result of his/her occupation, for example) before or after service. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
 * }

<p class="MapTitleContinued"> 29. Developing Claims for Service Connection for Asbestos-Related Diseases, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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c.   Action to Take When No Disability Is Claimed
<p class="MsoBlockText">A claim is not substantially complete if a Veteran alleges exposure to asbestos during service, but does not claim service connection for a specific disability. In cases such as this
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      inform the Veteran that exposure, in and of itself, is not a disability, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      ask the Veteran to identify the disability(ies) that resulted from exposure to asbestos during service.

<p class="MsoBlockText">

<p class="MsoBlockText">Important:

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      Do not

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     process the claim as a denial, or

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     establish end product (EP) control for the incomplete claim.

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      Whenever possible, telephone the Veteran to obtain the information needed to substantiate the claim.

<p class="MsoBlockText">

<p class="MsoBlockText">Reference:   For more information on what constitutes a substantially complete application, see

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      38 CFR 3.159(a)(3), and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      M21-1MR, Part I, 1.B.3.a. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt"> '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
 * }

30.   Developing Claims for Service Connection for Acquired Immune Deficiency Syndrome (AIDS)
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Introduction
<p class="MsoBlockText">This topic contains information on developing claims for service connection for acquired immune deficiency syndrome (AIDS ), including
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the definition of AIDS

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the causative agent of AIDS

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the tests available to verify AIDS

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      obtaining medical records, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      when to send the claim to the rating activity. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
 * }

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Change Date
<p class="MsoBlockText">July 20, 2009 {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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a.   Definition:   AIDS
<p class="MsoBlockText">Acquired immune deficiency syndrome (AIDS) is defined by the Centers for Disease Control (CDC) as “a disease at least moderately predictive of a defect in cell-mediated immunity occurring in a person with no known cause for diminished resistance to that disease.” {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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b.   Causative Agent of AIDS
<p class="MsoBlockText">AIDS is caused by the human immunodeficiency virus (HIV). {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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c.   Tests Available to Verify AIDS
<p class="MsoBlockText">The most commonly used lab test for AIDS is the HIV antibody test.
 * style="width:387.0pt;padding:0in 5.4pt 0in 5.4pt" valign="top" width="516"|

<p class="MsoBlockText">

<p class="MsoBlockText">The following two HIV antibody tests are available:

<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the screening enzyme-linked immunosorbent assay (ELISA) test, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the confirmatory Western Blot test. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
 * }

<p class="MapTitleContinued"> 30. Developing Claims for Service Connection for Acquired Immune Deficiency Syndrome (AIDS), Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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d.   Obtaining Medical Records
<p class="MsoBlockText">Request
 * style="width:387.0pt;padding:0in 5.4pt 0in 5.4pt" valign="top" width="516"|

<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      service treatment records (STRs) if they are not in the claims folder, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      records of treatment from a VAMC or VA outpatient clinic, if the Veteran indicates that he/she received treatment at one of these facilities.

<p class="MsoBlockText">

<p class="MsoBlockText">Send the Veteran VA Form 21-4142, Authorization and Consent to Release Information to the Department of Veterans Affairs(VA,)  if he/she

<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      reports treatment by a private hospital or physician, but

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      does not furnish the treatment records. {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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e.   When to Send the Claim to the Rating Activity
<p class="MsoBlockText">If a substantially complete claim exists, send the claim to the rating activity.
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<p class="MsoBlockText">

<p class="MsoBlockText">Reference:   For information on what constitutes a substantially complete claim, see

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      M21-1MR, Part I, 1.B.3.a, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      38 CFR 3.159(a)(3). <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt"> '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
 * }

31.   Developing Claims Based on Participation in Special Operations Incidents
<p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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Introduction
<p class="MsoBlockText">This topic contains information on developing claims based on participation in Special Operations incidents, including
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      a definition of Special Operations

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      developing Special Operations incidents

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the language to use for developing Special Operations incidents

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      an example of a “Special Operations Forces Incident” document

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      responses from the U.S. Special Operations Command (USSOCOM), and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      classified service records received from USSOCOM. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
 * }

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Change Date
<p class="MsoBlockText">March 20, 2011 <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
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a.   Definition:   Special Operations
<p class="MsoBlockText">Special Operations are small-scale covert or overt military operations of an unorthodox and frequently high-risk nature, undertaken to achieve significant political or military objectives in support of foreign policy.
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<p class="MsoBlockText">

<p class="MsoBlockText">Special Operations units are

<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      typically composed of relatively small groups of highly trained, armed personnel, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      often transported by helicopter, small boats, or submarines, or parachute from aircraft for stealthy infiltration by land.

<p class="MsoBlockText">

<p class="MsoBlockText">Examples:

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      U.S. Army’s Special Forces, commonly called the “Green Berets.”

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      U.S. Navy SEALs.

<p class="MsoBlockText">

<p class="MsoBlockText">Note:   Some Special Operations, such as counter-terrorism actions, may be carried out domestically under certain circumstances. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
 * }

<p class="MapTitleContinued"> 31. Developing Claims Based on Participation in Special Operations Incidents, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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b.   Developing Special Operations Incidents
<p class="MsoBlockText">The table below shows the development action to take when a Veteran claims that an injury or disability occurred during a Special Operations assignment. <p class="MsoNormal"> <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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 * }

<p class="MapTitleContinued"> 31. Developing Claims Based on Participation in Special Operations Incidents, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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c.   Language to Use for Developing Special Operations Incidents
<p class="MsoBlockText">Include the language below in the development letter for claims based on participation in Special Operations incidents:
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<p class="MsoBlockText">

<p class="MsoBlockText">Tell us more about your participation in a Special Operations unit by providing the following information on the attached VA Form 21-4138, Statement in Support of Claim:

<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext;mso-bidi-font-style:italic"> ·      To which branch of service and component were you assigned?

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext;mso-bidi-font-style:italic"> ·      What were the dates of your Special Operations tour of duty?

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext;mso-bidi-font-style:italic"> ·      ''Provide location (city/province and country) where the incident took place and the approximate date (within a 60-day range). ''

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext;mso-bidi-font-style:italic"> ·      If you were not assigned to a Special Operations unit but were attached to one, indicate to which unit and from what dates you were attached.

<p class="MsoBlockText">   

<p class="MsoBlockText">Please note that if you fail to respond or you provide an incomplete response, this may result in the denial of your claim.

<p class="MsoBlockText">

<p class="MsoBlockText">Note:   If possible, use the Modern Awards Processing-Development (MAP-D) application to insert the language into the letter. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
 * }

<p class="MapTitleContinued"> 31. Developing Claims Based on Participation in Special Operations Incidents, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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d.   Example:   Special Operations Forces Incident Document
<p class="MsoBlockText">An example of a “Special Operations Forces Incident” document is shown below.
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<p class="MsoBlockText">

<p class="MsoBlockText">Note:   The RO MRS will complete as much information as possible and submit this request via encrypted e-mail to VAVBASPT/RO/SOCOM. Allow 60 days for a response before sending a follow-up request. <p class="MsoNormal"> <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
 * }

<p class="MapTitleContinued"> 31. Developing Claims Based on Participation in Special Operations Incidents, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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e.   Responses From USSOCOM
<p class="MsoBlockText">Upon receipt of a request from VA, USSOCOM will research each claimed incident and provide
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      a “sanitized” summary of its research, or

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      a negative reply, if it finds no information.

<p class="MsoBlockText">

<p class="MsoBlockText">Notes:

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      The response will not include copies of documentation related to claimed incidents.

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      For certain incidents, USSOCOM may report that it cannot release any information. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
 * }

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f.   Classified Service Records Received From USSOCOM
<p class="MsoBlockText">Classified service records received from USSOCOM
 * style="width:387.0pt;padding:0in 5.4pt 0in 5.4pt" valign="top" width="516"|

<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      will often be from a casualty report

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      may be limited to

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     the date of the injury

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     the location where the injury occurred, and/or

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     a brief description of the injury or illness, or

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      may only confirm that the Veteran participated in Special Operations, because the operation is still considered classified.

<p class="MsoBlockText">

<p class="MsoBlockText">Note:   Because Special Operations have the characteristics of combat, 38 CFR 3.304(d) will apply in all cases where a Veteran’s participation in Special Operations is confirmed. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt"> '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
 * }

32.   Developing Claims Based on Exposure to Other Specific Environmental Hazards
<p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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Introduction
<p class="MsoBlockText">This topic contains information on developing claims based on exposure to other specific environmental hazards, including
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      locations of specific environmental hazards

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      end product control and tracking

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      guidelines for developing environmental hazard claims

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      using Department of Defense (DoD) records to establish exposure to environmental hazards

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      using alternate evidence to establish exposure to environmental hazards

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      centralized processing of Camp Lejeune claims and appeals

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the actions taken by the office of original jurisdiction (OOJ) upon receipt of a Camp Lejeune claim

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      a sample letter notifying the claimant of transfer of the Camp Lejeune claim

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      a sample FLASH notice for Camp Lejeune claims folders

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      the actions taken by the Louisville RO upon receipt of a Camp Lejeune claim, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      verification of Camp Lejeune service. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
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Change Date
<p class="MsoBlockText">December 16, 2011 <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 32. Developing Claims Based on Exposure to Other Specific Environmental Hazards, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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a.   Locations of Specific Environmental Hazards Identified by DoD
<p class="MsoBlockText"> The Department of Defense (DoD) has identified a number of environmental hazards at military installations in Iraq, Afghanistan, and elsewhere that could present health risks.
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<p class="MsoBlockText">

<p class="MsoBlockText"> These hazards include

<p class="BulletText1" style="margin-top:12.0pt;mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      large pit burns throughout Iraq, Afghanistan, and Djibouti on the Horn of Africa

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      particulate matter in Iraq and Afghanistan

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      a large sulphur fire at Mishraq State Sulphur Mine near Mosul, Iraq

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      hexavalent chromium exposure at the Qarmat Ali Water Treatment Plant at Basrah, Iraq

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      contaminated drinking water at Camp Lejeune, North Carolina, between 1957 and 1987, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      pollutants from a waste incinerator near the Naval Air Facility (NAF) at Atsugi, Japan.

<p class="MsoBlockText">

<p class="MsoBlockText">Reference:   For information on processing claims based on exposure to

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      all environmental hazards listed above, except contaminated drinking water at Camp Lejeune, see

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     Training Letter 10-03,  Environmental Hazards in Iraq, Afghanistan, and Other Military Installations,  and

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     M21-1MR, Part IV, Subpart ii, 2.C.13, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      contaminated drinking water at Camp Lejeune, see

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     | M21-1MR, Part IV, Subpart ii, 1.H.32.f through k, and

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     Training Letter 11-03,  Processing Disability Claims Based on Exposure to Contaminated Drinking Water at Camp Lejeune . <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 32. Developing Claims Based on Exposure to Other Specific Environmental Hazards, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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b.   Environmental Hazard EP Control and Tracking
<p class="MsoBlockText">Upon receipt of a substantially complete claim for service connection based on exposure to one or more of the environmental hazards listed in M21-1MR, Part IV, Subpart ii, 1.H.32.a
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      establish a standard end product (EP), such as EP 110, 010, or 020

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      determine whether the claim meets the criteria for expedited processing as an Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) claim, and   (Reference:   For more information, see VBA Letter 20-07-19 Revised, Priority Processing for Operations Iraqi Freedom & Enduring Freedom (OIF/OEF) Veterans.), and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      if the claim is based on service in Southwest Asia, enter the “Environmental Hazard in Gulf War” Special Issue identifier on the MAP-D Contentions screen.

<p class="MsoBlockText">

<p class="MsoBlockText">Important:

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      If a Veteran alleges exposure to an environmental hazard, but does not claim that a specific disability resulted from the exposure, the claim is not substantially complete.

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      In such cases as these

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     inform the Veteran that exposure, in and of itself, is not a disability

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     ask the Veteran to identify the disability(ies) that resulted from exposure to the environmental hazard, and

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     do not establish a pending EP until the Veteran has identified a disability that has resulted from exposure to the environmental hazard.

<p class="MsoBlockText">

<p class="MsoBlockText">Note:   Do not use the “Environmental Hazard in Gulf War” identifier for claims based on Atsugi or Camp Lejeune service.

<p class="MsoBlockText">

<p class="MsoBlockText">Reference:   For specific instructions on processing Camp Lejeune claims, see M21-1MR, Part IV, Subpart ii, 1.H.32.f through k. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 32. Developing Claims Based on Exposure to Other Specific Environmental Hazards, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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c.   Guidelines for Developing Environmental Hazard Claims
<p class="MsoBlockText">Use the guidelines below when developing claims for service connection based on exposure to environmental hazards.
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      Send the Veteran a standard section 5103 notice.

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      If the Veteran alleges exposure to environmental hazards during service, but does not claim service connection for a specific disability, inform the Veteran that he/she must at least identify a symptom or cluster of symptoms, because exposure, in and of itself, is not a disability.

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      Ask the claimant to provide at least some general information about the exposure event. Note:   Send a follow-up letter or telephone the Veteran if he/she fails to provide sufficient information regarding exposure and/or disability claimed because of such exposure.

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      Develop for service treatment records (STRs) and any VA and/or private medical records that are noted by the claimant.

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      Verify dates of military service and obtain military personnel records as per normal procedures.

<p class="MsoBlockText">

<p class="MsoBlockText">References:   For more information on

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      standard section 5103 notices, see M21-1MR, Part I, 1.B.3.b

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      specific section 5103 notice requirements for Camp Lejeune claims, see M21-1MR, Part IV, Subpart ii, 1.H.32.j

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      requesting evidence from

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     the claimant, see M21-1MR, Part III, Subpart iii, 1.B, and

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     other sources, see M21-1MR, Part III, Subpart iii, 1.C

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      developing for STRs and other service records, see M21-1MR, Part III, Subpart iii, 2.A, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      verifying military service, see M21-1MR, Part III, Subpart ii, 6.5. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 32. Developing Claims Based on Exposure to Other Specific Environmental Hazards, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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d.   Using DoD Records to Verify Exposure to Environmental Hazards
<p class="MsoBlockText"> DoD has provided VA a list of those who served at the Qarmat Ali Water Treatment Plant in Basrah, Iraq. If the Veteran is claiming exposure to an environmental hazard at this location, send an e-mail request for verification of service to the following Compensation Service mailbox: VAVBAWAS/CO/211/ENVIRO.
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<p class="MsoBlockText">

<p class="MsoBlockText">If exposure cannot be verified through an official list provided by DoD, review STRs, military personnel records, and all other available for evidence that corroborates the Veteran’s statement of exposure.

<p class="MsoBlockText">

<p class="MsoBlockText">Important:   Carefully review the Post-Deployment Health Assessment (PDHA) and Discharge Examination,  generally located in the STRs, for exposure information. The PDHA includes specific questions relating to exposure incidents.<span style="font-family:"Arial","sans-serif"">

<p class="MsoBlockText"><span style="font-family:"Arial","sans-serif"">

<p class="MsoBlockText">   Reference:   For information on using alternative evidence to establish exposure, see M21-1MR, Part IV, Subpart ii, 1.H.32.e. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
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e.   Using Alternative Evidence to Establish Exposure to Environmental Hazards
<p class="MsoBlockText">Because military service records will not verify all incidents of exposure, it is important to consider alternative evidence in establishing whether the Veteran participated in or was affected by an in-service exposure incident.
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<p class="MsoBlockText">

<p class="MsoBlockText">Alternative evidence includes

<p class="MsoBlockText"><span style="font-family:"Arial","sans-serif"">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      personal statements

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      buddy statements

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      unit histories

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      news articles, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      other lay evidence.

<p class="MsoBlockText"><span style="font-family:"Arial","sans-serif"">

<p class="MsoBlockText">Concede exposure to the claimed environmental hazard if the statements provided by the Veteran and/or others are consistent with the facts, places, and circumstances of the Veteran’s service.

<p class="MsoBlockText">

<p class="MsoBlockText">Reference:   For more information on considering evidence in claims for disability compensation, see

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      38 U.S.C. 1154(a), and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      38 CFR 3.303(a). <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
 * }

<p class="MapTitleContinued"> 32. Developing Claims Based on Exposure to Other Specific Environmental Hazards, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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f.   Centralized Processing of Camp Lejeune Claims
<p class="MsoBlockText">The Louisville Regional Office (RO) processes all disability claims that are based on exposure to contaminated drinking water at Camp Lejeune, including claims containing both Camp Lejeune and non-Camp Lejeune issues.
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<p class="MsoBlockText">

<p class="MsoBlockText">Exception:   The Winston-Salem and Salt Lake City ROs retain jurisdiction of Camp Lejeune claims associated with paperless claims folders.

<p class="MsoBlockText">

<p class="MsoBlockText">   The Louisville RO will retain jurisdiction of the Camp Lejeune claims until

<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      all Camp Lejeune issues are decided, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      no appeal has been received within the one-year appeal period.

<p class="MsoBlockText">

<p class="MsoBlockText">Note:   The Louisville RO has jurisdiction for any appeals received on Camp Lejeune claims and all other non-Camp Lejeune claims and/or appeals received during the one-year appeal period. <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
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g.   Actions Taken by the OOJ Upon Receipt of a Camp Lejeune Claim
<p class="MsoBlockText">Upon receipt of a substantially complete claim or appeal containing at least one Camp Lejeune issue, the office of original jurisdiction (OOJ)
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      sends the letter shown in M21-1MR, Part IV, Subpart ii, 1.H.32.h, to notify the claimant that his/her claims folder has been transferred to the Louisville RO

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      establishes the appropriate end product to control the Camp Lejeune issue, as well as other claimed issues, but does not initiate development on the claim

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      backfiles the FLASH notice shown in M21-1MR, Part IV, Subpart ii, 1.H.32.i in the center section of the claims folder, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      permanently transfers the claims folder to the Louisville RO.

<p class="BulletText1" style="margin-left:0in;text-indent:0in;mso-list:none;  tab-stops:.5in">

<p class="BulletText1" style="margin-left:0in;text-indent:0in;mso-list:none;  tab-stops:.5in">Note:   OOJs should send all mail that needs to be associated with a Camp Lejeune claim to the following address:

<p class="BulletText1" style="margin-left:0in;text-indent:0in;mso-list:none;  tab-stops:.5in">

<p class="BulletText1" style="margin-left:0in;text-indent:0in;mso-list:none;  tab-stops:.5in">Department of Veterans Affairs Louisville Regional Office

<p class="BulletText1" style="margin-left:0in;text-indent:0in;mso-list:none;  tab-stops:.5in">ATTN: CLCW Team

<p class="BulletText1" style="margin-left:0in;text-indent:0in;mso-list:none;  tab-stops:.5in">PO Box 2648

<p class="BulletText1" style="margin-left:0in;text-indent:0in;mso-list:none;  tab-stops:.5in">Louisville, KY   40201-2648 <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued"> 32. Developing Claims Based on Exposure to Other Specific Environmental Hazards, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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h.   Sample Letter Notifying    Claimant of Transfer of Camp Lejeune Claim
<p class="MsoBlockText">Below is a sample letter from the OOJ notifying a claimant that his/her Camp Lejeune claim has been transferred to the Louisville RO for processing. <p class="MsoNormal"> <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued">32. Developing Claims Based on Exposure to Other Specific Environmental Hazards, Continued {| border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse:collapse;mso-table-layout-alt:fixed;mso-padding-alt: 0in 5.4pt 0in 5.4pt"
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i.   Sample FLASH Notice for Camp Lejeune Claims Folders
<p class="MsoBlockText">Below is a sample of the FLASH notice the OOJ backfiles in the center section of the claims folder before transferring the folder to the Louisville RO. <p class="MsoNormal"> <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">
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j.   Action Taken by Louisville RO Upon Receipt of Camp Lejeune Claim
<p class="MsoBlockText">Upon receipt of a claims folder containing a Camp Lejeune claim or appeal, the Louisville RO
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<p class="MsoBlockText">

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      updates the Control of Veterans Records System (COVERS)

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      if necessary, sends a section 5103 notice that includes a request for

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     the month and year of arrival and departure for Camp Lejeune service, and

<p class="BulletText2" style="mso-list:l2 level1 lfo8"> -     where the Veteran lived (on-base or off-base) and worked on base

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:  Symbol;mso-bidi-font-family:Symbol;color:windowtext"> ·      enters the “Environmental Hazard – Camp Lejeune” Special Issue identifier on the MAP-D Contentions screen

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:  Symbol;mso-bidi-font-family:Symbol;color:windowtext"> ·      places a Corporate “Camp Lejeune” Flash on every Veteran’s record with verified service during any period between 1957 and 1987, and

<p class="BulletText1" style="mso-list:l12 level1 lfo5"><span style="font-family:Symbol;mso-fareast-font-family:Symbol;mso-bidi-font-family:  Symbol;color:windowtext"> ·      for appeals, establishes EP 685 in addition to the standard EP. <p class="ContinuedOnNextPa" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">Continued on next page '''<span style="font-size:16.0pt; mso-bidi-font-size:10.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:black;mso-ansi-language:EN-US;mso-fareast-language: EN-US;mso-bidi-language:AR-SA"> '''
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<p class="MapTitleContinued">32. Developing Claims Based on Exposure to Other Specific Environmental Hazards, Continued <p class="BlockLine" style="margin-left:0in;mso-border-between:.75pt solid windowtext; mso-padding-between:1.0pt">

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k.   Verification of Camp Lejeune Service
<p class="MsoBlockText"> If the Veteran is claiming Camp Lejeune service between 1957 and 1987, but military personnel and/or medical records or information obtained from the Veteran does not show it, initiate a PIES O18 request to obtain complete service records. These records may verify Camp Lejeune service through temporary duty orders or performance evaluations.
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<p class="MsoBlockText">

<p class="MsoBlockText">Note:   It is important to verify that the Veteran’s service at Camp Lejeune occurred during the period of water contamination, 1957 to 1987.
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