MOAA: Seeing Orange

Seeing Orange
You might be entitled to VA benefits for conditions connected to Agent Orange.

He was a teenage soldier assigned to a transportation unit settling into a new base near Long Binh, Vietnam, in 1966. He and others were tasked with clearing growth, and they hired machete-wielding local laborers to help. All went well for a couple of weeks until one morning a swarm of "big ants" infested the area, causing "nasty, welting bites." It brought work to a standstill. The unit didn't have any insecticide, but it did have a 55-gallon drum of herbicide that, the soldiers were told, would "kill anything." The drum was encircled with bright orange stripes — Agent Orange. The soldiers filled backpack spray units and thoroughly covered the area. The next day, the ants — and some of the foliage —were gone, and the unit went back to work. Today, that soldier has multiple myeloma, a cancer of bone marrow cells.

...He was a medic with the 1st Cavalry serving in Vietnam in 1969. On one mission, he and his company were airlifted into an area of jungle covered in white powder. With his troops enduring burning skin, tearing eyes, and constant sneezing, the company's captain learned the area had been sprayed with a chemical defoliant now ubiquitously known as Agent Orange. As the troops advanced through the defoliated area, the chemical got on their packs, clothing, and skin, and it would be two weeks before they could shower or change clothes. Today, that former medic has a neurological condition known as peripheral neuropathy, causing numbness and muscle weakness.

...He was assigned to the 525 Military Intelligence Group at Binh Loi, Vietnam, from November 1967 to January 1969. He occasionally traveled "up country" to Ban Me Tuit and Pleiku, sometimes passing through jungle. Today he has diabetes.

Common threads

Agent Orange History

The ongoing saga of Vietnam, as it relates to Agent Orange, has been fought in two phases. The first was the actual combat in the 1960s and early 1970s. The second phase came in the late 1970s and 1980s, when concerns about the herbicide's effects arose and the federal government, citing a lack of hard evidence, offered no compensation relative to those concerns (a class-action lawsuit against the manufacturers was settled out of court in 1987 for $180 million).

Accusations of government cover-ups swirl around studies that attempted to determine the health effects of Agent Orange. That became a moot point in the early 1990s when the VA, and then Congress, presumed all military members who served in Vietnam were exposed and consequently subjected to health conditions that could be related to Agent Orange. If a veteran who served in Vietnam becomes ill with one of the listed health conditions, that veteran might be entitled to disability compensation.

The VA takes its lead from the National Academy of Sciences' Institute of Medicine, which provides regular comprehensive reports to the VA, reviewing medical literature about human health effects from exposure to chemicals used in the herbicides. "If the literature indicates there's an association between exposures to these agents and some health outcome, then they document that for VA, and VA decides what to do about that," says Mark Brown, director of Environmental Agents Service with the VA Health Administration.

These three soldiers' stories, recounted on veterans' support group Web sites, have two important things in common — and direct contact with Agent Orange is not one of them (the soldier in the last example had no known encounter with the herbicide). Vietnam is the first commonality. By having served there between 1962 and 1975, veterans are presumed by the VA to have been exposed to Agent Orange and thereby are entitled to disability benefits for specific health conditions associated with the herbicide (the same presumption exists for veterans who served in Korea in 1968 or 1969).

In addition to service in Vietnam, the other commonality is that the onset of disease occurred long afterward. The 1st Cavalry medic first noticed his symptoms in 1978 — nine years after his Agent Orange encounter. The ant exterminator suffered several skin boils and infections in the years immediately following his 1966 tour, but his myeloma developed around 1994. The soldier with diabetes was diagnosed in 1996, 27 years after he left Vietnam.

"It doesn't matter how much of that illness is explained by Agent Orange," says Mark Brown, director of Environmental Agents Service with the VA Health Administration. "The presumptive is a blanket presumptive. It affects all [Vietnam] veterans; you don't have to prove it was connected."

Linking symptoms to service

The VA now links 12 diseases to Agent Orange with the addition of Chronic Lymphocytic Leukemia last year. (For a complete list of the 12 diseases and symptoms associated with them, see "Connected Conditions" below.) Despite the amount of news coverage and VA-generated publicity surrounding Agent Orange over the years, some Vietnam veterans might not know about the presumptive compensation standard. With no signs of illness, there was no urgency to pay attention. "Now if they are developing these diseases, they need to go back and have a second look," Brown says.

Brown recommends Vietnam veterans start with an Agent Orange registry exam, available at all VA health facilities. The exam involves a chest X-ray, urinalysis, and blood studies with a particular focus on the listed health conditions. A registry exam is not required to receive VA health care or compensation, nor does it lead directly to compensation. "The registry, today, is mostly outreach," Brown says. "It's the first entry into VA health care. It lets the veterans get their questions answered about health concerns they or their families may be experiencing."

Veterans don't have to get their exam at a VA facility, and Brown understands that Vietnam veterans in particular might be leery of going to the VA. "There were bad relations between Vietnam veterans as a whole and the VA, and we didn't do a great job of addressing health care needs of veterans," Brown says. "We've come a long way since the 1980s. We do a lot better."

Beyond sensitizing itself to Vietnam veterans' particular needs, the VA has made a concerted effort to sensitize all health care providers through a training module called the Veterans Health Initiative (VHI). "Vietnam was a long time ago," Brown says. "Doctors born after the war might as well be talking to a Civil War hero."

VHI gives health care providers background on the details and nature of the war and Vietnam veterans' specific concerns, especially as they pertain to Agent Orange. "Dealing with those concerns is very important," Brown says.

For an Agent Orange registry exam, contact the nearest VA medical facility or consult your own physician (refer your physician to the VHI at www.va.gov/vhi for insight into Agent Orange issues). For more information about Agent Orange, including VA policy changes, listed health conditions, and disability benefits, visit www.va.gov/agentorange.

If you served in the Vietnam War and you notice any of the following symptoms, visit your nearest VA medical facility or have your doctor examine you with an eye toward one of these service-connected medical conditions:

Disease	Symptoms
Chronic lymphocytic leukemia is one of four types of leukemia; it progresses slowly with increasing production of excessive numbers of white blood cells.	Increased fatigue and incidence of infections; shortness of breath; and weight loss.
Chloracne is a skin condition similar to acne among teenagers.	Oily skin and excessive blackheads and pimples.
Diabetes is a condition in which the body does not produce enough insulin or the cells ignore the insulin necessary for the body to use sugar.	Blurry vision; excessive thirst and hunger; frequent urination; increased fatigue; increased irritability; and weight loss.
Hodgkin's disease is a cancer that causes an enlargement of the lymph nodes, liver, and spleen, along with anemia. Non-Hodgkin's lymphoma is a cancer that affects lymph glands.	Increased incidence of infections; painless swelling in the neck, collarbone region, armpits, or groin; severe itching; and shortness of breath.
Multiple myeloma is a cancer of the bone marrow plasma cells.	Bleeding in the nose and gums; bone fractures; bone pain — especially in the back and ribs and spreading through the body; easy bruising; and increased fatigue.
Peripheral neuropathy is a condition of the nerves aside from the brain and spinal cord.	Chest pain; abnormalities in blood pressure; loss of coordination; muscle weakness; and numbness, tingling, burning sensations, or sharp pain in the body.
Porphyria cutanea tarda is a condition in which the skin exposed to the sun becomes fragile.	Changes in pigmentation; increased hair growth; increased iron levels in the liver, which also can lead to liver disease; and severe blistering and scarring of exposed skin.
Prostate cancer is a cancerous tumor in the male reproductive system.	Blood in urine or semen; burning while or difficulty urinating; difficult or painful erections; and pain in the lower back, hips, or thighs.
Respiratory cancers are cancers of the lung, larynx, trachea, and bronchus.	Bloody spit; fatigue; weight loss; persistent hoarseness and coughing; shortness of breath; and swelling of the neck and face.
Soft tissue sarcomas are malignant tumors in muscle, fat, blood vessels, and connective tissues.	Blockage in the gastrointestinal system; dull or persistent nerve or muscle pain; and painless lumps anywhere on the body.
Spina bifida is a congenital spinal cord deformity.	Spina bifida can affect children born to Vietnam veterans. These children are eligible for disability benefits including health care services and vocational training and rehabilitation.