Examples of Approved VA Benefits for Vietnam Veterans

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The Department of Veterans Affairs has a search site to look up specific benefit claim cases.  Below are of few examples of MPN-related claims granted (on appeal).

To search the entire VA claims database click here. -for best results be sure to fill in specific illness and search all possible years.

Myelofibrosis

Citation 18101521-Read full report here

FINDINGS OF FACT –

1. An unappealed claim for service connection for myelomonocytic leukemia was denied by the RO in an October 2011 rating decision. The Veteran was notified of the rating decision, but did not appeal.

2. Evidence received since the last final October 2011 rating decision is new and material, and relates to an unestablished fact necessary to substantiate the claim for service connection for myelofibrosis.

3. The Veteran has a current diagnosis of myelofibrosis.

4. The Veteran is presumed to have been exposed to herbicide agents, to include Agent Orange, in service based on his service in the Republic of Vietnam during the Vietnam Era.

5. The medical evidence of record establishes that the Veteran’s myelofibrosis is related to presumed herbicide agent exposure during service.

CONCLUSION OF LAW -New and material evidence has been received to reopen service connection for myelomonocytic leukemia, now claimed as myelofibrosis. The criteria to establish service connection for myelofibrosis are met.

REASONS AND BASES FOR FINDING AND CONCLUSION-(View full report by clicking on citation number above)… This language was included in the Finding…

A letter dated August 2014 from T.A., MD notes that the doctor provided care for the Veteran beginning in 2005 after he was diagnosed with leukemia. Doctor T.A. stated that he reviewed the Veteran’s military records and considered his exposure in Vietnam to Agent Orange. Citing reports by the Institute of Medicine and the Myeloproliferative Neoplasm Research Foundation, Doctor T.A. stated that Agent Orange is a known causative agent of the type of leukemia with which the Veteran was diagnosed. Considering the Veteran’s diagnosis, military and medical records, and the absence of a family history of bone marrow disease, Doctor T.A. opined that it is more likely than not that the Veteran’s leukemia is a direct result of his exposure to Agent Orange during service. 

Citation=0309503-Read full report here

FINDING OF FACT –  There is competent evidence attributing the diagnosis of primary myelofibrosis to the veteran’s service.

CONCLUSION OF LAW –  Primary myelofibrosis was incurred in service.

REASONS AND BASES FOR FINDING AND CONCLUSION-  Although the Veterans Claims Assistance Act of 2000, Pub. L. No. 106-475, 114 Stat. 2096, is applicable to the veteran’s claim, the Board finds that it is unnecessary to address its applicability in this case in view of the disposition reached herein. The veteran’s service records show that his occupational specialty was that of an aircraft engine mechanic during his military career. In 2000, the veteran was diagnosed with primary myelofibrosis. The veteran asserts that he developed this disease due to Agent Orange exposure while in Vietnam.

Citation 0731552-Read full report here

FINDINGS OF FACT:

1. The veteran served on active duty in the Republic of Vietnam during the Vietnam era.

2. He currently has myeloproliferative disorder with myelofibrosis; this condition was initially diagnosed many years after service.

3. Medical evidence is in relative equipoise as to whether the veteran’s myeloproliferative disorder with myelofibrosis was caused by exposure to Agent Orange in service.

 

Background/Analysis:

The veteran has submitted evidence which suggests an association between myeloproliferative disorder with myelofibrosis and exposure to chemicals, such as benzene. He submitted articles which discuss the use of Agent Orange during the Vietnam War. The articles indicate that Agent Orange was a 50-50 mix of two chemicals and that the combined product was mixed with kerosene or diesel fuel and dispersed by aircraft. Other articles note that benzene is a volatile aromatic hydrocarbon which causes various types of leukemia, lymphoma and blood diseases, including myelofibrosis. The greatest risk was to workers who use various petroleum solvents containing benzene such as painters, gasoline distribution workers, refinery workers, chemical workers, rubber workers, printers, newspaper pressworkers and shoe and leather workers. The veteran submitted additional articles regarding herbicide exposure, benzene exposure, dioxins and the health risks associated with exposure to small amounts of chemical benzene.

CONCLUSION OF LAW -Resolving all reasonable doubt in favor of the veteran, myeloproliferative disorder with myelofibrosis was incurred as the result of exposure to Agent Orange in service.

 

Essential Thrombocythemia

Citation 19144431 -Read full report here

FINDINGS OF FACT

1. Resolving reasonable doubt in his favor, the Veteran was exposed to Agent Orange during active service.

2. The Veteran’s thrombocythemia is associated with in-service Agent Orange exposure.

3. The Veteran’s venous stasis ulceration of the bilateral lower extremities is proximately due to his service-connected thrombocythemia

…The Veteran submitted two letters from his treating physicians linking his thrombocythemia to his Agent Orange exposure. An October 2010 letter from the Veteran’s oncologist, Dr. D.B., indicated that the Veteran was diagnosed with thrombocythemia and has been under his care since June 2009. Dr. D.B. wrote that the Veteran was exposed to Dioxin while in Vietnam. He indicated that the Veteran’s diagnosis of essential thrombocytosis was as likely as not related to Dioxin (Agent Orange). A January 2011 letter from Dr. N.B., a hemotologist, indicated that the Veteran was also under her care. Dr. N.B. wrote that the Veteran was exposed to dioxin on different occasions while serving in Vietnam. At the time, she indicated that she was not aware of any studies linking dioxin to essential thrombocythemia but felt that the Veteran’s condition may be as likely as not related to his dioxin exposure.

CONCLUSION OF LAW – Essential thrombocythemia, a form of leukemia, was incurred in active service.

 

Polycythemia Vera

Citation 1414817- Read full report here

FINDINGS OF FACT

1. The Veteran served in the Republic of Vietnam during the Vietnam era, and therefore he is presumed to have been exposed to herbicides.

2. The most probative evidence of record demonstrates that the Veteran’s polycythemia vera is etiologically related to his in-service herbicide exposure.

CONCLUSION OF LAW The criteria for service connection for polycythemia vera are met.

Please see language below in this case the “nexus” is specifically explained as contributing to the decision to grant benefits.

“Concerning Shedden element (3), a nexus between the Veteran’s in-service herbicide exposure and his current polycythemia vera, the Board notes that there are positive nexus opinions of record. An October 2009 treatment record by Dr. Green, D.O., indicated that it was notable that the Veteran had served in Vietnam and that it was entirely possible that he had been exposed to chemicals during his tour of duty which may have contributed to his myeloproliferative disorder (polycythemia vera is categorized as a myeloproliferative disorder). Also of record are several letters from Dr. Webb, M.D., the Veteran’s primary care physician. In the most recent letter, dated August 2012, Dr. Webb noted that the Veteran was previously evaluated by a hematologist who believed that chemical exposure during the Veteran’s tour in Vietnam, specifically Agent Orange, had contributed to his current medical condition. Dr. Webb went on to reason that given the lack of other possible etiologies for his condition and the mounting evidence that Agent Orange has been implicated in other cases of polycythemia, the Veteran’s exposure would make the most sense for a cause and effect relationship. Dr. Webb opined that, based on his review of the Veteran’s records, he concurred that the Veteran’s Vietnam exposure was at least as likely as not to be contributory to his current medical condition. In the absence of any contrary nexus evidence, the Board finds the private physicians’ opinions to be the most probative evidence concerning the etiology of the Veteran’s polycythemia vera. Accordingly, the Board finds Shedden element (3) has been satisfied.”

Susan: An Interview with a Caregiver

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How has your loved one’s MPN diagnosis impacted your life?

My husband was diagnosed 15 years ago while we were in our mid 30’s and the only information that was obtainable at that time was grim.  Needless to say, there were tears in the beginning…questions like, will he walk our then 6 year old down the aisle when she gets married?  Will I be a widow before my 50’s? However, as the information and medical treatments improved, so did our attitude towards the MPN’s.  In a way, our lives are so much more rich due to him having this disease.  We celebrate the little things more and don’t sweat the small stuff.  Work isn’t the driving force behind our partnership, it’s quality family time.  We now have two kids in college but remain incredibly close to them at all times.   We founded a support group and truly care about each of the 100+ members in this group, some of the members are as close as family members to us.

Do you feel like you had the knowledge and resources you needed to navigate the various challenges of dealing with this diagnosis.  

15 years ago, there wasn’t all that much information in terms of support around MPN’s.  But now, thanks to the MPN Research Foundation and MPN Advocacy and Education International, we feel like the information and support are just a click away.  Our support group meetings have been invaluable to me in terms of learning more about the disease and talking with other caregivers on how to continue to support our loved one.

What are your biggest challenges in trying to help your loved one?  

I remember back in 2005, we were at a Mayo MPN Conference in Arizona, one of the topics that was discussed was Hospice.  After listening for 20 minutes, I excused myself and went to the ladies room where I broke down and cried. A very wise, elder lady gave me a big hug and said, “Wrap it up.  You can’t show you’re weak to your partner, they need you to be strong for them.  You are their biggest advocate and you are so needed to help them win this fight, now…dry those tears and walk out with a smile on your face”.  I remember it so well.   I thought about what my husband was hearing during this talk and how frightening it must have been for him.  It shouldn’t have been his job to console me.  I needed to be there for him to console him, which is just what I did, thanks to my new friend.  Four years later, my husband had complications with his spleen and he spent 3+ weeks in the hospital.  It was hard juggling young children and being present for him at the hospital.  I knew the best decision was to have the help of friends, family and neighbors take over my role with the kids so I could be the best advocate for my husband.  I needed to be there, at the hospital, helping him navigate the complicated hospital maze.  There were discussions with the many medical team members who were rotating constantly.  My husband was highly medicated and found it hard to tell his story correctly.  There was NO better person than me to make sure his story was being told correctly so he got the proper care.  My kids got hugs and kisses from me at the end of the night, but it was my husband’s life at stake and I’m glad I made the choice to always be strong and present for him.

What thoughts or advice do you have for those just beginning a journey with a partner with an MPN?  

The journey that begins with a diagnosis of an MPN is an unexpected and unpredictable one.  But the only constant is the support that you can provide your loved one.  Being there with them at doctor’s appointments, medical conferences and support group meetings as well as occasionally checking in with them to see how they are doing are among the most valuable contributions you can provide.  Also, you may notice certain side effects of medications that the patient is unaware of such as mood swings, lack of engagement or loss of emotion, and can inform the doctor. It is the job of the advocate to pay attention to these changes and make sure steps are taken to resolve them. If you are a significant other, I believe it is best that you go on this journey together by making mutual decisions on things such as new medications and tests. My view is that every decision has potential positive or negative outcomes and you both have to live with them…so do it together.

 

A Veteran’s Widow Gets VA Approval

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In 2011, my husband filed a claim with the VA in hopes of having his myelofibrosis recognized as service related disease.  He believed his exposure to Agent Orange while in Vietnam caused his MPN. He died in May 2014. His claim had been denied twice. After he died, my son and I went to a hearing in June 2015 to once again have his case reviewed.  On January 13, 2017, I received notice from the VA stating my husband’s illness and death were related to his service in Vietnam and his benefits were approved. This was good news and a financial benefit for me. However, the VA has denied many more cases because MPNs are not included on their ‘presumptive’ list of service-related illnesses.

There were several things we did which I believe helped our case. For example:

  • We researched the cases where benefits have been approved.  In each of the approved cases I found there were letters from the veteran’s doctor in support of the connection between the illness and their service. Keep it simple.  It does not need to be too technical.
  • We were sure to include a nexus:  a statement of their job in the service and their exposure. Our letter of approval from the VA mentioned both our doctor’s letters and the nexus.
  • We created an executive summary of our case, and kept it to one page and provided all back up information with it.

We hope our victory is useful to other veterans in their effort to receive benefits for their MPN.

MPN Advocacy & Education International is creating a package
for Veterans with MPNs to assist in their efforts when filing a claim.  
We will keep you posted as it is finalized.  

Click here to learn more about service-related illnesses and Agent Orange.