For nearly two decades Valley Fever Survivor has been the only organization to provide the research focused on how to help veterans improve their Valley Fever disability ratings.
Thanks to the trailblazing research by David Filip and the tenacity of TSgt Michael Chechak and his wife Louise, Mike was able to dramatically increase his disability rating.
Mike and Louise came to us many years ago, desperately trying to get full disability payments for the medical complications from the Valley Fever infection he had during his decades-long military service. At that time he only had a 30% disability rating and they were unsuccessful at increasing the payment for years until they found us. 30% was not nearly enough since his Valley Fever reactivated several times over the years and he faced surgical complications from this disease. We are very proud that the information we provided enabled Mike to increase his rating to 100% disability, including retroactive payments.
For all the men and women who keep our country safe, Valley Fever Survivor® is pleased to present the information uncovered during Mike’s successful case. There are specific statutes that veterans’ legal representatives may need to understand when vets suffer due to Valley Fever (coccidioidomycosis). The information below will provide you with the ammunition you may need in a fight against the VA over a disability claim.
Establishing the Service Connection
Sometimes you will need to establish whether your Valley Fever infection can be recognized as having a “service connection.” A service connection to the disease is the way the government accepts responsibility for your illness because it stationed you in the area where you became infected.
The information quoted below was originally published to valleyfeversurvivor.com on May 21, 2004 from the Code of Federal Regulations. It was last updated and reviewed for accuracy and relevance with the information at https://www.govinfo.gov/content/pkg/CFR-2017-title38-vol1/html/CFR-2017-title38-vol1.htm on April 9, 2018. Additional information about the CFRs and CFR updates can be found at https://www.govinfo.gov/app/collection/cfr/
None of this information should be considered a substitute for appropriate medical advice or legal representation.
[Code of Federal Regulations] [Title 38, Volume 1] [CITE: 38CFR4.97] TITLE 38--PENSIONS, BONUSES, AND VETERANS' RELIEF CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS PART 4--SCHEDULE FOR RATING DISABILITIES--Table of Contents Subpart B--Disability Ratings Sec. 4.97 Schedule of ratings--respiratory system. ------------------------------------------------------------------------ Mycotic Lung Disease ------------------------------------------------------------------------ 6834 Histoplasmosis of lung. 6835 Coccidioidomycosis. 6836 Blastomycosis. 6837 Cryptococcosis. 6838 Aspergillosis. 6839 Mucormycosis. General Rating Formula for Mycotic Lung Disease (diagnostic codes 6834 through 6839): [note: The numbers below indicate the percentage of disability awarded. 100 means 100% disability, 50 means 50% disability, etc.] Chronic pulmonary mycosis with persistent fever, weight loss, night sweats, or massive hemoptysis.............100 Chronic pulmonary mycosis requiring suppressive therapy with no more than minimal symptoms such as occasional minor hemoptysis or productive cough.................. 50 Chronic pulmonary mycosis with minimal symptoms such as occasional minor hemoptysis or productive cough....... 30 Healed and inactive mycotic lesions, asymptomatic...... 0 Note: Coccidioidomycosis has an incubation period up to 21 days, and the disseminated phase is ordinarily manifest within six months of the primary phase. However, there are instances of dissemination delayed up to many years after the initial infection which may have been unrecognized. Accordingly, when service connection is under consideration in the absence of record or other evidence of the disease in service, service in southwestern United States where the disease is endemic and absence of prolonged residence in this locality before or after service will be the deciding factor. ------------------------------------------------------------------------
Unfortunately, this specific regulation does not address specific consequences of disseminated cocci. At least it mentions the possibility. It might be important in some disability cases to note the following:
[Code of Federal Regulations] [Title 38, Volume 1] [CITE: 38CFR3.309] TITLE 38--PENSIONS, BONUSES, AND VETERANS' RELIEF CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS PART 3--ADJUDICATION--Table of Contents Subpart A--Pension, Compensation, and Dependency and Indemnity Compensation Sec. 3.309 Disease subject to presumptive service connection. (a) Chronic diseases. The following diseases shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under Sec. 3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of Sec. 3.307 are also satisfied. ------------------------------------------------------------------------
Valley Fever (coccidioidomycosis) is on this list as a chronic disease. It is worth noting that in 38CFR3.307 the time limits on the service connection of chronic diseases should not have specific relevance to cocci. This is because it can manifest its symptoms years after the initial exposure and reactivate as much as 45 years later (or perhaps longer) as well. However, here is a quote from 38CFR3.307 to demonstrate the spirit of what it intends for chronic diseases.
[Code of Federal Regulations] [Title 38, Volume 1] [CITE: 38CFR3.307] The disease must have become manifest to a degree of 10 percent or more within 1 year (for Hansen's disease (leprosy) and tuberculosis, within 3 years; multiple sclerosis, within 7 years) from the date of separation from service as specified in paragraph (a)(2) of this section. ------------------------------------------------------------------------
It is a mixed blessing to veterans that no length of time for the onset of coccidioidomycosis was mentioned in the regulation above. It could be good, since cocci itself has had such wildly differing time frames of onset in different cases. It could also be bad because the lack of an explicit mention in law may allow a judge who is not knowledgeable on this issue to deny the full benefits that a veteran is rightfully due.
However, the downside may be mitigated. 38CFR3.307 says “No condition other than one listed in Sec. 3.309(a) will be considered chronic.” Since coccidioidomycosis is listed in 38CFR3.309(a), that means cocci is clearly codified as a chronic disease that can be connected to military service. 38CFR4.97 shows that a 100% disability rating can be awarded to veterans who are disabled by cocci. Even if the veteran previously had an acute case, it may be considered chronic if it reactivates.
Section 3.307 continues with caveats to consider. Valley Fever and other “diseases listed in Sec. 3.309(a) will be accepted as chronic, even though diagnosed as acute because of insidious inception and chronic development” with two exceptions:
“(1) Where they result from intercurrent causes, for example, cerebral hemorrhage due to injury, or active nephritis or acute endocarditis due to intercurrent infection (with or without identification of the pathogenic micro-organism);” This may complicate some legal cases. An example might be someone hurt in a traumatic auto accident with such force that a Valley Fever lesion is ruptured.
(2) The second exception might occur “where a disease is the result of drug ingestion or a complication of some other condition not related to service.” The vagueness of this part is troubling, since doctors may prescribe treatments (like immune system suppressing corticosteroids) that harm a patient and make a Valley Fever reactivation more likely. As written, the rule apparently presumes the additional disability to have been caused by the doctor or drug and not the effect of the service connected infection.
Either exception could be overcome. Attorneys seeking an increased disability rating may not choose to highlight the medical treatment at all. Simply ignoring it may ignore this objection if the other legal team does not bring it up in the proceedings. Alternately a legal case might focus on symptoms that started before any event in question, showing a continuity of symptoms that make accidents, treatments, and other potential exceptions irrelevant. Obviously it is best to speak with a legal representative to consider the best strategy.
Other factors are obviously important when considering disability from Valley Fever. For example, if someone chooses to live in an area endemic to Valley Fever (like Arizona) before his military service, and then was stationed in a base in Arizona, a Valley Fever case might be considered the result of either residence in the area as a civilian or during military duty. The infection’s connection to military service may not be clear. The same is true if a retired veteran chose to stay in areas that are endemic to this disease.
Valley Fever cases are often known to have symptoms occur years after the common incubation period of 1-4 weeks. A disability claim that tries to establish a service connection while the veteran had residence in endemic areas would benefit from documentation to show that the onset of symptoms matched the typical 1-4 week incubation period during military service. A service connection should be far easier to establish when veterans from outside the endemic areas were only there exclusively for their military duty, regardless of the time that it took for their symptoms to appear.
The legal tools presented here should be helpful background information for many legal cases. Veterans seeking compensation for their service connected Valley Fever should encourage their legal representatives to be aware of the information Valley Fever Survivor has presented on this page.