1. U.S. Code
  2. title 38
  3. part II
  4. chapter 11
  5. subchapter VI
  6. § 1157

Collapse to view only § 1157. Combination of certain ratings

§ 1151. Benefits for persons disabled by treatment or vocational rehabilitation
(a) Compensation under this chapter and dependency and indemnity compensation under chapter 13 of this title shall be awarded for a qualifying additional disability or a qualifying death of a veteran in the same manner as if such additional disability or death were service-connected. For purposes of this section, a disability or death is a qualifying additional disability or qualifying death if the disability or death was not the result of the veteran’s willful misconduct and—
(1) the disability or death was caused by hospital care, medical or surgical treatment, or examination furnished the veteran under any law administered by the Secretary, either by a Department employee or in a Department facility as defined in section 1701(3)(A) of this title, and the proximate cause of the disability or death was—
(A) carelessness, negligence, lack of proper skill, error in judgment, or similar instance of fault on the part of the Department in furnishing the hospital care, medical or surgical treatment, or examination; or
(B) an event not reasonably foreseeable; or
(2) the disability or death was proximately caused (A) by the provision of training and rehabilitation services by the Secretary (including by a service-provider used by the Secretary for such purpose under section 3115 of this title) as part of an approved rehabilitation program under chapter 31 of this title, or (B) by participation in a program (known as a “compensated work therapy program”) under section 1718 of this title.
(b)
(1) Where an individual is, on or after December 1, 1962, awarded a judgment against the United States in a civil action brought pursuant to section 1346(b) of title 28 or, on or after December 1, 1962, enters into a settlement or compromise under section 2672 or 2677 of title 28 by reason of a disability or death treated pursuant to this section as if it were service-connected, then (except as otherwise provided in paragraph (2)) no benefits shall be paid to such individual for any month beginning after the date such judgment, settlement, or compromise on account of such disability or death becomes final until the aggregate amount of benefits which would be paid but for this subsection equals the total amount included in such judgment, settlement, or compromise.
(2) In the case of a judgment, settlement, or compromise covered by paragraph (1) that becomes final on or after the date of the enactment of this paragraph and that includes an amount that is specifically designated for a purpose for which benefits are provided under chapter 21 or 39 of this title (hereinafter in this paragraph referred to as the “offset amount”), if such judgment, settlement, or compromise becomes final before the date of the award of benefits under chapter 21 or 39 for the purpose for which the offset amount was specifically designated—
(A) the amount of such award shall be reduced by the offset amount; and
(B) if the offset amount is greater than the amount of such award, the excess amount received pursuant to the judgment, settlement or compromise, shall be offset against benefits otherwise payable under this chapter.
(c) A qualifying additional disability under this section shall be treated in the same manner as if it were a service-connected disability for purposes of the following provisions of this title:
(1) Chapter 21, relating to specially adapted housing.
(2) Chapter 39, relating to automobiles and adaptive equipment.
(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1124, § 351; Pub. L. 87–825, § 3, Oct. 15, 1962, 76 Stat. 950; Pub. L. 91–24, § 3, June 11, 1969, 83 Stat. 33; Pub. L. 94–433, title IV, § 404(19), Sept. 30, 1976, 90 Stat. 1379; Pub. L. 98–223, title II, § 213(1), Mar. 2, 1984, 98 Stat. 46; renumbered § 1151 and amended Pub. L. 102–83, §§ 4(a)(1), 5(a), Aug. 6, 1991, 105 Stat. 403, 406; Pub. L. 104–204, title IV, § 422(a), Sept. 26, 1996, 110 Stat. 2926; Pub. L. 106–419, title III, § 303, Nov. 1, 2000, 114 Stat. 1853; Pub. L. 108–454, title III, § 304(a),(c), Dec. 10, 2004, 118 Stat. 3611.)

CITE AS: 38 USC 1151

§ 1152. Persons heretofore having a compensable status

The death and disability benefits of this chapter shall, notwithstanding the service requirements thereof, be granted to persons heretofore recognized by law as having a compensable status, including persons whose claims are based on war or peacetime service rendered before April 21, 1898.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1124, § 352; renumbered § 1152, Pub. L. 102–83, § 5(a), Aug. 6, 1991, 105 Stat. 406.)

CITE AS: 38 USC 1152

§ 1153. Aggravation

A preexisting injury or disease will be considered to have been aggravated by active military, naval, air, or space service, where there is an increase in disability during such service, unless there is a specific finding that the increase in disability is due to the natural progress of the disease.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1124, § 353; renumbered § 1153, Pub. L. 102–83, § 5(a), Aug. 6, 1991, 105 Stat. 406; Pub. L. 116–283, div. A, title IX, § 926(a)(15), Jan. 1, 2021, 134 Stat. 3830.)

CITE AS: 38 USC 1153

§ 1154. Consideration to be accorded time, place, and circumstances of service
(a) The Secretary shall include in the regulations pertaining to service-connection of disabilities (1) additional provisions in effect requiring that in each case where a veteran is seeking service-connection for any disability due consideration shall be given to the places, types, and circumstances of such veteran’s service as shown by such veteran’s service record, the official history of each organization in which such veteran served, such veteran’s medical records, and all pertinent medical and lay evidence, and (2) the provisions required by section 5 of the Veterans’ Dioxin and Radiation Exposure Compensation Standards Act (Public Law 98–542; 98 Stat. 2727).
(b) In the case of any veteran who engaged in combat with the enemy in active service with a military, naval, air, or space organization of the United States during a period of war, campaign, or expedition, the Secretary shall accept as sufficient proof of service-connection of any disease or injury alleged to have been incurred in or aggravated by such service satisfactory lay or other evidence of service incurrence or aggravation of such injury or disease, if consistent with the circumstances, conditions, or hardships of such service, notwithstanding the fact that there is no official record of such incurrence or aggravation in such service, and, to that end, shall resolve every reasonable doubt in favor of the veteran. Service-connection of such injury or disease may be rebutted by clear and convincing evidence to the contrary. The reasons for granting or denying service-connection in each case shall be recorded in full.
(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1124, § 354; Pub. L. 94–433, title IV, § 404(20), Sept. 30, 1976, 90 Stat. 1379; Pub. L. 98–542, § 4, Oct. 24, 1984, 98 Stat. 2727; Pub. L. 102–54, § 14(b)(1), June 13, 1991, 105 Stat. 282; renumbered § 1154 and amended Pub. L. 102–83, §§ 4(b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 116–283, div. A, title IX, § 926(d), Jan. 1, 2021, 134 Stat. 3831.)

CITE AS: 38 USC 1154

§ 1155. Authority for schedule for rating disabilities

The Secretary shall adopt and apply a schedule of ratings of reductions in earning capacity from specific injuries or combination of injuries. The ratings shall be based, as far as practicable, upon the average impairments of earning capacity resulting from such injuries in civil occupations. The schedule shall be constructed so as to provide ten grades of disability and no more, upon which payments of compensation shall be based, namely, 10 percent, 20 percent, 30 percent, 40 percent, 50 percent, 60 percent, 70 percent, 80 percent, 90 percent, and total, 100 percent. The Secretary shall from time to time readjust this schedule of ratings in accordance with experience. However, in no event shall such a readjustment in the rating schedule cause a veteran’s disability rating in effect on the effective date of the readjustment to be reduced unless an improvement in the veteran’s disability is shown to have occurred.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1125, § 355; Pub. L. 98–223, title I, § 101(c), Mar. 2, 1984, 98 Stat. 38; renumbered § 1155 and amended Pub. L. 102–83, §§ 4(b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–86, title I, § 103(a), Aug. 14, 1991, 105 Stat. 414.)

CITE AS: 38 USC 1155

§ 1156. Temporary disability ratings
(a)Assignment of Temporary Ratings.—
(1) For the purpose of providing disability compensation under this chapter to veterans, the Secretary shall assign a temporary disability rating to a veteran as follows:
(A) To a veteran who—
(i) was discharged or released from active duty not more than 365 days before the date such veteran submits a claim for disability compensation under this chapter;
(ii) has one or more disabilities for which a rating of total is not immediately assignable—(I) under the regular provisions of the schedule of ratings; or(II) on the basis of individual unemployability; and
(iii) has one or more—(I) severe disabilities that result in substantially gainful employment not being feasible or advisable; or(II) healed, unhealed, or incompletely healed wounds or injuries that make material impairment of employability likely.
(B) To a veteran who, as a result of a highly stressful in-service event, has a mental disorder that is severe enough to bring about the veteran’s discharge or release from active duty.
(C) To a veteran who has a service-connected disability that requires hospital treatment or observation in a Department of Veterans Affairs or approved hospital for a period in excess of 21 days.
(D) To a veteran who has a service-connected disability that has required convalescent care or treatment at hospital discharge (regular discharge or release to non-bed care) or outpatient release that meets the requirements of regulations prescribed by the Secretary.
(2) With respect to a veteran described in paragraph (1)(A), the Secretary may assign a temporary disability rating to such veteran regardless of whether such veteran has obtained a medical examination or a medical opinion concerning such veteran’s disability.
(3) With respect to a veteran described in paragraph (1)(B), the Secretary shall schedule a medical examination for such veteran not later than six months after the separation or discharge of such veteran from active duty.
(b)Termination of Temporary Disability Ratings.—
(1) Except as provided in paragraph (2), a temporary disability rating assigned to a veteran under this section shall remain in effect as follows:
(A) For a veteran who is assigned a temporary disability rating under subsection (a)(1)(A), until the later of the date that is—
(i) 12 months after the date of discharge or release from active duty; or
(ii) provided in regulations prescribed by the Secretary.
(B) For a veteran who is assigned a temporary disability rating under subsection (a)(1)(B), until the date on which a rating decision is issued to such veteran following the medical examination scheduled under subsection (a)(3).
(C) For a veteran who is assigned a temporary disability rating under subsection (a)(1)(C), until the later of the date that is—
(i) the last day of the month in which the veteran is discharged from the hospital as described in such subsection (a)(1)(C); or
(ii) provided in regulations prescribed by the Secretary.
(D) For a veteran who is assigned a temporary disability rating under subsection (a)(1)(D), until the date that is provided in regulations prescribed by the Secretary.
(2) The Secretary may extend a temporary disability rating assigned to a veteran under subsection (a) beyond the applicable termination date under paragraph (1) if the Secretary determines that such an extension is appropriate.
(c)Regulations.—The Secretary shall prescribe regulations to carry out the provisions of this section.
(d)Construction.—Nothing in this section shall be construed to preclude the Secretary from providing a temporary disability rating under an authority other than this section.
(Added Pub. L. 110–389, title II, § 211(a), Oct. 10, 2008, 122 Stat. 4149.)

CITE AS: 38 USC 1156

§ 1157. Combination of certain ratings

The Secretary shall provide for the combination of ratings and pay compensation at the rates prescribed in subchapter II of this chapter to those veterans who served during a period of war and during any other time, who have suffered disability in line of duty in each period of service.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1125, § 357; renumbered § 1157 and amended Pub. L. 102–83, §§ 4(b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406.)

CITE AS: 38 USC 1157

§ 1158. Disappearance

Where a veteran receiving compensation under this chapter disappears, the Secretary may pay the compensation otherwise payable to the veteran to such veteran’s spouse, children, and parents. Payments made to such spouse, child, or parent under the preceding sentence shall not exceed the amounts payable to each if the veteran had died from service-connected disability.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1125, § 358; Pub. L. 86–212, Sept. 1, 1959, 73 Stat. 436; Pub. L. 94–433, title IV, § 404(21), Sept. 30, 1976, 90 Stat. 1379; renumbered § 1158 and amended Pub. L. 102–83, §§ 4(b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406.)

CITE AS: 38 USC 1158

§ 1159. Protection of service connection

Service connection for any disability or death granted under this title which has been in force for ten or more years shall not be severed on or after January 1, 1962, except upon a showing that the original grant of service connection was based on fraud or it is clearly shown from military records that the person concerned did not have the requisite service or character of discharge. The mentioned period shall be computed from the date determined by the Secretary as the date on which the status commenced for rating purposes.

(Added Pub. L. 86–501, § 1, June 10, 1960, 74 Stat. 195, § 359; amended Pub. L. 87–825, § 6, Oct. 15, 1962, 76 Stat. 950; renumbered § 1159 and amended Pub. L. 102–83, §§ 4(b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406.)

CITE AS: 38 USC 1159

§ 1160. Special consideration for certain cases of loss of paired organs or extremities
(a) Where a veteran has suffered—
(1) impairment of vision in one eye as a result of service-connected disability and impairment of vision in the other eye as a result of non-service-connected disability not the result of the veteran’s own willful misconduct and—
(A) the impairment of vision in each eye is rated at a visual acuity of 20/200 or less; or
(B) the peripheral field of vision for each eye is 20 degrees or less;
(2) the loss or loss of use of one kidney as a result of service-connected disability and involvement of the other kidney as a result of non-service-connected disability not the result of the veteran’s own willful misconduct;
(3) deafness compensable to a degree of 10 percent or more in one ear as a result of service-connected disability and deafness in the other ear as the result of non-service-connected disability not the result of the veteran’s own willful misconduct;
(4) the loss or loss of use of one hand or one foot as a result of service-connected disability and the loss or loss of use of the other hand or foot as a result of non-service-connected disability not the result of the veteran’s own willful misconduct; or
(5) permanent service-connected disability of one lung, rated 50 percent or more disabling, in combination with a non-service-connected disability of the other lung that is not the result of the veteran’s own willful misconduct,
the Secretary shall assign and pay to the veteran the applicable rate of compensation under this chapter as if the combination of disabilities were the result of service-connected disability.
(b) If a veteran described in subsection (a) of this section receives any money or property of value pursuant to an award in a judicial proceeding based upon, or a settlement or compromise of, any cause of action for damages for the non-service-connected disability described in such subsection, the increase in the rate of compensation otherwise payable under this section shall not be paid for any month following a month in which any such money or property is received until such time as the total of the amount of such increase that would otherwise have been payable equals the total of the amount of any such money received and the fair market value of any such property received.
(Added Pub. L. 87–610, § 1, Aug. 28, 1962, 76 Stat. 406, § 360; amended Pub. L. 89–311, § 3(a), (b), Oct. 31, 1965, 79 Stat. 1155; Pub. L. 94–433, title IV, § 404(22), Sept. 30, 1976, 90 Stat. 1379; Pub. L. 98–160, title VII, § 702(3), Nov. 21, 1983, 97 Stat. 1009; Pub. L. 99–576, title I, § 109(a)(1), Oct. 28, 1986, 100 Stat. 3253; renumbered § 1160 and amended Pub. L. 102–83, §§ 4(b)(1), (2)(E), 5(a), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 107–330, title I, § 103, Dec. 6, 2002, 116 Stat. 2821; Pub. L. 110–157, title I, § 102, Dec. 26, 2007, 121 Stat. 1831.)

CITE AS: 38 USC 1160

§ 1161. Payment of disability compensation in disability severance cases

The deduction of disability severance pay from disability compensation, to the extent required by section 1212(d) of title 10, shall be made at a monthly rate not in excess of the rate of compensation to which the former member would be entitled based on the degree of such former member’s disability as determined on the initial Department rating.

(Added Pub. L. 91–241, May 7, 1970, 84 Stat. 203, § 361; amended Pub. L. 94–433, title IV, § 404(23), Sept. 30, 1976, 90 Stat. 1379; Pub. L. 98–160, title VII, § 702(4), Nov. 21, 1983, 97 Stat. 1009; renumbered § 1161 and amended Pub. L. 102–83, §§ 4(a)(3), (4), 5(a), Aug. 6, 1991, 105 Stat. 404, 406; Pub. L. 110–181, div. A, title XVI, § 1646(c), as added Pub. L. 110–389, title I, § 103(a)(2), Oct. 10, 2008, 122 Stat. 4148.)

CITE AS: 38 USC 1161

§ 1162. Clothing allowance
(a)Eligibility Requirements.—The Secretary, under regulations which the Secretary shall prescribe, shall pay a clothing allowance of $716 1
1 See Special Benefit Allowance Rates note below.
per year to each veteran who—
(1) because of a service-connected disability, wears or uses a prosthetic or orthopedic appliance (including a wheelchair) which the Secretary determines tends to wear out or tear the clothing of the veteran; or
(2) uses medication which—
(A) a physician has prescribed for a skin condition which is due to a service-connected disability; and
(B) the Secretary determines causes irreparable damage to the veteran’s outergarments.
(b)Continuous Nature of Payments.—Payments made to a veteran under subsection (a) shall continue on an automatically recurring annual basis until the earlier of the following:
(1) The date on which the veteran elects to no longer receive such payments.
(2) The date on which the Secretary determines the veteran is no longer eligible pursuant to subsection (c).
(c)Reviews of Claims.—
(1) The Secretary shall, in accordance with this subsection, conduct reviews of a claim on which a clothing allowance for a veteran under subsection (a) is based to determine the continued eligibility of the veteran for such allowance.
(2) The Secretary shall prescribe standards for determining whether a claim for a clothing allowance is based on a veteran’s wearing or use of a prosthetic, orthopedic appliance (including a wheelchair), or medication whose wear or tear or irreparable damage on a veteran’s outergarments or clothing is as likely as not subject to no change for the duration of such wearing or use.
(3)
(A) If the Secretary determines, pursuant to standards prescribed under paragraph (2), that a claim for a clothing allowance is based on wear or tear or irreparable damage that is as likely as not subject to no change, the veteran shall continue to be deemed eligible for receipt of a clothing allowance under this section until the Secretary—
(i) receives notice under subparagraph (B); or
(ii) finds otherwise under subparagraph (C) or (D).
(B) The Secretary shall require a veteran who is receiving a clothing allowance under subsection (a), based on the wearing or use of a prosthetic, orthopedic appliance (including a wheelchair), or medication, to notify the Secretary when the veteran terminates the wearing or use of such a prosthetic, orthopedic appliance, or medication.
(C) For each veteran who is receiving a clothing allowance under subsection (a), based on the wearing or use of a prosthetic, orthopedic appliance (including a wheelchair), or medication, the Secretary shall periodically review the veteran’s Department records for evidence that the veteran has terminated the wearing or use of such a prosthetic, orthopedic appliance, or medication.
(D) If a veteran who is receiving a clothing allowance under subsection (a), based on the wearing or use of a prosthetic, orthopedic appliance (including a wheelchair), or medication, has received such clothing allowance beyond the prescribed or intended lifespan of such prosthetic, orthopedic appliance, or medication, the Secretary may periodically request the veteran to attest to continued usage.
(4) If the Secretary determines that a claim for a clothing allowance under subsection (a) does not meet the requirements of paragraph (3)(A), then the Secretary may require the veteran to recertify the veteran’s continued eligibility for a clothing allowance under this section periodically, but not more frequently than once each year.
(5) When reviewing a claim under this subsection, the Secretary shall evaluate the evidence presented by the veteran and such other relevant evidence as the Secretary determines appropriate.
(d)Determination Regarding Continued Eligibility.—If the Secretary determines, as the result of a review of a claim conducted under subsection (c), that the veteran who submitted such claim no longer meets the requirements specified in subsection (a), the Secretary shall—
(1) provide to the veteran notice of such determination that includes a description of applicable actions that may be taken following the determination, including the actions specified in section 5104C of this title; and
(2) discontinue the clothing allowance based on such claim.
(Added Pub. L. 92–328, title I, § 103(a), June 30, 1972, 86 Stat. 394, § 362; amended Pub. L. 94–71, title I, § 103, Aug. 5, 1975, 89 Stat. 396; Pub. L. 94–433, title III, § 301, title IV, § 404(24), Sept. 30, 1976, 90 Stat. 1377, 1379; Pub. L. 95–117, title III, § 301, Oct. 3, 1977, 91 Stat. 1065; Pub. L. 95–479, title I, § 103, Oct. 18, 1978, 92 Stat. 1562; Pub. L. 96–128, title I, § 103, Nov. 28, 1979, 93 Stat. 984; Pub. L. 96–385, title I, § 103, Oct. 7, 1980, 94 Stat. 1529; Pub. L. 97–66, title I, § 103, Oct. 17, 1981, 95 Stat. 1027; Pub. L. 97–253, title IV, § 405(d), Sept. 8, 1982, 96 Stat. 804; Pub. L. 97–306, title I, §§ 103, 107, Oct. 14, 1982, 96 Stat. 1430, 1431; Pub. L. 98–223, title I, § 103, Mar. 2, 1984, 98 Stat. 38; Pub. L. 98–543, title I, § 103, Oct. 24, 1984, 98 Stat. 2736; Pub. L. 99–238, title I, § 103, Jan. 13, 1986, 99 Stat. 1766; Pub. L. 99–576, title I, § 103, Oct. 28, 1986, 100 Stat. 3251; Pub. L. 100–227, title I, § 103, Dec. 31, 1987, 101 Stat. 1553; Pub. L. 100–687, div. B, title XI, § 1103, Nov. 18, 1988, 102 Stat. 4124; Pub. L. 101–237, title I, §§ 103, 112, Dec. 18, 1989, 103 Stat. 2063, 2065; Pub. L. 102–3, § 4, Feb. 6, 1991, 105 Stat. 8; renumbered § 1162, Pub. L. 102–83, § 5(a), Aug. 6, 1991, 105 Stat. 406; Pub. L. 102–152, § 4, Nov. 12, 1991, 105 Stat. 986; Pub. L. 103–78, § 3, Aug. 13, 1993, 107 Stat. 768; Pub. L. 103–140, § 4, Nov. 11, 1993, 107 Stat. 1486; Pub. L. 105–98, § 4, Nov. 19, 1997, 111 Stat. 2156; Pub. L. 106–118, § 4, Nov. 30, 1999, 113 Stat. 1602; Pub. L. 107–94, § 4, Dec. 21, 2001, 115 Stat. 901; Pub. L. 107–330, title III, § 309(c), Dec. 6, 2002, 116 Stat. 2830; Pub. L. 108–454, title III, § 307(c), Dec. 10, 2004, 118 Stat. 3613; Pub. L. 109–111, § 2(c), Nov. 22, 2005, 119 Stat. 2363; Pub. L. 109–444, § 9(c), Dec. 21, 2006, 120 Stat. 3315; Pub. L. 109–461, title X, §§ 1005(c), 1006(b), Dec. 22, 2006, 120 Stat. 3467, 3468; Pub. L. 110–324, § 3(c), Sept. 24, 2008, 122 Stat. 3551; Pub. L. 111–37, § 3(c), June 30, 2009, 123 Stat. 1929; Pub. L. 117–328, div. U, title II, § 201(b), Dec. 29, 2022, 136 Stat. 5446.)

CITE AS: 38 USC 1162

§ 1163. Trial work periods and vocational rehabilitation for certain veterans with total disability ratings
(a)
(1) The disability rating of a qualified veteran who begins to engage in a substantially gainful occupation after January 31, 1985, may not be reduced on the basis of the veteran having secured and followed a substantially gainful occupation unless the veteran maintains such an occupation for a period of 12 consecutive months.
(2) For purposes of this section, the term “qualified veteran” means a veteran who has a service-connected disability, or service-connected disabilities, not rated as total but who has been awarded a rating of total disability by reason of inability to secure or follow a substantially gainful occupation as a result of such disability or disabilities.
(b) The Secretary shall make counseling services described in section 3104(a)(2) of this title and placement and postplacement services described in section 3104(a)(5) of this title available to each qualified veteran (whether or not the veteran is participating in a vocational rehabilitation program under chapter 31 of this title).
(c)
(1) In the case of each award after January 31, 1985, of a rating of total disability described in subsection (a)(2) of this section to a veteran, the Secretary shall provide to the veteran, at the time that notice of the award is provided to the veteran, a statement providing—
(A) notice of the provisions of this section;
(B) information explaining the purposes and availability of and eligibility for, and the procedures for pursuing, a vocational rehabilitation program under chapter 31 of this title; and
(C) a summary description of the scope of services and assistance available under that chapter.
(2) After providing the notice required under paragraph (1) of this subsection, the Secretary shall offer the veteran the opportunity for an evaluation under section 3106(a) of this title.
(Added Pub. L. 98–543, title I, § 111(a)(1), Oct. 24, 1984, 98 Stat. 2738, § 363; amended Pub. L. 100–687, div. B, title XIII, § 1301, Nov. 18, 1988, 102 Stat. 4127; renumbered § 1163 and amended Pub. L. 102–83, §§ 4(b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–291, § 2(a), May 20, 1992, 106 Stat. 178; Pub. L. 102–568, title IV, § 401(a)–(d)(1), Oct. 29, 1992, 106 Stat. 4336.)

CITE AS: 38 USC 1163

§ 1164. Presumptions of service-connection for Coronavirus Disease 2019
(a)Presumptions Generally.—
(1) For purposes of laws administered by the Secretary and subject to section 1113 of this title, if symptoms of Coronavirus Disease 2019 (in this section referred to as “COVID–19”) described in subsection (d) manifest within one of the manifestation periods described in paragraph (2) in an individual who served in a qualifying period of duty described in subsection (b)—
(A) infection with severe acute respiratory syndrome coronavirus 2 (in this section referred to as “SARS–CoV–2”) shall be presumed to have occurred during the qualifying period of duty;
(B) COVID–19 shall be presumed to have been incurred during the qualifying period of duty; and
(C) if the individual becomes disabled or dies as a result of COVID–19, it shall be presumed that the individual became disabled or died during the qualifying period of duty for purposes of establishing that the individual served in the active military, naval, or air service.
(2)
(A) The manifestation periods described in this paragraph are the following:
(i) During a qualifying period of duty described in subsection (b), if that period of duty was more than 48 continuous hours in duration.
(ii) Within 14 days after the individual’s completion of a qualifying period of duty described in subsection (b).
(iii) An additional period prescribed under subparagraph (B).
(B)
(i) If the Secretary determines that a manifestation period of more than 14 days after completion of a qualifying period of service is appropriate for the presumptions under paragraph (1), the Secretary may prescribe that additional period by regulation.
(ii) A determination under clause (i) shall be made in consultation with the Director of the Centers for Disease Control and Prevention.
(b)Qualifying Period of Duty Described.—A qualifying period of duty described in this subsection is—
(1) a period of active duty performed—
(A) during the national emergency declared by the President under the National Emergencies Act (50 U.S.C. 1601 et seq.); and
(B) before the date that is three years after the date of the enactment of the Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020; or
(2) training duty under title 10 or full-time National Guard duty (as defined in section 101 of title 10), performed under orders issued on or after March 13, 2020—
(A) during the national emergency declared by the President under the National Emergencies Act (50 U.S.C. 1601 et seq.); and
(B) before the date that is three years after the date of the enactment of the Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020.
(c)Application of Presumptions for Training Duty.—When, pursuant to subsection (a), COVID–19 is presumed to have been incurred during a qualifying period of duty described in subsection (b)(2)—
(1) COVID–19 shall be deemed to have been incurred in the line of duty during a period of active military, naval, or air service; and
(2) where entitlement to benefits under this title is predicated on the individual who was disabled or died being a veteran, benefits for disability or death resulting from COVID–19 as described in subsection (a) shall be paid or furnished as if the individual was a veteran, without regard to whether the period of duty would constitute active military, naval, or air service under section 101 of this title.
(d)Symptoms of COVID–19.—For purposes of subsection (a), symptoms of COVID–19 are those symptoms that competent medical evidence demonstrates are experienced by an individual affected and directly related to COVID–19.
(e)Medical Examinations and Opinions.—If there is a question of whether the symptoms experienced by an individual described in paragraph (1) of subsection (a) during a manifestation period described in paragraph (2) of such subsection are attributable to COVID–19 resulting from infection with SARS–CoV–2 during the qualifying period of duty, in determining whether a medical examination or medical opinion is necessary to make a decision on the claim within the meaning of section 5103A(d) of this title, a qualifying period of duty described in subsection (b) of this section shall be treated as if it were active military, naval, or air service for purposes of section 5103A(d)(2)(B) of this title.
(Added Pub. L. 116–315, title IV, § 4101(a), Jan. 5, 2021, 134 Stat. 5006.)

CITE AS: 38 USC 1164

§ 1165. Choice of sex of medical examiner for certain disabilities
(a)In General.—The Secretary shall ensure that a veteran who requires a medical examination from a covered medical provider in support of a claim for compensation under this chapter for a mental or physical health condition that resulted from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment may designate the sex of the medical provider who provides such medical examination.
(b)Covered Medical Providers.—For purposes of this section, a covered medical provider is any medical provider who is employed by the Department or is under any contract with the Department to provide a medical examination or a medical opinion when such an examination or opinion is necessary to make a decision on a claim.
(c)Notice.—Before providing any medical examination for a veteran in support for a claim described in subsection (a), the Secretary shall notify the veteran of the veteran’s rights under subsection (a).
(Added Pub. L. 116–315, title V, § 5502(a), Jan. 5, 2021, 134 Stat. 5050.)

CITE AS: 38 USC 1165

§ 1166. Claims involving military sexual trauma
(a)Processing.—
(1) The Secretary shall establish specialized teams to process claims for compensation for a covered mental health condition based on military sexual trauma experienced by a veteran during active military, naval, air, or space service.
(2) A peer support specialist of the Department—
(A) shall not be responsible for providing any assistance to a veteran regarding a claim described in paragraph (1), other than counseling services, guidance, and support, pursuant to duties determined by the Under Secretary for Health; and
(B) shall not participate in the adjudication of such a claim.
(b)Referrals to MST Coordinators.—The Secretary shall include, in forms for claims described in subsection (a), an option for a veteran to elect to be referred to a military sexual trauma coordinator of the Veterans Health Administration at the facility of the Department nearest to the residence of such veteran.
(c)Training.—
(1) The Secretary shall ensure that members of teams established under subsection (a) are trained to identify markers indicating military sexual trauma.
(2) The Secretary shall ensure that peer support specialists of the Department receive annual training on how to provide peer support regarding military sexual trauma.
(3) The Secretary shall provide annual training, regarding the processing of claims described in subsection (a), to the following individuals:
(A) Military sexual trauma coordinators of the Veterans Health Administration.
(B) Peer support specialists of the Department.
(d)Definitions.—In this section:
(1) The term “covered mental health condition” means post-traumatic stress disorder, anxiety, depression, or other mental health diagnosis described in the current version of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association that the Secretary determines to be related to military sexual trauma.
(2) The term “military sexual trauma” means, with respect to a veteran, a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment during active military, naval, air, or space service.
(Added Pub. L. 116–315, title V, § 5501(a)(1), Jan. 5, 2021, 134 Stat. 5048, § 1164; renumbered § 1166 and amended Pub. L. 117–16, § 7(a)(1), (b)(4)(A), June 8, 2021, 135 Stat. 284, 285; Pub. L. 117–271, § 1(a), (b)(1), Dec. 27, 2022, 136 Stat. 4179, 4180.)

CITE AS: 38 USC 1166

§ 1168. Medical nexus examinations for toxic exposure risk activities
(a)Medical Examinations and Medical Opinions.—
(1) Except as provided in subsection (b), if a veteran submits to the Secretary a claim for compensation for a service-connected disability under section 1110 of this title with evidence of a disability and evidence of participation in a toxic exposure risk activity during active military, naval, air, or space service, and such evidence is not sufficient to establish a service connection for the disability, the Secretary shall—
(A) provide the veteran with a medical examination under section 5103A(d) of this title; and
(B) obtain a medical opinion (to be requested by the Secretary in connection with the medical examination under subparagraph (A)) as to whether it is at least as likely as not that there is a nexus between the disability and the toxic exposure risk activity.
(2) When providing the Secretary with a medical opinion under paragraph (1)(B) for a veteran, the health care provider shall consider—
(A) the total potential exposure through all applicable military deployments of the veteran; and
(B) the synergistic, combined effect of all toxic exposure risk activities of the veteran.
(3) The requirement under paragraph (2)(B) shall not be construed as requiring a health care provider to consider the synergistic, combined effect of each of the substances, chemicals, and airborne hazards identified in the list under
(b)Exception.—Subsection (a) shall not apply if the Secretary determines there is no indication of an association between the disability claimed by the veteran and the toxic exposure risk activity for which the veteran submitted evidence.
(c)Toxic Exposure Risk Activity Defined.—In this section, the term “toxic exposure risk activity” has the meaning given that term in section 1710(e)(4) of this title.
(Added Pub. L. 117–168, title III, § 303, Aug. 10, 2022, 136 Stat. 1779.)

CITE AS: 38 USC 1168

§ 1167.1
1 Another section 1167 is set out preceding section 1168.
 Mental health consultations
(a)In General.—Not later than 30 days after the date on which a veteran submits to the Secretary a claim for compensation under this chapter for a service-connected disability relating to a mental health diagnosis, the Secretary shall offer the veteran a mental health consultation to assess the mental health needs of, and care options for, the veteran.
(b)Availability.—The Secretary shall—
(1) offer a veteran a consultation under subsection (a) without regard to any previous denial or approval of a claim of that veteran for a service-connected disability relating to a mental health diagnosis; and
(2) ensure that a veteran offered a mental health consultation under subsection (a) may elect to receive such consultation during the one-year period beginning on the date on which the consultation is offered or during such longer period beginning on such date as the Secretary considers appropriate.
(c)Rule of Construction.—A consultation provided to a veteran under this section shall not be construed as a determination that any disability of such veteran is service-connected for the purposes of any benefit under the laws administered by the Secretary.
(Added Pub. L. 117–328, div. V, title IV, § 404(a)(1), Dec. 29, 2022, 136 Stat. 5512.)

CITE AS: 38 USC 1167