One of four major types of leukemia, CLL is a disease that progresses slowly studies: Adult-onset (Type 2) diabetes, Hodgkin’s disease, multiple myeloma, non …
January 2003
Agent Orange and Chronic Lymphocytic Leukemia
What is chronic lymphocytic leukemia CLL? How many Vietnam veterans
are affected, and what is the evidence they are at risk?
One of four major types of leukemia, CLL is a disease that progresses
slowly with increasing production of excessive numbers of white blood
cells As the disease worsens, the person first may experience such
symptoms as fatigue, shortness of breath, weight loss, or frequent
infections Veterans who have experienced such symptoms do not
necessarily have the disease and should discuss any concerns with a
physician The chance of recovery from CLL largely depends on the
stage of the disease as well as the patients age and general health
The treatment plan also often depends on these factors
Based on the normal rate of CLL in adult American men, among the 31
million Vietnam veterans who served in southeast Asia, VA would expect
there might be 560 new cases every year The Institute of Medicine
IOM noted in a report to VA that nearly all cases occur after the age
of 50 The IOM discussed six studies that
distinguished CLL from other
forms of leukemia, two of them examining herbicide exposure as a risk
factor Although the evidence as a whole indicated persons exposed to
herbicides similar to Agent Orange or some of its components have a
heightened risk of CLL, VA is not able to estimate a firm number of CLL
cases that would be expected in Vietnam veterans because the findings
from these studies cannot be generalized
When will Vietnam veterans with CLL be able to receive compensation?
VA must undertake formal regulation development to implement Secretary
of Veterans Affairs Anthony J Principis decision Jan 23 to grant
service-connection to Vietnam veterans with CLL Usually a proposed
rule is published in the Federal Register, public comment is accepted
and a final rule follows based on the input received This process
involves coordination with the Office of Management and Budget, but VA
will make every effort to make the regulation effective as soon as
possible
Vietnam veterans who know they have a diagnosis of CLL may wish to
contact VA at the Special Issues Help Line at 1-800-749-8387 for more
information or may call their nearest benefits regional office for
guidance on claims at 1-800-827-1000 The new regulation, when
enacted, will enable VA to compensate in-country Vietnam veterans with
CLL on a presumptive basis, meaning VA will presume that the disease
was connected with the individuals service However, veterans will
not
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Agent Orange 2/2/2/2
receive disability compensation automatically and will need to apply
for the benefit Although claims can be filed now, claims cannot be
decided until the final regulation is effective Among the issues to
be resolved is whether disability compensation may be paid
retroactively
Does VA know of Vietnam veterans with CLL from its health care records?
How will VA be contacting those Vietnam veterans to let them know of
the possibility of new disability compensation benefits?
VA has not at this time established a mechanism to identify individual
veterans However, VA attempts to keep all of the 314,000 veterans who
have signed up for the Agent Orange Registry health examination program
informed about benefits
changes through newsletters and will highlight
the Secretarys determination in future mailings to the group
Additional outreach measures may be considered, and veterans are
encouraged to visit the VA Web site for the latest information between
mailings of Agent Orange Review Two VA Web sites with considerable
information about Agent Orange are
http://wwwvbavagov/bln/21/benefits/herbicide/ and
http://wwwvagov/agentorange/
Will compensation be retroactive for Vietnam veterans who previously
applied for compensation for leukemia and were turned down? If a
veteran died from chronic lymphocytic leukemia years ago, will his
widow be eligible for survivor benefits now?
VA will address the effective date in its regulation It would be
premature to speculate at this time about how the rules will apply
What other diseases does VA recognize as related to Agent Orange for
benefits purposes?
VA has established similar presumptions of service connection for ten
categories of disease found to have been associated with exposure to an
herbicide agent based on scientific studies: Adult-onset Type 2
diabetes,
Hodgkins disease, multiple myeloma, non-Hodgkins lymphoma,
acute and subacute peripheral neuropathy, porphyria cutanea tarda,
chloracne, prostate cancer, respiratory cancers cancer of the lung,
bronchus, larynx, or trachea, and soft-tissue sarcoma other than
osteosarcoma, chondrosarcoma, Kaposis sarcoma, or mesothelioma
To qualify for this presumption, chloracne and porphyria cutanea tarda
must be evident to a degree of disability of ten percent or more within
one year after the date of last exposure The other conditions are
presumed service connected if they are evident to a degree of
disability of ten percent or more at any time after exposure The
percentages refer to degree of severity based on medical findings that
are outlined in VA regulations
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Agent Orange 3/3/3/3
Why was the category of finding evidence of an association changed
now for CLL?
In each of its four previous biennial reports, the IOM concluded there
was inadequate/insufficient evidence to determine whether an
association exists between exposure to an herbicide agent and the
subsequent
occurrence of leukemia in exposed persons However, in
these previous reports, all forms of leukemia were considered together,
and as a group had not risen to the level of finding a link to Agent
Orange exposure VA requested the special review because of concerns
that CLL shares some similarities with non-Hodgkins lymphoma, already
associated with Agent Orange exposure or Vietnam service
People wishing to receive e-mail from VA with the latest news releases
and updated fact sheets can subscribe at the following Internet
address:
http://wwwvagov/opa/pressrel/opalist_listservcfm
Source:ekha.eu
