C&P Evaluations: For disability compensation, see your provider for a health exam first
According to scientific publications, between 25% to 33% of Gulf War Veterans will have at least some degree of medically unexplained, chronic symptoms, commonly known as chronic multisymptom illness (CMI) or Gulf War illness (GWI). To be considered for disability compensation for CMI/GWI, Veterans need to have a thorough medical evaluation, get a diagnosis, and have this diagnosis documented in their medical record. This usually requires more than one initial visit to a primary care provider or Compensation and Pension (C&P) clinic. This is also true for several other diseases presumed to be related to Gulf War service (https://www.publichealth.va.gov/exposures/gulfwar/medically-unexplained-illness.asp).
For example, if the Veteran has been seen by a gastrointestinal (GI) specialist, given an endoscopy, and shown to be diagnosed with irritable bowel syndrome (IBS) in their medical record, then using this information to support a diagnosis of IBS in a C&P clinic could be straight forward. If the Veteran has never been seen by a GI specialist, however, and is describing his or her symptoms for the first time to the C&P clinician, a diagnosis will not be feasible without a more complete work-up. In this case the work-up may require performing the necessary laboratory tests, imaging studies, and procedures to rule out other diseases.
VA recommends that Veterans have a work-up coordinated by their primary care provider and completed before starting the C&P process. A Gulf War Registry health exam before a C&P exam can also help the Veteran identify concerns, although a registry exam is not a disability exam. The registry exam information can be used to support a disability claim, but it is not a substitute for a C&P exam. Having complete records available of all consults, laboratory tests, imaging studies, and other testing or procedures performed, as well as a complete list of all diagnoses made by a primary care provider and/or specialists, helps both the Veteran and the C&P provider in the examination process.