Agent Orange presumption policy leads to higher VA health care use


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This post first appeared on VA Research Currents.

For Vietnam Veterans, having a medical condition presumed related to Agent Orange exposure is linked to greater use of Veterans Affairs health care.

That is the main finding of a study by researchers with the War Related Illness and Injury Study Center (WRIISC) at the VA New Jersey Healthcare System. They say the results show that a law passed by Congress nearly 30 years ago has largely met its goal: helping affected Veterans get the care they need.

The study results appeared in May 2018 in the journal Medicine.     

Agent Orange linked to 14 conditions

Agent Orange is a chemical defoliant that was sprayed by the U.S. during the Vietnam War to kill plants and clear land. It was contaminated with dioxin, which is known to cause cancer and other conditions. Twenty million gallons of Agent Orange were sprayed during the Vietnam War. About 2.7 million U.S. military personnel may have been exposed.

Veterans are eligible for compensation from the Veterans Benefits Administration if they have a service-connected disability. The higher the disability rating, the more compensation they are due. Veterans with higher service-connected disability ratings also have greater access to no-cost health care through the Veterans Health Administration. However, it is often difficult to prove direct service connection for Agent Orange-related conditions because they may develop years after exposure.

To address this problem, Congress passed the Agent Orange Act of 1991. The act directed VA to presume service-connected disability for conditions the National Academy of Sciences deemed related to Agent Orange. Veterans with these conditions qualify if they were in Vietnam between Jan. 9, 1962, and May 7, 1975.

Seven non-cancer conditions have been designated as presumptively service-connected for Vietnam Veterans: chloracne (a severe acne-like skin condition), ischemic heart disease, Parkinson’s disease, peripheral neuropathy, porphyria curtanea tarda (a skin condition that causes blisters, hair growth, and discoloration), AL amyloidosis (an immune-system disorder that can damage the organs), and Type 2 diabetes. Several forms of cancer are also included: chronic b-cell leukemias, Hodgkin’s disease, multiple myeloma, non-Hodgkin’s lymphoma, prostate cancer, respiratory cancers, and soft-tissue sarcoma.

Veterans with connected conditions use VA health care more often

To find out how this policy affected VA health care use, the researchers looked at 2013 data on 85,699 Vietnam Veterans. They found that those with one or more diagnoses of a presumptive condition were more likely to have multiple disabilities than those without one of the named conditions. While they were less likely to have a 100 percent disability rating than those with no presumptive condition, they were more likely to have individual unemployability. This means they cannot maintain employment because of service-connected disability.

Of those with any presumptive condition, 73 percent had Type 2 diabetes. About 44 percent had ischemic heart disease, and 16 percent had some form of cancer.

Looking at health care usage, the researchers found that 35 percent of those with a presumptive condition had five or more primary care visits in fiscal year 2013. Only about 15 percent of those without a presumptive condition had this many visits.

Forty-five percent of the presumptive condition group had five or more specialty care visits, compared with 15 percent of those without presumptive conditions. Of the presumptive-condition patients, 37 percent had at least one mental health visit, compared with 16 percent for those without any of the conditions.

In other terms, those with presumptive conditions were more than twice as likely as those without the conditions to be frequent users of primary and specialty care in the VA health care system. They were also more likely to visit emergency rooms than the other group.

The study shows that Agent Orange legislation has been effective, write the researchers, at lowering “the threshold for accessing [Veterans Benefits Administration] and [Veterans Health Administration] benefits for Vietnam Veterans who may have been exposed to dioxin.” The findings highlight the importance of presumptive service connection in serving Veterans, they conclude. The results may also indicate that Vietnam Veterans with these service-connected conditions are more likely than those without these conditions to choose VA for their care.

Dr. Dennis Fried, corresponding author on the paper, summed up the importance of the results: “In our era of increased Veteran choice with regard to health care delivery sites and greater integration of VHA and community care, these findings support the importance of VHA provision of services for conditions possibly related to military service.”

For more information on Agent Orange exposure, visit VA’s Agent Orange website. To learn more about VA research concerning Vietnam Veterans, visit www.research.va.gov/topics/vietnam.cfm.

Author

Tristan Horrom

Tristan Horrom is a writer and editor for VA’s Office of Research and Development. He joined VA in 2009. Tristan holds a master’s degree in professional writing from Towson University in Maryland

Comments

  1. David Sullivan    

    I guess this article blames us for Going to the VA to treat Cancer Type 2 Diabetes, Ischemic Heart??/

    1. Thomas Barnett    

      Yes David, looks like your correct. Once Again WE ARE THE BAD GUYS. They Spit on us coming home now the want to CRAP on us. Heck the VA has told me several times, ‘it didn’t happen’! Three tours in Nam working on Flight Deck (hook runner) during flight operations. Downtime melted and poured Zinc on ends of cables, cleaned AC filters ( you know the things that took all the crap out of the air). Sorry Mate for the ramble – just at my witts end cant get any help because Bush took away BLUE WATER sailors rights,

      God be with you Sir!

      Ahoy!

      1. Wayne F VARNER    

        I agree. When we came home we were disliked. I also recall when we went to the VA about Agent Orange we were denied. So for over 50 years the VA did zero until most of us died. Now they are doing little about us and care for us. They blame us yet denied us…..The facts were agent orange was used was well known to the VA in 1975 but they hid it!

    2. John Alex cerro    

      I’m a Vietnam veteran 1964-1968 I was in brown water and boots on the ground with navy seebees I have COPD
      They say that’s from smoking I also have depression and hard of hearing I started a claim there so slow I’m 71 years
      Old just wondering if it a waste of time the VA don’t want to help

  2. Jerry Miles Pondelicek    

    I have a through condition and have filed a claim. I was in Vietnam May 28, 1969 to June 29, 1970. I was exposed to Agent Orange the entire time l was there. I have been denied my thyroid claim 3 times. I believe Agent Orange is the cause of my thyroid diease.
    Is there anything else l can do?
    Thank you.
    Jerry M. Pondelicek
    (personal information redacted)

      1. alex fuentes    

        I had the same problem with my DD Form 214, I will help you get that changed.

    1. Richard Arrington    

      Contact Swords and Plowshares they will research and asssign a VA agent to look into your claim. I have a 100% Permantent and Total disability rating due to Agent Orange. I know from experience.

  3. Richard A. Outlaw    

    AND……If you were in the NAVY…..WE are denied unless boot were on-ground….

  4. James Donald Davis    

    During my service with HqPac GEEIA, I was sent TDY to Vietnam on classified communication jobs 8 times. My DD214 does not list any of the TDY. The records do show Korea 1968 and Thailand 1968. My claim has been in limbo since 2009. I submitted buddy statements but to no avail. I have diabetes 2, Ischemic Heart disease with open heart surgery and AICD implantation. I have 10% for tinnitus. The VA has treated and diagnosed these conditions in the past. I am at a loss as to how else to prove my possible exposure to AO and/or get the TDY records. Any suggestions would help. Thank you all for your service to our country.
    Don Davis

    1. James K. Peters    

      I had same problem, having several of those 179 day classified trips to Can Tho from 1st Special Forces Group (Okinawa) and the 46th Special Forces (Thailand).. My initial claim was disapproved. I finally got a hint from a health car provider who played 20 questions with me. We finally located several write-ups for awards written that stated they were for service in RVN. Most of these were found in official records. Some were not approved but submitted and therefore were “Official” US Army records. Another gift was in the write up for the Meritorious Unit Award that was awarded to 1st Special Forces Group in part for service in RVN. This established that 1st Special Forces while assigned to Okinawa, Japan did in fact serve in RVN. I resubmitted and was approved immediately.

    2. DianaBialkowski    

      Try calling the VA Veterans WH Complaint line at 1-855-948-2311. It has worked for several Veterans I have given the number to, it’s worth a try. I hear all of your frustrations and it ticks me off.

  5. James Wise    

    If you were on GUAM during the Vietnam Era then BE AWARE That Beautiful Island was liberally SPRAYED! Yes we were Poisoned too. We have the PROOF! Yet WE do not exist as far as the U.S.A. is concerned!

    1. Roger duke    

      I went TDY from Korea to Denise and Vietnam do not have any records. About the time time you were there.

    2. Gerard ulrich    

      I was stationed on Guam 1971 to 1974,never knew about this.

  6. THOMAS GRADY WILLIAMS    

    I have been denied several times also. I have heart attack .heart disease also and a stroke. Use a walker, cane and wheel chair but still denied also for movement control.

    I also wrote PRESIDENT TRUMP BUT NO ANSWER I also wrote the White VA CHIEF ( BIG CHIEF0 no answer

  7. Edward V, Baran Jr.    

    I was on the USS Jamestown AGTR-3 and it is on the list provided by the VA for
    Agent Orange but I was denied as well as many others. I feel for them because I am
    already 80% disabled and get most of every thing I need from the VA. I just received
    an electric scooter and carrying rack on the back of my car. I have an extreme breathing
    problem and get out of breathe so very easy.

  8. KARL h. sTEPHAN    

    Residing in Germany, it is highly difficult finding a doctor able to perform the physical examination and tests necessary
    to determine medical conditions related to exposure of Agent Orange. – I have porphyria curtanea tarda and most
    likely some other Agent Orange related medical conditions I am afraid to even think about. – Providing I could find
    a German doctor capable of working with Agent Orange information, would the medical report need to be translated
    into English before submitting the paperwork to VA? – Or, would I have to return to the States in order to undergo
    a thorough medical examination and be tested for Agent Orange conditions. – Thanks for guiding information

  9. JONATHAN NICKLES    

    Why do we not hear anything about SQUAMOUS CELL CARCINOMA… Hundreds if not thousands Viet Nam Vets has been diagnosed with this type of cancer… And, the administration act as if we were causative… Trying to place blame on alcohol … I myself was diagnosed with this form of cancer in 1986… And had to undergo seventeen years of reconstructive surgery. As of 20 June 2018 – I am 32 years cancer free…

  10. Robin S Dean    

    Except the Blue Water Sailors that got to drink Agent Orange and shower in Agent Orange – but our claims are automatically denied even though Congress included us, the VA has systematically denied us! HR 299 will fix some of that, so please Congress pass that Bill NOW – get it to the Senate and the President. 1/3 of our ranks have already died and this AO stuff is killing many of us. Plus our plan does not cost the taxpayers anything! Vets pay to help other Vets!

  11. Rosemary A Tucker    

    How about your TDY orders?

    1. James Donald Davis    

      Thanks for the suggestion, but I have been told that my TDY records do not exist, even though my team mates have “some” listed but not all.

  12. marc schlossman    

    Where are we with the other effects of Agent Orange,i.e. high blood pressure etc. that were to be evaluated and possibly put into place for other forms of disability.

    1. Finn    

      Were never recorded. Just go as ordered.

  13. Gary Fergson    

    I have peripheral neuropathy since 09. Is it still
    the VA’s policy that you have had it within one
    year after discharge. I spent 3yrs in SE Asia. A year and half at Udorn AB. The problem I have is I was
    discharged in 1971 before Congress voted on any presumptive diseases. So what can I do? I also
    had cancerous lymphoma, carcinoma and myeloma.

  14. Herman Nagora Jr    

    I am a disabled veteran who has total agent orange, 100% ,I am also the agent chairman of Staten island NY of 421 Vietnam vet, I have been up to date on all the latest information on agent orange , if there are any I would appreciate to either email me me or call me

    1. Ray Parker    

      What did you do in Udorn – I was there 71-72. (7thABCCC)

    2. Ray Parker    

      I was at Udorn 71-72 (7thABCCC). What did you do?

    3. Debbie Meeks    

      May I have your email address please?

  15. Gordon W Tingle    

    I have a bone marrow blood disorder, Myelodisplasia Syndrome, that the VA does not classify as Agent Orange caused. However, I don’t know how else I could have contracted this disease, except for AO. I have had several rounds of chemo and the disease seems to be controlled, but there is no cure. Any suggestions?

  16. Jack    

    The whitewashing continues with articles like this. It’s simple psychology: If we aren’t going to do anything for these slugs let’s just spend a lot of money telling them over and over again how much we are doing for them. Some will believe it right away and more will the more we hammer home the idea. And while we’re doing that a lot of them will die anyway. The problem takes care of itself. Pure and simple: the VA has avoided the enormity of this issue for years and will continue to do so. Whatever happened to that determination on the 27 additional diagnoses? I’ll tell you: Someone decided that the money isn’t there. End of story. The Director roulette continues. All of us with bladder cancer and all the other maladies are just unremarkable casualties of a war that probably doesn’t merit a paragraph in a 9th grader’s history book anymore.

  17. ALBERT WILLIAMS    

    TOO LITTLE TOO LATE ! ALL MY FRIEND WITH AGENT ORANGE DISEASES ARE DEAD! THANKS FOR NOTHING !

  18. Paul Dionne    

    What about the ones who served in Korea, who were exposed to it’s use on the DMZ? There were special ops teams who would trudge through sprayed fields to enter North Korea on missions. One such team was the Ghost Walkers, but most of their teams died from cancer as well as other illnesses, and because of the missions they took part in, they were denied services, because “they weren’t there.” Also, when they try to get copies of their records, to file for VA disability, the alphabet agencies will not release them for “national security” reasons. Come on people, that part of the war was over half a century ago, so by law they should no longer be classified.

    Our government is treating those vets like crap. There are ways to code files, where evidence of being in theater could be provided without releasing classified info. Congress needs to act on this NOW. If you want to read more go to Facebook.com/veteransnewstoday.

  19. Allen Wood    

    I was one of the lucky ones that had 4 by-pass surgery in VA Hospital and a year later and while I was 2000 plus miles from home found out through another veteran that my heart surgeries were presumptive and missed out on a years worth of benefits. What did VA say, starts the day you file. Not one person in the hospital ever,, ever mentioned that I could file. Now, I am 100% disabled just a day late or should I say a year late and $24,000 plus short. After all we are JUST veterans… I feel for the many guys who are last in a broken system that keeps trying to fix itself and continues to shoot itself in the foot over and over and over and over and over, well you all get the point. Sad but as long as the laziness in the system is allowed to stay employed it will stay the same. The unions have no business in VETERANS business… I wish you guys the best in this broken system…

  20. Robert G s.    

    I’ve had problems over the years myself but never had a reason explaining what was the cause . I’m 71 yrs old ,live by my self after being married for 50 yrs I have what they call PTSD .i guess I can’t bitch I’m still alive I should have died July 10 1967 but thank God and some luck I’m still here. God bless you all

  21. Larry Dudash    

    After a Year of going back and forth with the VA Benefit’s group with responses to their questions and sending me off for numerous tests they denied my claim saying the cycst on my body and glaucoma in both eyes and hearing loss were Not service (Agent Orange) related and that I made $21,000 on Social Security I was denied!!
    I too was sent there on TDY for 90 days then got extended for another 60 days in1965.
    The real kicker is earlier this year I was tested for pulmonary problems and when asked if I was exposed to Agent Orange I replied “I don’t know “ and the VA Hospital tester looked at my files online and she said “Yes You We’re “

  22. Robert Wilson    

    – The word “presumption” is an insult. There was no presumption with the plane that flew over the base spraying that crap around the perimeter in the dead zone. I remember tasting that shit for days and smelling it on my uniform. So i guess the government thinks i presume that is what it was. There are many Vets out there much worse off than i am and i truly feel sorry for you. I had a heart attack last summer so now i am working on (as the Dr. put it.)1/2 a heart. I was boots on the ground and our officers said it wouldn’t hurt us. I wonder how many of them today are suffering the effects we are. You can bet old Bone Spurs and his 3 mill weekends don’t care.

  23. Donald Crauswell    

    The VA has repeatedly denied claims for illness that is secondary to the 12 presumed illness’s, they know its wrong and its been proved time and again they are wrong and still they say F the VET. This is a sad shame.

  24. Paul Holman    

    My father served as chief of stores for agent orange, he developed prostate and bladder cancer and passed away in 1968. My mother was pregnant with my sister during this time and developed thryoid problems, my mother raised us children to be respectful and patriotic. After her filing for agent orange compensation and turned down numerous times she became disheartened with the VA because we lost our house as the local VA office said we didn’t qualify for benefits after all paperwork was submitted and we were approved, until the day of closing. Out of 6 boys in my family only one has not served due to failure to pass physical. I keep listening and keep waiting for VA to live up to promises made for all veterans war time and peace time, at least I don’t believe in holding my breath until it happens!

  25. Tammy Parlin Mount    

    I would like to know the affect it has had on the children of the men exposed…have read some reports of children born before the exposure are fine and their siblings born after have multiple health issues…would love to find out more about that…Myself and my two sisters and brother have internal issues…all conceived and born after exposure in Vietnam

  26. Kenneth W Kingsley    

    What’s going on with the presumptive for bladder cancer ? It has been on hold for two years !
    Have been treated for since 1998! Surgeries and check ups every three months! Nobody talks about agent Blue
    Which was arsenic based arsenic largest cause of bladder cancer ! Trump said he was going to take care of veterans now this is been on hold for two years it’s all about the money ! More talk and no action 50 years later !

  27. julio c perez    

    FOR YEARS I HA BEEN TRYING TO GET A PHISCAL EXAM TO FIND ANY AGENT ORANGE CONDITION WITH OUT ANY LUCK THANKS

  28. julio c perez    

    FOR YEARS I HAD CLAIM FOR A AGENT ORANGE EXAM WITH OUT ANY LUCK,,,

  29. John Raymond Dito    

    It took me over 30 years, and many appointments when finally one psycologist took the time to backtrack my records, and from what I had told her, before I broke down, she finally researched my info and found it to be true and exact. In 2002 I finaly received my benefits. So, what I say to all of you, please find someone from the VA to go bat for you. The only thing they did not do was back pay me for the whole 30 years plus. Could have been a millionaire, ha ha. USN retired.

  30. Ernest Tevebaugh    

    Thank you all! I was in Guam from 71-74 and didn’t know agent orange was sprayed there. I have had heart attack and stroke and from the stroke I lost my right eye. I recently had quadruple heart bypass. I’ve had lower back problems since I was in boot camp and even got stuck in my lower back by a CPO while I was in company formation on the parade ground at parade rest and he did it because he said I was moving around in reality my back was hurting. I have recently been diagnosed with stomach cancer and awaiting treatment. I am 67 years old and I’m not a drinker or smoker. Right after I got out of the Navy I was in the VA hospital for stomach problems and diagnosed with fibromyalgia. While in the Navy I had pneumonia. I’ve never applied for any disability. Just looking for anyone’s advice. Thank you all for your service and God bless you!

  31. Timothy Beardsley    

    They took my colon said I had multiple Colonic Plyposis I have a lot of inflammation inside especially in the bowel and small intestine I also have many scars on my arms and around the neck area and the Doctors ask what going on and I say looks like agent orange is kicking my ass and they roll them eyes I also had one idiot who called himself a Doctor who was my primary care doc told me he was the agent orange expert and he told me all my scars were from when I was a kid and scratched my self and now that I’m older my skin shows as it is older too. You can’t make this up oh yes I have that problem in my feet where the chemicals settle and my feet hurt tingle and really hurt bad and I am not diabetic but they look at me like I am nuts geeezzzz

  32. Finn    

    Were never recorded. Just go as ordered.

  33. John Winther    

    The VA motto is “Deny, Deny and hope you die”. The Blue Water Vets, Atomic Vets and others are always getting screwed by the VA

  34. diana bialkowski-mijares    

    Why isn’t my comment from June 22nd, 2018 showing up.

  35. Sgt_Berger    

    HR 299 is finally passed after 40+ years thanks to President Trump who once hearing about HR 299 picked up the phone and made one call.. that was all it took. It has gone un_noticed but they included “territorial seas” which is on 12 nautical miles from the coast. Little help for our many ships on the high seas.

    Now the next move is getting rid of CFR 38 4.25 the table used by the VA for combining service connected disabilities. It is heavily flawed.

  36. Jack Wilson    

    I flew out of Udorn daily combat missions Vietnam, N and S, Laos and another country. 269 in 12 months. Recovered in S Vietnam a number of times due to time sensitive information. BLANKET TDY ORDERS. Agent Orange claim denied due to not having been in S Vietnam. Even presented flight logs at that time. DD Form 214, as with other commenters, did not reflect combat but sufficient awards and decs for that time . Even SEA campaign awards not good enough. Still denied. VA asked if I had a picture in front of a Saigon sign for proof. Wasn’t motivated to carry Brownie for happy snaps. Having retired as a Col, my word was not sufficient until I requested a retired general who I flew with at that time wrote a letter confirming he was a co pilot on some of those missions. It took 10 years to convince VA Agent Orange eligibility even though Thailand was also sprayed.
    It is a clear conclusion that the VA /govt merely waits for attrition through delays that eventuality make health issues go away..always in the past and always will.

  37. Herman Nagora Jr    

    I am the agent orange chairperson of vva Staten island NY 421, if you can keep me updated on future reference, I would appreciate.

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