M21-1 Manual / Part VIII, Subpart iv, Chapter 5
Service Connection (SC) for Chronic Diseases
M21-1, Part VIII, Subpart iv, Chapter 5
Overview
In This Chapter | | This chapter contains the topic “SC for Chronic Diseases.” |
1. SC for Chronic Diseases
Introduction | | This topic contains information on SC for chronic diseases, including- definition of a chronic disease
- establishing whether a disease is chronic
- considering
- SC for a chronic disease, and
- presumptive SC
- establishing presumptive SC for chronic diseases, and
- action to take if a chronic disease was
- treated in service, and
- not treated in service.
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VIII.iv.5.1.a. Definition: Chronic Disease | | A chronicdisease is a disease- of prolonged duration, producing incapacitating symptoms of varying degree
- that may undergo remission, and
- that is seldom entirely cured with all residuals of damage being completely eradicated.
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VIII.iv.5.1.b. Establishing Whether a Disease Is Chronic | | If a diagnosis is prefaced with the word “chronic,” that does not necessarily establish the disease as chronic. 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. |
VIII.iv.5.1.d. Considering Presumptive SC | | Once a substantially complete claim is of record, the following conditions apply: - the possibility of entitlement to presumptive SC exists when the Veteran alleges inception within the limiting periods contained in 38 U.S.C. 1112
- the Veteran does not need to establish that the disease in question was definitely diagnosed within the presumptive period, and
- 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.
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VIII.iv.5.1.e. Establishing Presumptive SC for Chronic Diseases | | Use the table below to determine the service requirements the Veteran must meet before VA may establish presumptive SC for chronic diseases listed in 38 CFR 3.309(a).| If the Veteran served during … | Then … |
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| peacetime before January 1, 1947 | there is no provision for presumptive SC under 38 CFR 3.308(a). | - peacetime on or after January 1, 1947, or
- wartime
| the Veteran must have had active, continuous service of 90 days or more under 38 CFR 3.307. |
Note: In claims based on a period of active duty for training (ADT), there is no presumption of SC for chronic diseases under 38 CFR 3.309(a) (see Smith (Valerie Y.) v. Shinseki, 24 Vet.App. 40, 44 (2010)) unless SC has been established for a disability based on the period of ADT, as described in M21-1, Part III, Subpart i, 1.A.2.i. |
VIII.iv.5.1.f. Action to Take if a Chronic Disease Was Treated in Service | | Follow the instructions in the table below when service records show the Veteran was treated for a chronic disease. | If the Veteran ... | Then ... |
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| files a substantially complete claim for the condition | refer the case to the rating activity. | | did not file a claim for the condition | solicit a claim. |
References: For more information on |
VIII.iv.5.1.g. Action to Take if a Chronic Disease Was Not Treated in Service | | Even though certain chronic diseases were not treated during service, SC may still be established on a presumptive basis under the provisions of Reference: For more information on the diseases for which SC may be established on a presumptive basis and the service requirements that must be met, see 38 CFR 3.307. |
Source: VA M21-1 Adjudication Procedures Manual, M21-1, Part VIII, Subpart iv, Chapter 5 (U.S. government work, reproduced for reference). Browse all sections →