Agent Orange (Dioxin) and ESOPHAGEAL CANCERS
AND DIGESTIVE SYSTEM CANCERS
AS WELL AS OTHER Toxic Chemicals
ASSOCIATED TO Military Service in Vietnam
this IS A DRAFT AND IS NOT COMPLETE
Posted on: 08-22-2007
Hard copies will be sent to:
Congressman Christopher Shays -Democrat - Connecticut
Congressman Bernie Sanders - Independent - Vermont
Congressman Lane Evans - Democrat - Illinois
Congressman Christopher Smith - New Jersey Republican
Yes, out of the entire congress these four are the only four that after four years of searching that I can find that actually might give a damn.
This link is posted in support of Veterans widows and those Vietnam Veterans that have developed Esophageal Cancer as well as other "Cancers of the Digestive System."
A group of dedicated wives from California, Michigan, New Jersey, and Wisconsin have chosen to fight the government in this issue, rather than just give up.
I believe it is obvious to the whole world that ESOPHAGEAL CANCER among other forms of "Digestive System Cancers" are significantly higher in those Veterans who served in Vietnam during wartime and were exposed to the "weapons of mass destruction" toxic chemicals (plural) that were used as offensive and defensive weapons.
Many Veterans came home in poor health and one of the medical issues was gastrointestinal problems. Most of us thinking we had issues related to the malaria pills and once removed we would return to our old selves, with no medical issues. This in fact did not happen.
We were diagnosed with all kinds of issues of the gastrointestinal area of medicine while none of it made any sense. Diagnosed with spastic colon, colitis, diverticulitis, Chron's, IBS, Celiac, delayed stomach emptying causing gastroparesis, etc. Most of these were considered hereditary related or old age. Yet, we were young men with no hereditary trail to these disorders. Some had rectal bleeding. Aversion to milk products and heavy red meats when the year before they went; there were no aversions to any food products or drinks and no digestive system issues.
The Australian Veterans that served in III Corps reported the same issues: (1)
Many have developed Barrett's Esophagus, which can be a precursor to the cancer. This is from the body's deranged cell system replacing the esophageal tissue with tissue similar to what is found in the small intestines.
The Ranch Hand transcripts for those primarily exposed by skin contact only, stated: (2)
One of my Marines, tired of no VA answers, called one of the Gastrointestinal Disease centers and they told him that they had estimated about 70% came home with some form of gastrointestinal issue. I am trying to re- contact this Marine and get the details of this conversation.
I recall during the period of about five years after returning, while doctors tested me over and over again, that my mother found an article in our home town newspaper. This article was in reference to a news story concerning some doctors at the University of Florida and the study they were conducting to see "why so many Vietnam Veterans were coming home with gastrointestinal issues."
So this medical issue and problem has been "well known" since at least the early 1970's.
Too bad we did not have the Internet back then!
Government/VA Philosophy against veterans
Our own Veterans Administration in its entirety, to include the Secretary of the VA, operates as a White House after White House "budget control" rather than the tell the Veterans and their families the truth for over 40 years or even give Veterans a fair assessment of our toxic chemicals health status.
It is our Congress, rather than support the Veterans for their search for the truth, that remains deaf and blind in order to support these different White Houses and keep the government coffers for other programs.
Yes, that does include your own congressional representative and your two state senators; who state they care about Veterans.
While our own US government/VA studies, have been less than objective and truthful with regard to many medical issues for many reasons to include, politics and money; and the fact that the White House decision philosophy was made decades ago to "not support" the Vietnam Veterans of this nation for obvious "government wrong doing."
At this time in our "toxic chemical legacy," our own White House/government and the chemical companies became an "official tag team of coconspirators."
In fact, Admiral Zumwalt (deceased) appointed as a special assistant to the Secretary of the VA to resolve the toxic chemical issues stated in his report the following:
This is typical of what our government has done for over 40 years with the VA being the lead federal agency in government denial. Certainly the toxic chemical legacy of our Vietnam Veterans will fall into this above example of "the military knew as early as the mid-1980s that at least one substance used was emphatically not harmless, as originally believed - and by continuing to deny veterans access to the full information... By using the entire power of the United Sates Government and its contracted agencies egregious medical fraud has been committed against the nation's Veterans by our own government.
A more recent example of this medical fraud is our Gulf War Veterans. Many came home sick and dying while our government minimized this fact and our national media totally ignored these facts.
The lead agency for denial was; once again the White House directed VA and its contracted partner the NAS/IOM in representing that the Veteran's death, sickness and disabling disorders, and birth defects regarding our nation's Veterans was "associated to mental stress" in a war that took less than 200 hours and suffered very minimal casualties.
That in itself makes no medical sense.
Yet, here we have on October 14th, 2004 in the New York Times an article that states: (10)
Yet, for over a decade the VA and the NAS/IOM had concluded this ridiculous scenario that stress was the sole causation. Nice cover up for the DOD and our government.
Also bearing in mind that the original study group reported to President Bill Clinton in 1996 that "current scientific evidence does not support a causal link" between the veterans' symptoms and chemical exposures in the Persian Gulf.
Instead, the earlier group said, stress "is likely to be an important contributing factor to the broad range of physical and psychological illnesses currently being reported by gulf war veterans."
Some 697,000 American troops were sent to the Persian Gulf at the end of 1990 to drive the Iraqi forces of President Saddam Hussein out of Kuwait. Thirteen years after the war ended many veterans still complain of persistent fatigue, headaches, joint pain, numbness, diarrhea and other health problems. Sounds oh so familiar to the Vietnam Veterans.
In fact, the law to mandate this new study was passed in 1998 yet it was not acted on until 2002. Four more years of government/VA stalling.
Out of the 697,000 troops, 16% are conservatively estimated to be effected by this so called stress syndrome with significant similar symptoms in 2004. Many have already succumbed to this "stress syndrome."
In any deployment such as this only about 10-14% of the deployment is actual combat troops. So that means that all of the combat troops are either dead or dying from this so called stress syndrome. This also includes the same rate for our allies troops that were also deployed.
This is how the United States Government actually treats its veterans; including our congress. What you see on TV on CSPAN in the senate and the house, is a mirage and is a total facade as they recite the praises for the military men and women. It is all a big academy award winning show.
In other words, there is no "increased risk of incidence" or "significant increase" for Veterans and especially Vietnam Veterans.
This only exists in the world of civilians and the world of civilian constitutional law. It can no longer exist in the government created "Veterans World of VA Law," which is outside the constitution of the United States.
For over 20 years our government denied any causations of medical issues related to the toxic chemicals. To stop the onslaught of legitimate claims for death and disablement that developed after irrefutable evidence was being brought forward of the overwhelming medical issues the Veterans were developing our government then:
Set up an entire legal system that only applies to Veterans and is outside the constitution and constitutional law for the rest of the nation.
Rather than increased "risk of incidence" or "significant increase" our government and the VA then mandated "cause and effect" results.
After a court found that this "cause and effect" was impossible; given the numbers of toxic chemicals and the variety of exposures and was too stringent in favor of the government. The Secretary of the VA, while not challenging the court ruling, then wrote the CFR to only include the chemical formula for dioxin only, with a mandated statistical significant increase and a p-factor of 0.05 attached to it.
Note: A p-factor of 0.05 is the worlds scientific standard for proving there is no doubt or there is little chance the differences found were associated by chance alone.
Congress, in a total ruse, then passed the Dioxin Act of 1984. This had to be one of the biggest lies every put out by our Congress. This act gave the "benefit of the doubt" to the Veterans in this unknown toxic chemical legacy. Totally disregarded by the VA and the Secretary of the VA for over 21 additional years over the previous 20 years of denial of everything. With our own VA the lead denial federal agency, as directed by the White House.
By default because of these actions by the Secretary of the VA, supported by our own government there can be no toxic chemical associations to just "Service in Vietnam" in a toxic chemical environment. Only those medical issues found to a linear dose rate to dioxin alone can be associated out of the many many toxic chemicals used. Even many of these that are actually found are not being brought forward because the government scientists indicate they cannot find any overt disease that qualifies to a 100 year old ICD code. They find a damaging process related to dioxin but because they are unfamiliar and cannot explain what this unknown toxic chemical is doing in this damaging process; it then falls by the way side and once again is not reported to the medical community or the nation's Veterans.
In addition, many medical issues found in study comparisons between cohorts that reach a 50% increase or even higher are not considered significant in the eyes of our government for Veterans and their families. These issues do not even make the reports, so our nations doctors are even unaware of these significant medical findings in Vietnam Veterans. This is because while they show a significant increase they do not show a dose response to only dioxin. Remember, the VA created a new philosophy and requirement that there will be no associations based on "Service in Vietnam in a toxic chemical environment."
While the Secretary of the VA did make one exception and that is for female Veterans that had offspring with birth defects. To exclude the male Veterans that had the very same birth defects and at the very same rate; the VA then did not tie this association for female Veterans to a dioxin only but only to "Service in Vietnam." So the VA has made a exception to the dioxin only rule. Remember that! A totally different legal standard was used and the precedence was set.
Outside of our Vietnam Toxic Chemical Legacy this "Service in whatever campaign" does exist.
Remember the New York Times article regarding the Gulf War.
The VA Secretary himself through a spokesperson stated: (10)
Since all government studies for Vietnam Veterans have been corrupted and no study is allowed to only compare those that served versus those that did not serve with the additional government/VA mandate of finding a linear dioxin dose response. (See History) Even if the risk ratio is at 5 or greater it makes no difference to the collaborating government/VA. For the Vietnam Veterans there is no greater risk as stated above by the VA Secretary. Only government corruption and tyranny awaits them to a single end point linear dioxin dose response.
Referencing the Korean study that did not compare like cohorts but those that served versus those that did not serve. The data is very damning. Yet, our congress does nothing. (18)
If you look at the BVA cases in every instance you will see that the VA counselors make the statement, "that the Secretary of the VA has not determined an association to ESOPHAGEAL CANCER and Agent Orange." This is the legal term they use to deny you and as you will see in the History below there has never been a government study on Agent Orange. So that in itself, is nothing but VA counselor lies.
Then we have the statements of the decisions as follows:
DECISION OF THE
"The Board of Veterans’ Appeals (Board), in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991 & Supp. 1997), has reviewed and considered all of the evidence and material of record in the veteran's claims file. Based on its review of the "relevant evidence" in this matter, and for the following reasons and bases, it is the decision of the Board that the appellant has not met the initial burden of
submitting evidence sufficient to justify a belief by a "fair and impartial individual" that the claim of entitlement to service connection for the cause of death is well-grounded."
This is the "government fox" watching the government hen house (government mistake coffers) for the White House and the Congress.
"Fair and impartial" has got to be a joke. About as fair and forthcoming as the government studies have been. (See History section.)
There in lies the problem - The VA, following the march orders of the White House, can limit the issues to only one part of a toxic chemical compound. Then our congress turns around and gives the sole power to the Secretary of the VA to do anything he wants regarding Veterans on behalf of the White House, criminal or not. Then to keep anyone from challenging the VA our congress than sets up a legal system that is biased against Veterans and not under any rule of law or subject to any other courts review.
Congress has clearly precluded any judicial review of any Veterans Administration determinations as set forth in 38 U. S. C. paragraph 211a:
…"the decision of the administrator on any question of law or fact under any law administered by the Veterans Administration providing benefits for Veterans…shall be final and conclusive and no other court of the United States shall have power or jurisdiction to review any decision by an action in the nature of mandamus or otherwise."
A nice total government tyrannical package rolled into one by a collaborative government protecting "itself" for wrongdoing.
As I was reading this to my sister-in-law she exclaimed, "that sounds like communism!"
When any government agency says "Agent Orange" that is a lie and they really only mean dioxin. No, repeat NO, government study has studied the effects of Agent Orange. The government has mandated that all "herbicide studies" be reduced to "dioxin only" which was only one part of the herbicide Agent Orange and Agent Orange was only one of the 15 different formulas of herbicides used with multiple toxic chemicals used.
While the two main other herbicides used were Agent Blue and Agent White each with their own set of toxic medical issues from both acute and chronic exposures.
In fact, while the government states Agent Orange was the most widely used; the most widely used toxic chemical was 2,4-D used in both Agents Orange and White.
It is noted for the record, that all government studies were mandated to those exposed by skin contact alone.
It is noted for
the record, that methods of ingestion of toxic chemicals plays a role in what
will develop, how it will develop, and when it will develop.
It is noted for the record, that in some areas such as the Quang Tri area in Quang Tri Province that herbicide tapes show more Agent Blue used than Agent Orange.
It is also noted for the record, that most areas of Vietnam were indeed sprayed with all three major toxic chemicals.
It is also noted for the record, that in 1969 as the medical issues were rising and being noted as toxic chemical associated. The State Department, under Jim Baker, got involved in the investigations. After trips to Vietnam the state department report concluded that Agent Orange in its entirety with dioxin; was not a real threat. However, they stated there was some major concerns and issues about Agent Blue since it contained arsenic acid.
Yet, here we Veterans and families are; 40 years later, with the VA, directed by the White House, with every issue associated or non-associated to what they say is Agent Orange, when they really only mean dioxin alone. In spite of the many other toxic chemicals that obviously, according to the VA and the government contracted National Academy of Science, cannot harm Veterans for some magical medical fact.
How can this be?
If you were going to hang your hat on denial and protecting the government coffers from government mistakes and had your own independent omnipotent legal system. Would you not select the most unknown toxic chemical?
Especially, if you knew that the other toxic chemicals had already been characterized as to acute and chronic exposures for decades. Or that your partner in crime, Dow Chemical, and their toxic chemical compound called "Picloram" was DOW proprietary.
In addition, you knew that our own EPA, as the many Veterans' deaths, disabilities, and medical issues were manifesting as toxic chemical issues, in 1985 in order for DOW to re-qualify "Picloram" had demanded they reduce the hexachlorobenzene to less than 200 parts per million and that the nitrosamine be reduced.
Picloram now has less than 100 parts per million and no (zero) nitrosamine. There is no telling what the toxic chemical swill had in it as far as toxic chemical levels when used on Veterans and the terrain for over 10 years.
If you knew that in 1990 Doctor Daniel Teitelbaum, a noted toxicologist stated:
“What I do think...may bear on the Agent Orange issue, is the fact that in review of Dow’s 2,4-D documentation I found that there are significant concentrations of potentially carcinogenic materials present in 2,4-D "which have never been made known to the EPA, FDA, or to any other agency." Thus, in addition to the problem of the TCDD which, more likely than not, was present in the 2,4,5--T component of Agent Orange, the finding of "other dioxins" and closely related "furans and xanthones" in the 2,4--D formulation was of compelling interest to me.” (8)
The bottom line is; we more than likely have other forms of dioxins other than TCDD in the Agent Orange herbicide. Agent Orange was a 50/50 mixture of 2,4,5-T and the DOW 2,4-D referenced by Doctor Teitelbaum. With the additional issues included of closely related furans and xanthones in 2,4-D. This also creates a synergy effect with more than one toxic chemical in the same formula. This can increase the potency of the chemicals as far as 1600 times what each one would be separately. This is especially true if two are further apart on the chemical property scale.
In addition 2,4-D was used a separate herbicide under the nomenclature of Agent White.
Some researchers are saying they actually mixed Agent Orange and Agent Blue together to spray. I cannot verify that but if they did, it is a wonder any one is left alive.
Again, logically you would select the most unknown single toxic chemical that no one knows what it does, how it does it, and has never been characterized; in order to protect the government and the White House. Then you would demand a linear dose response when there is no proof of a linear dose response or that this single toxin will even have a linear dose response. Especially, since you have your own corrupt legal system given to you by the congress; you can now deny any study or animal study you want or even statistical increase data.
Remember the CFR used in VA denials only lists the chemical formula for TCDD.
Nitrosamine contained in Agent White (12)
Cacodylic acid (dimethyl arsenic acid) which was called Agent Blue (13)
Agent Blue: This was a code name for cacodylic acid (dimethyl arsenic acid) that was used from 1965 to 1970.
Agent Blue produces a spectrum of acute toxic symptoms that includes gastrointestinal disorders, eye irritation, and dermatitis. Studies in experimental systems have indicated that it has the potential for mutagenicity, clastogenicity (chromosome damages), and teratogenicity.
Carcinogenicity has not been tested adequately, but it should be noted that other inorganic arsenic compounds have been associated with liver, lung, skin, and stomach cancers.
It is highly toxic by inhalation, ingestion and through skin contact. It may cause irreversible effects and death. It may act as a teratogen or carcinogen; or skin, eye and respiratory irritant.
Chronic exposure may lead to:
While our own EPA in the 70's and 80's operated as a direct White House collaborative operative in our toxic chemical legacy issue. It seems that in 1992 they did get at least some integrity back.
Starting with what the EPA called their "Dioxin Reassessment" study in 1992. Which for all intensive purposes parallel a report that was done in 1979 by one of the EPA scientists who actually did have some integrity. For some "unknown and unexplained rationale" this report was shelved by the EPA in 1979 and not released.
Another hero EPA scientists during this time found that many of the chemical company studies being presented in actual court cases were fraudulent and corrupted. When she made this known to the EPA enforcement, her reward was to be punished and set aside by the EPA, operating as a White House and VA pawn.
Remember, the entire US Government using collaboration was denying any and all medical issues up until 1990, some 23 years while Vietnam Veterans died and became disabled. Denied any and all serious side effects from our toxic chemical legacy and exposures.
In reviewing the EPA reassessments in 1992, 1994, and 1996 the emergence of EPA dioxin expert Dr. Linda Birnbaum is a ray of hope for all Veterans. Although, there seems to be some end fighting going on between the less than truthful Ranch Hand studies and their studies that are slanted towards "government exoneration" as opposed to scientific facts and the new EPA dioxin expert at the EPA.
Very similar to the CDC that sold their "scientific soul" to our White House in the 80's. (14)
I find it very interesting and questionable when I do review a Ranch Hand report and find zero references to any EPA findings and OTA study findings. Also, I have seen references that there does seemed to be some disparity between the two entities. In reviewing both the EPA reassessments and the Ranch Hand scientific transcripts, not the published and crafted reports, I find many of the same issues being discussed and found. While the Ranch Hand then "exonerates the findings" the EPA expands on the issues.
How long before the White House or the new EPA Director at behest of the president who appointed him puts the clamps on Dr. Birnbaum is the question.
One issue that the EPA discusses in their reassessment is the immunotoxicity of dioxin.
That the threshold for immunotoxicity is 100 times less than that of a cancer. And that for some disorders created by dioxin there does not seemed to be a threshold. So much for the Ranch Hand study linear dose response only government/VA mandated study constraint.
One would also wonder if the threshold for immunotoxicity is 100 times less than that of cancer then where are the immunotoxicity issues listed on our VA and NAS/IOM hit parade. You cannot have one without the other, except at the VA.
I think most people are aware that cancer develops. It is not some magical medical moment you have cancer. It is a series of cell derangements and maturations that end up being a malignant cancer. This process can stop at any time for whatever reason leaving you with many other debilitating issues and even death from the autoimmune diseases that are created. Including other disorders such as medical conditions that may be in-between two cancers that are listed on our VA and NAS/IOM hit parade. These would be in the form of many issues and symptoms such as amyloydosis or many deranged antibody issues that are created, or even some form of connective tissue disorders.
The EPA discusses the lack of an immune system and the creation of an attacking immune system and that you can actually have both.
"The percentages of EBV positive samples amongst the esophagitis (42.3%), esophagus squamous cell carcinomas (42.8%) and esophageal aden carcinomas (42.8%) were rather high. If these results are borne out in further investigations, they suggest a possible role of the EBV virus in the etiology of esophageal diseases. The fact that a large percent of non-cancerous esophagitis samples were positive suggests the virus may play a role in the early stages of abnormalities of the esophagus,...
This is because the NAS/IOM operates under government constraints and goes more blind every two years, as it is time to put out their slanted and biased findings. Just as our congress does every election cycle in stating they support Veterans. All of it fictitious and sickening.
The Seveso, Italy dioxin accident has been characterized as a "National disaster." The actual 2,4,5-T release was estimated to be 100 grams (3.52 oz) to 20 kg (44.09 lbs) of dioxin was released into the air along with the estimated only 3,000 kg (6,613.9 pounds) of chemical that was released. The furthest contamination distance was 6 km (3.7 miles) to the south.
This absolutely pales in comparison to just the Rockpile FSB minimum of 506,000 pounds within 4.8 miles. (Not including the other firebase overlaps, the drift rates from the DMZ burm, tank spraying, tanker spraying, helicopter spraying, the additional toxic chemical poundage of Agents White and Blue.)
(2) Ranch Hand Official Transcripts (Not the government redacted published reports)
(3) Taped interview by Moon Callison with Admiral Zumwalt on July 26th 1999 discussing his role in the Department of Veterans Affairs Report “Classified Confidential Status 1, not for Publication and Release to the General Public.” A report regarding adverse health affects from exposure to Agent Orange; Dated May 5 1990. (America’s Defense Monitor (ADM's) Moon Callison interviews the former Chief of Naval Operations, for "Environmental Impact of War").
(4) Department of Veterans Affairs Report “Classified Confidential Status 1, not for Publication and Release to the General Public.” A report regarding adverse health affects from exposure to Agent Orange; Dated May 5 1990, page 37.
(5) Department of Veterans Affairs Report “Classified Confidential Status 1, not for Publication and Release to the General Public.” A report regarding adverse health affects from exposure to Agent Orange; Dated May 5 1990, page 23 and page 24.
(6) Department of Veterans Affairs Report “Classified Confidential Status 1, not for Publication and Release to the General Public.” A report regarding adverse health affects from exposure to Agent Orange; Dated May 5 1990, page 24.
(7) Department of Veterans Affairs Report “Classified Confidential Status 1, not for Publication and Release to the General Public.” A report regarding adverse health affects from exposure to Agent Orange; Dated May 5, 1990
(8) March of 2000, House of Representatives, Subcommittee on National Security, Veterans Affairs, and International Relations, Committee on Government Reform, Washington, DC, ; Oversight review of the Ranch Hand Study.
(9) Vietnam Veterans of America statement regarding the law suit against VA individuals.
York Times article titled, "Chemicals Sickened '91 Gulf War Veterans,
Latest Study Finds." October 14, 2004.
(11) Letter from Daniel Teitelbaum, M.D., P.C. to Admiral E.R. Zumwalt, Jr. (April 18, 1990).
12) Agency for Toxic Substances and Disease Registry.
(13) Recognition and Management of Pesticide Poisoning, 5th edition, U.S. EPA, Chapter 14.
(14) House Report HR 101-672.
(15) Re-Evaluation of Dioxin; A Presentation by Linda Birnbaum, Director Environmental Toxicology Division U.S. Environmental Protection Agency (EPA); To the 102nd Meeting of the Great Lakes Water Quality Board, Chicago, Illinois.
(16) Immunotoxicological Effects of Agent Orange Exposures to the Vietnam War Korean Veterans accepted May 28, 2003. Industrial Health 2003, 41, 158-166
(17) Sort-Long Term Morbidity and Mortality in the Population Exposed to Dioxin after the "Seveso Accident - Industrial Health 2003, 41, 127-138
(18) Impact of Agent Orange Exposures among Korean Vietnam Veterans accepted May 28, 2003, Industrial Health 41, 149-157
IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN
DISTRICT OF NEW YORK SHIRLEY IVY, Individually and as Representative of the
Estate of DONALD IVY, et al.
Plaintiffs, CV-89-03361 (E.D.N.Y.) (JBW) v. [B-89-0059-CA (E.D.TEX.)] DIAMOND SHAMROCK CHEMICALS COMPANY, et al. SEP 3, 1991
(20) American Journal of Epidemiology Vol. 153, No. 11 : 1031-1044 (Health Effects of Dioxin Exposure: A 20-Year Mortality Study)
Citation Nr: 0413922
Decision Date: 05/28/04 Archive Date: 06/02/04
DOCKET NO. 04-17 060 ) DATE
On appeal from the
Department of Veterans Affairs Regional Office in San Diego,
Entitlement to service connection for adenocarcinoma of the
Appellant represented by: California Department of
ATTORNEY FOR THE BOARD
J. Connolly Jevtich, Counsel
The veteran served on active duty from January 1967 to
This case comes before the Board of Veterans' Appeals (the
Board) on appeal from an April 1998 rating decision of the
San Diego, California, Department of Veterans Affairs (VA)
Regional Office (RO)
FINDINGS OF FACT
1. The veteran had service in the Republic of Vietnam during
the Vietnam era and is presumed to have been exposed to Agent
Orange during that time.
2. The veteran's adenocarcinoma of the esophagus is related
CONCLUSION OF LAW
Adenocarcinoma of the esophagus was incurred during active
service. 38 U.S.C.A. § 1110 (West 2002); 38 C.F.R. §§
3.303, 3.304 (2003).
REASONS AND BASES FOR FINDINGS AND CONCLUSION
There has been a significant change in the law during the
pendency of this appeal with the enactment of the Veterans
Claims Assistance Act (VCAA). 38 U.S.C.A. § 5100, 5102,
5103, 5103A, 5106, 5107, 5126 (West 2002). To implement the
provisions of the law, the VA promulgated regulations at 38
C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a)). The amendments
became effective November 9, 2000, except for the amendment
to 38 C.F.R. § 3.156(b) which became effective August 29,
2001. Except for the amendment to 38 C.F.R. § 3.156(a), the
second sentence of 38 C.F.R. § 3.159(c), and 38 C.F.R. §
3.159(c)(4)(iii), VA stated that "the provisions of this rule
merely implement the VCAA and do not provide any rights other
than those provided in the VCAA." 66 Fed. Reg. 45,629.
Accordingly, in general where the record demonstrates that
the statutory mandates have been satisfied, the regulatory
provisions likewise are satisfied. The Act and implementing
regulations eliminate the concept of a well-grounded claim,
redefine the obligations of VA with respect to the duty to
assist, and supersede the decision of the United States Court
of Appeals for Veterans Claims in Morton v. West, 12 Vet.
App. 477 (1999), withdrawn sub nom. Morton v. Gober, 14 Vet.
App. 174 (per curiam order) (holding that VA cannot assist in
the development of a claim that is not well grounded).
First, VA has a duty to notify the veteran and his
representative, if represented, of any information and
evidence needed to substantiate and complete a claim. 38
U.S.C.A. §§ 5102, 5103. Second, VA has a duty to assist the
veteran in obtaining evidence necessary to substantiate the
claim. 38 U.S.C.A. § 5103A. The Board is, at this time,
granting the veteran's claim; thus any deficiencies in this
case as to VCAA are harmless and nonprejudicial.
Service connection may be granted for disability resulting
from disease or injury incurred in or aggravated by service.
38 U.S.C.A. § 1110. For the showing of chronic disease in
service there is required a combination of manifestations
sufficient to identify the disease entity and sufficient
observation to establish chronicity at the time, as
distinguished from merely isolated findings or a diagnosis
including the word "chronic." Continuity of symptomatology
is required where the condition noted during service is not,
in fact, shown to be chronic or where the diagnosis of
chronicity may be legitimately questioned. When the fact of
chronicity in service is not adequately supported, then a
showing of continuity after discharge is required to support
the claim. 38 C.F.R. § 3.303(b) (2003).
A chronic, tropical, or prisoner-of-war related disease, or a
disease associated with exposure to certain herbicide agents,
listed in 38 C.F.R. § 3.309 will be considered to have been
incurred in service under the circumstances outlined in this
section even though there is no evidence of such disease
during the period of service. No condition other than the
ones listed in 38 C.F.R. § 3.309(a) will be considered
chronic. 38 U.S.C.A. §§ 1101, 1112, 1113, 1116; 38 C.F.R. §
A veteran who, during active military, naval, or air service,
served in the Republic of Vietnam during the period beginning
on January 9, 1962, and ending on May 7, 1975 shall be
presumed to have been exposed during such service to an
herbicide agent, unless there is affirmative evidence to
establish that the veteran was not exposed to any such agent
during that service. The last date on which such a veteran
shall be presumed to have been exposed to an herbicide agent
shall be the last date on which he or she served in the
Republic of Vietnam during the period beginning on January 9,
1962, and ending on May 7, 1975. "Service in the Republic of
Vietnam" includes service in the waters offshore and service
in other locations if the conditions of service involved duty
or visitation in the Republic of Vietnam. 38 U.S.C.A. §
1116(f); 38 C.F.R. § 3.307(a)(6)(iii).
If a veteran was exposed to an herbicide agent during active
military, naval, or air service, the following diseases shall
be service-connected if the requirements of 38 U.S.C.A. §
1116, 38 C.F.R. § 3.307(a)(6)(iii) are met, even though there
is no record of such disease during service, provided further
that the rebuttable presumption provisions of 38 U.S.C.A. §
1113; 38 C.F.R. § 3.307(d) are also satisfied: chloracne or
other acneform diseases consistent with chloracne, Hodgkin's
disease, multiple myeloma, non-Hodgkin's lymphoma, acute and
subacute peripheral neuropathy, porphyria cutanea tarda,
prostate cancer, respiratory cancers (cancer of the lung,
bronchus, larynx, or trachea), soft-tissue sarcomas (other
than osteosarcoma, chondrosarcoma, Kaposi's sarcoma, or
mesothelioma), diabetes, and chronic lymphocytic leukemia.
38 C.F.R. § 3.309(e).
Further, VA regulation provides that with chronic disease
shown as such in service (or within the presumptive period
under 38 C.F.R. § 3.307) so as to permit a finding of service
connection, subsequent manifestations of the same chronic
disease at any later date, however remote, are service
connected, unless clearly attributable to intercurrent
causes. For the showing of chronic disease in service there
is required a combination of manifestations sufficient to
identify the disease entity, and sufficient observation to
establish chronicity at the time, as distinguished from
merely isolated findings or a diagnosis including the word
"chronic." When the disease identity is established
(leprosy, tuberculosis, multiple sclerosis, etc.), there is
no requirement of evidentiary showing of continuity.
Continuity of symptomatology is required only where the
condition noted during service (or in the presumptive period)
is not, in fact, shown to be chronic or where the diagnosis
of chronicity may be legitimately questioned. When the fact
of chronicity in service is not adequately supported, then a
showing of continuity after discharge is required to support
the claim. 38 C.F.R. 3.303(b).
Service connection may be granted for any disease diagnosed
after service when all the evidence establishes that the
disease was incurred in service. 38 C.F.R. § 3.303(d);
Combee v. Brown, 34 F.3d 1039, 1042 (Fed. Cir. 1994).
A claim for service connection requires competent evidence of
a current disability; proof as to incurrence or aggravation
of a disease or injury in service, as provided by either lay
or medical evidence, as the situation dictates; and competent
evidence as to a nexus between the in-service injury or
disease and the current disability. Cohen v. Brown, 10 Vet.
App. 128, 137 (1997); Layno v. Brown, 6 Vet. App. 465 (1994).
The United States Court of Appeals for the Federal Circuit
has determined that a claimant is not precluded from
establishing service connection with proof of direct
causation. Combee; Ramey v. Brown, 9 Vet. App. 40, 44
(1996), aff'd sub nom. Ramey v. Gober, 120 F.3d 1239 (Fed.
Cir. 1997), cert. denied, 118 S.Ct. 1171 (1998). See also
Brock v. Brown, 10 Vet. App. 155, 160-61 (1997).
The veteran served on active duty from January 1967 to
October 1970. His service record confirms service in
Vietnam. Thus, exposure to Agent Orange is presumed. It is
further noted that the veteran served in combat and is
entitled to consideration of 38 U.S.C.A. § 1154(b).
The veteran was initially diagnosed as having esophageal
cancer in October 2002.
The veteran maintains that his esophageal cancer is a result
of exposure to Agent Orange during his service in Vietnam.
Esophageal cancer/adenocarcinoma of the esophagus is not one
diseases listed at 38 C.F.R. § 3.309(e). Thus, the Board
will consider if direct service connection is warranted.
In support of his claim, the veteran has submitted two
letters from his private treating physician, J. W., who is a
diplomate in internal medicine, medical oncology, and
hematology, as well as a March 2004 letter of another private
treating physician, Dr. D. B., another of his treating
physicians who is an oncologist specialist.
In the first letter of Dr. J. W., dated in January 2003. Dr.
J. W. stated that the veteran had been under his care for
esophageal cancer since November 2002. He indicated that the
veteran had no known risk factors for the development of his
neoplasm beyond his exposure to Agent Orange during service.
In support of his opinion, Dr. J. W. submitted medical
literature which addressed the health effects of dioxin
exposure in a 20-year mortality study. In reviewing this
literature, the physician found that there was an increased
relative risk of "other digestive cancers." Although the
study did not list these other types of cancers, he concluded
that the study factored out stomach, cancer, colon, rectum,
hepabillary, liver, and pancreatic cancer. The Board notes
that in viewing the study, these types of cancers were listed
under the heading of "digestive cancers" and were listed
individually. Also listed under "digestive cancers" was a
category entitled "other digestive." Dr. J. W. opined that
this other category, after factoring out the enumerated
cancers, left only esophageal and small bowel neoplasms
unaccounted for; thus, they were the cancers in the catchall
category. Dr. J. W. stated that he had not been able to find
a specific reference to adenocarcinoma of the esophagus and
Agent Orange due to the relatively rare occurrence of this
cancer as compared to breast, lung, colon, and rectal
cancers. However, with the referenced medical literature and
the lack of a specific study, it was his opinion that there
was an association between esophageal cancer and Agent
Orange. He stated that it was his belief that Agent Orange
was at least a factor or possibly the cause of the veteran's
In his second letter, dated in March 2003, Dr. J. W. expanded
on his earlier letter and addressed the veteran's documented
history of cigarette smoking and any etiological relationship
to his development of esophageal cancer. Dr. J. W. stated
that there was a strong association with tobacco use and
alcohol use and the development of squamous cell cancer of
the esophagus, however, not with adenocarcinoma, which is the
type of cancer from which the veteran suffers. Dr. J. W.
stated that in patients with Barrett's esophagus, there might
be an increased risk with tobacco, but the veteran did not
have a preexisting history of Barrett's esophagus. In sum,
the physician indicates that as the veteran did not have a
preexisting history of Barrett's esophagus, since most cases
do not have smoking as a risk factor, and because of the
Agent Orange components have been shown to increase
adenocarcinoma of the digestive tract, the physician felt
that it was likely that the veteran's exposure to Agent
Orange was a risk factor or causative factor in his
In April 2003, the veteran was afforded a VA examination.
The examiner reviewed the veteran's history and took note of
his past exposure to Agent Orange as well as tobacco use.
The examiner indicated that he had read literature with
regard to Agent Orange exposure. The examiner also indicated
that carcinoma of the esophagus, adeno or squamous, was not
listed as one of the Agent Orange diseases. However, the
examiner stated that in reviewing the article referenced by
Dr. J. W., there was discussion about the rate possibility of
cancers of the esophagus. Usually cancers of the esophagus
are squamous cell carcinoma and related to smoking and
alcohol use, rarely is the carcinoma adenocarcinoma of the
esophagus, which is often related to Barrett's esophagitis
which is due to reflux. The examiner noted that the veteran
did not seem to have reflux. The examiner indicated that the
article did say that gastrointestinal cancers are rare and
esophagus cancer is very rare. The examiner stated that the
Agent Orange protocol says that carcinoma of the esophagus is
not an accepted diagnosis from Agent Orange, it seemed as
likely as not that this carcinoma of the esophagus could be
related to Agent Orange.
In July 2003, the veteran's case was referred to the Under
Secretary for Health. The Chief Public Health and
Environment Hazards Officer provided a statement. She noted
that the veteran had served in Vietnam in 1969 and 1970. She
stated that he subsequently was diagnosed with adenocarcinoma
of the esophagus arising in the milieu of Barrett's esophagus
in 2002. She related that the most recent general Institute
of Medicine (IOM) national Academy of Sciences report of
herbicides used in Vietnam did not specifically address the
question of possible association between exposure to
herbicides and specifically esophageal cancer. She stated
that this indicated that the information obtained from their
extensive review of all available scientific and medical
literature, to include the medical literature cited above,
did not permit the IOM to assign this disorder to one of its
specific categories. Moreover, the IOM committee reviewed
the article cited by Dr. J. W., and apparently esophageal
carcinoma is not included with "other digestive" cancers in
that paper's analysis. The VA physician indicated that a lot
of weight was being given to the IOM findings on the health
effects from exposure to herbicides in Vietnam. Therefore,
at this time, she could not say that it was likely or at
least as likely as not that esophageal cancer was the result
of exposure to herbicides used in Vietnam.
In March 2004, Dr. D. B., stated that prior to his diagnosis
of adenocarcinoma of the esophagus, the veteran did not have
a history of gastrointestinal problems including
regurgitation, heartburn, nausea, vomiting, or early satiety.
Dr. D. B. noted that the veteran had a history of exposure to
Agent Orange. He stated that the veteran had very little of
the typical symptoms associated with the development of
adenocarcinoma of the esophagus such as reflux symptoms,
indigestion, and only presented with late symptoms of
dysphasia. The physician opined that it seemed reasonable
that his esophageal adenocarcinoma related to his past Agent
Orange exposure. The physician explained that while the
veteran had a history of tobacco use, this exposure was a
significant risk factor for squamous cell carcinoma of the
esophagus, not adenocarcinoma of the esophagus; thus, it was
unlikely that his social habits had any relation to the
development of adenocarcinoma of the esophagus. Dr. D. B.
concluded that the veteran had known Agent Orange exposure.
Agent Orange exposure was related to adenocarcinoma of the
digestive tract. The veteran had none of the usual/typical
risk factors of adenocarcinoma of the esophagus. He stated
that it was reasonable to conclude that his Agent Orange
exposure greatly increased his risk of developing
adenocarcinoma of the esophagus.
The Board disagrees with the AOJ's assessment in this case.
While the AOJ states that the doctors did not adequately
discuss or evaluate the veteran's other risk factors in
developing his cancer, the Board finds that this is not the
case. The private oncologists and the VA examiner who
examined the veteran did in fact consider the veteran's risk
factors and discussed them in each report. It was noted by
all three physicians that the veteran had a history of
smoking, but since he had adenocarcinoma and not squamous
cell carcinoma, this was not felt to be an etiological
factor. In addition, Barrett's esophagus was specifically
ruled out. Thus, the veteran's various risk factors were
The United States Court of Appeals for the Federal Circuit
Court has stated that service connection can be granted on a
direct basis, not just a presumptive basis. As such, other
diseases, besides those deemed by VA to be presumptive
diseases may be service-connected. In order for them to be
service-connected, there must be competent evidence
establishing a nexus to service. The fact that a condition
is not a presumptive disease is not relevant.
In this case, Dr. J. W. made such an assessment and opined
that the medical literature that he submitted did support his
conclusion. Dr. J. W. discussed his supporting medical
literature. In reviewing this literature, the physician
found that there was an increased relative risk of "other
digestive cancers." He addressed the fact that the study
did not specifically list adenocarcinoma of the esophagus.
However, he concluded that since the study factored out
stomach, cancer, colon, rectum, hepabillary, liver, and
pancreatic cancer, the "other digestive" category included
esophageal and small bowel neoplasms. Dr. J. W. is an expert
in oncology. He is competent to make that assessment. His
opinion is confirmed by Dr. D. B. and the VA examiner.
The VA examiner addressed the fact that the article did say
that gastrointestinal cancers are rare and esophagus cancer
is very rare. Likewise, Dr. J. W. stated that the veteran's
type of cancer was rare as compared to breast, lung, colon,
and rectal cancers. Dr. D. B., who did not appear to rely on
the referenced study, opined that the veteran had none of the
usual/typical risk factors of adenocarcinoma of the
esophagus. In essence, he indicated that the veteran's sole
risk factor was his Agent Orange exposure.
Thus, the Board does not agree with the AOJ with regard to
those arguments. The Board finds that the three supporting
medical opinions are competent and supported by medical
literature. The two private physicians are the veteran's
treating oncologists and are specialists in their field of
medicine. In addition, the VA examiner also had an
opportunity to examine the veteran. They are all in
agreement that the veteran's Agent Orange exposure played a
role in his development of adenocarcinoma of the esophagus.
They have supported their opinions, as noted above. However,
a question remains as to whether those positive opinions are
outweighed by the negative opinion of the Chief Public Health
and Environment Hazards Officer.
In reviewing this opinion, the Board notes that the Chief
Public Health and Environment Hazards Officer's opinion is
also competent. However, in this particular case, her
opinion is outweighed. First of all, she stated that the
veteran had been diagnosed with adenocarcinoma of the
esophagus arising in the milieu of Barrett's esophagus in
2002. The veteran's adenocarcinoma of the esophagus has not
been found to have any relationship to Barrett's esophagus
and has been deemed by the treating oncologists to be without
similar symptoms. The treating oncologists discussed such in
detail. The veteran has not had the typical symptoms, his
symptoms are not those of Barrett's esophagus or having
similarity to such. Second, she stated that the most recent
IOM report did not specifically address the question of
possible association between exposure to herbicides and
specifically esophageal cancer. She indicated that the
reason was that their extensive review of all available
scientific and medical literature, to include the cited
medical literature, did not permit the IOM to assign this
disorder to one of its specific categories. The Board has
recognized that esophageal cancer is not in fact a
presumptive disorder. However, the treating oncologists and
the VA examiner have indicated that the veteran's specific
type of cancer is so rare that there are insufficient
studies. This is not discounted by the Chief Public Health
and Environment Hazards Officer. As noted, she stated that
the most recent IOM report did not specifically address the
question of possible association between exposure to
herbicides and specifically esophageal cancer. However, it
was her opinion that such an omission amounted to that
disease having been ruled out as being associated by the IOM
committee as being associated with dioxin exposure. The
three other physicians raise the possibility that the
omission does not amount to an exclusion, but rather is based
on the rare occurrences of this type of cancer and lack of
studies in that regard. It was pointed out that while it is
not among the recognized types of cancers, the veteran's
cancer is very unusual and atypical. The three other
physicians felt that in this particular case, the fact that
there was not a specific study on esophageal cancer was not
determinative. It did not mean that there was no
relationship between adenocarcinoma and Agent Orange
In sum, the Chief Public Health and Environment Hazards
Officer stated that she could not say that it was likely or
at least as likely as not that esophageal cancer was the
result of exposure to herbicides used in Vietnam. However,
the Board finds it significant to note that she was requested
to state whether it was likely, as likely as not, or
unlikely, that the veteran's esophageal cancer was related to
Agent Orange. While, she indicated that she could not say
that it was likely or at least as likely as not that
esophageal cancer was the result of exposure to herbicides
used in Vietnam, she did not state that it was unlikely or
rule out that possibility. She basically indicated that it
was not currently recognized by IOM and that prevented her
from stating that it was likely or at least as likely as not
that esophageal cancer was the result of exposure to
herbicides used in Vietnam. Conversely, the three other
physicians opined that it was as likely as not that the
veteran's esophageal cancer was the result of exposure to
herbicides used in Vietnam.
The Board finds that the three positive opinions outweigh the
negative opinion. The three positive opinions are based on
expert knowledge in oncology, personal knowledge of the
veteran's history, examination and treatment of the veteran,
and supporting medical literature as reviewed and explained
in the medical reports. They discuss the unusual and rare
nature of the veteran's cancer. They rule out the other
possible risk factors for this cancer. They correctly note
that the veteran had Agent Orange exposure. They conclude
that Agent Orange exposure is an etiological factor. The
negative opinion appears to rest entirely on the fact that
esophageal cancer has not been determined to be a presumptive
disorder by the IOM. None of the veteran's specific
symptoms, unusual circumstances of his cancer, or accurate
factors were discussed. Nothing specific to the veteran's
case was referenced except for the fact that he served in
Vietnam and that he had esophageal cancer. The only other
specific reference was an analogy to Barrett's esophagus,
which the veteran has not had. In light of the foregoing,
the Board accords less probative weight to this opinion.
The evidence supports the claim of service connection for
adenocarcinoma of the esophagus. Accordingly, service
connection is warranted for adenocarcinoma of the esophagus.
Service connection is granted for adenocarcinoma of the
H. N. SCHWARTZ
Veterans Law Judge, Board of Veterans' Appeals
Department of Veterans Affairs
YOUR RIGHTS TO APPEAL OUR DECISION
The attached decision by the Board of Veterans' Appeals (BVA or Board) is
the final decision for all issues addressed in the "Order" section of the
decision. The Board may also choose to remand an issue or issues to the
local VA office for additional development. If the Board did this in your
case, then a "Remand" section follows the "Order." However, you cannot
appeal an issue remanded to the local VA office because a remand is not a
final decision. The advice below on how to appeal a claim applies only to
issues that were allowed, denied, or dismissed in the "Order."
If you are satisfied with the outcome of your appeal, you do not need to do
anything. We will return your file to your local VA office to implement
the BVA's decision. However, if you are not satisfied with the Board's
decision on any or all of the issues allowed, denied, or dismissed, you
have the following options, which are listed in no particular order of
? Appeal to the United States Court of Appeals for Veterans Claims
? File with the Board a motion for reconsideration of this decision
? File with the Board a motion to vacate this decision
? File with the Board a motion for revision of this decision based on
clear and unmistakable error.
Although it would not affect this BVA decision, you may choose to also:
? Reopen your claim at the local VA office by submitting new and
There is no time limit for filing a motion for reconsideration, a motion to
vacate, or a motion for revision based on clear and unmistakable error with
the Board, or a claim to reopen at the local VA office. None of these
things is mutually exclusive - you can do all five things at the same time
if you wish. However, if you file a Notice of Appeal with the Court and a
motion with the Board at the same time, this may delay your case because of
jurisdictional conflicts. If you file a Notice of Appeal with the Court
before you file a motion with the BVA, the BVA will not be able to consider
your motion without the Court's permission.
How long do I have to start my appeal to the Court? You have 120 days from
the date this decision was mailed to you (as shown on the first page of
this decision) to file a Notice of Appeal with the United States Court of
Appeals for Veterans Claims. If you also want to file a motion for
reconsideration or a motion to vacate, you will still have time to appeal
to the Court. As long as you file your motion(s) with the Board within 120
days of the date this decision was mailed to you, you will then have
another 120 days from the date the BVA decides the motion for
reconsideration or the motion to vacate to appeal to the Court. You should
know that even if you have a representative, as discussed below, it is your
responsibility to make sure that your appeal to Court is filed on time.
How do I appeal to the United States Court of Appeals for Veterans Claims?
Send your Notice of Appeal to the Court at:
Clerk, U.S. Court of Appeals for Veterans Claims
625 Indiana Avenue, NW, Suite 900
Washington, DC 20004-2950
You can get information about the Notice of Appeal, the procedure for
filing a Notice of Appeal, the filing fee (or a motion to waive the filing
fee if payment would cause financial hardship), and other matters covered
by the Court's rules directly from the Court. You can also get this
information from the Court's web site on the Internet at
www.vetapp.uscourts.gov, and you can download forms directly from that
website. The Court's facsimile number is (202) 501-5848.
To ensure full protection of your right of appeal to the Court, you must
file your Notice of Appeal with the Court, not with the Board, or any other
How do I file a motion for reconsideration? You can file a motion asking
the BVA to reconsider any part of this decision by writing a letter to the
BVA stating why you believe that the BVA committed an obvious error of fact
or law in this decision, or stating that new and material military service
records have been discovered that apply to your appeal. If the BVA has
decided more than one issue, be sure to tell us which issue(s) you want
reconsidered. Send your letter to:
Director, Management and Administration (014)
Board of Veterans' Appeals
810 Vermont Avenue, NW
Washington, DC 20420
Remember, the Board places no time limit on filing a motion for
reconsideration, and you can do this at any time. However, if you also plan
to appeal this decision to the Court, you must file your motion within 120
days from the date of this decision.
How do I file a motion to vacate? You can file a motion asking the BVA to
vacate any part of this decision by writing a letter to the BVA stating why
you believe you were denied due process of law during your appeal. For
example, you were denied your right to representation through action or
inaction by VA personnel, you were not provided a Statement of the Case or
Supplemental Statement of the Case, or you did not get a personal hearing
that you requested. You can also file a motion to vacate any part of this
decision on the basis that the Board allowed benefits based on false or
fraudulent evidence. Send this motion to the address above for the
Director, Management and Administration, at the Board. Remember, the Board
places no time limit on filing a motion to vacate, and you can do this at
any time. However, if you also plan to appeal this decision to the Court,
you must file your motion within 120 days from the date of this decision.
How do I file a motion to revise the Board's decision on the basis of clear
and unmistakable error? You can file a motion asking that the Board revise
this decision if you believe that the decision is based on "clear and
unmistakable error" (CUE). Send this motion to the address above for the
Director, Management and Administration, at the Board. You should be
careful when preparing such a motion because it must meet specific
requirements, and the Board will not review a final decision on this basis
more than once. You should carefully review the Board's Rules of Practice
on CUE, 38 C.F.R. 20.1400 -- 20.1411, and seek help from a qualified
representative before filing such a motion. See discussion on
representation below. Remember, the Board places no time limit on filing a
CUE review motion, and you can do this at any time.
How do I reopen my claim? You can ask your local VA office to reopen your
claim by simply sending them a statement indicating that you want to reopen
your claim. However, to be successful in reopening your claim, you must
submit new and material evidence to that office. See 38 C.F.R. 3.156(a).
Can someone represent me in my appeal? Yes. You can always represent
yourself in any claim before VA, including the BVA, but you can also
appoint someone to represent you. An accredited representative of a
recognized service organization may represent you free of charge. VA
approves these organizations to help veterans, service members, and
dependents prepare their claims and present them to VA. An accredited
representative works for the service organization and knows how to prepare
and present claims. You can find a listing of these organizations on the
Internet at: www.va.gov/vso. You can also choose to be represented by a
private attorney or by an "agent." (An agent is a person who is not a
lawyer, but is specially accredited by VA.)
If you want someone to represent you before the Court, rather than before
VA, then you can get information on how to do so by writing directly to the
Court. Upon request, the Court will provide you with a state-by-state
listing of persons admitted to practice before the Court who have indicated
their availability to represent appellants. This information is also
provided on the Court's website at www.vetapp.uscourts.gov.
Do I have to pay an attorney or agent to represent me? Except for a claim
involving a home or small business VA loan under Chapter 37 of title 38,
United States Code, attorneys or agents cannot charge you a fee or accept
payment for services they provide before the date BVA makes a final
decision on your appeal. If you hire an attorney or accredited agent within
1 year of a final BVA decision, then the attorney or agent is allowed to
charge you a fee for representing you before VA in most situations. An
attorney can also charge you for representing you before the Court. VA
cannot pay fees of attorneys or agents.
Fee for VA home and small business loan cases: An attorney or agent may
charge you a reasonable fee for services involving a VA home loan or small
business loan. For more information, read section 5904, title 38, United
In all cases, a copy of any fee agreement between you and an attorney or
accredited agent must be sent to:
Office of the Senior Deputy Vice Chairman (012)
Board of Veterans' Appeals
810 Vermont Avenue, NW
Washington, DC 20420
The Board may decide, on its own, to review a fee agreement for
reasonableness, or you or your attorney or agent can file a motion asking
the Board to do so. Send such a motion to the address above for the Office
of the Senior Deputy Vice Chairman at the Board.
DMZ Veteran 67-68
2078 Eastwood Drive
Snellville, GA 30078