Cancers Caused by Agent Orange

Agent Orange was an herbicide that was sprayed across Vietnam.  The chemicals used in Agent Orange are toxic.  Unfortunately, many Vietnam veterans were exposed to Agent Orange during their service.  VA has acknowledged that there are many cancers caused by Agent Orange.

Presumption that cancer was caused by Agent Orange exposure

Because of special rules put in place by VA, veterans who served in Vietnam are almost always presumed to have been exposed to Agent Orange during their service.  If a Vietnam veteran develops certain types of cancers, VA should also presume that the cancer was caused by this exposure to Agent Orange.  The cancers that VA presumes to be caused by Agent Orange exposure are:

If you are a Vietnam veteran who develops one of these cancers, you should file a claim for disability benefits with VA for your cancer.  A complete list of conditions presumed to have been caused by Agent Orange exposure is available here.

Proving service-connection for cancers presumed caused by Agent Orange exposure

Since the cancers listed above are  on the list of conditions that are presumed to have been caused by Agent Orange, VA should determine that they are a service-connected disability.  If VA does not, then you are probably going to need to file a notice of disagreement to appeal your denial of service connection.  If VA grants service connection, they should issue a rating decision giving VA’s opinion on the amount of your disability.

Even if the cancer that you develop is not on the list, you can attempt to prove that your cancer is service-connected.  All Vietnam veterans with “boots on the ground” benefit from the presumption that they were exposed to Agent Orange.

If your cancer or other medical condition is not on VA’s list, you can still try to prove that Agent Orange exposure caused it.  You could also try to prove that it was service-connected in some  other way.

How does VA calculate the disability rating for my cancer?

VA uses ratings tables published in the Code of Federal Regulations to rate medical conditions. The disability rating given by VA in the rating decision should depend on your particular type of cancer and the severity of it.  Some examples of ratings tables for the different types of cancer are discussed below.

Chronic B-cell Leukemias

Leukemia is rated using diagnostic code 7703.  Leukemia should be rated at 100% when it is in the active treatment phase.

7703   Leukemia:
With active disease or during a treatment phase 100
Otherwise rate as anemia (code 7700) or aplastic anemia (code 7716), whichever would result in the greater benefit.
Note: The 100 percent rating shall continue beyond the cessation of any surgical, radiation, antineoplastic chemotherapy or other therapeutic procedures. Six months after discontinuance of such treatment, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of §3.105(e) of this chapter. If there has been no recurrence, rate on residuals.

Six months after treatment is completed, there should be a mandatory VA examination and additional ratings should be based on residuals if there has been no recurrence.

Hodgkin’s disease

Hodgkin’s disease is rated using diagnostic code 7709.    Hodgkin’s disease should be rated at 100% when it is in the active treatment phase.

7709   Hodgkin’s disease:
With active disease or during a treatment phase 100
Note: The 100 percent rating shall continue beyond the cessation of any surgical, radiation, antineoplastic chemotherapy or other therapeutic procedures. Six months after discontinuance of such treatment, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of §3.105(e) of this chapter. If there has been no local recurrence or metastasis, rate on residuals.

Six months after treatment is completed, there should be a mandatory VA examination and additional ratings should be based on residuals if there has been no local recurrence or metastasis.

Multiple myeloma

There is no specific diagnostic rating code for multiple myeloma.  Depending on the area of the body affected, it may be rated using diagnostic code 5012.

5012   Bones, new growths of, malignant 100
Note: The 100 percent rating will be continued for 1 year following the cessation of surgical, X-ray, antineoplastic chemotherapy or other therapeutic procedure. At this point, if there has been no local recurrence or metastases, the rating will be made on residuals.

Non-Hodgkin’s Lymphoma

Non-Hodgkin’s Lymphoma is rated using diagnostic code 7715.  Veterans with Non-Hodgkin’s Lymphoma should receive a 100% rating during treatment and for six months after treatment is discontinued.

7715   Non-Hodgkin’s lymphoma:
With active disease or during a treatment phase 100
Note: The 100 percent rating shall continue beyond the cessation of any surgical, radiation, antineoplastic chemotherapy or other therapeutic procedures. Six months after discontinuance of such treatment, the appropriate disability rating shall be dtermined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of §3.105(e) of this chapter. If there has been no local recurrence or metastasis, rate on residuals.

Once treatment is discontinued, the veteran will be rated based on residuals unless there is a local recurrence or metastasis.

Prostate Cancer

Malignant prostate cancer should entitle an individual to a 100% rating.  This rating should continue until the prostate cancer is successfully treated (does not reoccur or metastasize).  After the prostate cancer is successfully treated, VA should assign a rating according to any residual voiding or renal dysfunction.  The tables explaining the various ratings are below.

7528   Malignant neoplasms of the genitourinary system 100
Note—Following the cessation of surgical, X-ray, antineoplastic chemotherapy or other therapeutic procedure, the rating of 100 percent shall continue with a mandatory VA examination at the expiration of six months. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of §3.105(e) of this chapter. If there has been no local reoccurrence or metastasis, rate on residuals as voiding dysfunction or renal dysfunction, whichever is predominant.

§4.115a   Ratings of the genitourinary system—dysfunctions.
Diseases of the genitourinary system generally result in disabilities related to renal or voiding dysfunctions, infections, or a combination of these. The following section provides descriptions of various levels of disability in each of these symptom areas. Where diagnostic codes refer the decisionmaker to these specific areas dysfunction, only the predominant area of dysfunction shall be considered for rating purposes. Since the areas of dysfunction described below do not cover all symptoms resulting from genitourinary diseases, specific diagnoses may include a description of symptoms assigned to that diagnosis.

Rating
Renal dysfunction:
Requiring regular dialysis, or precluding more than sedentary activity from one of the following: persistent edema and albuminuria; or, BUN more than 80mg%; or, creatinine more than 8mg%; or, markedly decreased function of kidney or other organ systems, estpecially cardiovascular 100
Persistent edema and albuminuria with BUN 40 to 80mg%; or, creatinine 4 to 8mg%; or, generalized poor health characterized by lethargy, weakness, anorexia, weight loss, or limitation of exertion 80
Constant albuminuria with some edema; or, definite decrease in kidney function; or, hypertension at least 40 percent disabling under diagnostic code 7101 60
Albumin constant or recurring with hyaline and granular casts or red blood cells; or, transient or slight edema or hypertension at least 10 percent disabling under diagnostic code 7101 30
Albumin and casts with history of acute nephritis; or, hypertension non-compensable under diagnostic code 7101 0
Voiding dysfunction:
Rate particular condition as urine leakage, frequency, or obstructed voiding
Continual Urine Leakage, Post Surgical Urinary Diversion, Urinary Incontinence, or Stress Incontinence:
Requiring the use of an appliance or the wearing of absorbent materials which must be changed more than 4 times per day 60
Requiring the wearing of absorbent materials which must be changed 2 to 4 times per day 40
Requiring the wearing of absorbent materials which must be changed less than 2 times per day 20
Urinary frequency:
Daytime voiding interval less than one hour, or; awakening to void five or more times per night 40
Daytime voiding interval between one and two hours, or; awakening to void three to four times per night 20
Daytime voiding interval between two and three hours, or; awakening to void two times per night 10
Obstructed voiding:
Urinary retention requiring intermittent or continuous catheterization 30
Marked obstructive symptomatology (hesitancy, slow or weak stream, decreased force of stream) with any one or combination of the following:
1. Post void residuals greater than 150 cc.
2. Uroflowmetry; markedly diminished peak flow rate (less than 10 cc/sec).
3. Recurrent urinary tract infections secondary to obstruction.
4. Stricture disease requiring periodic dilatation every 2 to 3 months 10
Obstructive symptomatology with or without stricture disease requiring dilatation 1 to 2 times per year 0

Respiratory Cancers

Respiratory cancers are generally rated using diagnostic code 6819 when they are malignant.

6819   Neoplasms, malignant, any specified part of respiratory system exclusive of skin growths 100
Note: A rating of 100 percent shall continue beyond the cessation of any surgical, X-ray, antineoplastic chemotherapy or other therapeutic procedure. Six months after discontinuance of such treatment, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of §3.105(e) of this chapter. If there has been no local recurrence or metastasis, rate on residuals.

This rating should continue until six months after the treatment is discontinued and there is no recurrence or metastasis.  At that point, a disability rating will be assigned based on residual dysfunction.  One common residual dysfunction of respiratory cancer is restrictive lung disease, The tables explaining the various ratings are below.

6845   Chronic pleural effusion or fibrosis.
General Rating Formula for Restrictive Lung Disease (diagnostic codes 6840 through 6845):
FEV-1 less than 40 percent of predicted value, or; the ratio of Forced Expiratory Volume in one second to Forced Vital Capacity (FEV-1/FVC) less than 40 percent, or; Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO (SB)) less than 40-percent predicted, or; maximum exercise capacity less than 15 ml/kg/min oxygen consumption (with cardiac or respiratory limitation), or; cor pulmonale (right heart failure), or; right ventricular hypertrophy, or; pulmonary hypertension (shown by Echo or cardiac catheterization), or; episode(s) of acute respiratory failure, or; requires outpatient oxygen therapy 100
FEV-1 of 40- to 55-percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; DLCO (SB) of 40- to 55-percent predicted, or; maximum oxygen consumption of 15 to 20 ml/kg/min (with cardiorespiratory limit) 60
FEV-1 of 56- to 70-percent predicted, or; FEV-1/FVC of 56 to 70 percent, or; DLCO (SB) 56- to 65-percent predicted 30
FEV-1 of 71- to 80-percent predicted, or; FEV-1/FVC of 71 to 80 percent, or; DLCO (SB) 66- to 80-percent predicted 10

Soft Tissue Sarcomas

Soft tissue sarcoma can be rated using various diagnostic codes depending on the type of soft tissue sarcoma.  These diagnostic codes include 5329, 7123, and 8540.  All three entitle the veteran to a 100% rating until six months after discontinuance of treatment.  At that point, the rating is determine based on residual impairment of function if there has been no local recurrence or metastasis.

5329   Sarcoma, soft tissue (of muscle, fat, or fibrous connective tissue)—100
Note: A rating of 100 percent shall continue beyond the cessation of any surgery, radiation treatment, antineoplastic chemotherapy or other therapeutic procedures. Six months after discontinuance of such treatment, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of §3.105(e) of this chapter. If there has been no local recurrence or metastasis, rate on residual impairment of function.

What if the rating decision is incorrect?

VA’s rating decision may be incorrect.  If it is, you can appeal the decision by filing a notice of disagreement.  Also, if your cancer gets worse, you can file for an increased rating.

VA presumes many different diseases were caused by Agent Orange exposure.  The types of cancer listed above are just some of the many diseases that are presumed to have been caused by exposure to Agent Orange in Vietnam.  Even if your cancer or other disease is not on the list of presumptive conditions, you can still attempt to prove that it was caused by Agent Orange exposure.

If you have any questions about filing a claim for a disability resulting from Agent Orange exposure or appealing a VA decision that you believe was made in error, consulting with a VA accredited attorney is probably a good choice.

What if I have more questions about my VA claim?

I understand you want your VA claim to be done as quickly as possible. But remember the ultimate goal – to win your VA disability compensation claim.

You may eventually get there on your own, but it may be after a series of decisions by the Regional Office and Board of Veterans Appeals. Sometimes claims are appealed and remanded several times, which can cause a claim to drag on for years. If you are interested in avoiding unnecessary delay in your claim and want to do everything you can to maximize your chances of success, it is probably a good idea for you to consult with an accredited veterans disability attorney.

We would be happy to talk to you. If you would like a free consultation with our Perkins Studdard veterans disability attorneys just click here or give us a call to begin the process.

Travis Studdard is an attorney who focuses on representing veterans in VA disability compensation claims.  He regularly writes about issues that are important to veterans and their families.
You can subscribe to his Veterans Disability channel on YouTube.

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