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Updated Sep 18, 2024

In This Section

  
This section contains the following topics:
 
Topic
Topic Name
1
2
3
 

 

1.  General Information on Developing Claims for SC for Disabilities Resulting From Exposure to Mustard Gas or Lewisite

 

Introduction

  
This topic contains general information on developing claims for SC for disabilities resulting from exposure to mustard gas or Lewisite, including

Change Date

  
April 14, 2017

VIII.iii.3.A.1.a.  SC Based on Full-Body Exposure to Mustard Gas or Lewisite During Military Service

  
38 CFR 3.316 authorizes service connection (SC) for certain diseases diagnosed in Veterans who underwent full-body exposure to mustard gas or Lewisite during military service. 
 
Full-body exposure means that the entire body was exposed to mustard agents or Lewisite as opposed to placement of drops of mustard agent or Lewisite on one or more locations on the skin. 
 
Mustard gas refers to either of two vesicants (blister-producing agents), sulfur mustard (Yperite) or nitrogen mustard. 
 
Lewisite is a mustard vesicant containing arsenic.

VIII.iii.3.A.1.b.  Confirmed Locations Where Service Members Have Been Exposed to Mustard Gas or Lewisite

  
The table below provides the known locations where Army and Navy personnel were exposed to mustard gas or Lewisite.
 
Important:  Follow the procedures listed in M21-1, Part VIII, Subpart iii, 3.A.3 to verify exposure.
 
Army
Navy
Bari, Italy
Bari, Italy
Bushnell, Florida
Camp Lejeune, North Carolina
Camp Lejeune, North Carolina
Charleston, South Carolina
Camp Sibert, Alabama
Great Lakes Naval Training Center, Illinois
Dugway Proving Ground, Utah
Hart’s Island, New York
Edgewood Arsenal, Maryland
Naval Training Center, Bainbridge, Maryland
Naval Research Lab, Washington, D.C.
Naval Research Laboratory, Virginia
Ondal, India
Naval Research Lab, Washington, D.C.
Rocky Mountain Arsenal, Colorado
USS Eagle Boat No. 58
San Jose Island, Panama Canal Zone
 
Notes:
  • This list is not all inclusive. Some American service members may have participated in Allied mustard agent testing in Finschhafen, New Guinea, and Porton Down, England.
  • Select merchant seaman were also exposed or killed at Bari, Italy. 

VIII.iii.3.A.1.c.  Action to Take When the Veteran Claims Exposure but Does Not Claim a Disability

  
A claim is not substantially complete if a Veteran alleges exposure to mustard gas or Lewisite during service but does not claim SC for a specific disability.  In cases such as these, follow the procedures for handling an incomplete application at M21-1, Part II, Subpart iii, 1.C.2.b and c.
 
Reference:  For more information on what constitutes a substantially complete application, see

 

2.  Centralized Processing of Claims Based on the Effects of Exposure to Mustard Gas or Lewisite

 

Introduction

  
This topic contains information on the centralized processing of claims based on the effects of exposure to mustard gas or Lewisite, including

Change Date

  
March 15, 2019

VIII.iii.3.A.2.a.  Centralized Processing of Claims and Legacy Appeals at the Muskogee RO

  
All claims and legacy appeals based on exposure to mustard gas or Lewisite received on or after January 19, 2005, are centrally processed at the Muskogee Regional Office (RO).
 
Exception:  In cases involving more than one special mission claim type, the National Work Queue (NWQ) routing rules may route the claim to the RO with jurisdiction of the other special mission claim type.

VIII.iii.3.A.2.b.  Forwarding Claims and Legacy Appeals to the Muskogee RO

  
Use the table below to determine how to route claims and legacy appeals based on exposure to mustard gas or Lewisite to the Muskogee RO.
 
If the claims folder is in …
Then …
paper format
send the claims folder to
 
Department of Veterans Affairs
VARO Muskogee (21-Mustard Gas)
Federal Building
125 S. Main Street
Muskogee, OK 74401
electronic format
ensure the Mustard Gas special issue indicator is affixed to the relevant contention(s).
 
Note:  If a mustard gas claim is already under the jurisdiction of the Muskogee RO and a subsequent claim is received, the Muskogee RO will process the subsequent claim.
 
Reference:  For more information on priority processing, see M21-1, Part X, Subpart i, 1.

 

3.  Developing Claims Based on the Effects of Exposure to Mustard Gas or Lewisite 

 

Introduction

  
This topic contains information on developing claims based on the effects of exposure to mustard gas or Lewisite, including

Change Date

  
September 18, 2024

VIII.iii.3.A.3.a.  Tracking Mustard Gas Claims

  
All claims for SC for disabilities resulting from exposure to mustard agents or Lewisite are controlled with 
  • a standard compensation end product (EP), and
  • the Mustard Gas special issue indicator on the relevant contention(s).
Note:  Affixing this special issue indicator triggers assignment of the claim to the Muskogee RO.
 
References:  For more information on

VIII.iii.3.A.3.b.  Developing to the Claimant in Mustard Gas Claims

  
The standard Section 5103 notice contained on VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits, is not sufficient for most mustard gas claims as it does not request the information needed to verify exposure to mustard gas or Lewisite.  In all claims based on such exposure, development to the claimant is required.
 
Exception:  Do not send a development letter if the evidence of record
  • provides the information the subsequent development letter solicits, or
  • is otherwise sufficient to decide the claim.
Use the table below to determine what language to insert into the subsequent development letter. 
 

If …
Then send a subsequent development letter with the VBMS development paragraph …
the Veteran files a substantially complete claim for SC for a disability due to mustard gas or Lewisite exposure

MG-circumstances of exposure.

Important:  Claims processors may contact a claimant by telephone to obtain the above information.
 
Reference:  For more information on obtaining and documenting information received from a claimant by telephone, see M21-1, Part III, Subpart i, 2.D.1.
the disability claimed as due to mustard gas or Lewisite exposure is not recognized as a presumptive condition under 38 CFR 3.316
MG-not a recognized condition.
 
References:  For more information on

VIII.iii.3.A.3.c.  When Development for Evidence of Full-Body Exposure Is Necessary

  
Do not request evidence of full-body exposure to mustard gas or Lewisite unless the Veteran alleges exposure and submits
  • competent lay or medical evidence of a disability listed in 38 CFR 3.316(a), or
  • medical or scientific evidence showing a causal relationship between a disease not listed in 38 CFR 3.316(a) and exposure.

VIII.iii.3.A.3.d.  Researching Exposure in ILER

  
The Individual Longitudinal Exposure Record (ILER) is a joint Department of Defense (DoD) and Department of Veterans Affairs (VA) web-based application that provides the ability to link a Veteran to military exposures and/or deployments.
 
Claims processors at the Muskogee RO must utilize ILER to conduct preliminary research regarding claimed in-service mustard gas-related exposures. 
 
Important:  ILER access should be requested in advance of receipt of a claim based on exposure in order to ensure that claims processing is not unnecessarily delayed.
 
Reference:  For more information on ILER and how to obtain access, see the ILER Guidance.

VIII.iii.3.A.3.e.  Procedure for Verifying Full-Body Exposure to Mustard Gas or Lewisite  

  
Verification of mustard gas or Lewisite exposure is a two-step process:
  • Check ILER.
  • If the mustard gas exposure is not verified in ILER, send a request to Compensation Service to ask DoD’s Deployment Health Directorate for a determination regarding exposure.
Follow the procedures in the table below when verifying a claim of exposure to mustard gas or Lewisite.
 
Step
Action
1
Is the claimant claiming a disability listed in 38 CFR 3.316(a)?
  • If yes, go to Step 3.
  • If no,
    • send the development letter referenced in M21-1, Part VIII, Subpart iii, 3.A.3.b, requesting scientific or medical evidence showing that the claimed condition is medically associated with exposure
    • allow the claimant 30 days to respond, and
    • go to the next step.
2
Did the claimant respond with the requested information?
  • If yes, go to the next step.
  • If no,
    • refer the claim for a decision, and
    • disregard the remaining steps in the table.
3
Is there competent lay or medical evidence of a disability listed in 38 CFR 3.316(a)?
  • If yes, go to the next step.
  • If no,
    • refer the claim for a decision, and
    • disregard the remaining steps in the table.
4
Obtain the Individual Exposure Summary/ILER response in accordance with the ILER Guidance.  Does ILER documentation verify the Veteran’s mustard gas or Lewisite exposure?
  • If yes, complete all other required claims development, including any necessary examinations.
  • If no, send a request to Compensation Service to assist in verifying exposure, as detailed in M21-1, Part VIII, Subpart iii, 3.A.3.f.
 

VIII.iii.3.A.3.f.  Referring Claims to Compensation Service When Exposure Is Not Listed in ILER

  
If the Veteran’s exposure is not documented in ILER, refer the claim to Compensation Service based on the table below.
 

If the claim is …
Then …
processed in the NWQ environment
  • complete the exposure template shown in M21-1, Part VIII, Subpart iii, 3.A.3.g
  • upload the template to the Veteran’s electronic claims folder (eFolder)
  • create an eFolder note stating the claim is referred to Compensation Service for verification of full-body exposure to mustard gas, and
  • affix the
    • Compensation Service Review – MG/CBRNE/Shad special issue indicator, and
    • Compensation Service Case Review tracked item in accordance with the NWQ Playbook to ensure proper routing to Compensation Service.
not processed in the NWQ environment
  • complete the exposure template shown in M21-1, Part VIII, Subpart iii, 3.A.3.g
  • upload the template to the Veteran’s eFolder
  • affix the
    • Compensation Service Review – MG/CBRNE/Shad special issue indicator, and
    • Compensation Service Case Review tracked item, and
  • manually broker the EP to Compensation Service (Washington DC).
Reference:  For more information on manually brokering an EP, see the VBMS Core User Guide.
 
Note:  Upon receipt, Compensation Service will forward this documentation to the Deployment Health Directorate for a determination regarding exposure. 
 
References:  For more information on

VIII.iii.3.A.3.g.  Exhibit:  Mustard Gas and Lewisite Exposure Request Template

  
Below is the mustard gas and Lewisite exposure request template that must be completed when requesting verification of exposure from Compensation Service.
 
 
DEPARTMENT OF VETERANS AFFAIRS
[RO name]
[RO address]
 
[current date]
 
Mustard Gas Manager                                                   In Reply Refer To:
Compensation Service (211)                                         [RO number]
Department of Veterans Affairs                                     [file number]
Central Office                                                                [Veteran’s name]
810 Vermont Ave. NW
Washington, DC 20420
 
SUBJECT:  Mustard Gas Verification Letter
 
BACKGROUND INFORMATION: 
  • Veteran’s
    • full name:
    • service number:
    • SSN:
    • EOD:
    • RAD:
    • full organizational designation (unit, company, division, etc.) at the time of alleged exposure(s):
    • date of birth:
    • date of death:
    • phone #:
  • Number of exposures:
  • Date of the alleged exposure(s) (month and year):
  • Geographical location of the alleged exposure(s):
  • Type of activity the Veteran was engaged in at the time of each exposure, such as basic training or involvement in a test or experiment:
  • Details of the exposure, including:
    • the length of time the Veteran was exposed:
    • the procedures that were followed before, during, and after the exposure:
    • the effect of the exposure on the Veteran’s body:
    • whether the Veteran received medical treatment following exposure: 
  • Disabilities alleged related to MG exposure: