[Code of Federal Regulations]
[Title 38, Volume 1]
[Revised as of January 1, 2007]
From the U.S. Government Printing Office via GPO Access
[CITE: 38CFR1.18]

[Page 15-16]
 
            TITLE 38--PENSIONS, BONUSES, AND VETERANS' RELIEF
 
                CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS
 
PART 1_GENERAL PROVISIONS--Table of Contents
 
Sec. 1.18  Guidelines for establishing presumptions of service 

connection for former prisoners of war.

    (a) Purpose. The Secretary of Veterans Affairs will establish 
presumptions of service connection for former prisoners of war when 
necessary to prevent denials of benefits in significant numbers of 
meritorious claims.
    (b) Standard. The Secretary may establish a presumption of service 
connection for a disease when the Secretary finds that there is at least 
limited/suggestive evidence that an increased risk of such disease is 
associated with service involving detention or internment as a prisoner 
of war and an association between such detention or internment and the 
disease is biologically plausible.
    (1) Definition. The phrase ``limited/suggestive evidence'' refers to 
evidence of a sound scientific or medical nature that is reasonably 
suggestive of an association between prisoner-of-war experience and the 
disease, even though the evidence may be limited because matters such as 
chance, bias, and confounding could not be ruled out with confidence or 
because the relatively small size of the affected population restricts 
the data available for study.
    (2) Examples. ``Limited/suggestive evidence'' may be found where one 
high-quality study detects a statistically significant association 
between the prisoner-of-war experience and disease, even though other 
studies may be inconclusive. It also may be satisfied where several 
smaller studies detect an association that is consistent in magnitude 
and direction. These examples are not exhaustive.
    (c) Duration of detention or internment. In establishing a 
presumption of service connection under paragraph (b) of this section, 
the Secretary may, based on sound scientific or medical evidence, 
specify a minimum duration of detention or internment necessary for 
application of the presumption.
    (d) Association. The requirement in paragraph (b) of this section 
that an increased risk of disease be ``associated'' with prisoner-of-war 
service may be satisfied by evidence that demonstrates either a 
statistical association or a causal association.
    (e) Evidence. In making determinations under paragraph (b) of this 
section, the Secretary will consider, to the extent feasible:
    (1) Evidence regarding the increased incidence of disease in former 
prisoners of war;
    (2) Evidence regarding the health effects of circumstances or 
hardships similar to those experienced by prisoners of war (such as 
malnutrition, torture, physical abuse, or psychological stress);
    (3) Evidence regarding the duration of exposure to circumstances or 
hardships experienced by prisoners of war that is associated with 
particular health effects; and
    (4) Any other sound scientific or medical evidence the Secretary 
considers relevant.
    (f) Evaluation of studies. In evaluating any study for the purposes 
of this section, the Secretary will consider:
    (1) The degree to which the study's findings are statistically 
significant;
    (2) The degree to which any conclusions drawn from the study data 
have withstood peer review;
    (3) Whether the methodology used to obtain the data can be 
replicated;
    (4) The degree to which the data may be affected by chance, bias, or 
confounding factors; and
    (5) The degree to which the data may be relevant to the experience 
of prisoners of war in view of similarities or differences in the 
circumstances of the study population.

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    (g) Contracts for Scientific Review and Analysis. To assist in 
making determinations under this section, the Secretary may contract 
with an appropriate expert body to review and summarize the scientific 
evidence, and assess the strength thereof, concerning the association 
between detention or internment as a prisoner of war and the occurrence 
of any disease, or for any other purpose relevant to the Secretary's 
determinations.

(Authority:
    38 U.S.C. 501(a), 1110)

[69 FR 60089, Oct. 7, 2004]

         Referrals of Information Regarding Criminal Violations