PACT Act Becomes Law

PACT Act brings a number of changes:

•  Expands VA health care eligibility for Veterans with toxic exposures and for Veterans who              served in Vietnam, the Gulf War, and the post-9/11 era.

• Add more than 20 presumptive conditions have been added related to toxic exposures (with various effective dates)
• Expands locations for presumptive exposure to Agent Orange
• Allows all Veterans enrolled in VA health care to receive toxic exposure screening

Cancers related to burn pit and other toxic exposures:

• Cancers of the brain, gastrointestinal tract, gliobastoma, head, kidney, lymphatic, lymphoma,         melanoma, neck, pancreas, reproductive tract, and respiratory tract.

Illnesses related to burn pit and other toxic exposures:

•  Asthma, chronic bronchitis, chronic obstructive pulmonary disease (COPD), chronic rhinitis, chronic sinusitis, constrictive bronchiolitis or obliterative bronchiolitis, emphysema, granulomatous disease, interstitial lung disease (ILD), pleuritis, pulmonary fibrosis, and sarcoidosis.

Required areas and times of exposure:

•  Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Uzbekistan, Yemen, and the airspace above any of these locations on or after 9/11/2001.
•  Bahrain, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, Somalia, the United Arab Emirates (UAE), and the airspace above any of these locations on or after 8/12/1990. 

 Changes related to Agent Orange:

• Adds hypertension and monoclonal gammopathy of undetermined significance (MGUS) to list of presumptive illnesses.
• Adds new areas of presumed exposure during certain time periods:  any U.S. or Royal Thai military base (1/9/1962-6/30/1976), Laos (12/1/1965-9/30/1969), parts of Cambodia (4/16/1969-4/30/1969), Guam or American Samoa and their territorial waters (1/9/1962-7/30/1980), and Johnston Atoll or on a ship that called at Johnston Atoll (1/1/1972-9/30/1977).

2022 Budget Request Submitted to Congress

For fiscal year 2022, the White House has requested nearly $270 billion be budgeted for the Department of Veterans Affairs, which represents a 10% increase from 2021.  The 2022 budget is the third largest among the Cabinet departments, behind Defense and Health and Human Services.  The budget request includes $152.7 billion for mandatory spending, which includes compensation, pensions, disability pay, education benefits and other required outlays.  The increase, according to VA, would fund a number of its priority programs for mental health care, homelss veterans, caregivers, and suicide prevention: 

• Mental health services would be provided a $1.5 billion to meet increased demand.  
• Homeless Veterans programs would see an increase of $2.2 billion, which will be used to support case management and help veterans obtain permanent housing using vouchers.
• The VA caregiver program was expanded in October 2020 to include wounded veterans who served between the end of the Vietnam War and September 11, 2001. Additional funding was requested as the number of eligible Veterans is expected to be approximately 52,000 users in fiscal year 2022.
• The budget submission requests $598 million for suicide prevention programs, which is nearly double that provided in fiscal year 2021.

Officials at VA acknowledged that the budget proposal follows an infusion of more than $36 billion in the past year for COVID-19 relief and recovery.   Nor does the VA budget include $18 billion provided by the American Jobs Plan for VA health care infrastructure or $260 million in the American Families Plan for veterans who are parents.

After the proposed budget submission, Congress will deliberate over the actual funding and draft the final language of the bill, hopefully by October 1^st.  

The National Defense Authorization Act for Fiscal Year 2021 - Agent Orange Additions

In January 2021, three more medical conditions were added to those on the presumptive list for Veterans exposed to herbicides in service:

• Bladder cancer
• Hypothyroidism
• Parkinsonism or Parkinson's Disease-like symptoms

This change in law is expected to involve nearly 240,000 Veterans, many of whom have been previously denied benefits.

VA a step closer to processing claims for new Agent Orange conditions

 In January 2021, the National Defense Authorization Act, was approved and added three additional conditions to the presumptive list related to Agent Orange exposure:  bladder cancer, hypothyroidism, and Parkinsonism or Parkinson-like symptoms.  VA estimates that roughly 52,000 Veterans and 6,000 surviving family members will be impacted in the first year of the new policy.

It was also announced by VA that it plans to automatically review previously denied claims and will notify those Veterans and their survivors regarding the status of those claims.  No time limit was provided by VA to re-adjudicate the claims for the additional Agent Orange conditions, but it was reported that at this time VA has a claims backlog of 190,000 claims.

Johnny Isakson and David P. Roe M.D. Veterans Health Care and Benefits Improvement Act of 2020

In January 2021, the Veterans Health Care and Benefits Improvement Act became effective and will impact many Veterans.   This new law includes many changes to enhance or expand education benefits for Veterans, military service members, their families and survivors, and also provides for improvement and/or expansion of various GI Bill programs.

 Blue Water Navy Veterans Act of 2019

VA announced that it will review claims by Blue Water Navy Veteran and their survivors who were previously denied benefits for conditions related to possible herbicide exposure in the offshore waters of Vietnam.  Approximately 90,000 Navy Veterans are now eligible for herbicide related benefits following enactment of the Blue Water Navy Vietnam Veterans Act of 2019 (PL 116-23), which became effective January 1, 2020.  This Act extends eligibility to Navy Veterans who served within 12 nautical miles offshore of Vietnam.

VA collaborated with the National Archives and Records Administration (NARA) to digitalize more than 29 million images from U.S. Navy and Coast Guard deck logs into a processing system that identifies ships that may have travelled in the territorial waters of Vietnam.  The work of identifying the system remains a work in progress

VA to expedite benefits for respiratory problems related to service in SW Asia

 A recent internal review by VA of reports and scientific evidence has resulted in recommendations to create new presumptions related to air-quality and burn pit exposure in Iraq, Afghanistan and other areas in SW Asia.  Initially, these conditions include asthma, sinusitis, and rhinitis.  VA estimates that 3.5 million Veterans were exposed to burn pits.  This announcement occurs at a time when Congress is considering a number of bills dealing with illnesses caused by exposure to pollutants from burn pits and other environmental hazards.

The next step in establishing new presumptions is for VA to undergo rulemaking to change its regulations.  Unfortunately, this can be a lengthy process in most instances, but Secretary Denis McDonough promised in a news release that this process would be treated as an “urgent matter”.  McDonough stated further that, “We are moving out smartly in initiating action to consider these and other potential new presumptions, grounded in science and in keeping with my authority as secretary of VA.”

Previously, VA has claimed that the science is not clear as to a clink between respiratory conditions and exposure to burn pits.  McDonough now asserts that VA will not only look to reports from the National academies of Science but also to other research available. 

Proposed burn pit legislation submitted in 2021:

Conceding Our Veterans’ Exposure Now and Necessitating Training Act (COVENANT Act) was introduced in March 2021, which proposes to streamline the VA claims process by creating a number of conditions as being presumptively linked to burn pit exposure.  These conditions include:

Asthma; cancer of head, neck, respiratory, gastrointestinal, reproductive system, lymphoma, lymphatic, kidney and brain; chronic obstructive pulmonary disease (COPD) as well as other diseases of the respiratory tract to include the sinuses.

Presumptive Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act of 2021 was introduced in April 2021.  This Act includes a number of conditions and is similar to those found in victims of the 9/11 attacks.

Veterans Burn Pit Exposure Recognition Act was introduced in February 2021 would recognizes and concedes exposure to various airborne contaminants from burn pits for Veterans deployed to Southwest Asia but does not provide for presumptions of the results of that exposure.

Toxic Exposure in the Military Act (TEAM) was introduced in April 2021 and would expand VA health care eligibility for those Veterans exposed to toxic substances in service.

SFC Heath Robinson Burn Pit Transparency Act was re-introduced in April 2021 requires VA to document a Veteran who may have been exposed to burn pits and provide a biannual report to Congress on the number of Veterans exposed, the conditions reported, and the number and status of disability claims related to that exposure, among other things.

Burn Pit Registry

In January 2013, (PL 112-600) was passed that required VA to establish a registry for those Veterans who served in Southwest Asia and were exposed to open burn pits. Information about airborne hazards and to sing up for the Open Burn Pit Registry is available at:

https://veteran.mobilehealth.va.gov/AHBurnPitRegistry/#page/home

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