M21-1 Manual / Part XIII, Subpart i, Chapter 3, Section C

Service Connection (SC) for Mental Conditions for Treatment Purposes Under 38 U.S.C. 1702

M21-1, Part XIII, Subpart i, Chapter 3, Section C

Overview

In This Section

This section contains the topic, “SC of Mental Conditions Under 38 U.S.C. 1702."

1. Service Connection (SC) of Mental Conditions for Treatment Purposes Under 38 U.S.C. 1702

Introduction

This section contains information on the evaluation of mental conditions for SC under 38 U.S.C. 1702, including

SC of mental conditions for treatment purposes under 38 U.S.C. 1702
when the Veterans Benefits Administration (VBA) must decide the issue of SC under 38 U.S.C. 1702
38 U.S.C. 1702 criteria for SC of mental conditions for treatment purposes
Veterans Health Administration (VHA) requests for 38 U.S.C. 1702 determinations
addressing a VHA-requested 38 U.S.C. 1702 determination in the rating decision, and
addressing the subordinate issue of 38 U.S.C. 1702 in the rating decision.

Change Date

Feburary 13, 2020

XIII.i.3.C.1.a.
SC for Mental Conditions for Treatment Purposes Under 38 U.S.C. 1702

38 U.S.C. 1702 creates a presumption of service connection (SC) for the purpose of eligibility for VA treatment for

psychoses based on wartime service, or
any mental condition based on Persian Gulf War service.

Claims for medical or psychological treatment are normally determined by the Veterans Health Administration (VHA) without referral to the Veterans Benefits Administration (VBA). However, a medical facility may require information or a determination from VBA References: For more information on

determining eligibility for medical care see M21-1, Part XIII, Subpart i, 3.A, and
the definition of Persian Gulf War service, see 38 CFR 3.2(i).

XIII.i.3.C.1.b. When VBA Must Decide the Issue of SC Under 38 U.S.C. 1702

VBA must decide the issue of SC for a psychosis or other mental condition under 38 U.S.C. 1702 when

requested by VHA, or
when a decision maker finds the facts support the 38 U.S.C. 1702 criteria in the course of denying SC for compensation purposes for
a psychosis based on wartime service, or
any mental disorder based on Persian Gulf War service.

References: For more information on
the 38 U.S.C. 1702 criteria, see M21-1 Part XIII, Subpart i, 3.C.1.c
VHA-requested determinations, see M21-1, Part XIII, Subpart i, 3.C.1.d
rating decision requirements, see M21-1, Part XIII, Subpart i, 3.C.1.e, and
considering issues within scope of a claim, see M21-1, Part V, Subpart ii, 3.A.2.

XIII.i.3.C.1.c. 38 U.S.C. 1702 Criteria for SC for Mental Conditions for Treatment Purposes

38 U.S.C. 1702 provides that SC is presumed for Department of Veterans Affairs (VA) treatment purposes for a Veteran of

any war period who develops a psychosis, or
the Persian Gulf War who develops any mental illness

within

two years after the date of separation (under other than dishonorable conditions) from such service, and
two years after the end of the war period.

Important: Both criteria must be met for the presumption to arise. The presumption that the qualifying disability was incurred in service for treatment purposes does not apply if

a qualifying mental ilness develops more than two years after the end of the war period, even if the condition develops less than, or at, two years after discharge, or
a qualifying mental illness develops more than two years after service discharge even if that was during wartime or less than, or at, two years thereafter.

Notes:

It is not necessary for the Veteran to have had 90 days of service to qualify.
Persian Gulf War Veterans who manifest primary diagnoses of substance abuse disorders within the applicable timeframes described above will be entitled to mental health treatment for those disorders under 38 U.S.C. 1702 even though the laws administered by VA prohibit awards of monetary benefits for conditions of misconduct etiology.

References: For more information on

the definition of psychosis, see
- 38 CFR 3.384, and
- M21-1, Part V, Subpart iii, 13.1.f, and
primary disabilities involving willful misconduct, see M21-1, Part X, Subpart iv, 1.D.

XIII.i.3.C.1.d. VHA Requests for 38 U.S.C. 1702 Determinations

The table below describes the process when VHA requests a VBA determination of SC under 38 U.S.C. 1702.

Stage	Description
1	VHA submits requests for determination of SC accompanied by a copy of a completed VA Form 10-10EZ, Application for Health Benefits, or VA Form 10-10EZR, Health Benefits Update Form, and VA Form 10-10M, Medical Certificate, and any other available professional report submitted with, or developed in conjunction with, the application for hospital or outpatient treatment.
2	Follow the procedure for processing a request for rating activity action in M21-1, Part XIII, Subpart i, 3.A.

XIII.i.3.C.1.e. Addressing a VHA-requested 38 U.S.C. 1702 Determination in the Rating Decision

Use the table below when issuing a rating decision in response to a request by VHA for a 38 U.S.C. 1702 determination.

If the criteria for SC under 38 U.S.C. 1702 ...	Then ...
are met	the decision should be a separate issue in the rating decision, and the Codesheet will show the text Active Psychosis/GW Mental, SC for Treatment Only.
are not met	the decision should be a separate issue in the rating decision and the Codesheet will show the text Active Psychosis/GW Mental, NSC-1702.

Note: When addressing a VHA request for a 1702 determination, the issue of SC of a mental disorder for treatment purposes under the provisions of 38 U.S.C. 1702shouldalways be listed as a separate or stand-alone issue. Reference: For more information on addressing the subordinate or inferred issue of 38 U.S.C. 1702 in the rating decision see M21-1, Part XIII, Subpart i, 3.C.1.f.

XIII.i.3.C.1.f. Addressing the Subordinate Issue of 38 U.S.C. 1702 in the Rating Decision

Use the table below when considering the subordinate issue of SC for treatment purposes under 38 U.S.C. 1702 based on a denial of SC for compensation purposes for

a psychosis based on wartime service, or
any mental illness based on Persian Gulf War service.

If the criteria for SC under 38 U.S.C. 1702 ...	Then ...
are established	in the rating decision address the subordinate issue as a separate decision from the decision on the mental conditon, and ensure the rating Codesheet, shows “Active Psychosis/GW Mental--SC for Treatment Only” or equivalent. *Exception*: If a previous decision has awarded entitlement, there is no need to address it again.
are not established	do not address the matter at all in the rating decision.

Important: SC for treatment purposes under 38 U.S.C 1702 is not a subordinate issue and should not be decided in cases for which

38 U.S.C. 1702 determination has not been requested by VHA
a bereavement diagnosis is the only diagnosis noted in the mental examination, as this is considered an acute and transitory condition, or
a claim for SC for compensation purposes of a psychosis based on any wartime service or any mental illness based on Persian Gulf War service is denied, and under the facts of record the 38 U.S.C. 1702 presumption would not arise.

Source: VA M21-1 Adjudication Procedures Manual, M21-1, Part XIII, Subpart i, Chapter 3, Section C (U.S. government work, reproduced for reference). Browse all sections →