In two previous blog posts, we discussed how veterans of Vietnam (or other areas where Agent Orange was stored or sprayed) exposed to Agent Orange can get presumptive service connection for their disability, instead of having to establish direct service connection. Remember that direct service connection involves a nexus between the disability and service. Presumptive service connection allows a veteran to only show that they served in Vietnam (or other area) during the relevant time period and they are presumed to have been exposed to Agent Orange. From there, there is a list of diseases that the VA has recognized as being related to Agent Orange.
The list can be found here, and the diseases include: AL Amyloidosis, Chronic B-cell Leukemias, Chloracne, Diabetes mellitus Type 2, Hodgkin’s Disease, Ischemic Heart Disease, multiple Myeloma, Non-Hodgkin’s Lymphoma, Parkinson’s Disease, Peripheral Neuropathy (Early-Onset), Porphyria Cutanea Tarda, Prostate Cancer, Respiratory cancers (including lung cancer), and Soft Tissue Sarcomas (other than osteosarcoma, chondrosarcoma, Kaposi’s sarcoma, or mesothelioma). If you have one of these diseases on the list, and you can establish that you were present in Vietnam during the proper time period (therefore establishing that you were exposed to Agent Orange), you can get service connected.
But what happens if you were exposed to Agent Orange but developed a condition that is not on the VA’s list? What happens when the VA has not conceded that your particular disability is related to Agent Orange?
We are here to encourage and remind you that there are still other ways to get service connected if you have a disability that is not on the VA’s list and you were exposed to Agent Orange. The two ways we are going to cover are direct service connection and secondary service connection.
Just because the presumption may not be available to you, it does not mean you cannot still pursue direct service connection. This means you would need to provide 1) a doctor’s statement that you currently suffer from the disease or its residuals, and 2) an opinion from a medical expert stating that it is at least as likely as not that Agent Orange caused the disease or disability. The first allows you to establish that you have a disability, and the second is a nexus statement linking your disability to service; that is how to get service connected.
The VA must weigh and consider the entire analysis that the doctor provides so you will want to make sure it includes as much relevant information as possible. In asking a doctor or medical expert to write you a report, there are a few things you will want to make sure he/she includes: 1) an analysis of relevant studies of Agent Orange, 2) the amount of time between the exposure to Agent Orange and the onset of the disease, and 3) other risk factors for developing the disease, such as genetic disposition or family history. The VA will not look favorably on a statement that only mentions a statistical correlation between Agent Orange exposure and your disease and bases their opinion on nothing else.
If you are not able to get a doctor’s opinion, and you only provide medical evidence to the VA that your disease is related to Agent Orange, what the VA should do is provide you with an examination. This will lead the examiner to produce a medical opinion addressing whether the disease is at least as likely as not related to your service. The examiner must consider direct service connection, not only the presumption or whether the VA considers the disease related, and then support the conclusion.
What if you have a disease that is on the VA’s list of recognized diseases related to Agent Orange, but this disease causes another condition that is not recognized by the VA? Remember that you still have another type of service connection available to you: secondary service connection. Secondary service connection is when either a service-connected condition contributes to the development of a new disability or where a service-connected disability aggravates a non-service connected condition. One common example of this is with type 2 diabetes, which often leads to other disabilities such as arteriosclerosis, cataracts, hypertension, neuropathy, hypoglycemia, coronary artery disease, heart attack, stroke, and even depression. Those other conditions can be service connected through the disease that is on the VA’s list.
The VA’s list of diseases associated with Agent Orange is being updated as new scientific evidence comes along. Your disease may be being studied by the Institute of Medicine and could be the next one to be recognized by the VA as being associated with Agent Orange exposure. If the disease is added to the list and gets presumptively service connected, you may be able to get retroactive benefits. And if the VA previously denied you disability benefits for a disease that the VA now recognizes as being associated with Agent Orange, you may want to reapply and file a new application for the same benefits under the new regulations. Do not lose hope if you are denied or if your disease is not on the VA’s list. Try other avenues to get service connected because presumptive service connection is not the only way, just one way.