Agent Orange Benefits
After the Vietnam War, returning Vietnam Veterans were complaining and seeking treatment for conditions not related to pre-existing or hereditary illnesses. Not only were Veterans getting sick but so were their children. Combined with emerging toxicologic evidence of negative effects of herbicides from animal studies and some positive findings from epidemiologic studies, it resulted in sustained controversy. To relieve the growing public clamor, in 1991, Congress passed Public Law (PL) 102-4, the Agent Orange Act of 1991, to address the long-term health effects on Veterans who during their service in Vietnam were exposed to herbicides—mixtures of 2,4-dichlorophenoxyacetic acid (2,4-D), 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), and its contaminant 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), picloram, and cacodylic acid.
That legislation directed the Secretary of Veterans Affairs to ask the National Academy of Sciences (NAS) to perform a comprehensive evaluation of scientific and medical information regarding the health effects of exposure to Agent Orange and other herbicides used in Vietnam. The first committee report, Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam (VAO), was published by the Institute of Medicine (IOM) in 1994. NAS has published a biennial update ever since, with the Eleventh Biennial Update in 2018 concerning the most recent and up to date information regarding the potential health effects of herbicides in Vietnam veterans or related aspects of herbicide or 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) exposure.
As a result, the VA determined that certain diseases are presumptively believed to have a causal relationship between herbicide exposure and the disease caused by exposure to Agent Orange and other herbicides and set for the following guidance in awarding those benefits:
Any Veteran that served in the Republic of Vietnam is entitled to apply and receive service-connected compensation to a list of presumptive conditions found to be related to exposure of certain herbicides during service in Vietnam. In addition, Veterans with service in Korea between January 9, 1962, and May 7, 1975, on Thailand military bases between January 9, 1962, and May 7, 1975, on C-123 airplanes between 1969 and 1986, and in testing and storage areas outside of Vietnam between 1944 and a yet-to-be-determined date, are eligible to apply and receive disability benefits as a result of diseases caused by Agent Orange exposure.
A recent change in the law allows that any Veteran that served in or near the demilitarized zone (DMZ) for any length of time between September 1, 1967, and August 31, 1971, or served in the Republic of Vietnam for any length of time between January 9, 1962, and May 7, 1975, may be entitled to get disability benefits for an illness believed to be the result of Agent Orange exposure. This may include serving aboard a vessel on the inland waterways or on a vessel operating not more than 12 nautical miles seaward from the demarcation line of the waters of Vietnam and Cambodia (as detailed in Public Law 116-23, the Blue Water Navy Vietnam Veterans Act of 2019).
What is Agent Orange?
Agent Orange is a herbicide mixture used from 1962 to 1971 by the US military to spray over Vietnam to defoliate inland hardwood and coastal mangrove forests that could conceal opposition forces, to destroy crops that those forces might depend on, and to clear tall grasses and bushes from the perimeters of US base camps and outlying fire-support bases. Mixtures of 2,4-D, 2,4,5-T, picloram, and cacodylic acid made up the bulk of the herbicides sprayed. The main chemical mixture sprayed was Agent Orange (a 50:50 mixture of 2,4-D and 2,4,5-T).
How were Veterans exposed to Agent Orange?
Surviving Vietnam veterans are at a much higher risk than the general public for various negative health effects due to their exposure to herbicides. Because deployment to the theater during the Vietnam War was not specifically recorded in military records, the number of U.S. military personnel who served in the Vietnam theatre of operations and the surrounding waters is unknown. Estimates range from 2.6 million to 4.3 million, depending on which dates are used to define the Vietnam era and which areas are included in the Vietnam theater of operations. In 2018, VA estimated that approximately 5,978,000 Vietnam-era veterans (deployed and non-deployed, defined as dates of service from August 1964 to April 1975) were living.
However, any Veteran with “boots on the ground” in the Republic in Vietnam or exposed on C-123 airplanes are entitled to the presumptive criteria for the diseases listed below. Blue Water Navy Veterans located within 12 nautical miles seaward of the demarcation line from Vietnam are also presumptively eligible for the diseases listed below. Korean Veterans that served “on or near the DMZ” are also eligible for the presumption. Thailand Veterans, however, do not have the same wide spectrum of presumption. Veterans that served on certain Royal Thai Air Force bases have to show that they were exposed coincident with their military occupational specialty (MOS). The specifics of providing exposure to Agent Orange in Thailand is complex. For simplicity’s sake, a Veteran must show service on or near the perimeter of the base. Some jobs that involved working on or near the perimeter are, but not limited to dog handlers; Veterans working on the flight-line, in the mechanist shop next to the flight line, in the barracks next to the perimeter, or supply services. Lastly, Veterans that were involved in testing or disposal of herbicides may be entitled to apply and receive benefits.
What are the conditions related to Agent Orange?
Listed below are the diseases presumptively believed to have been the result of Agent Orange exposure. However, if a Veteran believes a condition not on the list is casually related to Agent Orange exposure, they are also eligible to apply and provide competent medical evidence in support of their contention. The Veteran will need to show a diagnosis of a current disability and a “nexus” or link to between Agent Orange exposure and that disability. In these instances, scientific proof may be required. Acceptable forms of proof include an article from a medical journal or a published research study that supports a causal relationship between the current disability and exposure to the agents used in the herbicide mixture. And, of course, the Veteran must provide information on how such exposure occurred.
Cancers and other illnesses believed to have been found casually related to Agent Orange exposure include:
- Chronic B-cell leukemia: A type of cancer that affects your white blood cells (cells in your body’s immune system that help to fight off illnesses and infections)
- Hodgkin’s disease: A type of cancer that causes your lymph nodes, liver, and spleen to get bigger and your red blood cells to decrease (called anemia)
- Multiple myeloma: A type of cancer that affects your plasma cells (white blood cells made in your bone marrow that help to fight infection)
- Non-Hodgkin’s lymphoma: A group of cancers that affect the lymph glands and other lymphatic tissue (a part of your immune system that helps to fight infection and illness)
- Prostate cancer: Cancer of the prostate (the gland in men that helps to make semen)
- Respiratory cancers(including lung cancer): Cancers of the organs involved in breathing (including the lungs, larynx, trachea, and bronchus)
- Soft tissue sarcomas(other than osteosarcoma, chondrosarcoma, Kaposi’s sarcoma, or mesothelioma): Different types of cancers in body tissues such as muscle, fat, blood and lymph vessels, and connective tissues
- AL amyloidosis: A rare illness that happens when an abnormal protein (called amyloid) builds up in your body’s tissues, nerves, or organs (like your heart, kidneys, or liver) and causes damage over time
- Chloracne(or other types of acneiform disease like chloracne): A skin condition that happens soon after contact with chemicals and looks like acne often seen in teenagers.
- Diabetes mellitus type 2: An illness that happens when your body is unable to properly use insulin (a hormone that turns blood glucose, or sugar, into energy), leading to high blood sugar levels
- Ischemic heart disease: A type of heart disease that happens when your heart doesn’t get enough blood (and the oxygen the blood carries). It often causes chest pain or discomfort.
- Parkinson’s disease: An illness of the nervous system (the network of nerves and fibers that send messages between your brain and spinal cord and other areas of your body) that affects your muscles and movement—and gets worse over time
- Peripheral neuropathy, early onset: An illness of the nervous system that causes numbness, tingling, and weakness.
- Porphyria cutanea tarda: A rare illness that can make your liver stop working the way it should and can cause your skin to thin and blister when you’re out in the sun.
Interestingly, the 2018 NAS report found that there is now “sufficient evidence of an association” between exposure to herbicides and hypertension and monoclonal gammopathy of undetermined significance (MGUS), which is a precursor to multiple myeloma. However, despite the strong scientific medical evidence, the VA has not included either of these conditions to its list of presumptive diseases.
What compensation and benefits are available because of Agent Orange exposure?
For each condition listed in the presumptive diseases, when a Veteran is found eligible for compensation, the VA will assign a rating and effective date for that rating based on the Schedule for Rating Disabilities. The rate of compensation is based on a series of qualifying criteria for each condition, depending on its severity and associated symptomatology. The monthly payment amount on a disability rating for 2020, or the compensation benefits rate tables can be found here. In addition to disability compensation, benefits include healthcare, automobile allowance, clothing allowance, Specially Adapted Housing/ Special Home Adaptation Grants, Service-Disabled Veterans’ Insurance (S-DVI), Veterans’ Mortgage Life Insurance (VMLI), Vocational Rehabilitation and Employment (VR&E), education assistance, Dependents’ Educational Assistance (DEA), and Special Monthly Compensation (SMC). VA also offers compensation to eligible dependents of Veterans, including a surviving spouse, child(ren), and/or parent(s).