Because of worries about Agent Orange, about 270,000 Vietnam veterans — more than one-quarter of the 1 million receiving disability checks — are getting compensation for diabetes, according to Department of Veterans Affairs records obtained by The Associated Press through the Freedom of Information Act. More Vietnam veterans are being compensated for diabetes than for any other malady, including post-traumatic stress disorder, hearing loss or general wounds.
Tens of thousands of other claims for common ailments of age — erectile dysfunction among them — are getting paid as well because of a possible link to Agent Orange. And the taxpayers may soon be responsible for even more: The VA said Monday that it will add heart disease, Parkinson's disease and certain types of leukemia to the list of conditions that might be connected to Agent Orange.
Lawmakers and federal officials who have reservations about the spending are loath to criticize a program that helps servicemen.
The VA uses a complex formula when awarding benefits and does not track how much is spent for a specific ailment, but AP calculations based on the records suggest that Vietnam veterans with diabetes should receive at least $850 million each year.
Agent Orange was a dioxin-laden defoliant that was sprayed over jungles to strip the Viet Cong of cover. But the VA, interpreting that 1991 law and studies that indicated potential associations, has over time added ailments that have no strong scientific link to Agent Orange.
Tollerud's committee concluded that evidence was limited and that chance or other factors could not be ruled out. One large study released since then, costing $143 million and published in 2005 after 25 years of research, surveyed the airmen responsible for loading and dumping Agent Orange during Operation Ranch Hand, as the spraying missions were called. Some 23 percent of Americans 60 and older have diabetes, according to the Centers for Disease Control and Prevention. Spey, who lives in Hurricane, Utah, and organizes a Ranch Hands reunion every year, said cockpits were constantly covered in Agent Orange. Spey said he is not drawing any VA benefits and believes veterans face little more than the ailments of age.
While Spey said policymakers have gone too far in granting benefits, Navy veteran Jonathan Haas believes they have not gone far enough.
The VA eventually granted him 100 percent disability — he is now drawing $36,000 a year, according to VA records — in part for diabetes after medical records from his service indicated that his condition had developed before he left the military.
Some members of Congress are pushing to include those veterans who served off the coast of Vietnam — which would add an estimated 800,000 people to the 2.6 million who served there on land. The case of the Navy electrician who spent eight hours in Vietnam is detailed in the documents obtained by the AP. Disability benefits are a lot like workers' compensation, providing income to veterans who incurred ailments from their active-duty service.


Many veterans have a combination of ailments that are crunched in a formula to determine their benefits. Most veterans get a 20 percent disability rating for diabetes, which amounts to about $3,000 per year if it is their only ailment.
Congress gave the VA the ability to deem ailments "presumptive" — automatically awarded — because of exposure to Agent Orange. The list of "presumptive" medical problems has grown to include seven ailments with only a "limited or suggestive" link to Agent Orange — a link that scientists said could be influenced by other factors, such as chance or bias in scientific studies. Anthony Principi, a Vietnam veteran and former VA secretary who added diabetes to the list, said he struggled with the decision. The evidence of a link between Agent Orange and heart disease or Parkinson's is inconclusive, according to the Institute of Medicine.
The VA estimated earlier this year that heart disease compensation alone will cost taxpayers more than $30 billion over the next decade.
Erectile dysfunction is now the seventh-most-compensated disability for Vietnam veterans, with more than 80,000 getting benefits for it last year, and an AP review of hundreds of case summaries found that many of the claims stemmed from veterans with diabetes linked to Agent Orange. Spey, the Ranch Hand veteran, blames politicians who are unwilling to reject the claims of aging veterans. Jack Spey is seen outside the Ranch Hand operations building at Tan Son Nhut Air Base near Saigon. But the man successfully argued that he may have been exposed to Agent Orange during his stopover and that it might have caused his diabetes — even though decades of research into the defoliant have failed to find more than a possibility that it causes the disease. The agency estimates that the new rules, which will go into effect in two months unless Congress intervenes, will cost $42 billion over the next 10 years. Samet, a public health expert who led that study and now serves as director of the Institute for Global Health at the University of Southern California. That does not include the hefty costs of retroactive payments or additional costs for health care.
American forces often got a soaking, too, and Agent Orange was later conclusively linked to several horrific health ailments, including cancers. The nonprofit Institute of Medicine's biennial scientific analysis of available research, to which the VA looks for guidance, has repeatedly found only the possibility of a link between Agent Orange and diabetes, and that even a chance of a correlation is outweighed by factors such as family history, physical inactivity and obesity.
Yet the VA in 2001 put diabetes on the list of ailments that get automatic approval for benefits. He petitioned the VA for years for recognition of a diabetes link to Agent Orange, saying he saw large clouds of chemicals drift over the waters off Vietnam and engulf his ship.


The VA did that for five illnesses for which the Institute of Medicine found "sufficient evidence of an association," such as leukemia, non-Hodgkin's lymphoma and soft-tissue cancers.
But the VA is moving ahead with plans to add both illnesses to the list of presumptive conditions. Jim Webb, a Democrat and Vietnam combat veteran, questioned the decision to spend billions for heart disease coverage.
Type 2 diabetes, for example, can bring a host of complications, such as high blood pressure, erectile dysfunction or cataracts.
Because of concerns about Agent Orange, more than one-quarter of the 1 million Vietnam veterans receiving disability checks are getting compensation for diabetes and other common ailments of age, with erectile dysfunction among them, according to millions of VA claims records obtained by The Associated Press through the Freedom of Information Act.
She also said it is the best way to ensure that deserving veterans don't get lost in the shuffle. So Congress and the VA set up a system to automatically award benefits to veterans who needed only to prove that they were in Vietnam at any time during a 13-year period and later got one of the illnesses connected to Agent Orange. He led an Institute of Medicine committee that first reported in 2000 on a possible link between diabetes and Agent Orange. He unsuccessfully challenged the VA rule that provided automatic compensation for diabetes only for those who set foot in Vietnam or worked on the country's inland waterways. The benefits often transfer to surviving family members when a veteran dies of the disability. If each of the 270,000 Vietnam veterans got the minimum compensation for their diabetes, it would add up to $850 million every year. Principi said he expected a surge of diabetes claims but is still surprised by the numbers. Still a pilot, Spey says he is not drawing any VA benefits and believes veterans face little more than the ailments of age. In a bit of machismo, some like Spey said they took swigs of Agent Orange to prove they could handle it. But it has declined to provide health and financial support to Vietnamese people affected by the herbicide, with the American ambassador in Hanoi saying there is insufficient evidence that it causes health problems. They are paid in addition to any medical, education and pension coverage that veterans receive.



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