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condition during active service as required by $ 35.011 (a) (4).** (Sec. 1, 48 Stat. 8; 38 U.S.C. 701)

2.1086 Chronic diseases under Public, No. 2, 73d Congress. The service connection of chronic diseases under $ 35.011, pursuant to Public, No. 2, 73d Congress, is restricted to the following: Anemia, primary Arteriosclerosis Arthritis Cardiovascular-renal disease, including hypertension (This term applies to

combination involvements of the type of arteriosclerosis, nephritis and organic heart disease, and since hypertension is an early symptom long preceding the development of those diseases in their more obvious forms, a disabling hypertension within the 1 year period will be given the same benefit of

service connection as any of the chronic diseases listed). Diabetes mellitus Encephalitis lethargica residuals Endocarditis (This term is intended to cover all forms of valvular heart

disease). Endocarinopathies Epilepsies Hodgkin's disease Leukemia Leprosy Myocarditis Nephritis (Nephrolithiasis is not a chronic disease within the meaning of.

$ 35.011 but with a properly diagnosed nephritis, shown within 1 year from the date of discharge from service or the date prior to which a disability must have been incurred as provided in g 35.011 (a) (1), whichever is the earlier, a coexisting or subsequently developing nephrolithiasis may be considered as a part of the same condition). Organic diseases of the nervous system (This term is intended to include the

same disabilities as those listed on pages 34 and 35 of the Schedule for Rating Disabilities, 1933, under organic diseases of the central nervous system and residuals thereof.) Psychoses Tuberculosis, active Tumors, malignant, or of the brain Osteitis deformans (Paget's Disease)

No conditions other than those listed above will be considered chronic diseases except upon approval by the Administrator of Veterans Affairs. For the purposes of determining the existence of a 10 percent degree of active tuberculosis within 1 year of discharge, or the date prior to which a disability must have been incurred as provided in § 35.011 (a) (1), whichever is the earlier, active pulmonary tuberculosis diagnosticated by approved methods during the second year will be held to have preexisted the diagnosis 6 months in minimal (incipient) cases; 9 months in moderately advanced cases; and 12 months in far advanced cases.*+ (Sec. 1, 48 Stat. 8; 38

U.S.C. 701)

2.1087 Service connection for chronic constitutional diseases under Public, No. 141, 73d Congress. A chronic constitutional disease becoming manifest to a degree of 10 percent or more within 1 year from the date of separation from active service, upon the basis of medical or competent lay evidence, will be considered as having been incurred in active service. The medical evidence should set forth the physical findings and symptomatology elicited by examination within the 1 year period; and the lay evidence, which should

**For statutory and source citations, see note to 2.1000.

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not merely contain conclusions based upon opinion, should describe the material and relevant facts as to the veteran's disability observed during such period. Where there is affirmative evidence to show that the chronic constitutional disorder is due to an intercurrent disease or injury suffered between the date of separation from active service and the onset of the chronic constitutional disorder, service connection under this section will not be accorded.*+ (Sec. 11, 46 Stat. 995, sec. 27, 48 Stat. 524; 38 U.S.C. 471, 471a)

2.1088 Chronic constitutional diseases under Public, No. 141, 73d Congress. The diseases listed on page 75, Schedule of Disability Ratings, 1925, and those included in Extension No. 6 to such schedule, as well as the conditions enumerated in the second proviso of section 200 of the World War Veterans Act, 1924, as amended, are subject to the 1-year presumption of service connection provided for chronic constitutional diseases.*+ (Sec. 11, 46 Stat. 995, sec. 27, 48 Stat. 524; 38 U.S.C. 471, 471a)

CROSS REFERENCES: For application of rating schedule, see $8 2.1141–2.1178. For schedule for rating disabilities, see § 35.03.

2.1089 Presumptive service connection for diseases listed in the second proviso, section 200, World War Veterans' Act 1924, as amended. The presumption of incurrence for the diseases listed in 'the second proviso, section 200, World War Veterans' Act, 1924, as amended, applies under Public, No. 141, 73d Congress except where clear and unmistakable evidence discloses that the disease, injury, or condition had inception before or after the period of active military or naval service. The presumption is not applicable in cases where the disability is due to the misconduct of the veteran.** (Sec. 11, 46 Stat. 995, sec. 27, 48 Stat. 524; 38 U.S.C. 471, 471a)

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SERVICE CONNECTION FOR NEUROPSYCHIATRIC DISEASES

2.1090 Presumptive service connection for neuropsychiatric diseases. Where it is shown (by reports of physical examination, or acceptable medical or lay affidavits) that disability from neuropsychiatric disease, spinal meningitis, paralysis agitans, or encephalitis lethargica existed to a 10 percent degree or more, in accordance with the Schedule of Disability Ratings, 1925, and extensions thereto, prior to January 1, 1925 and where evidence does not show clearly and unmistakably that such disability had its inception prior or subsequent to the period of active military or naval service, a rating will be made that the disability from neuropsychiatric disease, spinal meningitis, paralysis agitans, or encephalitis lethargica is presumed to have been incurred in military service in accordance with the terms of the second proviso of section 200 of the World War Veterans' Act, 1924, as amended, as reenacted by Public, No. 141, 73d Congress; Provided, That the veteran had active military or naval service between April 6, 1917 and November 11, 1918, inclusive, or prior to April 2, 1920 with the United States military forces in Russia. Rebuttal of the presumption will be in order where there is clear and convincing evidence that the disability arose from intercurrent trauma, organic disease not itself connected with service, or intercurrent infection

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**For statutory and source citations, see note to 8 2.1000.

arising subsequent to discharge and not as a result of military service. (See also $ 2.1089)*+ (Sec. 11, 46 Stat. 995, sec. 27, 48 Stat. 524; 38 U.S.C. 471, 471a)

2.1091 Interpretation of spinal meningitis. Spinal meningitis will be interpreted as cerebrospinal fever, or cerebrospinal meningitis, i. e., the infectious disease due to the meningococcus, affecting primarily the cerebrospinal meninges. It will also be taken to include other primary forms of meningitis, such as primary pneumococcic or streptococcic meningitis, where the cerebrospinal meninges are involved alone or as a part of a generalized pneumococcic or streptococcic septicaemia.*+ (Sec. 11, 46 Stat. 995, sec. 28, 48 Stat. 524; 38 U.S.C. 471, 722)

2.1092 Presumption of service connection for spinal meningitis. The presumption of service connection will not be invoked where particular forms of meningitis are secondary to diseases or injuries not themselves service connected, such as (a) the pneumococcic form which is secondary to intercurrent pneumonia endocarditis, or disease or injury of the cranium or its fossae; (b) the pyogenic form, following intercurrent infections elsewhere in the body or occurring as a terminal condition in chronic maladies; (c) the miscellaneous forms, such as the meningitis secondarily supervening in intercurrent typhoid, diphtheria, influenza, etc. Disability, from inflammation of the spinal meninges occurring in cerebrospinal syphilis will be rated with the misconduct provision of the law in mind.*+ (Sec. 11, 46 Stat. 995, sec. 28, 48 Stat. 524; 38 U.S.C. 471, 722)

2.1093 Presumptive service connection for amoebic dysentery. Where it is shown (by a report of physical examination, or acceptable medical or lay affidavits) that a veteran had amoebic dysentery developing a 10 percent degree of disability or more prior to January 1, 1925 in accordance with the Schedule of Disability Ratings, 1925, and extensions thereto, and where it is not shown by clear and unmistakable evidence that such disability was incurred prior to or subsequent to enlistment or acceptance into active military or naval service, a rating will be made that the amoebic dysentery is presumed to have been incurred in service.*+ (Sec. 11, 46 Stat. 995, sec. 28, 48 Stat. 524; 38 U.S.C. 471, 722)

2.1094 Neuropsychiatric diseases included. The neuropsychiatric diseases included in the second proviso, section 200, World War Veterans' Act, 1924, as amended, include the following:

(a) Psychoses. Manic-depressive, dementia praecox, paranoid, associated with organic diseases or injuries.

(b) Psychoneuroses and neuroses. Neurasthenia, psychasthenia, hysteria, anxiety neurosis, occupational neurosis, compulsion neuro

(c) Vaso-motor and trophic disorders. Raynaud's disease, angioneurotic oedema, erythro-melalgia.

(d) Neurological diseases. Diseases of the cranial and peripheral nerves, diseases of the spinal cord, diseases of the pons, medulla and basal ganglia, diseases of the cerebellum, diseases of the meninges, diseases of the brain (embolism, hemorrhage into the brain, throm

sis, tics.

**For statutory and source citations, see note to $ 2.1000.

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bosis, hydrocephalus, tumors, abscess, muscular dystrophies and myopathies, chorea, anthetosis, tremors, paralysis agitans, multiple sclerosis).

(e) Endocrinopathies. Diseases of the thyroid gland (except neoplasms, simple enlargements and abscesses), diseases of the parathyroid glands, diseases of the pituitary (hypopituitarism, Froehlich's syndrome, dystrophia adiposogenitalis; hyperpituitarismacromegaly), diseases of the gonads, diseases of the adrenal glands, polyglandular syndromes.

(f) The Epilepsies.** (Sec. 11, 46 Stat. 995, sec. 28, 48 Stat. 524; 38 U.S.C. 471, 722)

SERVICE CONNECTION FOR TUBERCULOUS DISEASES

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2.1096 Presumptive service connection for active tuberculosis. Where an active tuberculous disease of 10 percent degree or more in accordance with the Schedule of Disability Ratings, 1925, and extensions thereto, is shown to have developed prior to January 1, 1925, such active tuberculous disease will be considered as incident to service in accordance with the second proviso of section 200 of the World War Veterans' Act, 1924, as amended, as reenacted under Public, No. 141, 73d Congress; provided, that the claimant had active military or naval service between April 6, 1917 and November 11, 1918, inclusive, or prior to April 2, 1920 with the United States military forces in Russia. (See 8 2.1089)*+ (Sec. 11, 46 Stat. 995, sec. 27, 48 Stat. 524; 38 U.S.C. 471, 471a)

2.1097 Evidence necessary to show active pulmonary tuberculosis. The showing of active tuberculosis disease of 10 percent degree or more prior to January 1, 1925, will be contingent upon reports of physical examination, or acceptable medical or lay affidavits, citing the facts that would demonstrate the existence of such condition. Lay affidavits when relevant, competent, and material, will be given due consideration in connection with the other evidence submitted; such affidavits to be acceptable must be confined to statements of fact and not of opinion.*+ (Sec. 11, 46 Stat. 995, sec. 28, 48 Stat. 524; 38 U.S.C. 471, 722)

2.1099 Findings establishing a diagnosis of active pulmonary tuberculosis. In all cases in which a determination is to be made of the development of active tuberculosis to a 10 percent degree of disability or more prior to January 1, 1925, as provided in section 200 of the World War Veterans' Act, 1924, as amended, as reenacted by Public, No. 141, 73d Congress, the following standards will be applied: Active pulmonary tuberculosis, diagnosticated by approved methods as outlined in $8 25.6021, 25.6022, will be held to have preexisted the diagnosis 6 months in minimal (incipient) cases; 9 months in moderately advanced cases; and 12 months in far advanced cases.** (Sec. 11, 46 Stat. 995, sec. 28, 48 Stat. 524; 38 U.S.C. 471, 722)

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**For statutory and source citations, see note to g 2.1000.

MISCELLANEOUS RULES ON SERVICE CONNECTION

2.1100 Natural progress under $ 35.011. The provisions of $35.011 (a) (4), relating to a specific finding that the increase in disability is due to the natural progress of a disease will be met by

finding of a constituted rating agency of the Veterans' Administration based upon available evidence of a nature generally acceptable as competent to show that an increase in severity of a disease or injury, or of the disabling effects thereof, or the acceleration in progress of a disease was that normally to be expected by reason of the inherent character of the condition, aside from any extraneous or contributing cause or influence peculiar to military service.** (Sec. 1, 48 Stat. 8; 38 U.S.C. 701)

2.1101 Proximate results. Disability which is proximately due to or the result of a properly service connected disease or injury is pensionable or compensable, unless such disability is shown to be the result of a non-service connected intervening cause. When service connection is thus established for a secondary condition, the secondary condition will be considered a part of the original condition for

purposes." (Sec. 3, 48 Stat. 9; 38 U.S.C. 703)

SERVICE CONNECTION FOR DENTAL DISABILITIES

2.1104 Required period of service. Compensation may be awarded for a dental condition under $ 35.011, and Public, No. 141, 73d Congress, where active service was performed on or after April 6, 1917, and prior to November 11, 1918, or prior to April 2, 1920, for persons who served with the United States military forces in Russia, or pension (under $ 35.011 only) where active service was performed in the Spanish American War, Boxer Rebellion or Philippine Insurrection as defined by $8 4.2000 (a), 4.2001 (a), 4.2002 (a). For the purposes of $ 35.011 the veteran must have been honor ably discharged, and under Public, No. 141, 73d Congress, not dishonorably discharged, and the disability must have been incurred in or aggravated by active service during the defined periods and not due to misconduct. However, where incurrence of the disability is shown prior to the beginning date of the war concerned or where the enlistment commenced subsequent to the termination thereof, service connection may be established only in accordance with $ 35.012.** (Sec. 1, 27, 48 Stat. 8, 524; 38 U.S.C. 471a, 701)

2.1105 Service connection. (a) Determinations relative to the origin or aggravation in active service of dental conditions will be in accordance with the requirements of $$ 35.011 (a) (1), 35.012 (a) (1), respectively, and section 28, Public, No. 141, 73d Congress.

(b) When a period of 6 months or over of continuous active service during a war time enlistment which began prior to November 11, 1918, is shown, service connection may be considered as having been established under the World War Veterans' Act, 1924, as amended, reenacted by Public, No. 141, 73d Congress, for any dental disability, except such as were recorded at time of enlistment, existed prior thereto, or otherwise rebutted, shown to have existed within 1

**For statutory and source citations, see note to $ 2.1000.

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