Nearly all veterans who served in overseas conflicts in the last 31 years would be granted presumptive benefits status for a host of respiratory illness and cancers under a sweeping proposal to be introduced by Senate leaders next week.
In addition, Vietnam veterans who suffer from high blood pressure would be granted the same presumptive status for their disability claims, potentially handing out billions more in payouts to the aging group.
The legislative package, dubbed the True Cost of War Recognition Act, represents the most ambitious attempt so far by Congress to address the long-term health effects of burn pits and other toxic exposure events on veterans who served in wars overseas, both recent and long past.
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Outside groups have successfully lobbied in recent years to broaden the number of illnesses linked to the use of the chemical defoliant Agent Orange during the Vietnam War. But hypertension has remained off the list, in large part because Veterans Affairs officials still have not accepted outside scientific studies that have shown a strong link between the two.
Similarly, advocates for years have complained that Veterans Affairs officials have done too little to react to rising cases of unusual, serious illnesses among veterans who worked near burn pit smoke during overseas deployments, or were exposed to other potential chemical poisoning on missions.
VA leaders in the past have argued that without more scientific backing — both in understanding what contaminants troops were exposed to and what long-term health effects those chemicals have on the human body — they could only offer partial solutions to the problem.
Lawmakers from both the House and Senate Veterans’ Affairs officials have vowed to force changes the issues this year. Committee leaders are expected to begin public debate on the new legislation as early as next week, with the hope of committee votes on the idea before Memorial Day.
A copy of the measure obtained by Military Times shows nine new lung illnesses that would be reclassified as presumed connected to burn pit exposure during military service: asthma, chronic obstructive pulmonary disease, chronic bronchitis, constrictive bronchiolitis, emphysema, pleuritis, pulmonary fibrosis, interstitial lung disease and sarcoidosis.
In addition, eligible veterans who are diagnosed with any form of respiratory cancer or glioblastoma (brain cancer) would also be granted presumptive benefits status.
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Typically, for veterans to receive disability benefits, they must prove that their ailments are directly connected to injuries or illnesses which happened as a direct result of their military service. In toxic exposure cases, that usually means combing through military medical and duty records, some of which have deteriorated or disappeared over the decades.
The presumptive distinction means that veterans only need to show that they contracted one of the illnesses after or during their military service, and that they served in the designated areas and time frames outlined under benefits law.
Under the TCRW Act, that eligible group would include all veterans who served in the following locations:
— in Iraq from August 1990 to March 1991 and from March 2003 until present day;
— in Afghanistan from September 2001 until present day;
— in Kuwait, Saudi Arabia, Oman and Qatar from August 1990 until present day;
— in Djibouti, Syria, Jordan, Egypt, Lebanon and Yemen from September 2001 until present day;
— any other area later determined by a federal agency where burn pits were used by the military overseas.
That group contains more than 4 million veterans and counting. More than 223,000 individuals have registered on VA’s Open Burn Pit Registry, but outside advocates believe that number likely undercounts the full number of individuals suffering from burn pit related illnesses.
Including hypertension as a presumptive condition for the Agent Orange list is expected to affect around 160,000 veterans. The new legislation also includes an expansion of Agent Orange presumptive status for individuals who served in Thailand, Laos, Cambodia, American Samoa and Guam during the 1960s and 1970s
The measure also includes new research by VA on the issue of toxic exposures, to include health trends for post-9/11 veterans and cancer rates among veterans.
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The price tag for the entire package is unknown. The hypertension presumptive alone has been estimated at more than $15 billion over a decade. Additional benefits for hundreds of thousands of younger veterans could easily exceed that amount.
Earlier this year, VA Secretary Denis McDonough vowed that money would not be a deciding factor in how the department approaches those disability payouts.
“People often are inclined to focus first on the cost,” he said. “I want to focus first on the facts and on the data.”
Lawmakers have said if they can advance the toxic exposure legislation in both chambers in the next few weeks, the are optimistic the entire package could be on the president’s desk for final signature by the end of the year. Implementation of the new presumptive rules would likely push any payouts to late 2022 at the earliest.