Medical claims against Agent Orange may be easier for Vietnam veterans

By Tom Philpott

The cost of war — on veterans' health and taxpayers' wallets — will loom a little larger in the new year when the Department of Veterans Affairs issues a final rule on whether three more diseases of Vietnam veterans, including heart disease, were caused by exposure to Agent Orange.

The rule, expected to be published soon, will make almost any veteran who set foot in Vietnam and is diagnosed with Parkinson's disease, B cell leukemia or ischemic heart disease (known also as coronary artery disease) eligible for disability compensation and VA medical care. The exception would be if credible evidence surfaces of a nonservice cause for the ailment.

Katie Roberts, VA press secretary, said no estimates will be available on numbers of veterans affected or the potential cost to the VA until after the rule change takes effect later this year. But the National Association for Uniformed Services was told by a VA official that up to 185,000 veterans could become eligible for benefits and the projected cost to VA might reach $50 billion, said Win Reither, a retired colonel on the veterans' association executive board.

The association also advised members that VA, to avoid aggravating its claims backlog, intends to “accept letters from family physicians supporting
claims for Agent Orange-related conditions.” It said thousands of widows whose husbands died of Agent Orange disabilities also will be eligible for
retroactive benefits and VA Dependency and Indemnity Compensation.

“This is huge,” said Ronald Abrams, co-director of the National Veterans Legal Services Program. The legal program has represented veterans in Agent Orange lawsuits for the last 25 years. The nonprofit law group publishes the “Veterans Benefits Manual,” a 1,900-page guide for veterans' advocates to navigate the maze for VA claims, appeals and key court decisions.

Abrams said he can't guess at how many more veterans will be eligible for benefits. But numbers, particularly of those with heart disease, will be very large, he suggested.

All of the veterans “who have been trying to link their heart condition to a service-connected condition won't have to do it now if they're Vietnam
vets,” Abrams said. For VA, it will mean “a significant amount of money — and many, many, many people helped.”

The excitement over expansion of benefits for Vietnam veterans, and worry by some within the Obama administration over the cost, flows from an announcement last October by VA Secretary Eric Shinseki.

He said three categories would be added to the list of diseases the VA presumes were caused by Agent Orange. Veterans with the presumptive Agent Orange ailments can get disability compensation if they can show they made even a brief visit to Vietnam from 1962 to 1975.

With a presumptive illness, claim applicants don't have to prove, as other claimants do, a direct association between their medical condition and
military service.

Shinseki said he based his decision on work of the Institute of Medicine of the National Academies. VA contracts with the institure to gather veterans'
health data and investigate links between diseases and toxic herbicide used in Vietnam to destroy vegetation and expose enemy positions.

In a speech last July, Shinseki, former Army chief of staff and a wounded veteran of Vietnam, expressed frustration that “40 years after Agent Orange was last used in Vietnam, this secretary is still adjudicating claims for presumption of service-connected disabilities tied to its toxic effects.”

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The following conditions are now presumptively recognized for service-connection for Vietnam veterans based on exposure to Agent Orange or other herbicides:  chloracne (a skin disorder), porphyria cutanea tarda, acute or subacute transient peripheral neuropathy (a nerve disorder), Type 2 diabetes and numerous cancers [non-Hodgkin’s lymphoma, chronic lymphocytic leukemia, soft tissue sarcoma, Hodgkin’s  disease, multiple myeloma, prostate cancer, respiratory cancers (including cancers of the lung, larynx, trachea, and bronchus), and chronic lymphocytic leukemia].