Parkinson’s Disease and VA Disability Compensation
Parkinson’s Disease (PD) is a disease of the central nervous system, characterized by the death of dopamine-producing cells in the brain. With less dopamine, a person has less ability to control their movements, body, and emotions.
Symptoms of Parkinson’s Disease
- Delayed movement
- Poor balance
- Sleep disturbances
- Urinary dysfunction
- Swallowing problems
- Mood disorders
- Cognitive deficits
VA Disability Ratings for Parkinson’s Disease
VA rates Parkinson’s Disease under 38 CFR § 4.124a – Schedule of Ratings, Neurological Conditions, and Convulsive Disorders, Diagnostic Code (DC) 8004. This diagnostic code assigns an automatic minimum 30 percent rating for the condition, but it does not take into account the symptoms associated with it.
Therefore, after beginning with the minimum 30 percent rating for Parkinson’s Disease, VA should continue rating as follows:
- Evaluate each of the veteran’s symptoms/residuals associated with Parkinson’s Disease
- Calculate the combined disability rating for those symptoms
- Assign the higher evaluation (i.e., the minimum 30 percent rating for the disease itself orthe combined rating of the symptoms)
Examples of symptoms/residuals of Parkinson’s Disease that VA can evaluate when assigning a disability rating include the following:
- Difficulty swallowing (dysphagia) – DC 7203
- Speech problems (dysarthria) – DC 8210
- Bladder incontinence (neurogenic bladder) – DC 7542
Secondary Service Connection for Disabilities Caused by Parkinson’s Disease
Parkinson’s Disease, while a neurological movement disorder, may affect other systems of the body which can lead to additional disabilities. In the instance of Parkinson’s Disease, a secondary service-connected disability would be a disability that was caused by the Parkinson’s Disease, once it has been deemed service-connected.
Below are some conditions which may be considered secondary to Parkinson’s Disease:
- Irregular Heartbeat
- Ischemic Heart Disease
- Heart Failure
- Injuries sustained from falling
- Gastrointestinal Complications
- Sleep Conditions, such as Sleep Attacks and Obstructive Sleep Apnea
Parkinson’s Disease and Agent Orange Exposure
Agent Orange is an herbicide agent that was used by the United States during the Vietnam War. More specifically, Agent Orange is a 50/50/ mixture of two kinds of herbicide agents: 2, 4-D and 2, 5-T. Additionally, Agent Orange contains a highly toxic dioxin called TCDD. The United States used Agent Orange during the Vietnam War to destroy enemy crops, disrupt supply lines, and prevent ambushes. As a result, Vietnam veterans have developed a number of health conditions that have been traced to Agent Orange exposure, including Parkinson’s Disease.
In July 2009, the Health and Medicine Division (formally known as the Institute of Medicine) concluded in its report, “Veterans and Agent Orange: Update 2008,” that there is suggestive but limited evidence that exposure to Agent Orange and other herbicides is associated with an increased chance of developing Parkinson’s Disease. As a result, VA added Parkinson’s Disease to its list of presumptive conditions associated with Agent Orange exposure.
Presumptive Exposure to Agent Orange
Presumption of service connection, as outlined by the Agent Orange Act of 1991, requires VA to assume that veterans who served during certain time periods and locations were exposed to Agent Orange. In relation to Parkinson’s Disease, veterans who served in the following locations and later developed Parkinson’s Disease do not have to prove that their condition is related to service:
- Veterans with “boots on the ground,” those serving on inland waterways in Vietnam, and “Blue Water” Navy veterans between January 9, 1962 and May 7, 1975;
- Veterans who flew or worked in C-123 aircraft during the Vietnam War era; and
- Veterans who served along the Korean Demilitarized Zone (DMZ) between September 1, 1967 and August 31, 197
VA also assumes service connection based on agent orange exposure for the following conditions, in addition to Parkinson’s Disease:
- AL Amyloidosis
- Bladder Cancer
- Chronic B-Cell Leukemia
- Chloracne (if it presents within one year of exposure to a degree of 10 percent disabling)
- Diabetes Mellitus Type 2
- Hodgkin’s Disease
- Ischemic Heart Disease (including Coronary Artery Disease, stable and unstable angina, myocardial infarction, and sudden cardiac death)
- Multiple Myeloma
- Non-Hodgkin’s Lymphoma
- Peripheral Neuropathy, Early Onset (if it presents within one year of exposure to a degree of 10 percent disabling)
- Porphyria Cutanea Tarda (if it presents within one year of exposure to a degree of 10 percent disabling)
- Prostate Cancer
- Respiratory Cancers, including Lung Cancer
- Soft Tissue Sarcomas (other than osteosarcoma, chondrosarcoma, Kaposi’s sarcoma, and mesothelioma)
The 2021 NDAA, National Defense Authorization Act, passed by Congress determined that there is a link between Parkinson’s-like symptoms are Agent Orange exposure.
Parkinson’s-like symptoms refers to a condition where the symptoms may resemble Parkinson’s Disease, but have not been formally diagnosed as such. The symptoms may include tremors, slowed movement, impaired speech, and muscle stiffness. The addition of Parkinson’s-like symptoms to VA’s presumptive condition list will make it easier for veterans with these symptoms to secure disability benefits.
Parkinson’s Disease and Military Burn Pit Exposure
Open-air burn pits are large areas of land that were used as a means of waste disposal on American bases in places like Iraq, Afghanistan, and Djibouti after September 11, 2001. 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
As these wastes were burned, harmful chemicals and toxic fumes were released into the atmosphere. As such, many veterans of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) have developed health conditions from hazardous exposures caused by these burn pits.
Burning hazardous materials and chemicals in open-air pits emits toxic substances and carcinogens that can cause a host of diseases, some severe and even deadly. Both Parkinson’s Disease and Parkinsonism (i.e., Parkinson’s-like symptoms) have been linked to these burn pits.
Research continues to be done to investigate what other conditions may be caused by burn pit exposure, but the full extent of the harm burn pits have caused is not yet known. However, research has indicated that one of the known chemical compounds released by burn pits includes the dioxin called TCDD which was also found in Agent Orange.
While VA does acknowledge certain conditions as being eligible for presumptive service connection if the veteran can prove exposure to Agent Orange, VA has not established a presumption for veterans exposed to burn pits. 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 pits claims. Often, VA does not have a way of verifying which veterans were near burn pits, so statements from the veteran themselves or buddy statements can help prove exposure.
Parkinson’s Disease and Traumatic Brain Injury (TBI)
Traumatic brain injury (TBI) occurs when brain function is disrupted by a traumatic event such as an IED blast, a gunshot wound, a car accident, etc. Rates of TBI among service members have increased substantially since the Iraq and Afghanistan wars.
VA diagnoses a veteran’s TBI as mild, moderate, or severe based on the severity of his or her symptoms. Importantly, if Parkinson’s Disease develops at any point following a moderate or severe TBI, the veteran will be presumptively service-connected for it.
Camp Lejeune Contaminated Water Exposure and Parkinson’s Disease
VA has established a list of presumptive conditions, including Parkinson’s Disease, for service members that served at Camp Lejeune for at least 30 cumulative days from August 1, 1953 through December 31, 1987. Therefore, Camp Lejeune veterans do not need to prove that their Parkinson’s Disease is connected to their military service.
TDIU and Special Monthly Compensation (SMC) for Parkinson’s Disease
Due to the fact that Parkinson’s Disease is such a disabling condition that often affects daily functioning, veterans can check to see if they qualify for Special Monthly Compensation (SMC) – a monthly benefit for veterans who have service-connected conditions that result in severe impairment, including the loss or loss of use of extremities, blindness, the need of regular aid and attendance, etc.
Furthermore, total disability based on individual unemployability (TDIU) may be an option if a veteran’s Parkinson’s Disease precludes them from securing and following substantially gainful employment. Here, veterans will be paid at the 100 percent level regardless of their combined disability ratings.
There are generally two pathways to become eligible 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 is uniquely hinders their ability to obtain substantially gainful employment and therefore should not be rated on the standard disability rating criteria.
Was Your VA Disability Claim for Parkinson’s Disease Denied?
If VA denied your claim, the veteran’s disability team at Chisholm Chisholm & Kilpatrick LTD may be able to assist you. Whether you are filing an initial claim, appealing a denial of benefits, or seeking an earlier effective date, an accredited attorney from CCK may be able to guide you through the process. For more information, as well as a complimentary case review, contact us online or at 800-544-9144.
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