Multiple Sclerosis Centers of Excellence
Frequently Asked Questions Relating to Military Service
To ask a question send an email to MSCentersofExcellence@va.gov.
- Does getting multiple sclerosis (MS) have any connection with being exposed to Agent Orange?
- How did the seven-year presumptive rule come about for MS?
- Has the diagnosis of MS been related to the Persian Gulf Illness?
- What is the most current incidence and prevalence rates of MS in the Veteran population?
- What effect does the vast array of vaccinations like Malaria, Hepatitis A and B, and others that military personnel receive during their tour of duty contribute to the development of MS?
- I am a service-connected Veteran diagnosed with MS in 2022 at 70 percent (I required a cane or crutches). Now I'm almost totally wheelchair bound (90 to 95 percent). How do I go about getting re-rated?
- I have diabetes in addition to MS. May both be used to determine my level of eligibility for benefits and services?
- How does a compensation and pension examiner determine "loss of use" for a Veteran with MS?
1. Does getting MS have any connection with being exposed to Agent Orange?
At this time, there is no proven link between Agent Orange and MS. The VA has created a website that answers questions about Agent Orange because many disorders are linked to this exposure. The VA also has a research program that studies this exposure and its effects on health. However, if you were honorably discharged from the military, you can get medical services with the VA.
2. How did the seven-year presumptive rule come about for MS?
Service-connection is given for disabilities that were not found on active duty but are "presumed" to have started during service. For certain disabilities, if they show up to a compensable degree (deserve at least a 10 percent rating) within one year of leaving active duty, a Veteran can still get service-connection for them. The one-year presumptive conditions include high blood pressure, arthritis, and diabetes, among several others. All are listed in Code of Federal Regulations (CFR) 38, 3.309. There are also a few disabilities with longer presumptive periods, such as MS, which is seven years and gets a 30 percent rating.
MS is diagnosed based on medical history and neurological exam. Symptoms often happen years before a diagnosis is made. Neurologic symptoms that occur within seven years of discharge can be used to support service-connection for MS, no matter when the diagnosis is made. The Paralyzed Veterans of America (PVA) are strong advocates for Veterans getting the benefits they deserve. They know the VA health care system well. They are a great resource for Veterans who want to better understand their options for MS service-connection. The PVA healthcare hotline is 800-232-1782. The Disabled American Veterans (DAV) are also a great resource. Visit their Find Your Local Office webpage to find your local DAV National Service Officer.
3. Has the diagnosis of MS been related to the Persian Gulf Illness?
At the present time, there is no strong evidence to suggest that Gulf War Veterans are at higher risk for MS or demyelinating diseases in general.
4. What is the most current incidence and prevalence rates of MS in the Veteran population?
At this time, there are no exact estimates of how common MS is in the entire Veteran population. Part of the problem is that only about 40% of Veterans get their care within the VA Health Care System (VHA). So, tracking down all cases would be very difficult and costly. We do know that around 20,000 Veterans with MS are seen each year in the VHA. Based on work recently published about national MS rates (that VHA helped with), we found that MS among VHA users increased from a rate of 141 per 100,000 Veterans in 1999 to a rate of 262 per 100,000 Veterans in 2014.
5. What effect does the vast array of vaccinations like Malaria, Hepatitis A and B, and others that military personnel receive during their tour of duty contribute to the development of MS?
In the civilian population, vaccinations have been carefully studied over a long period of time. No evidence has been found of higher risk of developing MS. These results apply to the military population as well.
6. I am a service-connected Veteran diagnosed with MS in 2022 at 70 percent (I required a cane or crutches). Now I'm almost totally wheelchair bound (90 to 95 percent). How do I go about getting re-rated?
We encourage Veterans to work closely with their VA MS care providers and social worker when they would like to be re-rated for MS disability. We also encourage Veterans to work with a recognized Veteran Service Organization (VSO). A VSO will require you to complete a VA Form 21-22 (see list of Recognized Service Organizations on page 3). A VSO will submit your claim and advocate, navigate, and case manage the claim on your behalf. They will also work closely with your MS care providers and MS social worker. The claims process can be complicated and sometimes frustrating. So, it is important to work closely with your MS Team and a designated VSO.
There are many advantages of working with a VSO:
- They have access to the Veterans Benefits Administration (VBA) system and can track and manage your claim.
- A VSO will check in with your MS providers and MS social worker. They will know when to request a re-exam called a Disability Benefits Questionnaire (DBQ) and submit it on your behalf to the VBA.
- A VSO can advise and advocate for you during the claims process.
Veterans may also wish to consider applying for other benefits including, but not limited to, Special Monthly Compensation (SMC), also known as Aid and Attendance. A VSO can help to apply for these benefits on your behalf with the VBA.
7. I have diabetes in addition to MS. May both be used to determine my level of eligibility for benefits and services?
Yes. For example, a Veteran might have 30 percent eligibility for MS and 20 percent eligibility for diabetes, which combines to 40 percent. Notice that 30 percent and 20 percent do not add up to 50 percent in this case. The VA Schedule for Rating Disabilities "combines" the evaluations rather than "adds" the evaluations. It works this way: the first (largest) rating is 30 percent. That means you are 30 percent disabled and 70 percent able. If you have another disability, say 20 percent, then it is 20 percent of the remaining 70 percent of your abilities or 14 percent. 30 percent plus 14 percent equals 44 percent which rounds down to 40 percent.
8. How does a compensation and pension examiner determine "loss of use" for a Veteran with MS?
Compensation and pension examiners base their decisions on several factors. These include review of the medical record, an interview with the Veteran, and exam findings or observations during the appointment. Documentation from a neurologist or physiatrist describing the degree of mobility problems could be useful in establishing "loss of use." The physician could either write a detailed note for the Veteran's medical record or write a letter submitted with a "Statement in Support of Claim" when a Veteran requests that their claim be re-evaluated. It may also be helpful to get assistance from a Veteran Service Officer in pursuing a claim.
