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38 CFR § 3.317 · Presumptive

Gulf War Syndrome VA Rating

Gulf War Syndrome is not one diagnostic code. It is a presumption under 38 CFR § 3.317 that lets Southwest Asia veterans be service-connected for chronic symptoms with no diagnosis and no nexus opinion. The VA then rates the disability by analogy, most often from 10% up to 100%. A 40% rating pays $795.84/month in 2026.

10%Intermittent or Medication Controlled$180.42/mo
20%Mild Restriction of Daily Activities$356.66/mo
40%Moderate Restriction (50 to 75 Percent of Baseline)$795.84/mo
60%Severe Restriction or Six Weeks Incapacitation$1,435.02/mo
100%Nearly Constant and Incapacitating$3,938.58/mo

Rating Criteria by Level

Because an undiagnosed illness has no diagnostic code of its own, the VA rates it by analogy under 38 CFR § 4.20, picking the code whose symptoms most closely match yours. The scale below is diagnostic code 6354 (chronic fatigue syndrome), the code most commonly used for multisymptom Gulf War claims. Fibromyalgia presentations are rated under DC 5025, which caps at 40%, and gastrointestinal presentations are usually rated under the irritable bowel syndrome code.

10%Intermittent or Medication Controlled
$180.42/mo

Criteria: Debilitating fatigue, cognitive impairment, or other impairment of health that waxes and wanes, producing periods of incapacitation of at least one but less than two weeks per year, or symptoms controlled by continuous medication.

This is the entry level and the one the presumption requires you to reach: the disability must be at least 10% disabling to qualify under 38 CFR 3.317. Symptoms controlled by daily medication still count at this level, so do not omit prescriptions from your claim file thinking that treated symptoms are not compensable.

20%Mild Restriction of Daily Activities
$356.66/mo

Criteria: Symptoms that are nearly constant and restrict routine daily activities by less than 25 percent of the pre-illness level, or that wax and wane with periods of incapacitation of at least two but less than four weeks per year.

The comparison is always against your own pre-illness baseline, not against an average person. Document what you could do before deployment and what you can do now. Work absence records, a spouse statement, and a symptom calendar are what move a claim from 10% to 20%.

40%Moderate Restriction (50 to 75 Percent of Baseline)
$795.84/mo

Criteria: Symptoms that are nearly constant and restrict routine daily activities to 50 to 75 percent of the pre-illness level, or that wax and wane with periods of incapacitation of at least four but less than six weeks per year.

This is the most commonly assigned level for well-documented Gulf War illness claims, and it is also the maximum schedular rating when the disability is rated by analogy to fibromyalgia under DC 5025. If your symptom picture is dominated by widespread musculoskeletal pain, 40% is your schedular ceiling and the strategy shifts to claiming additional distinct conditions.

Most common outcome: also the schedular ceiling for fibromyalgia claims
60%Severe Restriction or Six Weeks Incapacitation
$1,435.02/mo

Criteria: Symptoms that are nearly constant and restrict routine daily activities to less than 50 percent of the pre-illness level, or that wax and wane with periods of incapacitation of at least six weeks total per year.

A single 60% rating meets the schedular threshold for TDIU on its own. If Gulf War illness is rated at 60% and it prevents you from holding substantially gainful employment, you can apply for TDIU and be paid at the 100% rate without meeting the 100% schedular criteria.

100%Nearly Constant and Incapacitating
$3,938.58/mo

Criteria: Symptoms that are nearly constant and so severe as to restrict routine daily activities almost completely, and which may occasionally preclude self-care.

The 100% schedular level is uncommon for Gulf War illness because it requires near total incapacitation documented over time. Veterans with severe but not total impairment more often reach the 100% payment level through a combined rating across multiple symptom clusters, or through TDIU.

How to Service-Connect Gulf War Syndrome

A standard claim needs a diagnosis, an in-service event, and a nexus. 38 CFR § 3.317 removes two of those three for Persian Gulf veterans. There are three separate routes under the regulation, and your symptoms decide which one applies.

Undiagnosed Illness

Chronic symptoms that no physician can attribute to a known diagnosis. The regulation lists the qualifying signs: fatigue, skin symptoms, headache, muscle pain, joint pain, neurologic and neuropsychological symptoms, respiratory symptoms, sleep disturbance, gastrointestinal symptoms, cardiovascular symptoms, abnormal weight loss, and menstrual disorders. You need objective indications, which can be medical signs or non-medical evidence such as documented work absences.

Medically Unexplained Chronic Multisymptom Illness

Three named conditions qualify even though they carry a diagnosis: chronic fatigue syndrome, fibromyalgia, and functional gastrointestinal disorders including irritable bowel syndrome. If you carry one of these diagnoses and served in the theater, the presumption applies directly with no nexus letter needed.

Presumptive Infectious Diseases

Nine infectious diseases are presumptive for Southwest Asia service, and for these the covered locations also include Afghanistan, Syria, Djibouti, and Uzbekistan: brucellosis, Campylobacter jejuni, Coxiella burnetii (Q fever), malaria, Mycobacterium tuberculosis, nontyphoid Salmonella, Shigella, visceral leishmaniasis, and West Nile virus. Qualifying chronic complications of these diseases are covered as well.

Two conditions apply to all three routes. The disability must be chronic, meaning it has lasted six months or longer, and it must have become at least 10% disabling during qualifying service or by December 31, 2026. It also cannot be attributable to a cause unrelated to service, such as a documented post-service injury.

What Happens at Your C&P Exam

Gulf War claims use the Gulf War General Medical Examination protocol, which is broader than a single condition exam. The examiner will typically:

  • Take a full deployment history, including dates in theater and specific exposures such as burn pits, oil well fires, pesticides, depleted uranium, and pyridostigmine bromide pills
  • Run a systematic review of every body system rather than only the ones you listed on the claim form
  • Order lab work and imaging specifically to rule out known diagnoses, since ruling them out is what establishes the undiagnosed illness
  • Document the frequency and duration of incapacitating episodes, which drive the percentage more than any single symptom does
  • Compare your current activity level against your pre-deployment baseline
  • State whether each symptom cluster is attributable to a known diagnosis, partially explained, or medically unexplained

Bring a symptom calendar covering at least six months with dates, duration, and what each episode stopped you from doing. Incapacitation is measured in weeks per year, so undated descriptions like "constant fatigue" cannot be converted into a percentage. Employment records showing missed days and lay statements from family members are explicitly allowed as objective evidence under § 3.317 and often carry the claim.

Conditions Commonly Claimed Alongside Gulf War Illness

Gulf War veterans rarely have a single claim. Symptoms that can be tied to a known diagnosis are rated under that diagnosis, and each one adds its own rating to your combined total, so it is worth separating them rather than folding everything into one undiagnosed illness claim.

Sinusitis

Chronic sinusitis is both a Gulf War and a PACT Act presumptive condition. Rated 0 to 50% on incapacitating episodes requiring antibiotics.

Asthma

Presumptive under the PACT Act for burn pit and Southwest Asia service. Rated 10 to 100% on FEV-1 values and medication requirements.

PTSD

Combat and deployment stressors are frequently claimed alongside the physical symptom clusters. Rated 0 to 100% on the mental disorders scale.

Migraines

Headache is one of the listed § 3.317 signs, but a diagnosed migraine disorder is rated separately at 0 to 50% on prostrating attack frequency.

Sleep Apnea

Sleep disturbance is a listed sign, and a sleep study confirming apnea moves it to DC 6847, where a CPAP prescription rates 50%.

Peripheral Neuropathy

Numbness and burning in the extremities are common neurologic complaints. When nerve conduction testing confirms neuropathy, it is rated under the nerve codes.

Depression / Anxiety

Chronic unexplained illness frequently produces or worsens mood disorders. Often granted secondary to the physical condition.

Irritable Bowel Syndrome

A functional gastrointestinal disorder that qualifies directly under the § 3.317 presumption. Rated 0 to 30% on frequency of abdominal distress.

SourcesLast reviewed: July 2026

Gulf War Syndrome VA Rating FAQ

Is Gulf War Syndrome a presumptive VA condition?
Yes. Under 38 CFR 3.317, a veteran who served in the Southwest Asia theater and has a qualifying chronic disability is presumed service-connected. The presumption covers undiagnosed illness, medically unexplained chronic multisymptom illness (chronic fatigue syndrome, fibromyalgia, functional gastrointestinal disorders), and a list of specific infectious diseases. No nexus opinion is required.
Do I need a diagnosis to get VA disability for Gulf War illness?
No, and that is the entire point of the presumption. If your symptoms cannot be attributed to a known diagnosis, they are claimed as an undiagnosed illness and rated by analogy under 38 CFR 4.20. You still need objective indications of the illness, which can be medical signs or non-medical evidence such as documented work absences and changes in behavior.
What percentage does the VA give for Gulf War Syndrome?
There is no fixed percentage. The VA rates the disability by analogy, most often under DC 6354 (chronic fatigue syndrome) or DC 5025 (fibromyalgia). Levels run 10%, 20%, 40%, 60%, and 100%. A 40% rating pays $795.84 per month and a 60% rating pays $1,435.02 per month at 2026 rates for a veteran alone.
Which locations qualify for the Gulf War presumption?
Iraq, Kuwait, Saudi Arabia, the neutral zone between Iraq and Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, Oman, the Gulf of Aden, the Gulf of Oman, the Persian Gulf, the Arabian Sea, the Red Sea, and the airspace above them, for service on or after August 2, 1990. Afghanistan, Syria, Djibouti, and Uzbekistan qualify for the specific infectious disease presumptions.
Is there a deadline for Gulf War illness symptoms to appear?
Yes. The disability must have appeared during qualifying service or become at least 10% disabling by December 31, 2026. The VA has extended this presumptive period several times by rulemaking. There is no deadline on filing the claim itself, only on when the illness manifested.
Can Gulf War Syndrome be rated 100%?
Yes, when rated by analogy to chronic fatigue syndrome. The 100% level requires nearly constant symptoms so severe that they almost completely restrict routine daily activities and may occasionally preclude self-care, paying $3,938.58 per month in 2026. Most veterans reach the 100% payment level through combined ratings or TDIU instead.
How long do symptoms have to last to count as chronic?
Six months or more. Under 38 CFR 3.317 a disability is chronic if it has existed for six months or longer, measured from the earliest documented date the symptoms appeared. Symptoms that come and go still count as chronic as long as the overall course spans six months.
Can I claim Gulf War illness and a diagnosed condition at the same time?
Yes, but not for the same symptoms. Once a symptom is attributed to a known diagnosis, it is rated under that diagnosis instead of the undiagnosed illness presumption. Many Gulf War veterans carry both: a diagnosed condition such as sinusitis, asthma, or a mental health condition, plus a separate undiagnosed illness rating for the symptoms that remain unexplained.
Does Gulf War Syndrome qualify for TDIU?
Yes. A single 60% rating meets the schedular TDIU threshold on its own, and a 40% Gulf War rating combined with other service-connected conditions reaching 70% total also qualifies. If the illness prevents substantially gainful employment, TDIU pays at the 100% rate regardless of your schedular percentage.