Public Law 97-37 (Layman’s Terms)

by William Paul Skelton, Ill, MD F.A.C.P.

All ex-POWs should keep these and/or make copies. Whenever you open your claim, take them with you and make sure the adjudication officer sees them and have him read them! Make sure he knows all about them. Tell him your own story as it relates to your problem.....


 Also known as articular trauma. This disorder looks and is treated just like degenerative arthritis (arthritis associated with age) except it is caused by severe damage to a single or few joints producing early onset arthritis. Since it has a definite cause, it is called a secondary form of arthritis. This is an extremely difficult diagnosis to make, but in general one has to prove that a specific trauma occurred to a single or very few joints, and other changes consistent with degenerative arthritis are not present throughout the rest of the body at the same time. In short, these changes need to be localized.


 The total lack of vitamins in the diet. This disorder is a fatal condition unless it is supplemented with vitamins within a few weeks. Therefore, most individuals suffer from hypovitaminosis, which is a relative deficiency or vitamins in the diet. The specific type, intensity and duration of deprivation determines the long-term effects.


Caused by a severe lack of vitamin BI (thiamine) in the diet. This produces changes in the nerves (both in the brain and extremities) and the heart. Brain changes could produce dementia or psychosis. Nervous changes are usually associated with numbness and/or painful feet. Beriberi heart disease is an acute condition, similar to congestive heart failure, except that the heart pumps more blood than in normal congestive heart failure and it is associated with the presence of an excessive amount of lactic acid in the body. It is unknown at the current time whether this can produce a chronic state.


A disease characterized by frequent and watery stools, usually with blood and mucus, and accompanied by rectal pain and abdominal, fever, and dehydration. This is an infection in the colon and can be caused by a multitude of different organisms, the most common of which is amoeba which can produce a mild or severe dysentery and possibly he associated with a chronic irritable colon. Bacillary dysentery is associated with the bacteria shigella, but will not cause a chronic state. There are multiple other bacteria that can cause dysentery which usually do not produce chronic states. Viral dysentery can also present like amoebic or bacillary dysentery and will not produce a chronic state.


The actual freezing of tissue. This is graded on a continuum with one representing mild to four representing mummification of the tissue. The extremities furthest from the heart are usually affected, with primarily the nose, ears, fingertips, and toes being involved. This usually produces long-term side effects such as numbness, discoloration, excessive swelling, and pain in the affected area.


Infection with any type of worms that parasitize the human. Most infections usually resolve spontaneously either with proper treatment or as the natural course of the disease. Strongyloides is known to persist in a permanent state in humans due to its ability to reinfect the host.


Merely means bad nutrition. The nutritional depletion may be either caloric. vitamin, fatty acid, or mineral deficiency, or more likely a combination. Depending on the type. intensity, and duration, it may yield permanent side effects or no lasting side effects at all.



Literally meaning rough skin in Italian, also known as black tongue in dogs. It is caused by a virtual lack of vitamin B3 (niacin) in the diet, producing the classical trio of diarrhea, dermatitis, and dementia. All are easily treated early on with no side effects. The dementia, if left untreated, may produce permanent mental deficits.



The lack of protein and calories in the diet, generally produces no lasting side effects. However, vitamin deficiencies other than the aforementioned B1 (beriberi) and B3 (pellagra) can have very disastrous effects on one’s body. Also deficiencies of certain fatty acids and essential minerals in the diet can have lasting and long term sequela.


 A generic term for any of the insanities. Generally, it is thought of as a mental disorder causing gross disorganization of a person’s mental capacity and his ability to recognize reality and communicate with others regarding the demands of everyday life.



Characterized by discrete periods of apprehension or fear with at least four of the following during an attack: shortness of breath, feelings or heart skipping, chest pain, dizziness, sweating, fainting, trembling, fear of dying, or doing something uncontrollable during an attack. These attacks need to occur at least three times within a three week period, not associated with physical exertion or life threatening situations. Also there needs to be an absence of severe physical or other mental illness which could cause these symptoms.


Characterized by generalized persistent anxiety and with symptoms of at least three of the following four categories: (1) Motor tension as characterized by shaking, jumpiness, trembling and restlessness; (2) Autonomic hyperactivity. such as sweating, cold or clammy hands, high or irregular heart rate, dry mouth, etc.; (3) Apprehensive expectations, anxiety, worry, fear, anticipation of misfortune to himself or others; (4) Tendency to insomnia, hyperattentiveness, irritable. All these symptoms had to have lasted at least one month. Also, there needs to be an absence of all other mental disorders and physical disorders which could explain the symptoms.



This may be either obsessions or compulsions. Obsessions are recurrent persistent ideas or impulses that are thoughts that invite consciousness and are experienced as senseless or repugnant. Attempts are made to ignore or suppress them. Compulsions are repetitive and seemingly purposeful behaviors that arc performed in certain similar manners. The behavior is felt by the individual to produce or prevent some future event. Generally, the individuals recognize the senselessness of the behavior and do not derive pleasure from carrying it out, although it often relieves tension. Also, the obsessive or compulsive individuals are associated with a significant sense of distress in that it interferes with social or role functioning.



The re-experiencing of a trauma of a past recognized stress or that can produce symptoms of distress. This re-experiencing needs at least one of the following: (I) Recurrent and intrusive recollection of the event; (2) Recurrent dreams; (3) Sudden feelings that the trauma was occurring because of an association, an environmental or ideational situation Also involved is reduced involvement with the external world beginning after the trauma, revealed by at least one of the following: (1) Hyperalertness or exaggerated startle response; (2) Sleep disturbance; (3) Guilt about surviving when others have not; (4) Memory impairment or trouble concentrating; (5) Avoidance of activities that arouse recollection of the traumatic event; (6) Intensification of symptoms by exposure to events that symbolize or resemble the traumatic event.


This is a category that is used for diagnosis when the affected individual appears to have an anxiety disorder that does not meet the criteria for entry into any of the other known anxiety disorders.


Characterized by depressive periods in which the patient feels sad and/or down and has a loss of interest in the usual activities that cause pleasure or involvement in usual past times. These depressive periods are separated by periods of normal mood, lasting a few days to a few weeks, but no more than a few months at a time. During the depressive period, at least sleep or too much sleep, low energy or chronic tiredness, loss of self esteem, decreased effectiveness or productivity at work, social withdrawal, loss of interest in pleasurable activities, excessive anger, inability to respond with apparent pleasure to praise or reward, less active or talkative than usual, pessimistic attitude about the future, tearful or crying thoughts about death or suicide. There are also no psychotic features present.


Literally Greek for the suffering of nerves outside of the brain and spinal cord. There are several different causes for peripheral neuropathy, and vitamin deficiency and possibly mineral deficiency are just two. Other causes to be considered are various toxins such as lead, copper, and mercury, a hereditary pre-disposition to neuropathy, deposition of amyloid or protein produced by one’s own body mounted in response to an infection, infections such as by leprosy, which is the most common form of neuropathy in the world, and multiple other less common causes.


Irritable bowel syndrome (IBS) is a common disorder of the intestines that leads to crampy pain, gassiness, bloating, and changes in bowel habits. Some people with IBS have constipation (difficult or infrequent bowel movements); still others have diarrhea ( frequent loose stools, often with an urgent need to move the bowels); and some people experience both. Sometimes the person with IBS has a crampy urge to move the bowels but cannot do so. Through the years, IBS has been called by many names - colitis, mucous colitis, spastic colon, spastic bowel, and functional bowel disease. Most of these terms are inaccurate.



A peptic ulcer is a sore or hole in the lining of the stomach or duodenum (the first part of the small intestine). In addition to the pain caused by the ulcer itself, peptic ulcers give rise to such complications as hemorrhage from the erosion of a major blood vessel; perforation of the wall of the stomach or intestine, with resultant peritonitis; or obstruction of the gastrointestinal tract because of spasm or swelling in the area of the ulcer. The direct cause of peptic ulcers is the destruction of the gastric or intestinal mucosal lining by hydrochloric acid, an acid normally present in the digestive juices of the stomach.



A disorder caused by lack of oxygen to the tissues of the heart, in which the muscles of the heart are affected and the heart cannot pump properly. Ischemic cardiomyopathy is a cause of heart failure and is a complication of ischemic heart diseases such as acute MI, angina, and unstable angina.

Symptoms include: chest pain, experienced under the sternum,  may radiate to the neck, jaw, back, shoulder, arm, may feel tight, pressure, crushing, squeezing,  may or may not be  relieved by rest or nitroglycerin

sensation of feeling the heart beat (palpitations)

irregular or rapid pulse

shortness of breath, especially with activity, or shortness of breath that occurs after lying down for a while


fatigue, weakness, faintness

decreased alertness or concentration

decreased urine output

excessive urination at night

overall swelling

breathing difficulty when lying down

high blood pressure

Examination may reveal an irregular heartbeat, and heart and lung sounds may be abnormal. There may be other signs of heart failure. Decreased functioning and enlargement of the heart may show in these tests: coronary angiography,  echocardiogram,  chest X-ray, chest CT scan, MRI of chest. An ECG may show enlargement, old MI, ischemic changes, arrhythmias, or other abnormality. A biopsy of the heart may be needed to rule out other disorders. Lab tests may be used to rule out other disorders and to assess the condition of the heart.