VA's new position on Agent Orange an opportunity for more coverage of veterans' health issues

by Eileen Beal, M.A.

Vietnam veterans can now seek health care benefits for illnesses related to exposure to Agent Orange, according to Mary Ellen McCarthy, Special Projects Counsel for the United States Senate Committee on Veterans' Affairs.

McCarthy, speaking to a packed session at the National Aging and Law Conference in early December, explained the decision is a result of Nehmer v. U.S. Department of Veterans Affairs, which invalidated VA's denials of claims based on diseases related to Agent Orange exposure made on or after Sept. 25, 1985.

Veterans are seeking the benefits from the U.S. Department of Veterans Affairs in increasing numbers, McCarthy said. "Right now, the VA is reviewing about 17,000 claims."

Fifteen illnesses are linked to service-related exposure to the chemical defoliant. Veterans who present with these health conditions and were involved in on-the-ground fighting or small-craft patrols of rivers and shores during the war qualify for health care without any out-of-pocket expenses.

The conditions:

Acute and subacute transient peripheral neuropathy
Amyloid light chain (AL) amyloidosis
B cell leukemias (including hairy cell leukemia)
Chloracne
Chronic lymphocytic leukemia
Diabetes mellitus (type 2)
Ischemic heart disease
Hodgkin's disease
Multiple myeloma
Non-Hodgkin's lymphoma
Parkinson's disease
Pophryia cutanea tarda
Prostate cancer
Respiratory cancers
Soft tissue sarcoma (except osteosarcoma, chondrosarcoma, Kaposi's sarcoma or mesothelioma)

It is worth noting that the illnesses most Agent Orange-exposed veterans are being compensated for – such as diabetes and erectile dysfunction – have never been authoritatively linked to the defoliant. Associated Press reporter Mike Baker writes:

The VA, interpreting that 1991 law and studies that indicated potential associations, has over time added ailments that have no strong scientific link to Agent Orange. The nonprofit Institute of Medicine's biennial scientific analysis of available research, to which the VA looks for guidance, has repeatedly found only the possibility of a link between Agent Orange and diabetes, and that even a chance of a correlation is outweighed by factors such as family history, physical inactivity and obesity.

Types of health benefits

While cash benefits and/or pensions are paid to veterans and their survivors, for disability "incurred or aggravated" during military service, (see info on service-related case benefits) the health benefits of interest to vets and survivors include:

Provision of health care – including in-patient and out-patient care – at a local/regional VA Hospital. Medicare does not pay for care and currently most veterans who do not have service-connected disabilities and/or have income above certain amounts are not being accepted for care. See eligibility criteria.
VA-financed nursing home care. Care is provided for short-term stays or where the veteran has a service-connected disability rated at 70% or more.
Civilian Health and Medical Program of Veterans Affairs (CHAMPVA). This program (often confused with another military program, TRICARE) is available only for spouses and dependents of veterans who are totally and permanently disabled due to service-connected disabilities and surviving spouses and dependents of veterans who died of a service-connected disability. See eligibility criteria.
Unreimbursed Medical Expenses. The UME deduction can enable some veterans and family members to obtain medical care, health insurance and/or home or institutional care.

Significantly more disabled and/or low-income vets and their families could qualify for these – and other health care benefits – but they aren't applying for them, said McCarthy. This means that those who have significant contact with the vets and the elderly – lawyers, physicians, social services case managers, and even those who are doing admissions at assisted living facilities – need to get more information on VA benefits to their clients.

For health care journalists, it means doing more coverage of vets' health care issues and challenges.

Sources and Resources

Some information from a handout, "VA Benefits: Identifying Veterans and VA Resources to Assist Them," provided by Mary Ellen McCarthy, Dec. 8, 2010.

Federal Benefits for Veterans, Dependents & Survivors is an excellent source of info on vet's health care benefits and services. The state-by-state appendix listing VA facilities is a goldmine of contact information.

Information about VA benefits and services can also be found on the VA website, but unless you know what you are looking for it's a difficult to navigate site.

VA manuals and directives can be downloaded, as well as pamphlets and guides.

To reach VA expert, Mary Ellen McCarthy, Special Projects Counsel, United States Senate Committee on Veteran's Affairs: 202-224-9126 and/or Maryellen_mccarthy@vetaff.senate.gov

The folks assigned to health care issues at the following organizations, all of which helped convene the National Aging and Law Conference, can also provide info and insight on issues affecting vets and the elderly:

National Caregiver Support Line: On Feb. 1, 2011, the Department of Veterans Affairs launched a toll-free National Caregiver Support Line to serve as a resource/referral center. Calls will be answered by VA employees who are licensed clinical social workers. The National Caregiver Support Line will be open Monday through Friday, 8 a.m.-11 p.m., and Saturday 10:30 a.m. to 6 p.m. Eastern time. The National Caregiver Support Line Toll-Free number is 1-855-260-3274. The VA also has updated its caregiver website: www.caregiver.va.gov.

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