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M21-1, Part IV, Subpart ii, Chapter 1, Section F – Developing Claims for Service Connection (SC) for Disabilities Resulting From Exposure to Mustard Gas or Lewisite

Overview


In This Section

This section contains the following topics:
Topic
Topic Name
1
2
3

1.  General Information on Developing Claims for SC for Disabilities Resulting From Exposure to Mustard Gas or Lewisite


Introduction

This topic contains general information on developing claims for SC for disabilities resulting from exposure to mustard gas or Lewisite, including

Change Date

April 14, 2017

IV.ii.1.F.1.a.  SC Based on Full-Body Exposure to Mustard Gas or Lewisite During Military Service

38 CFR 3.316 authorizes service connection (SC) for certain diseases diagnosed in Veterans who underwent full-body exposure to mustard gas or Lewisite during military service.
Full-body exposure means that the entire body was exposed to mustard agents or Lewisite as opposed to placement of drops of mustard agent or Lewisite on one or more locations on the skin.
Mustard gas refers to either of two vesicants (blister-producing agents), sulfur mustard (Yperite) or nitrogen mustard.
Lewisite is a mustard vesicant containing arsenic.

IV.ii.1.F.1.b.  Confirmed Locations Where Service Members Have Been Exposed to Mustard Gas or Lewisite

The table below provides the known locations where Army and Navy personnel were exposed to mustard gas or Lewisite.
Important:  Follow the procedures listed in M21-1, Part IV, Subpart ii, 1.F.3 to verify exposure.
Army
Navy
Bari, Italy
Bari, Italy
Bushnell, Florida
Camp Lejeune, North Carolina
Camp Lejeune, North Carolina
Charleston, South Carolina
Camp Sibert, Alabama
Great Lakes Naval Training Center, Illinois
Dugway Proving Ground, Utah
Hart’s Island, New York
Edgewood Arsenal, Maryland
Naval Training Center, Bainbridge, Maryland
Naval Research Lab, Washington, D.C.
Naval Research Laboratory, Virginia
Ondal, India
Naval Research Lab, Washington, D.C.
Rocky Mountain Arsenal, Colorado
USS Eagle Boat No. 58
San Jose Island, Panama Canal Zone
Notes:
  • This list is not all inclusive. Some American service members may have participated in Allied mustard agent testing in Finschhafen, New Guinea, and Porton Down, England.
  • Select merchant seaman were also exposed or killed at Bari, Italy.

IV.ii.1.F.1.c.  Action to Take When the Veteran Claims Exposure but Does Not Claim a Disability

A claim is not substantially complete if a Veteran alleges exposure to mustard gas or Lewisite during service but does not claim SC for a specific disability.  In cases such as these, follow the procedures for handling an incomplete application at M21-1, Part I, 1.B.1.g and h.
Reference:  For more information on what constitutes a substantially complete application, see

2.  Centralized Processing of Claims Based on the Effects of Exposure to Mustard Gas or Lewisite


Introduction

This topic contains information on the centralized processing of claims based on the effects of exposure to mustard gas or Lewisite, including

Change Date

March 15, 2019

IV.ii.1.F.2.a.  Centralized Processing of Claims and Legacy Appeals at the Muskogee RO

All claims and legacy appeals based on exposure to mustard gas or Lewisite received on or after January 19, 2005, are centrally processed at the Muskogee Regional Office (RO).
Exception:  In cases involving more than one special mission claim type, the National Work Queue (NWQ) routing rules may route the claim to the RO with jurisdiction of the other special mission claim type.

IV.ii.1.F.2.b.  Forwarding Claims and Legacy Appeals to the Muskogee RO

Use the table below to determine how to route claims and legacy appeals based on exposure to mustard gas or Lewisite to the Muskogee RO.
If the claims folder is in …
Then …
paper format
send the claims folder to
Department of Veterans Affairs
VARO Muskogee (21-Mustard Gas)
Federal Building
125 S. Main Street
Muskogee, OK 74401
electronic format
ensure the Mustard Gas special issue indicator is affixed to the relevant contention(s).
Note:  If a mustard gas claim is already under the jurisdiction of the Muskogee RO and a subsequent claim is received, the Muskogee RO will process the subsequent claim.
References:  For more information on

3.  Developing Claims Based on the Effects of Exposure to Mustard Gas or Lewisite 


Introduction

This topic contains information on developing claims based on the effects of exposure to mustard gas or Lewisite, including

Change Date

March 15, 2019

IV.ii.1.F.3.a.  Tracking Mustard Gas Claims

All claims for SC for disabilities resulting from exposure to mustard agents or Lewisite are controlled with
  • a standard compensation end product (EP), and
  • the Mustard Gas special issue indicator on the relevant contention(s).
Note:  Affixing this special issue indicator triggers assignment of the claim to the Muskogee RO.
References:  For more information on

IV.ii.1.F.3.b. Developing to the Claimant in Mustard Gas Claims

The standard Section 5103 notice contained on VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits, is not sufficient for most mustard gas claims as it does not request the information needed to verify exposure to mustard gas or Lewisite.  In all claims based on such exposure, development to the claimant is required.
Exception:  Do not send a development letter if the evidence of record
  • provides the information the subsequent development letter solicits, or
  • is otherwise sufficient to decide the claim.
Use the table below to determine what language to insert into the subsequent development letter.
If …
Then send a subsequent development letter from VBMS with the following language …
the Veteran files a substantially complete claim for SC for a disability due to mustard gas or Lewisite exposure
In order to assist us with verifying your claimed exposure to mustard gas or Lewisite during your military service, please tell us the details about your exposure, including:
  • your full organizational designation (unit, company, division, etc.) at the time of alleged exposure(s)
  • the number of exposures
  • the date of the alleged exposure(s) (month and year)
  • the geographical location of the alleged exposure(s)
  • the type of activity you were engaged in at the time of each exposure, such as basic training or involvement in a test or experiment
  • details of the exposure, including
    • the length of time you were exposed
    • the procedures that were followed before, during, and after the exposure
    • the effect of the exposure on your body, and
    • whether you received medical treatment following exposure. 
Important:  Claims processors may contact a claimant by telephone to obtain the above information.
Note:  When sending the letter, create a custom tracked item with a 30-day suspense titled MG-circumstances of exposure.
Reference:  For more information on obtaining and documenting information received from a claimant by telephone, see M21-1, Part III, Subpart iii, 1.B.1.
the disability claimed as due to mustard gas or Lewisite exposure is not recognized as a presumptive condition under 38 CFR 3.316
We may consider that [contention] is associated with mustard gas or Lewisite exposure if you send us scientific or medical evidence showing that the claimed condition is medically associated with such exposure. If a doctor has expressed an opinion regarding the relationship of the claimed condition to exposure to mustard gas or Lewisite, send us that opinion, the reasons and bases for that opinion, and the clinical treatment records. In addition, the doctor should provide literature that supports the opinion. Literature may consist of scientific or medical journal articles, etc., that support the doctor’s opinion that your exposure is related to the currently diagnosed condition.
Note:  Create a custom tracked item with a 30-day suspense titled MG-not a recognized condition.
References:  For more information on

IV.ii.1.F.3.c.  When Development for Evidence of Full-Body Exposure Is Necessary

Do not request evidence of full-body exposure to mustard gas or Lewisite unlessthe Veteran alleges exposure and submits
  • competent lay or medical evidence of a disability listed in 38 CFR 3.316(a), or
  • medical or scientific evidence showing a causal relationship between a disease not listed in 38 CFR 3.316(a) and exposure.

IV.ii.1.F.3.d.  Requesting Access to the DoD and VA Chem-Bio Database

The Department of Defense (DoD) and Department of Veterans Affairs (VA) Chemical Biological Warfare Exposure System (Chem-Bio) is a consolidated database for mustard gas, Shipboard Hazard and Defense (SHAD), and Chem-Bio participants.
The Muskogee RO must maintain primary and alternate points of contact (POCs) and with access to the Chem-Bio Database.  POCs are responsible for conducting preliminary research regarding claimed in-service mustard gas-related exposures.  Access should be requested in advance of receipt of a claim based on exposure in order to ensure that claims processing is not unnecessarily delayed.
Important:  To request access to the Chem-Bio Database, send a completed DD Form 2875, System Authorization Access Request (SAAR), to the following Compensation Service mailbox: VAVBAWAS/CO/MUSTARDGAS.

IV.ii.1.F.3.e.  Procedure for Verifying Full-Body Exposure to Mustard Gas or Lewisite  

Verification of mustard gas or Lewisite exposure is a two-step process:
  • Check the Chem-Bio Database or send a request to Compensation Service.
  • If the Veteran is not in listed in the database, send a request to Compensation Service to ask DoD’s Deployment Health Directorate for a determination regarding exposure.
Follow the procedures in the table below when verifying a claim of exposure to mustard gas or Lewisite.
Step
Action
1
Is the claimant claiming a disability listed in 38 CFR 3.316(a)?
  • If yes, proceed to the next step.
  • If no,
    • send the development letter referenced in M21-1, Part IV, Subpart ii, 1.F.3.b, requesting scientific or medical evidence showing that the claimed condition is medically associated with exposure
    • allow the claimant 30 days to respond, and
    • proceed to Step 5.
2
Is there competent lay or medical evidence of a disability listed in 38 CFR 3.316(a)?
  • If yes, proceed to the next step.
  • If no, refer the claim for a decision.
3
Attempt to verify exposure through the Chem-Bio Database, or follow the procedure in M21-1 Part IV, Subpart ii, 1.F.3.f to submit an inquiry to Compensation Service if database access has not yet been granted.
4
Was exposure verified by the action in Step 3?
  • If yes,
    • upload relevant documentation of exposure to the Veteran’s eFolder, and
    • complete all other required claims development, including any necessary examinations.
  • If no, send a request to Compensation Service to assist in verifying exposure, as detailed in M21-1, Part IV, Subpart ii, 1.F.3.g.
5
Did the claimant respond with the requested information?
  • If yes, return to Step 3.
  • If no, refer the claim for a decision.

IV.ii.1.F.3.f.  Forwarding Requests for Verification of Full-Body Exposure to Compensation Service

When the RO’s POC or alternate POC does not have access to the Chem-Bio Database, send an e-mail message to Compensation Service (VAVBAWAS/CO/MUSTARDGAS) requesting verification of full-body exposure.
The e-mail message should include
  • the Veteran’s
    • full name
    • e-mail address
    • telephone number
    • date of birth
    • date of death (if applicable)
    • Social Security number (SSN)
    • branch of service
    • service number, and
    • dates of service
  • the date of the alleged exposure (month and year)
  • the geographic location of the alleged exposure
  • the unit to which the Veteran was assigned at the time of alleged exposure
  • the type of exposure (full-body, patch, etc.), and
  • the disabilities claimed as having resulted from exposure.

Upon receipt of the e-mail, Compensation Service personnel will review the Chem-Bio Database and confirm whether the Veteran is listed in the database.  If the Veteran’s name does not appear in the database, follow the instructions at M21-1, Part IV, Subpart ii, 1.F.3.g.


IV.ii.1.F.3.g.  Referring Claims to Compensation Service When Veterans Are Not Listed in the Chem-Bio Database

If the Veteran is not listed in the Chem-Bio Database,
  • refer the claim to Compensation Service based on the table below, and
  • mail copies of the Veteran’s service personnel records to Compensation Service at the following address:
Department of Veterans Affairs
Compensation Service (211B)
ATTN:  Mustard Gas Manager
810 Vermont Ave, NW
Washington, DC  20420
Important:  The documentation should include
  • the Veteran’s
    • full name
    • service number
    • SSN, and
    • full organizational designation (unit, company, division, etc.) at the time of alleged exposure(s)
  • the number of exposures
  • the date of the alleged exposure(s) (month and year)
  • the geographical location of the alleged exposure(s)
  • the type of activity the Veteran was engaged in at the time of each exposure, such as basic training or involvement in a test or experiment
  • details of the exposure, including
    • the length of time the Veteran was exposed
    • the procedures that were followed before, during, and after the exposure
    • the effect of the exposure on the Veteran’s body, and
    • whether the Veteran received medical treatment following exposure, and
  • any three-inch by five-inch index card in the service records documenting exposure to mustard gas or Lewisite.  (In some cases, DoD placed in the service records a three-inch by five-inch index card containing detailed information about mustard gas or Lewisite exposure).
If the claim is …
Then …
processed in the NWQ environment
  • create a VBMS eFolder note stating the claim is referred to Compensation Service for verification of full-body exposure to mustard gas, and
  • affix the Compensation Service Review – MG/CBRNE/Shad special issue indicator and add the Compensation Service Review tracked item in accordance with the NWQ Playbook to ensure proper routing to Compensation Service.
not processed in the NWQ environment
  • add the Compensation Service Reviewtracked item
  • e-mail a request for verification of full-body exposure to mustard gas to the following Compensation Service mailbox:  VAVBAWAS/CO/MUSTARDGAS, and
  • upload the email to the Veteran’s VBMS eFolder.
Note:  Upon receipt, Compensation Service will forward this documentation to the Deployment Health Directorate for a determination regarding exposure.
References:  For more information on
Historical_M21-1IV_ii_1_SecF_08-07-2015.docx May 21, 2019 54 KB
Change-August-7-2015-Transmittal-Sheet-M21-1IV_ii_1_SecF_TS.docx May 21, 2019 43 KB
Historical_M21-1IV_ii_1_SecF_8-18-17.docx May 21, 2019 61 KB
3-15-19_Key-Changes_M21-1IV_ii_1_SecF.docx May 21, 2019 55 KB
Historical_M21-1IV_ii_1_SecF_4-14-17.docx May 21, 2019 70 KB
Transmittal-Sheet-09_29_06.docx May 21, 2019 29 KB
Transmittal-Sheet-12_13_05.docx May 21, 2019 31 KB
Transmittal-Sheet-M21-1MRIV_ii_TS.docx May 21, 2019 43 KB
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