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Veterans Benefits AdministrationM21-1, Part III - page 42 / 71





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M21-1, Part IIIFebruary 25, 2005

Change 131

i.  Subsequent Review.  A claim for compensation based on radiation exposure as a consequence of service with the occupation forces of Hiroshima or Nagasaki, Japan, or in connection with nuclear testing that was denied prior to enactment of Public Law 98-542, “The Veterans' Dioxin and Radiation Exposure Compensation Standards Act,” on October 24, 1984, must receive a complete, new review if the claim is subsequently reopened.  New and material evidence need not be submitted to reopen these claims.  Handle this type of claim as if it were an initial ionizing radiation claim.  Refer to subparagraph b for proper action to be taken.  


a.  General.  Many people with asbestos-related diseases have only recently come to medical attention because the latent period varies from 10 to 45 or more years between first exposure and development of disease.  In addition, exposure to asbestos may be brief (as little as a month or two) or indirect (bystander disease).

b.  Responsibility.  The rating activity is responsible for determining whether or not military records demonstrate evidence of asbestos exposure in service and ensuring that development is accomplished to determine if there is pre-service and post-service evidence of occupational or other asbestos exposure.


a.  Post-Traumatic Stress Disorder.  Service connection for post-traumatic stress disorder (PTSD)

requires medical evidence diagnosing the condition in accordance with 38 CFR 4.125(a); a link, established by medical evidence, between current symptoms and an in-service stressor; and credible evidence that the claimed in-service stressor occurred.  (38 CFR 3.304(f))

b.  Evidence of a Stressor in Service.    Obtain all available evidence from the service department showing that the veteran served where the stressful event occurred.  Also obtain evidence supporting the veteran’s description of the event.

(1)  Combat Stressors.  The following individual decorations are examples of decorations which

may serve as evidence that the veteran engaged in combat:

Air Force Cross

Air Medal with "V" Device

Army Commendation Medal with "V" Device

Bronze Star Medal with "V" Device

Combat Action Ribbon

Combat Aircrew Insignia

Combat Infantry Badge

Combat Medical Badge

Distinguished Flying Cross

Distinguished Service Cross

Joint Service Commendation Medal with "V" Device

Medal of Honor

Navy Commendation Medal with "V" Device

Navy Cross

Purple Heart

Silver Star


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