Agent Orange Exposure and Respiratory Cancers

Veterans who develop a type of respiratory cancer and were exposed to Agent Orange or other herbicides during military service do not have to prove a connection between their disease and service to be eligible for VA disability benefits.  Instead, VA awards presumptive service connection as long as the respiratory cancer is the primary cancer – the original site where a cancer began.  It cannot be resulting from another form of cancer.

Types of Respiratory Cancers Associated with Agent Orange Exposure

Generally speaking, cancer is the uncontrolled growth of abnormal cells in the body.  Respiratory cancers include cancer of the lungs, trachea, larynx, and bronchus.  The symptoms of respiratory cancers related to Agent Orange exposure vary depending on the location and overall severity.  However, each type of respiratory cancer most commonly presents with the following:

• Lung cancer. A new cough or cough that doesn’t go away, coughing up blood, shortness of breath, chest pain, and hoarseness.
• Cancer of the trachea. A dry cough, hoarseness, breathlessness, difficulty swallowing.  
• Cancer of the larynx. Hoarseness, voice changes, sore throat or earache, feeling a lump in the throat.
• Cancer of the bronchus. Cough, chest pain, coughing blood.  

To diagnose respiratory cancers, doctors typically conduct imaging tests or biopsies to examine cell or tissue samples.  Research has shown that veterans who were exposed to Agent Orange in service may be at risk for developing such diseases.

Research Findings on Respiratory Cancers and Agent Orange Exposure

The Institute of Medicine of the National Academy of Science, Engineering, and Medicine concluded in its 1994 report “Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam” and in future updates that there is “limited/suggestive evidence of an association between exposure to herbicides (2,4-D; 2,4,5-T and its contaminant TCDD; cacodylic acid; and picloram) and respiratory cancers.  As a result, VA added respiratory cancers to the list of presumptive conditions related to Agent Orange exposure.

How Does VA Rate Respiratory Cancers?

When respiratory cancers are malignant, or active, they are generally rated under 38 CFR § 4.97, Schedule of ratings – Respiratory System, using Diagnostic Code (DC) 6819.  For this DC, VA assigns a 100 percent disability rating throughout the time the cancer is active and the veteran is receiving treatment for it.  Six months after the veteran finishes treatment, VA will schedule a Compensation & Pension examination to determine the current status of the cancer.  If the cancer is no longer active and in remission, it will be evaluated based on its residuals.  For example, one common residual of respiratory cancer is restrictive lung disease.  If that is the case, the veteran will be rated using the General Rating Formula for Restrictive Lung Disease.