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Gulf War Health and Medicine Division Reports

VA is required by law to contract with the Health and Medicine Division (HMD) (formally known as the Institute of Medicine) of the National Academy of Sciences, Engineering, and Medicine to scientifically review evidence for possible connections between Gulf War Veterans’ illnesses and exposure to environmental agents or preventive medicine during military service.

VA also is required to study the best treatments for these illnesses and distribute the information within VA to improve the care we provide to Veterans.

2018 report on generational health 

HMD released Gulf War and Health: Volume 11: Generational Health Effects of Serving in the Gulf War on November 28, 2018. This report focuses on the reproductive effects of exposures and the health effects of exposures on future generations.

2016 report on health effects 

HMD released Gulf War and Health: Volume 10: Update of Health Effects of Serving in the Gulf War on February 11, 2016. This report has a special focus on neurological disorders, cancer, and chronic multisymptom illness. VA is working on its response to this report.

2014 report on blast exposures

The HMD released Gulf War and Health: Long-Term Effects of Blast Exposures on February 13, 2014. This report describes the scientific and medical evidence regarding exposure to blast and health effects. 

2013 report on treatment of chronic multisymptom illness

HMD released Gulf War and Health: Treatment for Chronic Multisymptom Illness on January 23, 2013. This report describes the scientific and medical research on the treatment of chronic multisymptom illness in Gulf War Veterans.

VA’s response to 2006 and 2010 HMD reports

VA assumes that certain illnesses are related to qualifying military service, which is called "presumption of service connection."

VA’s final rule that took effect on August 15, 2011 specified that functional gastrointestinal illnesses (FGIDs), such as irritable bowel syndrome and functional dyspepsia (indigestion), are included in the existing presumption of service connection for medically unexplained chronic multisymptom illnesses. Eligible Gulf War Veterans may receive disability compensation for these disorders.

At this time, VA has decided that it will not add further to the existing presumptions, based on the September 12, 2006 HMD report and April 9, 2010 HMD report. Read the notice in the Federal Register on April 14, 2011 for the rationale behind VA’s decision.

However, claimants may still seek to establish service connection individually for diseases and illnesses associated with service in the Gulf War.

Gulf War connected illnesses

VA already has established presumptions or special rules for some of the diseases and illnesses addressed in the 2006 and 2010 HMD reports. For example:

  • VA presumes amyotrophic lateral sclerosis (ALS) diagnosed in all Veterans with 90 days or more continuous active military service is related to their service. Because this presumption applies to all Veterans, there is no need for a separate presumption for Gulf War Veterans.
  • When a Veteran of any period of service receives a valid diagnosis of posttraumatic stress disorder (PTSD), service connection may be granted if the illness is associated with an in-service stressful event.
  • VA presumes certain medically unexplained illnesses are related to Gulf War service without regard to cause.

Also, VA recognizes nine infectious diseases as associated with military service in Southwest Asia, Iraq, and Afghanistan, which were addressed in HMD’s Gulf War and Health report Infectious Diseases.

Future Gulf War and Health HMD reports

In 2017, VA charged HMD to conduct a study to assess the current research available on possible generational health effects that may be the result of exposures experienced by deployed Gulf War Veterans. HMD will provide recommendations on the future research that should be undertaken to answer important questions about possible generational effects of toxic exposures in this Veteran population. HMD plans to report its recommendations in early 2019.

Past Gulf War and Health HMD reports

Environmental health coordinators directory


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