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Updated Dec 21, 2021

 

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

Change Date

  
July 29, 2021

VIII.iv.5.1.a.  Definition:  Chronic Disease

 
A chronic disease 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.

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.c.  Considering SC for a Chronic Disease

 
When deciding any claim for service connection (SC) for a chronic under 38 CFR 3.309(a), it is also necessary to consider SC based on
  • manifestation of the claimed disease during service, and
  • a presumption that the disease, which was first manifested following discharge from service, is nevertheless related to service.

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. 

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 …
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 …
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.