If you're a veteran who worked in close proximity to open air burn pits during the Iraq and Afghanistan wars, in Djibouti, or in the Southwest Asia theater of operations, you may have returned home with symptoms of respiratory illness, or been diagnosed with chronic bronchitis or a rare illnesses known as constrictive bronchiolitis.
Many veterans of the Vietnam War who were exposed to Agent Orange developed different types of respiratory cancers. Similar to their cases, these respiratory conditions and other illnesses are eligible for disability from the United States Department of Veterans Affairs (VA).
However, obtaining VA benefits for respiratory illnesses isn’t always easy. There are some respiratory medical conditions that have been given a presumptive service connection. (This means that if you are veteran who served during the Gulf War have been diagnosed with a certain medical condition you don’t need the usual amount of evidence to file a disability claim and can more easily secure VA disability compensation. Generally when veterans apply for disability benefits they must prove that their time in service either caused or aggravated their adverse medical conditions. In legal terms this is known as a nexus. But when VA grants presumptive status for an illness that skips the need for proof of a nexus making the path to getting disability payouts a little easier.)
The presumptive condition list includes:
- Asthma diagnosed after service
- Chronic bronchitis
- Chronic rhinitis
- Chronic sinusitis
- Constrictive bronchiolitis or obliterative bronchiolitis
- Interstitial lung disease
- Pulmonary fibrosis
- Respiratory cancer (of any type)
The VA has also added nine respiratory cancers to the list of presumptive conditions for veterans who were exposed to burn pit smoke in Iraq, Afghanistan, and other overseas locations.
The nine respiratory cancers are:
- Squamous cell carcinoma of the larynx,
- Squamous cell carcinoma of the trachea,
- Adenocarcinoma of the trachea,
- Salivary gland-type tumors of the trachea,
- Adenosquamous carcinoma of the lung,
- Large cell carcinoma of the lung,
- Salivary gland-type tumors of the lung,
- Sarcomatoid carcinoma of the lung,
- Typical and atypical carcinoid of the lung.
Personnel exposed to excessive radiation during their service who developed lung cancer, bronchioloalveolar carcinoma, or cancer of the pharynx may also qualify for a presumptive service connection.
Additionally, people exposed to Agent Orange and other herbicides that have resulted in cancer of the trachea, lung, bronchus, or larynx are eligible. For most other respiratory illnesses, veterans must prove the service connection.
It is important to have an experienced disability lawyer to help you. Because the VA looks at each claim individually, working with a disability lawyer can improve your chances of getting your claim approved.
How Does the VA Rating System Work?
The VA ratings for the respiratory system are based on three main things:
- How well the lungs take in air
- How well the lungs absorb oxygen into the blood
- How the lungs exhale leftover gasses
To make determinations in these three areas, the VA requires an individual to go through pulmonary function tests (PFTs) to show if the lungs are functioning properly and how the body is affected. Because the lungs provide oxygen into the blood stream, if you have a severe lung condition, it can affect the heart, so various heart tests are included as part of the PFTs.
Here's a brief look at some of these tests and their VA ratings:
This series of tests records how the lungs and the airway to the lungs function. Ideally, a patient performs the tests before and after taking medication. If not, the doctor needs to explain the reasons for this in the medical report. The performance results after medication are the ones that must be used for the VA rating unless the results prior to taking the medication are worse—and this isn’t usually the case.
Here are the measurements used for the rating:
- Forced Vital Capacity (FVC). After taking a full breath, the FVC indicates the maximum amount of air you can exhale.
- Forced Expiratory Volume in one second (FEV-1). This indicates the greatest amount of air you can blow out in a single second.
- Ratio of FEV-1 to FVC. This measurement is used to determine the ratio between both the maximum amount of exhaled air and the air blown in one second.
- Flow-Volume Loop. This test is calculated from the spirometry results and charts the patient’s entire lung capacity—his ability to move air by inhaling completely, exhaling completely, and then inhaling quickly again. The results are presented on a graph, but it’s the doctor’s analysis that matters. He needs to state if there’s an obstruction that’s blocking the patient’s airflow.
This test, also known as a stress test, determines how much oxygen is being used by the body when it’s performing at "maximum capacity." This is defined as the greatest amount of physical activity that can be "repeated and sustained" by the patient.
When the VA rates these conditions, the agency gives one rating for each respiratory condition, and uses the rating that best reflects the patient’s general, overall condition. Here's a brief look at some of these ratings:
- FEV-1. If the results are less than 40 percent, you'll likely get a rating of 100 percent.
- FEV-1. If the results are 40–55 percent, you'll likely get a rating of 60 percent.
- FEV-1. If the results are 56–70 percent, you'll likely get a rating of 30 percent.
- FEV-1. If the results are 71–80 percent, you'll likely get a rating of 10 percent.
- FEV-1/FVC. If the results are less than 40 percent, you'll likely get a rating of 100 percent.
- FEV-1/FVC. If the results are 40–55 percent, you'll likely get a rating of 60 percent.
- FEV-1/FVC. If the results are 56–70 percent, you'll likely get a rating of 30 percent.
- FEV-1/FVC. If the results are 71–80 percent, you'll likely get a rating of 10 percent.
- Exercise test. If the results are less than 15 ml/kg/min with the limitation caused by a respiratory or heart condition, you'll likely get a rating of 100 percent. If the results are
15–20 ml/kg/min with the limitation caused by a respiratory or heart condition, you'll likely get a rating of 60 percent.
We Can Help
If you're a veteran suffering from a respiratory illness you believe is service-related, particularly if you worked near open burn pits during your tour of duty, contact Cuddigan Law at 402-933-5405 or email us [email protected]. We’ll evaluate your claim to help determine your eligibility for benefits.