"Presumed" is a better word, in my opinion, because officially, the VA uses the word "presumptive" when they evaluate ALS claims.
For anyone who wants to know about the military connection to ALS and the federal veteran benefits you are eligible for:
A few years after the 1991 Persian Gulf War, during which we kicked Saddam Hussein's army out of Kuwait, an extraordinary number of veterans began to be diagnosed with ALS, so the government did a study to figure it out. Shortly thereafter, they stopped the study and simply declared that anyone who got ALS who had served anywhere in the world in any military service would be granted VA benefits. They said a diagnosis of ALS would automatically be presumed to be connected to your military service (unless there was proof to the contrary.)
You see, normally if you become disabled by any medical condition, the VA would treat and compensate you ONLY IF you could PROVE that your military service caused or exacerbated the disabling condition. You would submit a claim to the VA, showing proof that A) you had a disabling condition, B) you were serving in the military at the time and place where you got the condition, and C) a "nexus," meaning a connection between the two. In short, for conditions other than ALS, you had to prove that your service "more likely than not" caused your disability.
HOWEVER, ALS is different.
After doing a study of ALS claims, the government decided that no proof was needed. If you had served just 90 days of active duty, and sometime later in your life you became diagnosed with ALS, the VA would automatically presume that your ALS was connected to your service. {ALS is a "presumptive" condition.) They would then compensate you for your diminished enjoyment of life and inability to work in your usual trade. Also, the VA would treat you or pay for treatment. There are also benefits granted to the surviving family, such as payments for a college education.
Currently, a veteran who gets diagnosed with "probable ALS" is automatically granted Service Connection, is awarded "Permanently and Totally (P&T) disabled" status, and is rated as 100 percent disabled. You don't have to prove the service did it to you. You just have to be a veteran, have ALS, and apply.
In the case of ALS, you must have served on Active Duty (for duty other than training) for 90 consecutive days. A letter of diagnosis from a doctor saying you have been diagnosed with "probable ALS" or "definitive ALS" is required. That is all you need to start the ball rolling.
The VA will schedule you for a face-to-face interview with a "Compensation and Pension" evaluater, who will ensure you meet the requirements for the award.
The process is expedited, and so it might take weeks or months to be approved, instead of the usual many months to years that most claims take to be approved.
The monthly cash compensation is significant, and it increases as your ALS progresses. For instance, when you lose use of both legs and an arm, they will add SMC-Special Monthly Compensation. When you become bed-bound, your SMC goes up again. Also, the VA pays for a $10,000 life insurance policy for you. They will give you equipment, such as a power wheel chair and a eye-gaze controlled computer that can be hooked up to control some appliances in your home. They will grant you a significant amount to buy a disabled-modified vehicle. They will give you two grants for your home: one is several thousand dollars to pay for modifications such as a roll-in shower; the other is a major grant of tens of thousands of dollars that you can use to build, buy, or modify a home. Finally, your spouse and children can be paid while attending college--it's about a thousand per academic month.
Of course, there's more. Right now, understand that the VA is divided into three different kingdoms: VBA, VHA, and NCA. The VBA has a big regional office in your state that handles most of the money-type benefits--compensation and education, for instance. Then there is the VHA , which handles the "health" stuff. They have an office at your local VA hospital. The third kingdom, called the National Cemetery Administration, handles funerals, tombstones and burials, of course. There are nat'l cemeteries all over the USA.
The VHA side takes care of palliative healthcare and hospice care either provided by or paid by your local VA hospital. That VA hospital will issue things when you need them: cane, walker, foot orthotics (AFO), wheelchair, shower chair, toilet chair, power wheelchair, electric patient lift, hospital bed, cough assist machine, etc.
The local VA hospital will also give you permanent and portable ramps, or even send a contractor out to build a ramp for you.
The grants have one condition which could be a "catch" for fast-progressing PALS. The grant is only to be provided if the veteran is likely to benefit from it. So if you are facing months of waiting time while your house is being built/modified, and you are not expected to live long enough to benefit from it, the local VA could theoretically deny the grant. Although I've never heard of that actually happening.
For the vehicle grant, there are plenty of disabled van retailers who specialize in selling vans modified for your type of wheelchair. They know how to do the paperwork and they know who to submit it to. The right salesperson can take care of all of this, ensuring you get the best deal, putting out little or no money, and providing a brand new van to you every two years.
VETERANS with ALS are encouraged to 1) download and read the 10-page PDF document at the top of this "Military" subforum called "Guide to Veterans Benefits" and 2) get a "service officer" to help guide you through the process. I highly recommend getting the PVA--the Paralyzed Veterans of America--to represent you and help you out, because they specialize in the needs of paralyzed vets.