hello everyone thank you so much for tuning in today to the veterans legal lowdown my name is
maura black i'm an attorney at chisholm chisholm and kilpatrick and i'm joined today by nick briggs
a claims agent at chisholm chisholm and kilpatrick today we're going to be discussing va's proposed
changes to presumptive regulations specifically va is proposing to create
presumptive service connection rules for rare respiratory cancers that may be related to
particulate matter exposure in southwest asia we are going to talk briefly about what the new
presumptions look like what the proposals are what we know of them so far and we have been tracking
them although they're not finalized yet we're then going to talk about the list of conditions
that are going to be made presumptively related to particulate matter exposure and we're also
going to talk about some background information as needed as we go along just so that everyone's on
the same page about what the effect of the new rules would be for folks who do experience the
type of cancers that are on this proposed list so just to get us started the veterans health
administration specifically their team that works on health outcomes for military exposure matters
previously began a focused review of scientific and medical evidence related to particulate matter
exposure and toxic chemicals in the air water and soil and the subsequent development of rare
respiratory cancers among veterans who served in southwest asia based on these findings the va is
proposing a rule that will add presumptive service connection for these rare respiratory cancers for
certain veterans again we're going to talk about eligibility requirements and also what the types
of cancers are that we're discussing the proposal was officially announced on march 1st of this year
uh 2022 and in that proposal va announced its intention to add nine rare respiratory cancers
to the list of presumptive service connected disabilities for veterans who serve for any
period of time in the southwest asia theater of operations all of these uh proposed ads to the
presumptive list were announced as part of the comprehensive and overdue support for troops
or the cost of war act of 2021 which intends to expand access to health care and disability
compensation benefits for toxic exposure veterans so this that is a condensed um
amount of information that's kind of our roadmap though again we are going to be talking about
first what is presumptive service connection so that we all understand the import of the terms
that we're talking about what are the types of cancers that have been proposed to be presumed
to particulate matter exposure in southwest asia and then finally how do you meet the requirements
so where do you have to have served and at what time to meet the requirements for these
new presumptions nick can you please talk to us about just an overview what is presumptive service
connection so that folks are aware of the impact of these proposed rules absolutely thanks maura
so va presumes service connection for certain conditions based on the time
and location of the veteran service the reason for that being it's often hard for veterans to
prove specific environmental exposures but we know based off of where they were and when they were
serving that they were likely exposed even if we can't prove it so with that in mind the intention
for these presumptions is to make it easier for veterans to secure disability compensation when
they otherwise might have a difficult time proving something that we generally know occurred anyway
so because of these presumptions the regulations tend to eliminate the need for veterans to provide
a nexus opinion they simply need to show that they were serving at a certain place at a certain time
and that they've since developed a specific diagnosed condition
and once those two factors are met the link between the two is presumed
so in this particular case that we're going over today the presumptive service connection
is going to be related to chemical exposures and particulate matter exposure in the southwest asia
theater of operations so when we're talking about these conditions we're talking about veterans who
have served in the gulf war era okay important information i think because we talk sometimes
in the context of presumptions we talk about presumptions of exposure
and also presumptions of a link between a certain exposure and the development of a disability so
although both concepts are kind of in play today the primary focus is really that va's proposals
would presume or concede or acknowledge a link between the cancers that are on this list and
the types of exposures that you mentioned nick that a veteran would have experienced during
their service and again we are going to talk about qualifying details later so where do you
have to have served and at what time so that you can understand whether you are entitled to
the presumption of exposure um to the to the toxic chemicals that are known to cause these cancers so
we are going to now go through the list of the types of cancers that va has put on this list
so nine respiratory cancers have been proposed by the va to be presumed to be associated to
particulate matter and toxic chemical exposure in southwest asia they are i'm just going to list
them they're kind of lengthy names so please bear with me for a minute um the first one is
squamous cell carcinoma of the larynx also squamous cell carcinoma of the trachea
adenocarcinoma of the trachea salivary gland type tumors of the trachea which are very
rare tracheal tumors and they comprise less than 0.1 percent of respiratory tract cancers
nevertheless those are on the list adenosuamis carcinoma of the lung which is also a relatively
rare subtype of non-small cell lung cancer large cell carcinoma of the lung salivary gland
type tumors of the lung which are also uncommon lung conditions sarcomatoid carcinoma of the lung
and typical and atypical carcinoid of the lung the last is carcinoid tumors that often grow more
slowly than other types of cancers so as you can see these are all affecting sort of respiratory
um type body parts that are implicated by this type of exposure sort of dovetailing the research
and the presumptions that were introduced not too long ago for asthma rhinitis and sinusitis
but these are a whole different list of conditions that now veterans who do experience these issues
and who do have qualifying service in southwest asia and at the times that we're going to discuss
can link to their military service without needing a medical nexus opinion
so veterans who have served in the southwest asia theater of operations and have been diagnosed
with the cancers that i just mentioned are encouraged to file a claim for disability benefits
if they have not previously filed claims for benefits for these conditions
then they can file a new claim if they have previously filed claims for these issues they
want to file a supplemental claim so just keep in mind that anything that hasn't been claimed before
you can use the new claim form anything that has been claimed before and has been denied you want
to think about filing a supplemental claim since the issue has already been before the adjudicators
and as far as eligibility according to va any veteran who has manifested one of the
respiratory cancers on the list to any degree at any time during or after separation from service
in the southwest asia theatre of operations and other areas will be potentially eligible for
presumptive service connection and for va benefit purposes the southwest asia
theater of military operations refers to the following areas at any time between august 2nd
1990 and the present so important dates there august 2nd 1990 and the present this is an ongoing
um not bookended yet time period which is important for folks to remember the areas
that are on the list or that qualify are iraq kuwait saudi arabia the neutral zone between iraq
and saudi arabia bahrain qatar the united arab emirates oman the gulf of aden the gulf of oman
waters of the persian gulf the arabian sea and the red sea and the air space above these locations so
now we know what the types of cancers are that are on the list and there's nine of them
that are affecting respiratory functions we know the dates of qualifying service
august 2nd 1990 through to the present and we know the locations that i just listed that va
considers to be part of southwest asia theater service um the location and time period list
also includes veterans who served in operation iraqi freedom and operation new dawn respectively
between 03 and 2010 and 2010 and 2011. so nick can we talk about how looking forward how this
might affect research that's conducted affecting populations that were exposed to the types of
particulate matter and chemicals that we know were in the air and affecting people in southwest asia
and also if there's any tie-in between this issue and burn pits because burn pits is
burn pit exposure i should say is a question that we are often asked by
folks looking to get benefits for conditions that they believe to be related to burn pit exposure
so can you talk to us a little bit about what some um some future areas that we might want
to consider and keep track of related to this issue yeah absolutely thanks maura
so one thing to keep in mind is that as we discussed at the very beginning this is part
of an ongoing review of existing scientific and medical literature and this is the second set
of conditions that they've made presumptive based off of this particular matter exposure
last year in august of 2021 there were three new respiratory conditions that were linked to
particulate matter being chronic asthma rhinitis and sinusitis and those were conceited based off
of a combination of particulate matter exposure and burn fit exposure and with those particular
conditions you need to have the same sort of area of service that you already talked about
and to have developed the condition within 10 years and in addition to the regions that you
included this new regulation also included afghanistan djibouti syria and uzbekistan
as areas where there were particulate matter exposure and burn pit exposure
as examples of the potential sources of the chemicals these veterans were being exposed to
so again these are just different sets of conditions being added to the presumptive
list based off of existing scientific and medical literature but obviously there's new studies being
published all the time and one of the particular areas of concern when these studies are being
you know conducted moving forward is going to be what specific diseases might be related to
the burn fit exposure in particular because at this point there are many veterans who are
exposed to burn pits who were also exposed to particulate matter but we want to emphasize up
front that it's possible to have been exposed to particulate matter without being near a burn pin
so these cancers these conditions aren't exclusive to burn pit exposure they're really targeted
toward anybody who served in the countries that you noted earlier but the reason why the burn
pits themselves are important is because it's a particular type of toxic chemical pollution
and exposure that's in the air the water and the soil around these burn pits and there are many
more chemicals that could result in additional conditions being added to the list down the road
that's really helpful to know because again this is a topic of concern for a lot of folks who
served in southwest asia or family members and friends of our veterans and you do not need to
show specific burn pit exposure to avail yourself of these new presumptions
so that's important for people to keep in mind exactly burn pits are really just
one particular source of exposure to this particulate matter that we're talking about
and for toxic exposures generally in the person gulf area exactly in terms of timing we do not
have an exact timeline or an expected date when these nine respiratory cancers will be
added to va's presumptive list currently va has stated that once their rulemaking is complete
va will be conducting outreach to impacted veterans and survivors to inform them about
their potential eligibility but we again you know we know it's important for people to
understand when the timing of these new rules will be we know that the the agency can take a
while with these things especially when they have only so far announced a pretty general
statement about the status of their current rulemaking which is still in a proposal stage
so we will be tracking this issue we will be providing further updates as we have any
we're also going to be summarizing the content of today's discussion i believe through a blog post
that should be available relatively shortly if it isn't already so please feel free to review it
the list of cancers is again a little bit lengthy and they're pretty specific so if you have any
questions as to which disabilities on the list might apply to you please do take a look at the
information that we provide on the blog and again that'll be another location where we're going to
be sharing updates as we have any again still no timeline so we're really not sure when all of this
is going to become effective and we don't know when va will start reaching out to people that
might be impacted by these rules so best to stay on top of it which is what we're planning on doing
nick did you have any closing thoughts or any additional advice you wanted to provide for people
sure so first one to emphasize we this is an ongoing process they added three conditions
last summer they've already added three nine more conditions this spring so it's an ongoing process
and it's going to continue moving forward as new research comes in and those areas are examined
but it's also important to remind people that these are presumptions established by regulation
meaning that nothing precludes you from seeking direct service connection
while these regulations kind of sort themselves out that's important because ultimately if you're
able to get a medical opinion from your doctor or another medical provider that links your exposure
to your current diagnosis you can still get service connection even if the presumption
hasn't been established yet so nothing about this should discourage you from filing a claim
if you think there's a relationship between your persian gulf service and your conditions and it's
certainly not worth waiting while the presumptions kind of figure themselves out you know file that
claim sooner rather than later that's a really excellent point that we always try to make so
thank you nick for bringing that up that we always try to make in discussions about presumptions
the mistake that va makes repeatedly as we've seen in our practice i know nick can attest to
this is that if something is not presumed to be related to a type of exposure and service
they routinely deny those claims the presumptive list is certainly not a catch-all list we know
that it's taken many many years since 1990 the beginning of the presumptive period and today
for ba to conduct the research and to approve and recognize that there is a link between southwest
asia exposures uh particulate matter exposures toxic chemical exposures the types that are well
researched now uh and very known and um it's just taken quite a while for them to recognize that
certain disabilities stem from that exposure so the list that we have is great any additions are
certainly helpful and welcome so that certain people with these types of disabilities don't
have to go through the hoops of showing a nexus to service between their conditions
and their time in the military but uh this is in no way meant to deter people who have different
disabilities that they believe might be related to their exposure in service or as you said nick
disabilities now that aren't yet added that we know will be in the future or that we hope will be
assuming all goes well with the proposal so great point and thank you
that is all we have for today but again we will be staying on top of this and keeping you all updated
uh please visit our blog about this issue again with uh to obtain more detailed information about
the status of va's proposals and thank you all for tuning in uh our blog is located if
i didn't say it already at cck dashlaw.com and please subscribe to our youtube channel
as well that's another great source of updates on these and other issues affecting
veterans law so we hope to see you all there in the future and thank you again for tuning in today
you