The symptoms described by the Veteran during a Gulf War General Medical examination should be addressed in the examination report. Veterans are qualified to report symptoms such as those listed in 38 CFR 3.317(a)(3) and (b). As the US Court of Appeals for Veterans Claims (CAVC) pointed out, “[o]bjective medical evidence is not required for an award of service connection under section 1117,” (Gutierrez v. Principi 2004). The Court further found that Veterans, spouses, family members, and friends are all competent to report visible manifestations of conditions and the effects of symptoms such as joint pain and fatigue that are capable of lay observation.

In addition, the US Court of Appeals for the Federal Circuit in Joyner v. McDonald said that objective indications include both objective evidence perceptible to an examining physician and “other, non-medical indicators that are capable of independent verification [quoting 38 CFR 3.317(a)(3)]” Non-medical indicators include evidence such as time lost from work, the Veteran having sought treatment for his or her symptoms, and changes in the Veteran’s appearance, physical abilities, and mental or emotional attitude (Federal Register, 1995).