Hypertension has long been a concern for veterans, especially those who served in Vietnam and were exposed to Agent Orange. The recent approval of hypertension as a service-connected disability under the PACT Act marks a significant milestone in addressing the health concerns of veterans who have been battling this condition for years. Leah explores the relationship between hypertension and Agent Orange exposure, the implications of the recent approval, and some of the medical aspects involved.
The Impact of Agent Orange: A Toxic Legacy
During the Vietnam War, the U.S. Air Force sprayed around 11 million gallons of Agent Orange, a potent herbicide, across Vietnamese forests to strip away cover for insurgents. Used between 1962 and 1971, Agent Orange was highly toxic due to its dioxin content, a dangerous carcinogen. Vietnam War veterans may have been exposed to dioxin in Agent Orange through inhalation, ingestion of contaminated food or drink, or absorption via skin, eyes, or mouth. This exposure has had lasting health impacts on Vietnam veterans, with hypertension being a significant concern linked to Agent Orange.
The PACT Act and Service Connection
The approval of hypertension as a presumed service-connected disability for Agent Orange exposure is a crucial development. For years, veterans suffering from hypertension sought recognition for their condition, attributing it to exposure during their service in Vietnam.
Passed in August 2022, the Honoring Our Promise to Address Comprehensive Toxics (PACT) Act made it easier for Vietnam War veterans exposed to Agent Orange to qualify for VA disability benefits. The PACT Act added hypertension and monoclonal gammopathy of undetermined significance (MGUS) to the list of presumptive conditions. Veterans no longer need to prove that Agent Orange caused their high blood pressure, as the VA now presumes these conditions were caused or aggravated by their exposure during service in or around Vietnam.
The PACT Act’s acknowledgment of this link is a monumental win for Vietnam veterans, opening the door to disability benefits that are rightfully deserved.
Understanding Hypertension
Before talking about the specifics of Agent Orange exposure, it’s essential to understand hypertension. Defined by a systolic blood pressure of 140 or above or a diastolic blood pressure of 90 or above, hypertension is a serious medical condition. It is often diagnosed through sustained elevated blood pressure levels, requiring careful monitoring and, in some cases, medication.
Understanding How VA Defines Hypertension
Before talking about the specifics of Agent Orange exposure, it’s essential to understand hypertension. Hypertension is a serious medical condition often diagnosed through sustained high blood pressure levels, requiring careful monitoring and, in some cases, medication.
While the VA’s decision on hypertension and Agent Orange exposure is beneficial, it’s important to note that its disability process defines hypertension more strictly than leading medical organizations. The CDC, American College of Cardiology, and American Heart Association define hypertension as a systolic pressure over 130 mm Hg and diastolic over 80 mm Hg, which is also accepted by VA doctors.
To qualify for veteran disability benefits, you must have either of these:
- A systolic blood pressure (SBP) of 160 mm Hg or higher and a diastolic blood pressure (DBP) of 90 mm Hg or higher.
- A SBP of 160 mm Hg with a DBP under 90 mm Hg (isolated systolic hypertension).
To strengthen your claim, ask your doctor to complete a Disability Benefits Questionnaire that thoroughly documents your hypertension and treatment strategy.
Presumptive Agent Orange Conditions
Hypertension now joins a list of presumptive Agent Orange conditions, including Hodgkin’s disease, ischemic heart disease, and diabetes mellitus type 2, allowing veterans meeting specific parameters to be granted service connection more easily. This development is part of ongoing efforts to recognize and address the health issues resulting from Agent Orange exposure. While nexus letters—medical opinion letters—are not required for and service connections, those conditions considered presumptive in nature generally have a nexus established by way of a veteran serving in a specific location at a specific time.
Research Supporting the Link
Several research studies have explored the association between Agent Orange exposure and hypertension. One such study, “Herbicide Exposure, Vietnam Service, and Hypertension Risk in Army Chemical Corps Veterans,” published in the Journal of Occupational and Environmental Medicine in 2016, analyzed medical records of 3086 Army Chemical Corps veterans to investigate this relationship. The study found that 81.6% of Chemical Corps members who sprayed herbicides in Vietnam reported high blood pressure, while only 64.6% of those who neither served in Vietnam nor sprayed herbicides reported the same condition. The results reinforced the connection between Agent Orange and hypertension, recognizing the latter as a service-connected disability.
Another study, “Cytochrome P450 1A1 is Required for Vascular Dysfunction and Hypertension Induced by 2,3,7,8-Tetrachlorodibenzo-p-Dioxin (TCDD),” published in Toxicological Sciences in 2010, analyzes the molecular mechanisms linking herbicide exposure to vascular dysfunction and hypertension. The key findings of this study are that TCDD exposure leads to an increase in reactive oxygen species (ROS) production, endothelial dysfunction, and high blood pressure, depending on the presence of CYP1A1.
These studies provide valuable insights for Vietnam veterans and healthcare professionals seeking to understand and address the health impacts of Agent Orange exposure.
Establishing Hypertension and Agent Orange Service Connection
Veterans who served in areas affected by Agent Orange and have developed hypertension may now qualify for VA disability pay and benefits without needing to prove a direct service connection, thanks to the PACT Act. Here are some important considerations:
- VA Hypertension Diagnosis:
If you’re managing high blood pressure with medication, it can support a VA diagnosis. Even without medication, ensure your doctor properly documents your hypertension, as the VA has specific criteria. A nexus letter linking your hypertension to military service, particularly Agent Orange exposure, can also be beneficial at times. - Documented Blood Pressure Readings:
Your blood pressure readings should be documented over three different days, with at least two readings per day. Keeping a personal log or getting readings from a pharmacy can provide crucial evidence during your C&P Exam. - Service and Deployment Records:
Here are the specific locations and periods during which Veterans must have served to establish a service connection for hypertension due to Agent Orange exposure:- Any U.S. or Royal Thai military base in Thailand from January 9, 1962, to June 30, 1976
- Laos from December 1, 1965, to September 30, 1969
- Mimot or Krek, Kampong Cham Province, Cambodia from April 16, 1969 to April 30, 1969
- Guam, American Samoa, or their territorial waters from January 9, 1962 to July 30, 1980
- Johnston Atoll or any U.S. ship visiting Johnston Atoll from January 1, 1972 to September 30, 1977
- The Republic of Vietnam from January 9, 1962 to May 7, 1975
- Additional Evidence:
Include lay statements from family and friends when applicable to further support your case. Moreover, consulting a Veterans law attorney can help ensure your claim is as compelling as possible.
Rating and Compensation for Hypertension
The compensation for hypertension is outlined in the 38 Code of Federal Regulations. Veterans diagnosed with hypertension may qualify for benefits like free toxin screenings, subsidized health care, and disability compensation. The ratings range from 0% to 60%, with the severity of hypertension determining the assigned rating. For example, a 10% rating is assigned if the diastolic or systolic pressure falls within a certain range, and the ratings increase based on the severity of the condition. Medication management can also be considered in determining the appropriate compensation level.
Conclusion
The recognition of hypertension as a service-connected disability for veterans exposed to Agent Orange is a significant step forward in addressing the health concerns of those who served in Vietnam. The PACT Act’s approval brings hope and relief to many Vietnam veterans who have long struggled with hypertension. As more conditions are added to presumptive lists, it is crucial to continue research and advocacy efforts to ensure that veterans receive the disability benefits they rightfully deserve. The journey toward comprehensive recognition and support for veterans exposed to Agent Orange continues, and the approval of hypertension as a service-connected disability is a noteworthy achievement in this ongoing battle.
Also read: What to Expect in a Plantar Fasciitis C&P Exam
At Prestige Veteran Medical Consulting, a veteran-owned company, we specialize in Independent Medical Opinions (IMOs) known as Nexus letters.
Our purpose is to empower YOU, the veteran, to take charge of your medical evidence and provide you with valuable educational tools and research to guide you on your journey.
Understanding the unique challenges veterans face, our commitment lies in delivering exceptional service and support.
Leveraging an extensive network of licensed independent medical professionals, all well-versed in the medical professional aspects of the VA claims process, we review the necessary medical evidence to incorporate in our reports related to your VA Disability Claim.
Prestige Veteran Medical Consulting is not a law firm, accredited claims agent, or affiliated with the Veterans Administration or Veterans Services Organizations. However, we are happy to discuss your case with your accredited VA legal professional.
