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What are structural versus functional conditions in relation to the presumptive Gulf War?

With so many differently categorized conditions, it’s easy to get confused by the VA’s many qualifying factors and categories. Regarding presumptive Gulf War conditions, The VA only considers functional conditions as eligible for receiving disability benefits.

Here’s the difference between structural conditions vs functional conditions, plus some examples on how Veterans make mistakes in filing for Gulf War Presumptive claims:

What are structural conditions?

Structural conditions are the most straightforward. These medical conditions are clearly verified through medical testing – such as GERD, a broken bone, back injury, or another condition visible through physical exam, medical imaging, or lab testing.

What are functional conditions?

Compared to structural conditions, functional conditions are harder to prove due to medical tests and imagery being normal in most cases. Conditions such as chronic fatigue syndrome, functional dyspepsia, and IBS are all considered functional conditions since they are typically diagnosed based on a Veteran’s reported experience and symptoms with most testing showing normal results.

Where do Veterans go wrong with their claims regarding these conditions?

Gulf War presumptive conditions are considered “unexplained illnesses”, suggesting that the exposure has caused the symptoms rather than a typical bodily process. Oftentimes, Veterans will try to claim structural conditions as Gulf War presumptive, resulting in a denied claim. The following are the two most common mistaken claims:

  • Claiming GERD as Gulf War presumptive: This would be denied because GERD is a structural condition with findings on lab tests and inflammation/redness on endoscopy procedures. Examples of functional conditions with similar symptoms as GERD include functional dyspepsia or simply a diagnosis of chronic heartburn.

  • Claiming diverticulosis as Gulf War presumptive: This would be denied because diverticulosis is a structural condition. A colonoscopy will show pockets of thinning tissue (similar in appearance to swiss cheese) that can get inflamed when food gets stuck in them causing symptoms. IBS is an example of a functional condition that produces similar symptoms (abdominal pain, cramping, diarrhea, constipation, bleeding, etc), but the colonoscopy results are normal for an IBS patient.

How to file your claims the right way

Identifying your condition correctly and filing claims for VA disability benefits doesn’t have to be hard. We’re here to make it a simple and easy process. Bolster your knowledge on filing your VA disability claims by watching our free, 60-minute educational webinar. For a more comprehensive level of education, sign up for our course "Master Service Connection: A Course To Maximize Your VA Disability Rating FAST!".

Connect with a medical expert at MRPY to get a Nexus Letter written for your claim here on our services page, or sign up for an expert chart review here. Help is just a click away.

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