Veterans with Persian Gulf Sand Lung and Skin Diseases

The fine sand found throughout the Persian Gulf and the rest of Southwest Asia has been identified as a possible contributing factor, if not the outright cause, of many of the conditions associated with Gulf War Syndrome. Breathing in sand dust and other fine particulate matter can embed those particles deep into the lungs. They can lead to Desert Storm lung disease and many other health problems. Simultaneously, sand dust can scour the skin, leading to skin diseases common in Gulf War veterans.

VA benefits lawyer shares knowledge on Gulf sand lung and skin disease claims:

Desert Storm Lung Disease and Skin Disease May Explain Gulf War Syndrome

Your lungs were not intended to breathe in large quantities of small particulate matter. Veterans who served in Iraq, Kuwait, Saudi Arabia, and other Persian Gulf countries during the Gulf War period from 1990 to the present breathed in massive volumes of sand dust.

What is Sand Dust?

There is no scientifically accepted sand dust meaning. However, desert dust storms often kick up particles of 60 microns or less. Particles between 2.5 microns and 10 microns can be inhaled deep into the lungs where they embed in the lung tissue. Particles smaller than 2.5 microns can work their way into the bloodstream.

What is Desert Storm Lung Disease?

Under the prevailing theories, Desert Storm lung disease results from physical damage to the lungs caused by breathing in sand dust. The sand in lungs from beach and desert dust storms consists primarily of silica. Silica is the crystalline mineral used to make glass. The silica crystals abrade and cut the lungs, which develop scar tissue when those microscopic injuries heal.

Silicosis, the medical name for breathing problems resulting from lungs scarred by silica crystals, is a well-known affliction among construction and manufacturing workers engaged in stone cutting, sandblasting, mining, and other activities that generate dust. This is the same silicosis Iraq and other Gulf War veterans can suffer as a result of breathing in sand dust.

Sand dust does not break down in the lungs. In small quantities, the body’s natural defense to foreign objects in the lungs is to envelop the foreign body and carry it away. In large quantities, the body is unable to keep up and the accumulated sand dust combines with the scar tissue to stiffen the lungs and inhibit breathing.

Worse yet, the body’s attempt at removing silica from the lungs in large quantities can overwhelm the immune system. The overworked immune system becomes depressed, leaving the body vulnerable to bacteria, viruses, and chemicals in the environment.

According to the theory, the depressed immune system is unable to battle the effects of oil well smoke, depleted uranium, chemical weapon residue, and other Gulf War contaminants. The depressed immune system caused by Desert Storm lung disease left Gulf War veterans open to the broad range of illnesses such as chronic fatigue, pain, and inflammation.

What is Desert Storm Skin Disease?

Sand dust also causes skin disease in some Gulf War veterans. The fine sand dries out and abrades the skin. Skin disease from Iraq, Saudi Arabia, Kuwait, and other locations in the Southwest Asia Theater of Operations resulting from sand dust can manifest as chronic dermatitis, eczema, and skin inflammation.

Disability Rating for Silicosis and Desert Storm Lung Disease

Disabilities arising from exposure to Persian Gulf sand are rated by the VA based on the individual body systems affected. For example, when sand dust exposure leads to breathing problems, skin conditions, and chronic fatigue, a VA disability rating would be assessed for each of the three disabilities. An overall rating would then be calculated using VA math.

Testing for Silicosis and Desert Storm Lung Disease

There are three tests used to measure lung capacity – forced vital capacity (FVC), diffusion capacity of the lung for carbon monoxide by the single breath method (DLCO (SB)), and maximum exercise capacity.

The FVC test measures the maximum volume of air that you can exhale after taking a deep breath. The FVC test is intended to measure lung capacity (or loss of lung capacity) as well as distinguish between obstructive lung disorders and restrictive lung disorders.

Obstructive lung disorders interfere with the lungs’ ability to exhale. As a result, the volume of air exhaled during the FCV test is abnormally low because residual air is left in the lungs after exhalation.

Restrictive lung disorders interfere with the lungs’ ability to inhale. As a result, the volume of air exhaled during the FCV test is abnormally low because less air can be inhaled to fill the lungs.

Silicosis is an unusual lung disease because it begins as an obstructive lung disorder and progresses to a restrictive lung disorder.

The DLCO (SB) test measures the change in pressure of a test gas that is inhaled, held in the lungs for ten seconds, then exhaled. Because the lungs’ purpose is to exchange inhaled gas with exhaled gas, the nature of the test gas changes while held in the lungs. By measuring those changes, the DLCO (SB) test can tell doctors how efficiently your lungs operate.

Silicosis causes loss of lung efficiency because the sand dust changes the structure of the lungs and reduces the lungs’ ability to exchange gases with the bloodstream.

The maximum exercise capacity test determines your need for supplemental oxygen while walking on a treadmill or cycling on a stationary bike. If you struggle to walk or cycle without an oxygen mask, the test measures the amount of oxygen needed for each minute of exercise.

Because silicosis decreases both your ability to exhale and your overall lung capacity, it can inhibit your ability to perform physical tasks without experiencing shortness of breath.

VA Disability Rating for Silicosis and Desert Storm Lung Disease

Silicosis and other breathing problems arising from desert sand dust are rated by the VA using its ratings schedule for interstitial lung disease. This ratings schedule assigns a rating based on the loss of lung capacity.

The ratings vary from 10% to 100% depending on the results of the FVC test, DLCO (SB) test, or maximum exercise capacity test. When FVC is below 50% of the predicted level or DLCO (SB) is below 40% of the predicted level, the VA assigns a 100% disability rating for Desert Storm lung disease. Similarly, if a veteran experiences pulmonary hypertension or requires outpatient oxygen therapy to treat breathing problems, a 100% disability rating may be assigned.

VA Disability Rating for Desert Storm Skin Disease

There is no VA disability rating schedule for skin diseases arising from sand dust. Rather, the skin condition is rated based on the closest analogous skin condition for which the VA has a rating schedule.

For example, when sand dust exposure causes eczema or a skin condition analogous to eczema, the general ratings schedule for skin conditions is used to assign a rating. The ratings on this schedule range from 0% to 60% based on the amount of skin affected and the frequency of therapy needed to treat the condition.

To obtain a VA disability rating greater than 0% for a sand-induced skin condition, the condition must affect at least 5% of the entire body or exposed areas or require intermittent systemic therapy rather than topic treatment to control it. If the condition affects more than 40% of the entire body or exposed areas or requires constant or near-constant system therapy, the VA can assign the maximum disability rating of 60%.

In this video, one of our VA Disability Lawyers teaches you how to use our VA Disability Calculator.

VA Disability Rating for Autoimmune Conditions

Medical studies have tied silicosis to autoimmune conditions such as rheumatoid arthritis, systemic lupus, and systemic sclerosis. If evidence shows that your autoimmune condition was caused by silicosis, the VA can assign a rating to these conditions depending on their severity.

Rheumatoid arthritis is an autoimmune disorder that causes joint inflammation. The rating for rheumatoid arthritis ranges from 10% to 100% depending on the level of incapacitation. Rheumatoid arthritis can also be rated based on residual ratings of affected body parts.

Lupus is characterized by periodic outbreaks of skin rash, joint inflammation, fever, and fatigue. The VA ratings schedule for lupus assigns a rating that ranges from 10% to 100% depending on the frequency and duration of outbreaks.

Systemic sclerosis is not specifically rated. However, it can be rated using the multiple sclerosis rating process in which a minimum rating of 30% is assigned, with the ability to issue a higher rating depending on the veteran’s specific manifestation.

VA Disability Rating for Chronic Pain

Non-specific chronic pain is a symptom associated with service in the Gulf War period. This may be the result of a silicosis-induced autoimmune disorder that causes systemic inflammation. It may also be the result of an immune system depressed by silicosis that is unable to fight off infection.

Fortunately, the VA’s former policy of rejecting disability claims based strictly on pain rather than a disease or condition causing the pain has been reversed. Under a case decided in 2018, the VA changed its policy to allow VA disability claims for chronic pain that is so severe that it interferes with a veteran’s ability to work.

The Federal Circuit further held that pain alone, even in the absence of a diagnosis, can serve as a functional impairment and qualify as a [Veteran’s] disability under section 1110, irrespective of the underlying cause.  

Saunders v. Wilkie, Apr 3, 2018

The VA assigns a disability rating for chronic pain based on the body part affected. For example, chronic hip and back pain that results from silicosis or Desert Storm lung disease would be rated under the VA’s ratings schedules for musculoskeletal disabilities.

How to Receive Your VA Disability Benefits for Chronic Pain

VA Disability Rating for Chronic Fatigue Syndrome

Yet another consequence of autoimmune disorders or a depressed immune system brought on by silicosis or Desert Storm lung disease is chronic fatigue. The chronic fatigue syndrome ratings schedule allows the VA to assign a rating ranging from 10% to 100% depending on the frequency and severity of symptoms and the impact on the veteran’s ability to perform self-care and other routine daily activities. For example, when a veteran experiences chronic fatigue that is so constant and severe that it completely restricts routine daily activities, including occasionally restricting self-care, it may be rated at 100%.

The VA invites Persian Gulf Veterans to sign up in the Airborne Hazards and Open Burn Registry – aka the Burn Pit Registry.

Establishing a Service Connection for Silicosis and Desert Storm Lung Disease

For the VA to grant VA disability benefits, you must establish a connection between your disability and your military service. Gulf War veterans are entitled to a presumptive service-connection for medically unexplained multi-symptom illnesses. For these illnesses, the veteran is not required to establish a service connection. Rather, a service connection is presumed unless the VA has evidence that rebuts the connection.

However, the presumption does not apply to silicosis, Desert Storm lung disease, or Desert Storm skin disease. This means that you must show that your lung condition or skin condition manifested during, was caused by, or was worsened by your military service.

For silicosis, it would take a highly coincidental series of events to rebut the presumption that something other than service in the Persian Gulf caused it. For example, if you worked as a miner or sandblaster before or after your service, it may be possible to show that silicosis was due to your work rather than your service. However, barring any other explanation, a doctor’s letter or opinion that your silicosis was a result of dust storms in the Southwest Asia Theater of Military Operations would be strong evidence of a service connection.

Similarly, Desert Storm lung disease and Desert Storm skin disease are caused by sand dust. If your diagnosis is consistent with a condition caused by sand dust, evidence that your only encounter with sand dust was during your military service would support a claim of a service connection.

The regions that count include these countries and the bodies of water around them as well as the airspace above them:

• Iraq
• Afghanistan
• Kuwait
• Saudi Arabia
• Bahrain
• Djibouti
• Gulf of Aden
• Gulf of Oman
• Oman
• Qatar
• United Arab Emirates
• Waters of the Persian Gulf, Arabian Sea, and Red Sea

Secondary Service-Connected Disabilities to Sand Dust Exposure

As mentioned above, veterans with silicosis and Desert Storm lung disease are prone to developing autoimmune diseases, chronic fatigue syndrome, and chronic pain because their immune system is compromised by the particulate matter in their lungs. When claimed as secondary service-connected disabilities these disorders can increase your overall VA disability rating.

To claim a secondary service-connected disability, you must first establish a service connection for a primary disability. As mentioned above, barring some other explanation, silicosis due to dust inhalation that occurred during service should support a service connection.

Once a lung disorder is established as service-connected, you can then claim secondary service-connected disabilities that arise from your primary service-connected disability. You would need to submit evidence establishing a link between the primary and secondary disabilities. This evidence usually consists of a doctor’s opinion supported by journal articles or medical studies that establish a nexus between the primary and secondary disabilities.

If the VA grants a claim for a secondary service-connected disability, the individual ratings are aggregated using VA math. This is not a simple addition of the disability ratings, but rather a formula that attempts to consider the overall impact on your health due to individual disabilities. For example, a 30% disability rating for service-connected lung disease and a 20% disability rating for secondary service-connected chronic pain results in an overall disability rating of 40%, not 50%.

Obstacles to VA Disability Claims for Desert Storm Lung Disease and Skin Disease

In some ways, Desert Storm lung disease and skin disease are easier for the VA to understand than other Gulf War illnesses. Sand dust and lung scars are visible and, unless there is some other explanation, it is difficult to deny a link between them.

However, obstacles can arise. If your symptoms did not manifest until long after your discharge, it is easier for the VA to reject a service connection by blaming other causes for your lung disease. In fact, the lack of immediate symptoms has been held against veterans filing VA disability claims for lung diseases caused by sand dust.

Under these circumstances, it may be helpful to contact a VA benefits lawyer to discuss the records and evidence needed to overcome a claim rejection. VA lawyers have experience in both VA procedures and obtaining and presenting medical evidence needed to support disability claims.

Regardless of where you are located or whether you were deployed, contact a VA attorney to discuss your VA disability claim for Desert Storm lung disease or skin disorder.