How to file a Gulf War illness claim — undiagnosed illnesses and chronic multisymptom illness under 38 CFR 3.317
Under 38 CFR 3.317, a Persian Gulf veteran — anyone who served on active duty in the Southwest Asia theater on or after August 2, 1990 — is presumed service-connected for a chronic disability from an undiagnosed illness or a medically unexplained chronic multisymptom illness (chronic fatigue syndrome, fibromyalgia, functional gastrointestinal disorders) that has lasted at least six months and became manifest during that service or to a degree of 10% by December 31, 2026. Certain infectious diseases are presumptive too. VA lists the recognized locations, which now include Afghanistan and other countries for undiagnosed illnesses. These claims are filed on VA Form 21-526EZ like any other and rated by analogy to the body system affected.
What you'll need
- VA Form 21-526EZ
- Service records showing where and when you served in the Southwest Asia theater
- Medical records showing the signs and symptoms, how long they have lasted, and any diagnoses (chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome and similar) or negative work-ups
- Lay statements describing the symptoms and their effect on work and daily life
- A free accredited representative (CVSO or VSO)
Step-by-step
Step 1: Confirm qualifying service
For undiagnosed and chronic multisymptom illnesses VA recognizes service on or after August 2, 1990 in Afghanistan, Bahrain, Egypt, Iraq, Israel, Jordan, Kuwait, the neutral zone between Iraq and Saudi Arabia, Oman, Qatar, Saudi Arabia, Syria, Turkey, the United Arab Emirates, and the waters of the Arabian Sea, Gulf of Aden, Gulf of Oman, Persian Gulf and Red Sea (airspace included except over Afghanistan, Egypt, Israel, Jordan, Syria and Turkey). For the infectious-disease presumptions the list is Bahrain, Iraq, Kuwait, the neutral zone, Oman, Qatar, Saudi Arabia, the UAE and those waters, plus Afghanistan for service after September 19, 2001. Post-9/11 service in these places counts — "Gulf War" is not limited to 1990–91.
Step 2: Match the condition to the regulation
Presumptive under 3.317(a): an undiagnosed illness, or a medically unexplained chronic multisymptom illness — chronic fatigue syndrome, fibromyalgia, or functional gastrointestinal disorders such as irritable bowel syndrome, functional dyspepsia or functional abdominal pain — shown by objective indications (signs a physician can observe, or other verifiable indicators) and lasting six months or more, or recurring over a six-month period. Symptoms the regulation names include fatigue, skin signs, headache, muscle and joint pain, neurological and neuropsychological signs, respiratory symptoms, sleep disturbance, gastrointestinal signs, cardiovascular signs, abnormal weight loss and menstrual disorders. The disability must have appeared during Southwest Asia service or to a compensable (10%) degree by December 31, 2026, and it is not covered if the evidence shows it was caused by something after service or by a known diagnosis. Diagnosed illnesses with partly understood causes, such as diabetes or multiple sclerosis, are not "medically unexplained."
Step 3: Infectious diseases
Also presumptive for qualifying service: brucellosis, Campylobacter jejuni, Coxiella burnetii (Q fever), malaria, nontyphoid salmonella, shigella and West Nile virus if diagnosed within one year of separation (malaria sooner in some cases), and Mycobacterium tuberculosis and visceral leishmaniasis if diagnosed at any time after separation. Long-term effects of these infections recognized by VA can be service-connected as well.
Step 4: File the claim and prepare for the exam
File VA Form 21-526EZ online, by mail, in person or through a free accredited representative, listing each sign or symptom (for example "chronic fatigue," "joint pain," "irritable bowel syndrome") rather than only a label, and submit records showing how long each has lasted and any negative test results. VA will usually schedule a Gulf War general medical exam. Bring a record of frequency and severity and how the symptoms affect work and daily activities; the condition is rated by analogy to a diagnosed condition with similar symptoms, so the functional effect decides the percentage. If VA denied the claim before and your location or condition is now covered, file a Supplemental Claim (VA Form 20-0995).
Reference: https://www.va.gov/disability/file-disability-claim-form-21-526ez/
Step 5: Related benefits
The PACT Act added more than 20 burn pit and toxic-exposure presumptive conditions for Gulf War and post-9/11 veterans in many of the same locations; file those separately under the PACT Act guide. Gulf War era and post-9/11 combat veterans also have enhanced eligibility to enroll in VA health care, and VA offers a free Gulf War Registry health exam that documents exposures and symptoms. A condition or location not listed can still be claimed with evidence linking it to service.
Critical tips
- The regulation's manifestation deadline has been extended several times; the current date in 38 CFR 3.317 is December 31, 2026 — file now rather than waiting.
- A diagnosis of chronic fatigue syndrome, fibromyalgia or IBS does not defeat the claim — those are the named chronic multisymptom illnesses.
- Hypertension is a PACT Act Agent Orange presumptive, not a Gulf War presumptive; claim it on its own basis.
- A county veterans service officer can file the claim for free: warriorsfund.org/find-cvso.
- In crisis: dial 988 then press 1, or text 838255.