Hypertension linked to Agent Orange

[rainvet]

Hypertension linked to Agent Orange Date: 7/28/2007

The IOM (Institute of medicine) http://www.iom.edu/
has issued a report stating that those exposed to Agent Orange have
higher instances of Hypertension.

The VA has not yet listed Hypertension as a presumptive condition
related to Agent Orange, but could fairly soon if they choose too.

In order to get the earliest possible date for payments, I suggest
you file for compensation if you have a medical diagnosis of
Hypertension and served in Vietnam during that war.

You should have your doctor review the report (if possible) and state
that your hypertension is mostly caused by exposure to agent orange
if this is the case; your doctor may believe hypertension is caused
by your smoking, obesity, etc. But if there is no other reason for
your hypertension your doctor can state that agent orange exposure is
the most likely cause. Also cite the new IOM report in your VA claim.
See and read report online at:
http://www.iom.edu/CMS/3793/4689/44596.aspx

---Start article --- Agent Orange linked to blood pressure
Washington July 29, 2007

War veterans exposed to the defoliant Agent Orange during the Vietnam
War may face increased risk of high blood pressure, an expert panel
has warned.

Citing what it called limited but important evidence, a report was
issued by a panel of the US Institute of Medicine.

It was the latest in a series issued every two years assessing the
health effects of exposure to Agent Orange and other chemicals used
in Vietnam.

The panel said recent studies of Vietnam veterans offered evidence
that Agent Orange caused elevated rates of high blood pressure.

The panel, which reviewed about 350 epidemiological and animal
studies, also pointed to evidence linking the chemicals to AL
amyloidosis, a rare disease in which protein builds up around organs.

Agent Orange has already been linked to health problems including
several rare cancers, type II diabetes and birth defects in the
children of the veterans exposed.

The new findings may bring veterans one step closer to getting
government-paid medical services for these conditions.

The panel said recent studies of Vietnam veterans who handled Agent
Orange and the other defoliants offered evidence that they had
elevated rates of high blood pressure.

The University of Kentucky's Hollie Swanson and other members of the
panel said the evidence for both of the links was limited or
suggestive, but still persuasive.

"It's important to know what things might be associated with Agent
Orange exposure, given the number of people exposed. Many of them are
in their 60s now, late 50s," panel member Richard Fenske of the
University of Washington said.

"They're getting to a stage in their lives where certain kinds of
diseases may become evident that may not have been evident in youth."

Researchers are still trying to understand exactly how toxic
contaminants in these herbicides, particularly the chemical TCDD,
cause damage, Swanson said.

The Department of Veterans Affairs must now decide if it will
formally recognize the link between Agent Orange exposure and these
conditions, according to Jerry Manar, an official with the group
Veterans of Foreign Wars of the United States.

If it does, the report will help hundreds of thousands of veterans
get treatment in VA medical centers for hypertension and associated
heart disease and strokes, Manar said.

"This relieves a huge burden from veterans," he added. {REUTERS}

[rainvet]

Agent Orange May Boost Vietnam Vets' Hypertension Risk

FRIDAY, July 27 (HealthDay News) -- Exposure to the defoliant herbicide Agent Orange during the Vietnam War may be raising blood pressure levels for the aging veterans of that conflict.

That's the biggest change in the latest of a series of reports from the U.S. Institute of Medicine on the long-term health effects of Agent Orange. The report was released Friday.

The IOM's Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides last issued its updated findings in 2005; this report is based on data collected up to 2006. The reports are compiled at the request of the U.S. Department of Veterans Affairs.

"In two new studies, Vietnam veterans with the highest exposure to herbicides exhibited distinct increases in the prevalence of hypertension; the prevalence of heart disease was also increased," the report found, although the IOM committee stopped short of suggesting that wartime exposure to Agent Orange is currently raising veterans' risk of ischemic heart disease.

The group said the latest data on hypertension risk is of a much higher quality than prior research looking at links between Agent Orange and heart disease or heart disease risk factors. However, the new findings are "consistent" with those gleaned from prior research.

There were other changes to the IOM's latest update ofVeterans and Agent Orange: Health Effects of Herbicides Used in Vietnam, which is issued every two years (this is the seventh such report).

As new data have emerged, a few important cancer types -- malignancies of the brain, stomach, colon, rectum and pancreas -- were moved from a category labeled "limited or insufficient evidence ofnoassociation [with Agent Orange]" to a more neutral category --"inadequate or insufficient evidence to determine association."

The committee was deadlocked and indecisive on whether to move two more tumor types -- breast cancer and melanoma -- as well as ischemic heart disease, from the "inadequate or insufficient evidence to determine association" category up to a category that implies there might be a connection to Agent Orange exposure -- "limited or suggestive evidence of association."

According to the report, "the committee could not reach consensus about the strength of the evidence" on those issues.

Finally, data on an illness linked to multiple myeloma, called amyloidosis, did satisfy the criteria needed to include it in the "limited or suggestive evidence of association" category, associating it for the first time with exposure to the herbicide.

All of these category changes are important, since the VA often consults the committee's reports when making medical or disability coverage decisions for Vietnam veterans. Certain conditions -- sarcomas, non-Hodgkin's lymphomas, chronic lymphocytic leukemia, and Hodgkin's disease -- have been found by the committee to be clearly associated with Agent Orange exposure, for example. The status of other conditions remains more ambiguous.

That ambiguity continues to rile veterans advocates such as Phil Kraft, executive director of the Darien, Conn.-based National Veterans Services Fund. He said that while he "admires the perseverance" of the IOM committee, too many sick Vietnam vets are still fighting for proper care.

http://www.washingtonpost.com/

[rainvet]

FRIDAY, July 27 (HealthDay News) -- Exposure to the defoliant herbicide Agent Orange during the Vietnam War may be raising blood pressure levels for the aging veterans of that conflict.

That's the biggest change in the latest of a series of reports from the U.S. Institute of Medicine on the long-term health effects of Agent Orange. The report was released Friday.

The IOM's Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides last issued its updated findings in 2005; this report is based on data collected up to 2006. The reports are compiled at the request of the U.S. Department of Veterans Affairs.

"In two new studies, Vietnam veterans with the highest exposure to herbicides exhibited distinct increases in the prevalence of hypertension; the prevalence of heart disease was also increased," the report found, although the IOM committee stopped short of suggesting that wartime exposure to Agent Orange is currently raising veterans' risk of ischemic heart disease.

The group said the latest data on hypertension risk is of a much higher quality than prior research looking at links between Agent Orange and heart disease or heart disease risk factors. However, the new findings are "consistent" with those gleaned from prior research.

There were other changes to the IOM's latest update ofVeterans and Agent Orange: Health Effects of Herbicides Used in Vietnam, which is issued every two years (this is the seventh such report).

As new data have emerged, a few important cancer types -- malignancies of the brain, stomach, colon, rectum and pancreas -- were moved from a category labeled "limited or insufficient evidence ofnoassociation [with Agent Orange]" to a more neutral category --"inadequate or insufficient evidence to determine association."

The committee was deadlocked and indecisive on whether to move two more tumor types -- breast cancer and melanoma -- as well as ischemic heart disease, from the "inadequate or insufficient evidence to determine association" category up to a category that implies there might be a connection to Agent Orange exposure -- "limited or suggestive evidence of association."

According to the report, "the committee could not reach consensus about the strength of the evidence" on those issues.

Finally, data on an illness linked to multiple myeloma, called amyloidosis, did satisfy the criteria needed to include it in the "limited or suggestive evidence of association" category, associating it for the first time with exposure to the herbicide.

All of these category changes are important, since the VA often consults the committee's reports when making medical or disability coverage decisions for Vietnam veterans. Certain conditions -- sarcomas, non-Hodgkin's lymphomas, chronic lymphocytic leukemia, and Hodgkin's disease -- have been found by the committee to be clearly associated with Agent Orange exposure, for example. The status of other conditions remains more ambiguous.

That ambiguity continues to rile veterans advocates such as Phil Kraft, executive director of the Darien, Conn.-based National Veterans Services Fund. He said that while he "admires the perseverance" of the IOM committee, too many sick Vietnam vets are still fighting for proper care.

http://www.washingtonpost.com/

[Sgt D]

REPORT: VA NOW ACCEPTING CLAIMS FOR HYPERTENSION

LINKED TO AGENT ORANGE EXPOSURE -- Will determine

service-connected status at a later date, but

claims are expected to be approved.

VA begins taking claims related to Agent Orange exposure

By Chris Roberts
El Paso Times



Veterans Affairs has started taking claims for hypertension related to Agent Orange exposure, but it will determine at a later date whether the claims will be honored as being military "service-related," according to service organizations who received notices from VA.

A letter from the Texas Veterans Commission to its county service officers indicates that the claims are expected to be approved.

The claims won't be actively "worked" until the VA makes its decision.

Requests for comment made to local VA agencies were referred to Washington, D.C.

However, after two days, the public affairs office in Washington, D.C., still had no comment.

If the claims are approved, it could mean as much as $300 a month for Bob Snow, a retired soldier who worked as a forward observer directing artillery fire in the Vietnamese jungles.

Snow - who worked with special forces soldiers and Montagnards, a French name for the indigenous people of Vietnam's central highlands - operated in areas sprayed with Agent Orange, a defoliant that knocked down vegetation used as cover by the enemy.

Snow retired in 1982 and was diagnosed with hypertension by the VA in 1983.

However, the condition was not considered service related and therefore his disability compensation was limited.

If hypertension is connected to Agent Orange claims, it could mean as much as an extra $300 per month for Snow, which he said will relieve some of the pressure of the rising cost of living.

Jeri Elena Mark worked as a radar mechanic for Hawk missile systems at a base in Vietnam where she watched planes drop Agent Orange on vegetation surrounding the camp, which was being shelled.

She had experienced high blood pressure, a symptom of hypertension, during her Army career, usually associated with flashbacks from her Vietnam service.

She retired in 1985, but her exposure is not considered combat-related, so she would get no increase in disability payments.

However, her family would receive benefits after her death if the cause is related to hypertension

copied from www.vawatchdog org 5-9-2008

[CEDAR FALLS]

REPORT: VA NOW ACCEPTING CLAIMS FOR HYPERTENSION

LINKED TO AGENT ORANGE EXPOSURE -- Will determine

service-connected status at a later date, but

claims are expected to be approved.

VA begins taking claims related to Agent Orange exposure



Just got turned down filed for Hypertension secondary to DM11 related to AO
VA stated Hypertension/benign/essential and not related no SC and that was with readings of 220 down to 158

[TinCanMan]

I'd re-file that claim. Hypertension was identified as having a Limited or Suggestive Evidence of Association to herbicide Exposure in the IOM report "Veterans and Agent Orange Update: 2006" When that happens, the VA is required to consider the evidence and add it to the list of presumptive conditions if they believe there is a positive link. That's what they are doing now and they've yet to make a decision but they are accepting claims in case the decide to add it. Your claim will be added and an effective date established but no work will be done on it till they make the decision to add or not.

When you re-file, do not claim your hypertension is secondary to DMII. Just state Hypertension presumptive of herbicide exposure.

If they do add, your effective date should go back to the date you first claimed hypertension, not the date of this new claim.

[redpierna]

One can not imagine all that goes on behind close doors at VA centers across the fruited plain. As veterans we are all day dreaming if we think that the VA is going to approve hypertension for service connection. I have documents that show that when I was in active duty I had high cholesterol and blood pressure- these stats are according to the American Heart Association. The VA in its infinite wisdom, however, does not consider these numbers to be high enough to warrant any compensation. VA range for these two diseases are dramatically different (infinitively higher) than the AHA. Military doctors are in cohoots with the VA system. And, who can blame them! The chances of you dying from a stroke or heart attack are dramatically higher than you dying from a back condition. I just had triple-heart bypass surgery a short while back. While I was recuperating from a subsequent lung blood clot. pneumonia, and fluid build-up in my right lung, a hospital VA rep came in and filed a claim for me based on my condition. After nine months of waiting, the VA sends me paperwork telling me that I got didly squat for my condition. All this after I had shown them the documents that proved that my cholesterol and BP were issues/conditions that were diagnosed but not treated while I was in active duty. So for all you guys thinking that the VA will approve service connection for hypertension.... good luck. I am an old fart and I, with the help of the ALMIGHTY, am able to survive with the little money my wife and I make. Besides serving in Gulf One, I too served in Nam, and, I have documents from the VA that slow that I was exposed to Agent Orange. Let me tell you, It will take these lame brains 25 years to sort this Agent Orange/hypertension connection. And, guess where all of us Nam veterans will be in 10-15 years from now? And, this is the strategy that the VA uses to deal with us. We are fighting a battle that we will never win.....unless someone speaks up and demands that these people that we put in office to get off their duffs and do what is right- we will never see any positive results. I feel bad for all those veterans that are now in harms way, giving their very best to keep this country afloat. They don't have the slightest clue of what awaits them later on down the road with our VA system. It is up to us as veterans to let them know about the Veterans Administration and their on your face/we don't give a crap about you system of dealing with veterans.

[TinCanMan]

Such a load of emotional baloney I haven't heard in a long time. Just have to tell you that high cholesterol is a lab finding useful to physicians in assessing your condition. In and of itself it means nothing unless you have a doctor that says what it means. The VA recognizes hypertension beginning with 160mmHg/90mmHg which the AMA calls Stage 2. The AMA recognizes Stage 1 Hypertension beginning with 140mmHg/90mmHg. This is a bit lower than what the VA recognizes but there's nothing infinite at all about it. The VA also requires Hypertension or isolated systolic hypertension must be confirmed by readings taken two or more times on at least three different days. A couple of isolated incidences does not qualify as hypertension. If you meet these requirements you can qualify for a diagnosis of hypertension.

The IOM reported "limited or suggestive evidence of an association" between herbicide and hypertension in their report of July 2007. The VA is examining this information and will add it if they agree a positive link exists. That link may or may not exist but there is no reason to believe it will be 25 years before that happens. That's just rhetorical nonsense. There have been a number of conditions added to the presumptive list. DMII and CLL were added recently within 18 mos of the release of the IOM reports. There should be no reason this will be any different. As a matter of fact its only been 11 mos since the IOM report. In the mean time they are accepting claims based on hypertension presumptive of exposure to herbicide.

The VA awards compensation on the basis of statute, regulation and medical facts, not emotional nonsense. If you disagree with their findings, file an appeal. If you disagree with the statutes and regulations, contact your legislators.

I'd certainly be interested in seeing exactly what the VA said was the reason they rejected your claim. Every decision contains a section titled "Reasons", "Reasons and Bases", "Reasons for Decision" or something very similar. Tell us what it said in your decision, verbatim.

[TinCanMan]

OK. found this on another website. Apparently, the Fast Letter I was looking for was finally distributed. This is how Hypertension claims are going to be handled until a decision by the Secretary is made.


May 21, 2008

Director (00/21) In Reply Refer To: 212B
All VA Regional Offices and Centers Fast Letter 08-14


SUBJ: Interim Guidance on Claims Involving Hypertension Based on Herbicide Exposure

This letter provides interim procedures for controlling claims involving service connection for hypertension based on herbicide exposure. The enclosure provides general answers to questions employees may receive from the public regarding such claims.

Background

Every two years, the Institute of Medicine (IOM) of the National Academies reviews evidence about the health effects of exposure to herbicides. In its recent release, Veterans and Agent Orange: Update 2006, IOM reported findings of limited or suggestive evidence that exposure to herbicides is associated with an increased chance of developing high blood pressure (hypertension). A finding of "limited or suggestive evidence" means that evidence suggests an association between exposure to herbicides and the outcome, but a firm conclusion is limited because chance, bias, and other confounding factors could not be ruled out with confidence.

Under Public Law 102-4, the Agent Orange Act of 1991, as extended by the Veterans Education and Benefits Expansion Act of 2001, Public Law 107-103, the Secretary of the Department of Veterans Affairs (VA) must determine whether a presumption of service connection is warranted for each disease IOM identifies as positively associated with herbicide exposure.

Current Status

The Secretary has not yet decided whether to add hypertension to the list of presumptive disabilities associated with herbicide exposure. If he determines service connection is warranted, VA will publish a regulatory amendment in the Federal Register. If he decides otherwise, VA will publish notice of that decision in the Federal Register.

Acknowledging Herbicide-Related Compensation Claims

When VA receives claims expressly seeking service connection for hypertension based on herbicide exposure, or dependency and indemnity compensation on that basis, it will acknowledge those claims in a letter to the claimant with the following language approved by the Office of the General Counsel:

"We have received your claim of service connection for high blood pressure (or hypertension) [or "We have received your claim for dependency and indemnity compensation"] based upon exposure to Agent Orange. Currently, VA is not taking action on such claims until it reviews the report of the Institute of Medicine of the National Academies, entitled Veterans and Agent Orange: Update 2006. VA must determine whether service connection is warranted for hypertension based upon herbicide exposure. If VA determines service connection is warranted, we will propose the appropriate regulations. If service connection for hypertension based upon herbicide exposure is not warranted, we will publish a notice to that effect in the Federal Register. In the interim, VA will track your claim until we make our decision. We will also tell you whether you need to do anything else to help support your claim."

Controlling Claims Affected by the Secretary's Decision

Control all claims for hypertension from veterans who VA presumes to have been exposed to herbicides, for whom exposure has been established on a factual basis, or who otherwise claim exposure. This includes the following veterans:

· Veterans who served in the Republic of Vietnam from January 9, 1962, to May 7, 1975.
· Veterans who served along the demilitarized zone (DMZ) in Korea from April 1968 to July 1969.
· Veterans filing claims under Haas v. Nicholson, where the only evidence of herbicide exposure is receipt of the Vietnam Service Medal or service on a vessel off the shore of Vietnam.

Apply the following procedures when a veteran seeks service connection for hypertension based on herbicide exposure, as well as any secondary disability (e.g., stroke secondary to hypertension):

Original or new claims

· If a veteran's claim for service connection is new and involves no other issues, control the claim using an EP maturing on September 1, 2008.
· Send a letter to the claimant with the approved language acknowledging the claim.
· Do not send notice under the Veterans Claims Assistance Act of 2000 (VCAA), develop, or otherwise adjudicate the claim. However, if a review indicates that VA can grant the benefits sought using existing regulations, decide the claim.

Previously denied claims

· If a veteran's claim for service connection for hypertension was previously denied and no additional issues are claimed, control the claim with an EP maturing on September 1, 2008.
· Send a letter to the claimant with the approved language acknowledging the claim.
· Do not send VCAA notice, develop, or otherwise adjudicate the claim
Claims involving hypertension and additional Issues

· If a veteran is claiming service connection for additional issues that are not related to the claim for hypertension, establish the appropriate EP and control the claim for hypertension with an EP maturing on September 1, 2008.
· Send a VCAA notice on the issue(s) not related to hypertension. Separately send a letter to the claimant with the approved language for the issue of hypertension.
· Do not send VCAA notice, develop, or adjudicate the claim for hypertension or any conditions claimed as secondary to hypertension.
· Develop and rate all other issues.
· Under the controlling EP, send a decision notice letter to the claimant on the issue(s) not related to hypertension.
· If there are any other deferred issues, continue the controlling EP. Do not defer the issue of hypertension in the rating decision.
Claims for Dependency and Indemnity Compensation (DIC)

Control with an EP maturing on September 1, 2008, all claims for DIC involving veterans whose hypertension or a hypertensive-related illness was either the primary or contributory cause of death and who are presumed to have been exposed to herbicides, who have had exposure to herbicides conceded on a factual basis, or whose surviving dependent claims the veteran was so exposed.

Do not send VCAA notice, develop, or adjudicate the claim for service connection for the cause of death.

Appeals involving hypertension

If a claimant files an appeal on the denial of service connection for hypertension, establish an EP maturing on September 1, 2008.
Process the appeal in the standard manner.
If the alleged basis of service connection is related to herbicide exposure, send a letter to the claimant with the approved language and defer any appeal action pending the Secretary's decision. Replace the word "claim" with "appeal."
Note: If a review of the evidence reveals that a grant of service connection for hypertension is warranted based on current regulations, such as through direct service connection, prepare the rating decision granting the benefit and establish an EP 695 maturing on September 1, 2008, so that, if the Secretary allows a presumption of service connection, an earlier effective date under Nehmer vs. U.S. Veterans' Administration may be considered.

Controlling Claims for Hypertension Not Based on Herbicide Exposure

As stated earlier, specially control all claims for hypertension from veterans presumed exposed to herbicides. Include those claims for hypertension when the veteran has not expressly claimed herbicide exposure (e.g., hypertension secondary to diabetes mellitus). The following procedures apply when a claim for hypertension not based on herbicide exposure is received from a veteran who is presumed exposed to herbicides:

Original, new, or reopened claims

· Process the claim in the usual manner.
· Do not send the approved acknowledgment language.
· Establish a future EP maturing on September 1, 2008. Use this to control all cases, whether the decision is a grant or denial.
· If service connection is not granted, include the following language in the decision notice letter:

"The Secretary of Veterans Affairs is currently deciding whether service connection is warranted for hypertension based upon herbicide exposure. If service connection is warranted, we will reconsider this issue. We will then advise you whether you need to do anything to help support it. If VA determines service connection based upon herbicide exposure is not warranted, we will not, of our own initiative, take any additional action on this issue."

[TinCanMan]

In addition to the Texas veterans Commission and the NVLSP, VA insiders are reporting the Secretary will include Amyloidosis to the list of conditions presumptive of exposure to herbicide. 38 CFR 3.309(e) will be modified accordingly. Hypertension did not make the cut and will not be added. Have not yet seen a Fast Letter or a notice of proposed rule making in the Federal Register. Just a matter of time, I suppose.