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Veterans Law

VA Disability for Chronic Lymphocytic Lymphoma: Burn Pit Exposure

May 26, 2021
VA Disability for Chronic Lymphocytic Lymphoma_ Burn Pit Exposure

Chronic lymphocytic leukemia is a form of blood cancer which begins in the bone marrow.  The cancer can progress slowly or rapidly, based on what form it takes.  There are generally two forms of chronic lymphocytic lymphoma, or CLL.  One form is referred as the slower-growing form, while the other is the faster-growing form.

The slower-growing form can remain stable for years and has normal, or slightly below normal, levels of red blood cells, platelets, and neutrophils in the blood, with an increased number of lymphocytes (i.e., white blood cells).

The faster-growing form has an excessive number of CLL cells in the blood which can block normal cell production.  As a result of this, the faster-growing form can cause a person to have less fully functioning red cells and platelet levels than normal.

CLL is the most common form of leukemia in adults.  People with CLL may be at risk for a number of different conditions as a result of their lowered number of healthy blood cells.

Symptoms of Chronic Lymphocytic Lymphoma

  • Exhaustion
  • Difficulty breathing, or shortness of breath
  • Chills or night sweats
  • Risk of infection
  • Swollen lymph nodes
  • Weight loss
  • Pain, or a sense of fullness, in the stomach

Conditions Associated with Chronic Lymphocytic Lymphoma

  • Anemia—Anemia is a condition that occurs when a person has a low number of red blood cells. Anemia usually causes fatigue and difficulty breathing, or shortness of breath.
  • Neutropenia—Neutropenia occurs when a person has a low number of white cells, which prevent the immune system from guarding against infection effectively
  • Thrombocytopenia—This condition occurs when the person has a low number of platelets. This can cause bleeding and bruising.

Compensation and Pension (C&P) Exams for Chronic Lymphocytic Leukemia

If a veteran files a claim for Chronic Lymphocytic Leukemia, VA may request a Compensation and Pension exam, or C&P exam.  To request an exam, VA may send the veteran a letter or call them.  It is important to follow through with scheduling and attending this exam, otherwise VA could deny the veteran’s claim.

The exam will usually be performed by a VA physician or a VA contracted physician.  Before the exam, the examiner will review the veteran’s c-file.  This will contain any documentation that has previously been submitted to VA, as well as the veteran’s medical and service records.

The veteran may also use a DBQ, or Disability Benefits Questionnaire, to bolster their claim.  A Disability Benefits Questionnaire is a form created by the VA so that the veteran may address important aspects of their condition, such as symptoms, severity, possible causes, and relation to other disabilities.  The veteran may also have their private doctor fill out a DBQ for them.  In claims for Chronic Lymphocytic Leukemia, DBQs can be helpful because a private doctor which may treat the veteran’s cancer can provide insight into the veteran’s condition.

VA Ratings for Chronic Lymphocytic Leukemia

Chronic Lymphocytic Leukemia is rated under Diagnostic Code 7703 for Leukemia.  Unlike other forms of cancers or leukemias, CLL does not have an inactive phase.  This means that VA never rates CLL as anemia, aplastic anemia, or on the residuals of the cancer.  As such, there is only one rating that can be given for CLL.

  • 100%—This rating, for leukemia, is given to veterans with an active leukemia disease or during a treatment phase. While other forms of leukemia may be rated under Diagnostic Code 7700 and Diagnostic Code 7716 for anemia and aplastic anemia, CLL is not because it does not have an inactive phase.

Additionally, the 100 percent rating for CLL continues, even after treatment has ceased.   

Burn Pits and Chronic Lymphocytic Leukemia

Veterans who served in the post-9/11 era may have been exposed to toxins through military burn pits.  As a result, many veterans have developed Chronic Lymphocytic Leukemia from the exposure they incurred during their service.

What are Military Burn Pits?

Military burn pits are large areas of land where waste was incinerated by the military and its contractors.  The United States Military used burn pits as part of its waste disposal protocol in places such as Iraq and Afghanistan in the post-9/11 era.  The practice was effective in reducing large quantities of waste, but the pits emitted plumes of toxic smoke.  The following materials have been linked to military burn pits:

  • Human waste
  • Medical waste
  • Ammunition
  • Paint
  • Plastic
  • Rubber
  • Styrofoam
  • Other toxic chemicals
  • Spoiled food
  • Lubricants
  • Petroleum

What Conditions Have Been Linked to Burn Pits?

There is currently little conclusive research on the long-term health impacts of burn pits.  The main dioxin released by burn pits is called TCDD and was also one of the major toxins found in Agent Orange.  TCDD has been linked to cancers, such as chronic lymphocytic leukemia, and other serious disabilities.

Unlike veterans exposed to Agent Orange, VA has not established a presumption for veterans exposed to burn pits.  As such, burn pit claims are adjudicated on a case-by-case basis.

VA does not have a consistent approach to deciding burn pit claims, so lay evidence submitted by veterans can often be the key to a grant of benefits. In many cases, VA does not have a way to confirm whether veterans served near burn pits, so statements from the veterans themselves, or buddy statements from their fellow service members, can help prove exposure.  The following conditions have been linked to burn pit exposure:

  • Acute and subacute peripheral neuropathy
  • Acute Myeloid Leukemia
  • AL Amyloidosis
  • Allergic Rhinitis
  • Asthma
  • Autoimmune Disorders
  • Basal Cell Carcinoma
  • B-Cell Lymphoma
  • Bladder Cancer
  • Bone Cancer
  • Brain Cancer
  • Bronchial Problems
  • Bronchitis
  • Chronic B-Cell Leukemias
  • Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)
  • Chronic Lymphocytic Lymphoma
  • Chronic Myelogenous Leukemia
  • Chronic Obstructive Pulmonary Disorder (COPD)
  • Conjunctivitis
  • Constrictive Bronchiolitis
  • COPD (need to know if the Veteran did/does smokes, and for how long)
  • Diabetes Mellitus II
  • Epilepsy
  • Gall Bladder Condition
  • Glaucoma
  • Glioblastoma Multiform, and other brain cancers
  • Hashmimoto Syndrome (Thyroiditis)
  • Headaches and Migraines
  • Hodgkin's Disease
  • Hodgkin's Lymphoma
  • Hydrocephalus
  • Hypertension
  • Intestinal Cancers
  • Ischemic Heart Disease (AKA Coronary Artery Disease)
  • Kidney Cancer
  • Leukemia
  • Lung Cancer, and other respiratory cancers such as cancer of the pharynx, larynx, etc.
  • Lung Condition
  • Lupus
  • Lymphoma
  • Lymphomas
  • Medulloblastoma
  • Multiple Myeloma
  • Multiple Sclerosis
  • Myelodysplasia
  • Non-Hodgkin's Lymphoma
  • Non-Ischemic Cardiomyopathy
  • Pancreatic Cancer
  • Papillary Thyroid Carcinoma
  • Parkinson’s Disease, Parkinson’s-like Syndromes, including Parkinsonism
  • Peripheral Vascular Disease
  • Poryphyria Cutanea Tarda
  • Prostate Cancer
  • Psoriasis
  • Psoriatic Arthritis
  • Pulmonary Condition
  • Pulmonary Embolism
  • Reactive Airway Syndrome
  • Renal Cancer
  • Renal Cell Carcinoma
  • Respiratory Condition
  • Rheumatoid Arthritis
  • Scheuermann Syndrome
  • Sinusitis
  • Sjorgen Syndrome (chronic autoimmune disease affecting salivary glands and tear glands)
  • Sleep Disturbances
  • Small Cell Carcinoma
  • Soft Tissue Carcinoma
  • Soft Tissue Sarcomas
  • Spinal Nerve Issues
  • Stroke
  • Testicular Cancer
  • Thyroid Cancer
  • Tonsil Cancer
  • Trachea Cancer

New Proposed Burn Pit Legislation 2021

As of 2021, there are several major bills currently pending in Congress that deal with the toxic exposure caused by burn pits.  These bills include:

  • Conceding Our Veterans’ Exposure Now and Necessitating Training Act (COVENANT)
  • Presumptive Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act of 2021
  • Veterans Burn Pit Exposure Recognition Act
  • Toxic Exposure in the American Military Act (TEAM)

If passed into law, any of these bills would offer much-needed relief to veterans suffering the toxic effects of burn pit exposure.  Specifically, the COVENANT Act would make any type of lymphatic cancer, such as chronic lymphocytic leukemia, a presumptive condition.  This would then make it much easier for veterans to be granted service connection for their CLL and receive VA disability benefits.

TDIU and Chronic Lymphocytic Leukemia

Veterans who are prevented from working because of their chronic lymphocytic leukemia may be able to receive a monthly VA disability called total disability based on individual unemployability, or TDIU.  This benefit compensates veterans at the 100 percent rating level, even if their disability rating may be less than that.

There are generally two pathways for veterans seeking TDIU:

  • 38 CFR § 4.16a (“Schedular”) – For this form of TDIU, the veteran must have:
    • One condition rated at minimum 60 percent OR two conditions that can be combined to reach 70 percent, where one condition is at minimum 40 percent
  • 38 CFR § 4.16b (“Extraschedular”) – This form of TDIU is for veterans who may not be able to meet the necessary criteria for schedular TDIU, but are still unable to obtain substantially gainful employment on account of their conditions.  In this instance, the veteran must prove that their condition hinders their ability to obtain substantially gainful employment and therefore should not be rated based on the standard disability rating criteria.

Getting Assistance with VA Disability Benefits for Chronic Lymphocytic Leukemia

As chronic lymphocytic leukemia is currently not a presumptive condition for military burn pit exposure, it can be difficult to become service-connected for the condition.  This can lead to much frustration for veterans seeking VA disability benefits for their condition.  If you need help with your VA disability claim for chronic lymphocytic leukemia, contact the VA disability lawyers at Chisholm Chisholm & Kilpatrick for a free consultation at 800-544-9144.