Agent Orange was a herbicide widely used by the US military during the Vietnam War. It contained a toxic chemical called dioxin, which has been linked to various health conditions. Recognising the adverse effects of Agent Orange exposure, Congress has passed several laws to provide benefits and medical care to veterans who were exposed to this herbicide. The VA operates on a ‘presumption of service connection’ for certain health conditions associated with Agent Orange exposure. This means that if a veteran served in Vietnam or in certain other locations during specific periods and develops any of the designated conditions, they are presumed to be related to their military service. Some of the recognised conditions include type 2 diabetes, certain types of cancers (e.g. prostate cancer, lung cancer), Parkinson’s disease and ischemic heart disease. In 2022, Congress passed the Sergeant First Class Health Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act, adding more than 20 presumptive disabilities for Agent Orange, burn pits and other toxic exposures. The PACT Act is perhaps the largest healthcare and benefits expansion in VA history. The most common disabilities we encounter are mental health conditions including depression, anxiety and posttraumatic stress (PTSD). Mental health conditions can be directly related to stressful or traumatic events during military service, or as a result of an already service-connected physical disability. Secondary service connection is a concept within veterans’ disability law that allows veterans to receive compensation for disabilities that are not directly caused by their military service but are linked to a service-connected condition. For example, veterans are often limited in their activities of daily living due to pain, which can have a dramatic effect on veterans’ mental health. Also, common side effects of an in-service traumatic brain injury (TBI) include behavioural and cognitive changes, which are often separately rated as mental health conditions. One of the unique aspects of veterans’ disability law is the veteran-friendly burden of proof: ‘at least as likely as not’ (50/50). Although veterans bear the burden of proof, when there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a claim, the VA must afford the benefit of the doubt to the veteran. Once the veteran provides evidence sufficient to satisfy the elements for service connection, the VA must grant service connection and assign a disability rating and effective date. The VA assigns a disability rating to each eligible condition, ranging from 0% to 100% in increments of 10%. The rating reflects the severity of the disability and determines the amount of compensation the veteran will receive. Higher ratings indicate more significant disabilities. The amount of compensation 30 LAWYER MONTHLY JUNE 2023 is based on the veteran’s disability rating. The VA provides a chart that specifies the monthly payment rates corresponding to each rating. As of 2023, the rates start at around $166 per month for a 10% disability rating and approximately $3,621 per month for a 100% disability rating. Veterans who are unable to secure substantial employment due to their service-connected disabilities may be eligible for individual unemployability benefits. This program provides compensation at the 100% rate, even if the veteran’s disability rating is below that level. Lastly, the VA must determine the effective date of an award – the starting point from which the VA calculates the payment of disability benefits. The effective date is of great significance because it plays a crucial role in determining the amount of retroactive benefits a veteran may receive. Retroactive benefits are the payments that cover the period from the effective date to the date of the award decision. If Empathy may be the most important attribute for success in this field. But without establishing healthy boundaries, it can also lead to burnout very quickly.
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