Agent Orange and TCDD
The PACT Act expanded qualifying locations and added hypertension and MGUS to the herbicide presumptive list.
1962–1975 and expanded locations
Vietnam War Exposures
Vietnam-era analysis includes Agent Orange and other tactical herbicides, the TCDD dioxin contaminant, shipboard asbestos, fuels, solvents, lead, coatings, and combustion products.
All wartime eras
Hazards and evidence questions
Naval asbestos
Ship, compartment, overhaul period, insulation disturbance, ventilation, and actual maintenance task are more probative than Navy service alone.
Fuels, solvents, and coatings
Aircraft, vehicle, vessel, and equipment work may create inhalation and dermal pathways that require task-specific reconstruction.
Watch this first
Illnesses caused by and connected to Agent Orange
VA walks through the diseases it accepts as linked to herbicide exposure. Watch it with your own diagnoses in front of you. If one of yours is on that list and your service fits, the claim is presumptive and you do not owe VA a nexus opinion. If it is not on the list, you are in a direct, facts-found claim instead, and the evidence you need is different.
Source: U.S. Department of Veterans Affairs, official channel
Accuracy safeguard: “Vietnam-era veteran” is not itself proof of herbicide exposure. Each presumption has specific service facts.
Unique and shared
What this generation is up against
Nobody argues about boots on the ground anymore. Set foot in Vietnam between January 9, 1962 and May 7, 1975 and exposure is conceded; the only fight left is over the diagnosis. So the fight moved to the edges of the map. Blue Water Navy service was excluded for decades until the Blue Water Navy Vietnam Veterans Act of 2019 restored the presumption for service within 12 nautical miles of the coast, and it is still denied when a ship’s track or deck logs cannot be produced. Thailand base perimeters, Guam, American Samoa, Johnston Atoll, Laos, and two Cambodian provinces were only added by the PACT Act in 2022. Thousands of veterans were denied under the older, narrower rules, took the denial as final, and never filed again. Those claims are still viable, and the law that killed them no longer exists.
The second problem is that Vietnam service was industrial service, and the words “Agent Orange” swallow the rest of the file. A boiler tender spent three years inside asbestos lagging. A flight-line mechanic breathed JP-4 and washed parts in solvent to the elbow. A hull technician cut lead paint with a needle gun in an unventilated compartment. The moment a claim says herbicide, the examiner answers the herbicide question and stops reading. Asbestos exposure in an engine room from 1968 to 1971 is a different claim under a different regulation, and if it is not pleaded separately it never gets answered at all.
Two veterans of the same conflict rarely carry the same claim, and veterans of different conflicts often carry the same one. The first panel is what belongs to this era alone. The second is the layer this era shares with the rest of the site — and it is the layer that reopens old denials.
Only this era
Unique to Vietnam-era service
These are the exposures that belong to this era and to the operations that supported it, including operations that continued long after the war ended.
- The six tactical herbicides and the dioxin in them. Agent Orange, Purple, Pink, Green, White, and Blue. The contaminant that drives the disease list is TCDD dioxin, which persists in soil and in human tissue for years after the spraying stopped.
- Herbicide handling far from Vietnam. Storage, loading, spray-rig maintenance, and drum handling at Thai air bases, Guam, Johnston Atoll, and stateside test, storage, and transport sites. A veteran who never saw Vietnam can still be inside the herbicide regulations.
- C-123 aircraft after the war. Flight, ground, and maintenance crews who worked on the airframes that flew Operation Ranch Hand are covered for service between 1969 and 1986 — more than a decade after the last spray mission.
- Blue Water and brown water service. Offshore service within 12 nautical miles of the Vietnam coast, and service on the inland waterways, with the shipboard distillation of contaminated water as part of the exposure argument.
- Shipboard industry at war footing. Engine rooms, fire rooms, and repair shops ran continuously for months. Asbestos lagging, fuels, solvents, welding fume, and lead coatings were not incidents — they were the job description.
Crosses eras
Shared with veterans of other eras
Vietnam veterans are usually surprised by how much of their file runs on regulations shared with other generations. It matters, because a shared regulation means a shared argument — and shared precedent.
- One herbicide disease list. The list at 38 CFR § 3.309(e) that decides your claim is the identical list a Korean DMZ veteran uses, including the hypertension and MGUS entries the PACT Act added in 2022.
- Asbestos, from the 1940s into the 1990s. Every ship, boiler room, and older barracks in every era. This is decided on the facts of the rating, never presumed, and it is the single most under-claimed exposure in Navy and Marine Corps files.
- Solvents, fuels, exhaust, and lead coatings. Trichloroethylene, perchloroethylene, carbon tetrachloride, Stoddard solvent, JP-4 and JP-5, leaded gasoline, and red lead primer appear in Korean War, Cold War, Gulf War, and post-9/11 files too.
- Camp Lejeune water contamination between August 1, 1953 and December 31, 1987. Thirty cumulative days or more at Camp Lejeune or MCAS New River in that period supports presumptive service connection for eight conditions, regardless of which war was being fought.
- PFAS and aqueous film-forming foam. Firefighting foam entered military use in the 1970s and stayed in use for decades on flight lines and in fire schools across every era that followed.
Conditions
What these exposures can cause
A Vietnam file usually has two halves and only one of them gets written. The presumptive half is nearly automatic. The occupational half — what the ship, the shop, and the flight line did to you — has to be built from scratch, and it is often worth more in rating points than the presumption is.
Presumptive
Diseases VA presumes from herbicide exposure
For qualifying service, exposure is conceded and these diagnoses are presumed service-connected without any medical opinion linking them to service. The list at 38 CFR § 3.309(e) holds eighteen entries:
- Type 2 diabetes mellitus
- Ischemic heart disease
- Hypertension (added by the PACT Act in 2022)
- Monoclonal gammopathy of undetermined significance, or MGUS (added by the PACT Act in 2022)
- Parkinson disease and parkinsonism
- Early-onset peripheral neuropathy
- Prostate cancer
- Respiratory cancers — lung, bronchus, larynx, trachea
- Bladder cancer
- Non-Hodgkin lymphoma
- Hodgkin disease
- Multiple myeloma
- Chronic B-cell leukemias, including chronic lymphocytic leukemia and hairy cell leukemia
- Soft-tissue sarcoma (other than osteosarcoma, chondrosarcoma, Kaposi sarcoma, or mesothelioma)
- AL amyloidosis
- Chloracne or other acneform disease consistent with chloracne
- Porphyria cutanea tarda
- Hypothyroidism
Facts-found
Shipboard and occupational disease
None of this is presumed. Each is granted when the file establishes the exposure, the diagnosis, and an opinion connecting the two — and each is rated separately from anything the herbicide list already covers.
- Asbestosis, pleural plaques and thickening, and malignant mesothelioma, which can surface forty years or more after the last exposure
- Chronic obstructive pulmonary disease and chronic bronchitis from fuel vapor, welding fume, and exhaust in enclosed spaces
- Bladder, kidney, and liver disease following long-term degreasing solvent work
- Chronic myelogenous and other benzene-associated blood disorders in fuel handlers and engineering ratings
- Lead-related hypertension, kidney impairment, and cognitive complaints in hull technicians, gunner’s mates, and paint crews
- Hearing loss and tinnitus — flight decks, engine rooms, and gun mounts, and still the most common under-claimed rating in this era
Secondary and direct
What VA does not presume and still grants
A presumption is a floor, not a ceiling. These conditions are not on any list and are granted every day, because they grew out of something that is already service-connected.
- Peripheral neuropathy that appeared decades after service — outside the early-onset presumption, but squarely inside a diabetes claim as a complication
- Diabetic retinopathy, chronic kidney disease, and erectile dysfunction, each separately ratable once diabetes is service-connected
- Congestive heart failure and arrhythmia following service-connected ischemic heart disease
- Voiding dysfunction, urinary frequency, and erectile dysfunction after prostate cancer surgery or radiation — the residuals are where the long-term rating actually lives
- Depression, anxiety, and sleep impairment secondary to chronic pain, cancer treatment, or breathing disease
- Sleep apnea secondary to service-connected respiratory or weight-related disease, rated on its own code and combined
One time limit is written into the herbicide list itself: early-onset peripheral neuropathy must have become manifest to a degree of 10 percent within one year of the last exposure. Later neuropathy is not excluded from compensation — it is argued as a complication of a service-connected disease, or directly on the facts, instead of under the presumption. For asbestos and other interstitial lung disease, the full breathing rating schedule is reproduced in plain language on our respiratory evidence page.
Rating criteria
Possible ratings, spelled out
Prostate cancer is the most commonly granted presumptive condition in this era, and it is also the one where veterans are most often surprised by what happens after treatment. Here is what the schedule actually says — including the rule that governs the day VA proposes to take the 100 percent away.
DC 7528Presumptive for qualifying service
Prostate cancer and other malignant neoplasms of the genitourinary system
38 CFR § 4.115b
100%
Assigned for active malignancy. The 100 percent evaluation continues for six months following the cessation of surgery, X-ray therapy, antineoplastic chemotherapy, or other therapeutic procedure.
In plain terms: The six months run from the end of treatment, not from the diagnosis and not from the date of the rating decision. If treatment continued longer than VA assumed, the 100 percent should have continued with it.
After six months
A mandatory VA examination is required. If there has been no local recurrence or metastasis, the disability is rated on the residuals — voiding dysfunction or renal dysfunction, whichever is predominant.
In plain terms: This is the moment most files are lost. The residual rating is only as good as the examination that measures it, and a veteran who does not describe his pad use, his nighttime voiding, and his catheter use in specific numbers will be rated at zero for problems he lives with every day.
Any reduction
A reduction that lowers compensation must follow 38 CFR § 3.105(e): VA issues a rating proposing the reduction, states the facts and reasons, and gives you 60 days to submit additional evidence or request a predetermination hearing.
In plain terms: Read that word again. It is a proposal, and you are entitled to answer it. A letter proposing to reduce your rating is not a decision — it is a deadline.
Loss of use of a creative organ after prostate surgery or radiation is separately compensable as special monthly compensation under 38 CFR § 3.350, in addition to the schedular rating for the residuals. It is not automatic and it is very often never claimed.
Rated under § 4.115aResidual rating
Voiding dysfunction — the residual most prostate claims land on
38 CFR § 4.115a
60%
Urine leakage requiring the use of an appliance, or the wearing of absorbent materials which must be changed more than four times per day.
40%
Urine leakage requiring the wearing of absorbent materials which must be changed two to four times per day.
40%
Urinary frequency with a daytime voiding interval of less than one hour, or awakening to void five or more times per night.
30%
Obstructed voiding with urinary retention requiring intermittent or continuous catheterization.
20%
Urine leakage requiring the wearing of absorbent materials which must be changed less than two times per day; or urinary frequency with a daytime voiding interval between one and two hours, or awakening to void three to four times per night.
10%
Urinary frequency with a daytime voiding interval between two and three hours, or awakening to void two times per night; or marked obstructive symptomatology with any of the following: post-void residuals greater than 150 cc, uroflowmetry showing a markedly diminished peak flow rate, recurrent urinary tract infections secondary to obstruction, or stricture disease requiring periodic dilatation.
Voiding dysfunction is rated on whichever of the three areas — urine leakage, urinary frequency, or obstructed voiding — produces the highest evaluation. Only one of the three is paid, so the examination has to capture the worst one accurately. Count the pads. Count the nighttime trips. Bring the numbers in writing.
DC 7703, 7709, 7712, 7715Presumptive for qualifying service
Blood cancers on the herbicide list
38 CFR § 4.117
Codes covered
7703Leukemia, including chronic B-cell leukemias
7709Hodgkin disease
7712Multiple myeloma
7715Non-Hodgkin lymphoma
100%
Assigned with active disease or during a treatment phase. The 100 percent evaluation continues for six months following the cessation of therapy, after which a mandatory VA examination is required and the disability is rated on its residuals.
Residuals after a blood cancer are commonly rated as anemia, neuropathy from chemotherapy, bone pain, fatigue, or immune impairment — each under its own diagnostic code, each with its own criteria, and each combined rather than absorbed. A file that reports “in remission” and nothing else invites a zero.
Nothing here is a promise about your claim. The reason to read the criteria is simple: the rating is built from what the examination and the treatment records say about your function, in the schedule’s own vocabulary. When the records are silent, the rating is low — and the fix is a better record, not a louder argument.
Combine your ratingsEligibility
Who qualifies — and how to file
Three doors, and the one you choose determines which regulation the rater applies. Choose deliberately.
Door 1 — Herbicide presumption by location and date
Vietnam between January 9, 1962 and May 7, 1975, including inland waterways and offshore service within 12 nautical miles; Thailand bases through June 30, 1976; Laos, Cambodia, Guam, American Samoa, and Johnston Atoll within their listed windows; C-123 crews from 1969 to 1986. Inside this door, a listed disease is presumed.
What the file needs
Dates and locations from the DD-214 and personnel recordFor offshore service: ship name and the deck logs or trackFor Thailand or Guam: base and duty location on the installationThe diagnosis, named on the § 3.309(e) list
Door 2 — Occupational exposure on the facts
Asbestos, solvents, fuels, lead, and noise are never presumed for this era. They are proven. Direct service connection under 38 CFR § 3.303(d) needs the exposure, the diagnosis, and an opinion — and it can be worth more than the presumption.
What the file needs
Rating or MOS and, more importantly, the work actually performedShip, hull number, and the spaces you worked inCommand history or shop records showing the materials in useBuddy statements describing the conditions, not the friendshipA clinician who addresses the occupational exposure by name
Door 3 — Residuals and secondary conditions
The most common under-rating in this era is a granted condition whose consequences were never claimed. Prostate cancer rated at zero after treatment while the veteran wears pads daily. Diabetes at 20 percent while the neuropathy and kidney disease sit unclaimed in the chart.
What the file needs
The already service-connected conditionEach residual or secondary diagnosis, separately namedSpecific numbers: pads per day, voidings per night, catheter useAn opinion tying the second condition to the first
The filing sequence, in order
Order matters more than speed. Every step below is free, and the first one protects money you have not been awarded yet.
- 1
File the Intent to File first, today
VA Form 21-0966An Intent to File locks your effective date for one year. Everything you are later awarded is paid back to the date VA received that form, not the date you finished gathering evidence. It takes minutes and costs nothing.
- 2
File the claim and name every diagnosis separately
VA Form 21-526EZOne form can carry many conditions, but each one has to be named. "Breathing problems" is not a claim; asthma, chronic sinusitis, and chronic rhinitis are three claims with three sets of criteria, and each is rated on its own before the ratings are combined.
- 3
Pull the exposure record VA already holds
The Individual Longitudinal Exposure Record compiles what the government already knows about where you served and what was there. For exposure that is not on a presumptive list, ask for a Toxic Exposure Risk Activity determination under 38 U.S.C. § 1168 — that determination is what turns an unlisted exposure into a developed one.
- 4
Decide whether you want representation
VA Form 21-22aForm 21-22a appoints an accredited agent or attorney; form 21-22 appoints a veterans service organization. Representation is never required. No one may lawfully charge you a fee to prepare or file an original claim.
- 5
If a decision is already wrong, choose the correct lane
VA Form 20-0995 / 20-0996 / 10182A Supplemental Claim (20-0995) is for new and relevant evidence. Higher-Level Review (20-0996) is for a decision that got the existing evidence wrong and allows no new evidence. A Board appeal (10182) is for the law itself. Choosing the wrong lane can cost a year and, in the worst case, an effective date.
If you were denied before 2019 for Blue Water service, or before 2022 for Thailand, Guam, American Samoa, Johnston Atoll, Laos, or Cambodia, you were denied under a law that has since changed. That is exactly what a Supplemental Claim exists for. Filing an original claim is free, and no one may lawfully charge a fee to prepare or file one.
Sign up for the VA registry
The Agent Orange Registry health exam
A free VA health examination for veterans with possible herbicide exposure. It is not a claim and it is not a compensation and pension examination — but it puts your exposure concern and a documented baseline of your health into the VA system, and a decades-old file usually has neither.
- Open to Vietnam service between January 9, 1962 and May 7, 1975, including brown-water and offshore service within 12 nautical miles; Thailand base service between January 9, 1962 and June 30, 1976; Laos between December 1, 1965 and September 30, 1969; the Mimot and Krek areas of Cambodia between April 16 and April 30, 1969; Guam and American Samoa between January 9, 1962 and July 31, 1980; Johnston Atoll between January 1, 1972 and September 30, 1977; the Korean demilitarized zone between September 1, 1967 and August 31, 1971; and C-123 crews between 1969 and 1986.
- Also open to veterans who tested, transported, stored, or sprayed herbicides anywhere, including at stateside sites.
- You do not have to be enrolled in VA health care to get the exam, and there is no copay for it.
- It includes an exposure history, a physical examination, and any laboratory work the clinician orders. Results and your stated concerns go into your VA medical record.
- No laboratory test can confirm or rule out herbicide exposure. Any clinic that offers a test proving it is selling you something.
- Spouses and children are not eligible for this exam.
How to get on the registry
Ask the Environmental Health Coordinator at your VA medical center, or have your VA primary care team place the referral. If you do not know who the coordinator is at your facility, call MyVA411 at 800-698-2411, available 24 hours a day, seven days a week, and ask to be connected.
MyVA411, 24 hours a day800-698-2411
A registry exam is not a claim, and enrollment in a registry is not evidence of exposure. Do both: get the exam so your health is on the record, and file the claim so the effective date starts running.
Need this looked at by a doctor?
Registry exams and exposure evaluations start with a clinician. Our doctor page has the words to use at the appointment, the direct phone number and VA email of the exposure coordinator at your own VA medical center, and every VA registry you can sign up for.
Who else this touched
The family this era reached
Vietnam-era herbicide service carries the widest family benefits of any era. Biological children with spina bifida and the children of women veterans with covered birth defects have their own dedicated benefit programs — benefits that are separate from, and do not require, the veteran's own claim to be granted first.
- Spina bifida monthly allowance, health care, and vocational training for biological children of Vietnam veterans (38 C.F.R. § 3.814).
- Covered birth-defects allowance, health care, and vocational training for biological children of women Vietnam veterans (38 U.S.C. § 1815; 38 C.F.R. § 3.815).
- DIC and Chapter 35 (DEA) education benefits for survivors when an Agent Orange presumptive condition causes or contributes to death.