Gulf War Presumptive Conditions: A Complete Guide for 2026

Approximately 25-32% of the 697,000 veterans who served in the 1990-1991 Gulf War report chronic symptoms that doctors often cannot fully explain: persistent fatigue, widespread pain, cognitive difficulties, and gastrointestinal problems. The VA recognizes these as "Gulf War illness" and provides presumptive service connection, meaning you do not need to prove that your deployment caused your condition.

Understanding Gulf War Illness

Gulf War illness (also called Gulf War syndrome or chronic multisymptom illness) is unlike most other VA claims. Instead of requiring a specific disease diagnosis, the VA acknowledges that Gulf War veterans developed real, disabling symptoms from the toxic environment of their service: smoke from oil well fires, pesticides, chemical weapons destruction, depleted uranium, infectious disease vaccines, sand and particulate matter, and burn pits.

The PACT Act extended the presumptive period for Gulf War conditions, ensuring veterans filing through 2031 remain covered.

Covered Locations and Service Periods

Southwest Asia Theater of Operations

The VA covers service from August 2, 1990 to present in:

• Iraq, Kuwait, Saudi Arabia
• Bahrain, Qatar, Oman, United Arab Emirates
• The neutral zone between Iraq and Saudi Arabia
• Persian Gulf, Gulf of Aden, Gulf of Oman, Arabian Sea, Red Sea
• Airspace above these locations

Afghanistan

Covered from September 19, 2001 to present with the same presumptive conditions.

No Minimum Service Requirement

Unlike Camp Lejeune (which requires 30 days), there is no minimum time requirement. Even a few days in a covered location qualifies you for Gulf War presumptive conditions if you develop qualifying symptoms.

Gulf War Presumptive Conditions

Category 1: Chronic Multisymptom Illness

This is the broadest category. You qualify if you have a chronic disability resulting from one or more of these symptom clusters lasting 6 months or more:

Fatigue: Persistent exhaustion that does not improve with rest and interferes with daily functioning. Different from normal tiredness.

Head, Eyes, Ears, Nose, Throat, and Respiratory: Chronic headaches, vision or hearing problems, chronic sinus problems, persistent cough, shortness of breath.

Musculoskeletal: Chronic widespread pain, joint pain, muscle pain, joint stiffness.

Gastrointestinal: Chronic diarrhea, constipation, abdominal pain, nausea, indigestion.

Neurological: Cognitive difficulties (memory, concentration, attention problems), dizziness, numbness or tingling, tremors.

Mood and Sleep: Depression, anxiety, insomnia and other sleep disturbances.

Skin: Chronic rashes, skin sensitivity, unexplained skin lesions.

Category 2: Functional Gastrointestinal Disorders

These are specific diagnosed conditions that are presumptive:

• Irritable bowel syndrome (IBS): Chronic abdominal pain with altered bowel habits
• Functional dyspepsia: Chronic indigestion without a clear cause
• Functional abdominal pain syndrome: Chronic abdominal pain without identifiable cause

Category 3: Chronic Fatigue Syndrome

Severe chronic fatigue lasting 6+ months that is not relieved by rest. Must include multiple associated symptoms like unrefreshing sleep, cognitive impairment, and post-exertional malaise.

Category 4: Fibromyalgia

Chronic widespread musculoskeletal pain lasting 3+ months with associated fatigue, sleep disturbances, and cognitive difficulties ("fibro fog").

How Gulf War Conditions Are Rated

Undiagnosed Illness (Diagnostic Code 6354)

Fibromyalgia (Diagnostic Code 5025)

IBS (Diagnostic Code 7319)

Chronic Fatigue Syndrome (Diagnostic Code 6354)

Same scale as undiagnosed illness, from 10% to 100% based on functional impact.

How to File a Gulf War Claim

Step 1: Confirm Your Service

Verify your DD-214 shows service in the Southwest Asia theater or Afghanistan. Deployment orders, campaign medals (Southwest Asia Service Medal, Iraq Campaign Medal, Afghanistan Campaign Medal), and unit records can supplement.

Step 2: Document Your Symptoms Thoroughly

For undiagnosed illness claims, create a detailed symptom journal:

• List every chronic symptom you experience
• Note how long you have had each symptom (must be 6+ months)
• Describe severity and frequency
• Explain how symptoms affect daily activities and work
• Record treatments you have tried and their effectiveness

Step 3: Get Medical Evidence

For diagnosed conditions (fibromyalgia, CFS, IBS), get clear medical records documenting the diagnosis. For undiagnosed illnesses, get records showing:

• Your complaints to doctors about chronic symptoms
• Diagnostic testing performed to rule out other conditions
• Treatment attempts and medications prescribed
• Doctor statements that they cannot identify a specific disease explaining your symptoms

Step 4: File Your Claim

File at VA.gov using Form 21-526EZ. Be specific about your symptoms rather than just writing "Gulf War syndrome." List the actual symptom clusters you experience, state you are claiming Gulf War presumptive conditions, and upload all documentation.

Step 5: Attend the C&P Exam

Be extremely thorough at this exam:

• Bring your symptom journal with specific examples
• Describe your worst days, not a good day
• Explain every functional limitation in detail
• Mention all body systems affected
• Describe how symptoms fluctuate and how often you have bad days

The examiner can only rate symptoms you report. Do not minimize or be stoic.

Step 6: Review Your Decision

Check that presumptive service connection was granted and the rating reflects your symptom severity. If rated lower than expected, it is often because the C&P exam did not fully capture your condition. Appeal with additional evidence from treating doctors.

Secondary Conditions

Gulf War illness often causes or worsens other conditions that may be separately ratable:

Mental Health

• Depression from chronic pain and fatigue limiting daily life
• Anxiety from uncertainty about unexplained health problems
• PTSD may be aggravated by chronic illness

Sleep Disorders

• Insomnia from pain, GI symptoms, or cognitive symptoms
• Sleep apnea connected to fatigue and reduced activity

Other

• GERD from IBS medications or chronic stress
• Hypertension from chronic pain and inflammatory processes
• Obesity from inability to exercise due to fatigue and pain

Each secondary condition requires a medical opinion linking it to your service-connected Gulf War condition.

Common Issues and Tips

Symptoms started years after service: The PACT Act extended the presumptive period through 2031. Delayed onset is actually characteristic of many toxic exposure conditions. File even if symptoms appeared decades after deployment.

Multiple overlapping symptoms: Claim the most specific diagnosis you have (fibromyalgia, CFS, IBS), then also claim "undiagnosed illness" for symptom clusters not covered by those diagnoses. Be clear about which symptoms you are attributing to which claim to avoid pyramiding.

Proving symptom severity: Keep detailed diaries, get lay statements from family and friends, obtain buddy statements from fellow Gulf War veterans, and get employer statements about workplace limitations or missed work.

Next Steps

If you served in the Southwest Asia theater and experience chronic, unexplained symptoms, do not wait to file. Use the Veterans Benefits Finder to see how Gulf War conditions and their secondary effects affect your total disability rating and available benefits.