What is Gulf War Syndrome?

If you’ve ever wondered “What is Gulf War Syndrome?” this blog post is for you!

Gulf War Syndrome impacts thousands of veterans who deployed to the Persian Gulf during their service. Also known as Gulf War Illness, the term refers to unexplained chronic symptoms that are usually lifelong. 

If you are experiencing health concerns that may be associated with Gulf War Syndrome, you aren’t alone. An estimated one-third of all Gulf War Veterans experience symptoms. 

Unfortunately, each person experiences the symptoms of Gulf War Syndrome differently. This makes it very difficult for health care providers to recognize and treat Gulf War Syndrome effectively from person to person. 

The symptoms of this syndrome are also often confused with other conditions. Many healthcare providers are not familiar with Gulf War Syndrome, and the illness can easily be mistaken for other conditions. This contributes to the fact that 80% of VA claims for Gulf War-related disabilities are denied.

Until recently, VA training on this illness was optional for medical providers—further complicating the issue.

In spite of the challenges with diagnosis and claims, this health issue is so widespread that Gulf War Syndrome receives national-level attention. Congress created a federal advisory committee in 1998 to make recommendations to the Secretary of Veteran Affairs on how military service during the Gulf War impacts veterans’ health. 

With this federally mandated research, reports have confirmed that there is a link between chronic illness and Gulf War service; however, the exact cause is still unknown. 

To succeed with a Gulf War Syndrome-related claim, you must document your symptoms, understand the VA Claims process, and stay informed about what you’re legally entitled to as a veteran. It’s also critical to see a doctor immediately and get an independent medical opinion. 

What Causes Gulf War Syndrome?

Although extensive research started in the mid-1990s, the direct cause of the syndrome remains unexplained. There is no single source or exposure identified that is known to cause Gulf War Syndrome. 

However, there is an extensive list of possible causes, so note any of the following exposures listed below and make sure you discuss these with your provider. 

Studies conducted by the Institute of Medicine are inconclusive, but the list of possible causes includes exposure to:

• Burning oil-well fires
• Pollution
• Pesticides
• Depleted uranium
• Vaccinations, including those for Anthrax
• Anti-nerve gas tablets (Pyridostigmine Bromide)

Gulf War Syndrome Symptoms

If you are a veteran experiencing Gulf War Syndrome, you may be experiencing a combination of two or more of the symptoms or conditions listed below. 

Keep in mind that the VA deems Gulf War Syndrome a “Medically Unexplained Illness,” and symptoms must be chronic, existing for six months or more:

• Chronic fatigue syndrome
• Fibromyalgia
• Irritable Bowel Syndrome or other functional gastrointestinal disorder
• Any illness that warrants a presumptive service connection (more on this below)

Any of the following symptoms are signs of an undiagnosed illness:

• Fatigue
• Headaches
• Joint Pain
• Muscle Pain
• Skin symptoms
• Indigestion
• Insomnia
• Dizziness and other neurological symptoms
• Cardiovascular symptoms
• Memory problems
• Weight loss
• Menstrual disorders

Although Gulf War Syndrome may be associated with a higher risk of additional illnesses—including depression, PTSD, and diabetes—the VA does not necessarily attribute these to Gulf War Syndrome.

Who is at Risk for Gulf War Syndrome?

More than 650,000 service members served in Operation Desert Shield and Desert Storm in 1990 and 1991. An estimated one-third of those service members experience Gulf War Syndrome symptoms.

The VA recognizes Gulf War service in the Southwest Asia area of military operations from Aug. 2, 1990, onward as being potentially linked to long-term health problems. Any veteran who served from this date onward meets the wartime service requirements.

The VA defines the Southwest Asia theater of military operations as:

• Iraq, Kuwait, Saudi Arabia
• The neutral zone between Iraq and Saudi Arabia
• Bahrain, Qatar, and the United Arab Emirates (UAE)
• Oman
• The Gulf of Aden and the Gulf of Oman
• The waters of the Persian Gulf, the Arabian Sea, and the Red Sea
• The airspace above these locations

This includes Operation Iraqi Freedom and Operation New Dawn.

Most recently, the VA has expanded Gulf War Syndrome to service in Afghanistan. Learn more here. 

How to prove Gulf War Syndrome Symptoms

The good news is that the VA recognizes Gulf War Syndrome as a “presumptive” service disability. This means that the VA assumes certain disabilities were caused by military service. 

Under the traditional VA disability compensation process, to receive compensation a veteran must prove the connection between his or her military service and the illness being claimed. With a presumptive service connection, the link (nexus) between a condition and your service is already presumed.  

In this case, you qualify for presumptive service-connection if you served in the Southwest Asia Theater of Operations, have a condition that began within one year of your date of separation, and the condition has been rated as at least 10 percent disabling by Dec. 31, 2021. 

The bad news is that with presumptive service disabilities, many veterans assume they automatically qualify for disability compensation for serving during a specific time and place regardless of symptoms—or even that they will automatically receive benefits without applying. 

The burden is still on you to prove that you have the disabilities mentioned above. You still have to file a claim and prove that you have the conditions. And if your symptoms can be related to a previously diagnosed illness, chances are the VA will deny your claim.

VA conditions for Gulf War Syndrome presumptive service disability:

• You must have been deployed in support of Operation Desert Shield and/or Operation Desert Storm between 1990-1991. 
• There must be no other underlying medical conditions that would explain your symptoms. *NOTE: if you do have an underlying condition that could explain some symptoms, you may still receive a diagnosis of Gulf War Syndrome if the severity of your symptoms is not explained by your underlying condition. So it is still worthwhile for you to seek medical help and pursue a claim. 
• You must experience at least two or more chronic symptoms associated with Gulf War Syndrome that began when you were deployed or shortly thereafter. Those symptoms must also persist. Most providers will consider a condition chronic if the duration of the symptom is at least six months. 

Clinical Case Definitions

Within the VA, Gulf War Syndrome falls under the umbrella of chronic multisystem illness (CMI). 

To describe most illnesses, the medical community creates clinical case definitions to make diagnoses consistent. These clinical case definitions create a standard that defines the common symptoms of a typical case of an illness. 

Unfortunately, the VA has not yet decided on one clinical case definition for Gulf War Syndrome. Understanding the two main case definitions helps you recognize whether the VA might provide disability compensation for you in your case. 

The two primary clinical case studies the VA uses, both recognized by the National Academy of Medicine, originate from the CDC and the Kansas Case Definitions.

CDC Case Definition

At least one symptom from two of these three categories:

• Fatigue
• Musculoskeletal
• Mood or cognition

Kansas Case Definition 

At least one symptom in three of these six categories:

• Fatigue or sleep issues
• Pain symptoms
• Neurological / cognitive / mood issues
• Gastrointestinal problems
• Respiratory issues
• Skin problems

Eligibility for VA Health Care

Health Care Benefits

The good news is that with so many veterans impacted by this illness, the VA offers tools even if you’re not enrolled in VA health care. Several health care benefits exist for Gulf War Veterans with no need to prove service.

Gulf War Registry Health Exam

For the Gulf War Registry health exam, you don’t need to be enrolled in the VA healthcare system. This no-cost exam helps identify long-term health issues for veterans who served in Operation Desert Shield, Operation Desert Storm, Operation Iraqi Freedom, or Operation New Dawn.

Your military records don’t even have to show you served in one of these operations; your ability to get the exam is based on your memory alone of serving in one of these operations. 

Your provider will be looking for long-term health conditions related to environmental exposure during this exam. You’ll discuss possible exposures and overall medical history with your provider. 

Bringing with you your deployment history and medical records from civilian providers is essential for documenting any possible exposures. Be as thorough as possible, and note specific locations and dates. If you remember any possible exposures of concern mentioned above, make sure to bring those up with your provider and document them. 

Additionally, expect a physical exam as well as lab tests to be done. A VA health provider will discuss results face-to-face with you as well as in a follow-up letter. 

Find your local VA Environmental Health Coordinator here to schedule your no-cost Gulf War Registry health exam. 

Even if you are in a remote location, don’t let this stop you from receiving your no-cost exam! The Orlando VAMC recently started utilizing telehealth for registry exams. You’ll join an encrypted virtual medical room on your computer with your provider. Physical exams are now possible with the use of virtual equipment that uses the zoom function of your camera. 

Gulf War Registry

The Airborne Hazards and Open Burn Pit Registry enables veterans to take an online questionnaire to document environmental exposures from their service. This registry helps you identify changes in your health over time. Not only is this a helpful tool for veterans, but it helps the VA understand and respond to health problems more effectively. 

Clinical treatment at the VA War Related Illness and Injury Study Center (WRIISC) 

The WRIISC specializes in helping veterans with difficult to diagnose illnesses or those with health issues originating from deployment.  There are 3 locations where you can seek treatment.

• Washington, DC
• East Orange, New Jersey
• Palo Alto, California 

E-consults are available for veterans. You can also find out how to obtain a referral here if you have medically unexplained symptoms, many tests, and treatment with no improvement, or deployment-related exposures. 

How to Claim Gulf War Syndrome

If you decide to file for disability compensation for Gulf War Syndrome, there are two paths you can take: filing for medically unexplained diagnosed chronic illnesses (fibromyalgia, chronic fatigue syndrome, etc.) AND / OR undiagnosed illnesses. 

If you are filing for a medically unexplained diagnosed chronic illness, be smart. Filing for diagnosed and undiagnosed illnesses with the same symptoms will slow down the claims process, resulting in denial. Here is a list of redundant symptoms that you would not claim if you have already been diagnosed with one of these illnesses:

Here is a list of redundant symptoms that you would not claim if you have already been diagnosed with one of these illnesses: 

Redundant Symptoms for Undiagnosed Illnesses

• Fibromyalgia
• Chronic Fatigue Syndrome
• Muscle pain
• Fatigue
• Joint pain
• Headaches
• Cognitive issues
• Sore/tender throat
• Cardiovascular issues
• Insomnia
• Exertional exhaustion
• Arm and leg numbness

Make sure that your examiner has your statements and research from the VSO sent in with your claim. You need to document symptoms as much as possible. Providing complete medical records, including any records from civilian doctors, is vital. This is known as “objective medical evidence.” 

Objective medical evidence (also called independent medical opinions) can include records showing time lost from work due to your symptoms, detailed statements from you on your symptoms (Form 21-4138), and detailed statements from others who know your condition. You can learn more about filing a claim for disability compensation here.

Gulf War Syndrome Treatment

It can be challenging to get treatment because of the symptoms that veterans experience can be easily dismissed as insignificant by the health care system. If this has been your experience, document symptoms as much as possible.

If you’ve been diagnosed with Gulf War Syndrome, expect your provider to help create a plan for care that is tailored specifically to you. Since symptoms vary so much from person to person, keep in mind there is no one approach to managing symptoms. What works for someone else may not work for you. 

The goal is to treat each symptom individually and create strategies to manage symptoms. Many veterans impacted by Gulf War Syndrome find that cognitive behavior therapies and improving lifestyle habits improve the overall quality of life. 

How to Get a VA Rating for Gulf War Syndrome

At VA Claims Insider, we help veterans understand and take control of the claims process, so they can get the rating and compensation they’re owed by law. 

We can help you service-connect your disability and get a higher rating from the VA. We can also help you with the medical evidence needed to win your appeal.

Our process takes the guesswork out of filing a VA disability claim and supports you every step of the way in building a fully-developed claim (FDC) – so you can increase your rating in less time! If you’ve filed your VA disability claim and have been denied or have received a low rating – or you’re not sure how to get started – reach out to us, so you can FINALLY get the disability rating and compensation you deserve. 

Take advantage of a  FREE VA Claim Discovery Call. We’ve supported more than 15,000 veterans to win their claims and increase their ratings. NOW IT’S YOUR TURN.  You served … you deserve.

About the Author

Trisha Penrod

Trisha Penrod is a former active-duty Air Force officer. As an Intelligence Officer, she led teams of analysts to apply advanced analytic skills to identify, assess, and report potential threats to U.S. forces.

Trisha attended the U.S. Air Force Academy and holds an MBA from Webster University.  After receiving an honorable discharge in 2018, Trisha worked as a growth marketer and utilizes her analytic skills to help others accomplish their business goals.