WASHINGTON—A recent political development, more than 50 years in the coming, has the potential to significantly change who receives benefits for Parkinson’s disease through the VA.
About 2.6 million veterans who served during the Vietnam War were potentially exposed to the herbicide Agent Orange (2,4,5-trichlorophenoxyacetic acid and 2,4-dechlorophenoxyacetic acid), according to the VA. The Institute of Medicine, now the Health and Medicine Division of the National Academies of Sciences, Engineering and Medicine, determined in its report Veterans and Agent Orange: Update 2008 that “suggestive but limited evidence [indicates] that exposure to Agent Orange and other herbicides used during the Vietnam War is associated with an increased chance of developing Parkinson’s disease.”
More evidence linking the two has emerged since that report. A study of Korean veterans exposed to the defoliant during the Vietnam War recently found a number of significant differences between Parkinson’s patients with Agent Orange exposure and those without it. Agent Orange-exposed veterans had less facial expression, worse motor symptoms and notably different brain imaging, researchers found, suggesting “the possibility of different pathophysiology of PD in patients exposed to Agent Orange from idiopathic PD.”1
The VA recognized PD as a presumptive illness arising from Agent Orange exposure in 2010. That meant veterans filing disability claims for PD who were exposed to the chemical did not have to prove an association between their disease and military service.
But, based on a restrictive reading of the law providing benefits for servicemembers exposed to Agent Orange, the VA limited disability compensation to veterans who could demonstrate “boots on the ground” in Vietnam or its inland waterways. As a result, servicemembers who served in the waters off of Vietnam, often called the “Blue Water Navy,” did not qualify for presumptive coverage, if they developed PD.
That changed in January when a federal court ruled in Procopio v. Wilkie that veterans who served in the ships offshore of Vietnam are entitled to a presumption of service connection for illnesses linked to Agent Orange exposure in disability claims.
Five months later, President Donald Trump signed into law H.R. 299, the Blue Water Navy Vietnam Veterans Act of 2019. The new law codified coverage for veterans who served in the 12 nautical mile territorial sea of the Republic of Vietnam and expanded presumptive benefits to also include veterans who served in the Korean Demilitarized Zone. In addition, the law included a stay allowing the VA to wait until January 2020 to begin processing claims.
“Tonight, we can finally tell the tens of thousands of veterans who were exposed to Agent Orange during the Vietnam War but wrongly denied benefits that justice is finally coming. By passing the Blue Water Navy Vietnam Veterans Act, Congress has proven to the nation, to our veterans and their families, and the surviving loved ones of those we lost to toxic exposure, that we have righted a terrible injustice,” said Rep. Mark Takano (D-Calif.), who introduced the bill, after the Senate unanimously passed it.
Many veterans groups shared his view. “The VFW is proud of the 116th Congress for ending this benefits inequity, and we salute President Trump for quickly signing H.R. 299 into law,” said Veterans of Foreign Wars National Commander B.J. Lawrence.
Other veterans advocates were less pleased, notably John Wells, executive director of Military-Veteran Advocacy and one of the attorneys who represented Alfred Procopio Jr. in his suit against the VA.
“The Procopio [ruling] gives us a chance to move into the waters offshore which extends past the territorial sea. That could result in another 55,000” veterans qualifying for coverage beyond those specified by the new law, he told U.S. Medicine.
The VA estimated that the number of Blue Water veterans is as high as 420,000 to 560,000.
Wells put the number closer to 90,000, based on “the Congressional Research Service and the Navy Historical and Heritage Command. We also did an analysis based on the 713 ships that deployed and their manning levels as well as factoring in crew rotations.”
VA Secretary Robert Wilkie cited the larger number in explaining the need to wait until January to begin processing claims, as provided under the law.
“If that law was not passed, the VA would have had to continue to process the claims under Procopio. It was a harmful action by the chairman of the House veterans committee that actually hurt veterans,” Wells said.
For those who served in the territorial waters of Vietnam and who have illnesses such as Parkinson’s disease that will be presumptively associated with their service, however, both the court ruling and the new law represent a light at the end of a decadeslong tunnel.
- Yang Y, Cheon M, Kwak YT. Is Parkinson’s Disease with History of Agent Orange Exposure Different from Idiopathic Parkinson’s Disease? Dement Neurocogn Disord. 2016;15(3):75–81.
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