VA Disability for Hashimoto’s Disease: Burn Pit Exposure
What is Hashimoto’s Disease?
Hashimoto’s disease, or Hashimoto’s thyroiditis, is the most common cause of hypothyroidism in the United States. The condition is also referred to as chronic lymphocytic thyroiditis. Hashimoto’s disease is an autoimmune disorder where the thyroid is chronically inflamed. The condition can be genetic, meaning it often runs in families.
Over time, the thyroid gland can weaken, which may impair the production of thyroid hormones. This could lead to a decrease in thyroid function, or hypothyroidism. The condition may affect any age group, but most commonly affects middle-aged women.
Symptoms of Hashimoto’s Disease
- Swelling in the throat, or the appearance of a goiter
- Swelling in the face
- Swelling of the tongue
- Weight gain
- Exhaustion, fatigue, or sluggishness
- Muscle weakness
- Joint pain or stiffness
- Infertility or miscarriage
- Decreased libido
- Increased menstrual bleeding
- Hair loss
- Dry or discolored, pale skin
- Increased sensitivity to cold
Complications that Can Arise from Hashimoto’s Disease
- Heart problems, including heart failure
- Depression, memory loss, or other mental health conditions
- Birth defects in babies born to mothers with hypothyroidism, as well as an increased risk of stillborn or premature births
- Myxedema coma, a form of coma that can be caused by untreated hypothyroidism
Treating Hashimoto’s Disease
Importantly, having Hashimoto’s disease does not automatically mean a person has hypothyroidism. To diagnose Hashimoto’s disease, a doctor may perform a physical examination and blood tests. These blood tests can measure a person’s hormone levels and determine how effectively the thyroid is functioning.
Three tests may be performed to test the thyroid: TSH test, free T4 and total T3 test, and the thyroid peroxidase antibody test. These tests can also determine what course of treatment should be taken. For example, if the tests reveal low thyroid hormone levels, then a doctor may prescribe thyroid hormone replacement therapy. Another treatment could be a kind of medicine called levothyroxine, a daily pill that can help regulate thyroid function and thyroid hormone levels.
VA Disability Benefits Ratings for Hashimoto’s Disease
Though not the same as hypothyroidism, Hashimoto’s disease is rated under Diagnostic Code 7903, the same diagnostic code used to rate hypothyroidism. The rating criteria for Hashimoto’s disease, which are based on the symptoms of hypothyroidism, are listed below:
- 10%–The veteran has symptoms of fatigability or continuous medicated is required to control the veteran’s symptoms.
- 30%–The veteran has symptoms of fatigue, constipation, and mental sluggishness.
- 60%–The veteran has symptoms of muscular weakness, mental disturbance, and weight gain.
- 100%– The veteran has symptoms such as cold intolerance, muscular weakness, cardiovascular involvement, mental disturbance (such as dementia, slowing of thought, or depression), bradycardia (less than 60 beats per minute), and sleepiness.
Compensation and Pension (C&P) Exams for Hashimoto’s Disease
When a veteran files a claim for Hashimoto’s disease, 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 on their behalf. A private doctor who treats the veteran’s Hashimoto’s disease may be able to provide VA with more insight into the veteran’s condition.
Burn Pits and Hashimoto’s Disease
Veterans who served in the post-9/11 era may have been exposed to toxins emitted by military burn pits that were used during this time period. As a result of this exposure, many veterans have developed Hashimoto’s disease, as well as hypothyroidism in some cases.
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
- Other toxic chemicals
- Spoiled food
What Conditions Have Been Linked to Burn Pits?
Currently, there is little conclusive research on the long-term health impacts of burn pits. TCDD, the main dioxin released by burn pits, was also one of the major toxins in Agent Orange. TCDD has been linked to cancers and other serious disabilities.
VA has not established a presumption for veterans exposed to burn pits as it has for veterans exposed to Agent Orange. Since there is no presumption, VA adjudicates burn pit claims on a case-by-case basis.
VA does not have a consistent approach to deciding these claims, so lay evidence from veterans is key to winning burn pit claims. Often, VA does not have a way of proving veterans were near burn pits, so statements from the veteran themselves or buddy statements can help prove exposure. The following conditions have been linked to burn pit exposure:
- Asthma diagnosed after service
- Head cancer (of any type)
- Neck cancer (of any type)
- Respiratory cancer (of any type)
- Gastrointestinal cancer (of any type)
- Reproductive cancer (of any type)
- Lymphoma cancer (of any type)
- Lymphomatic cancer (of any type)
- Kidney cancer
- Brain cancer
- Pancreatic cancer
- Chronic bronchitis
- Constrictive bronchiolitis or obliterative bronchiolitis
- Granulomatous disease
- Interstitial lung disease
- Pulmonary fibrosis
- Chronic sinusitis
- Chronic rhinitis
New Proposed Burn Pit Legislation 2021
As of 2021, there are several major bills currently pending in the Senate and the House of Representatives 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)
Any of these bills, if passed, would offer much-needed relief to veterans suffering the toxic effects of burn pit exposure. However, none of the proposed bills include hypothyroidism or Hashimoto’s disease as presumptive conditions.
Agent Orange, Hypothyroidism, and Hashimoto’s Disease
In 2021, the National Defense Authorization Act added hypothyroidism, and two other conditions, to the list of presumptive conditions for which VA grants service connection for veterans who were exposed to Agent Orange during their service. Specifically, in order to be eligible for presumptive service connection for hypothyroidism, the veteran needs to have served in one of the following locations during the specified time frames:
- Boots-on-the-ground in Vietnam, veterans with service aboard a ship that operated in the inland waterways of Vietnam (i.e., Brown Water veterans), or veterans with service aboard a ship in Vietnam’s territorial seas (i.e., Blue Water Navy veterans) between January 9, 1962 and May 7, 1975
- On or near the Korean demilitarized zone (DMZ) between September 1, 1967 and August 31, 1971
- Active duty and reservist personnel who had regular contact with C-123 aircraft between 1969 and 1986
Essentially, the addition of hypothyroidism to the list means that veterans do not have to prove a medical nexus between their condition and their military service.
What is Agent Orange?
During the Vietnam War, the United States used several herbicides to destroy its enemy’s crops. The goal was to interrupt their food supply and destroy foliage in the jungle to increase visibility and prevent ambush attacks.
Among these chemical agents, and perhaps the most well-known of the “rainbow herbicides” used during the Vietnam War, was an herbicide called Agent Orange. Agent Orange contained a mixture of two kinds of herbicide agents (i.e., 2,4-D and 2,4,5-T). However, as a byproduct of its production, it also contained the highly toxic dioxin contaminant 2,3,7,8-TCDD.
As a result of this dioxin contaminant, many veterans who were exposed to Agent Orange have developed serious health conditions. Hypothyroidism is one of these conditions.
The Link between Agent Orange and Burn Pits
Exposure to burns pits has also been associated with exposure to particulate matter and dioxins. Particulate matter can be particularly harmful when it enters the bloodstream or the lungs and has been associated with chronic respiratory conditions.
The main dioxin released by burn pits is called TCDD and was also one of the major toxins in Agent Orange. TCDD has been linked to various cancers and other serious disabilities. While VA acknowledges Agent Orange exposure has been linked to health conditions and offers presumptive service connection for some health conditions related to exposure, VA does not extend presumptive service connection to military burn pit exposure. Presumptive service connection means that the VA acknowledges the link between exposure and certain health conditions, therefore removing much of the burden to prove the connection between the condition and the exposure.
While veterans with Hashimoto’s Disease may be able to receive presumptive service connection if they are veterans of the Vietnam War era, there is no presumption of service connection for veterans with exposure stemming from burn pits. This can make it difficult for veterans with Hashimoto’s disease resulting for exposure to burn pits to secure VA disability benefits.
TDIU and Hashimoto’s Disease
Veterans who are prevented from working because of their Hashimoto’s disease may be able to receive a monthly VA disability benefit 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 to prove eligibility for 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 achieve the ratings necessary 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 on the standard disability rating criteria.
Veterans who may not have a 100 percent rating for their Hashimoto’s disease may be able to receive compensation at the 100 percent rating level through TDIU.
Getting Assistance with VA Disability Benefits for Hashimoto’s Disease
As Hashimoto’s disease is currently not a presumptive condition for military burn pit exposure, it can be difficult to become service-connected for this condition. This can lead to much frustration for veterans seeking VA disability benefits for their condition. Additionally, the way in which VA rates Hashimoto’s disease can seem complicated and hard to differentiate from hypothyroidism.
A VA accredited lawyer or representative can be helpful for veterans trying to navigate VA law for their Hashimoto’s disease. If you need assistance filing an initial claim or appealing a denial of VA disability benefits for Hashimoto’s disease, the VA disability lawyers at Chisholm Chisholm & Kilpatrick may be able to help. Contact us at 800-544-9144 for a free consultation with our office.
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