International Waldenstrom s Macroglobulinemia VA Benefits

Waldenstrom’s Macroglobulinemia and Veterans Affairs (VA) Benefits - Updated January, 2010

Do you have Waldenstrom’s Macroglobulinemia (WM)? Are you a Vietnam Veteran of a United States Uniformed Service? If you answered yes to both questions, you may qualify for Department of Veterans Affairs (VA) Disability Compensation, medical care, and other benefits. However, you must apply. Even if you answered no, there may be other benefits available to you. Similar benefits may be available to Vietnam Veterans of some other nations, such as Australia.

The VA has determined that certain diseases are more prevalent among Vietnam Veterans and are presumed to be associated with exposure to Agent Orange (AO), the herbicide used to defoliate jungles in Southeast Asia during the Vietnam War. See http://www.va.gov/agentorange.
One of the diseases is non-Hodgkin’s lymphoma (NHL). The VA and the American Cancer Society (ACS) classify WM as a type of NHL. Therefore, Vietnam Veterans of a United States Uniformed Service who have WM are qualified for VA benefits, including disability compensation.

You qualify for VA disability compensation if you served in a United States Uniformed Service in Vietnam at any time, no matter how short a time, during the Vietnam War (1962-1975). You do not need to have been aware of being exposed to AO and you do not have to provide evidence of exposure.

If you served in any other place where you may have been exposed to AO or another herbicide or defoliant, you may also qualify, but you must provide evidence of exposure. Locations where AO was used are at herbicide tests and storage in the U.S. and herbicide tests and storage outside the U.S. If you served in the US Navy offshore from Vietnam, you should apply. Although the VA revised their requirements in 2002 to require that the veteran had to actually have set foot in Vietnam, and that was sustained by the US Supreme Court, the VA regulations specifically cover NHL for “service in the waters offshore, or service in other locations if the conditions of service involved duty or visitation in Vietnam.” See http://bluewaternavy.org/NHL/nhl.htm. If you served in Thailand, see http://bluewaternavy.org/Thailand/thaibase.htm.

If you are not qualified for VA disability compensation (for example, although you have WM, you have not served anywhere where you would have been exposed to AO), you may still qualify for a VA disability pension. The requirements for a disability pension are different than those for disability compensation. You must be a wartime veteran with limited income and you must be unable to work or be age 65 or older.

Unlike Social Security Disability (SSDI), you are eligible for VA disability compensation even if you are able to work. If you are unable to work and under the full Social Security retirement age (65-67, depending on year of birth), you should also apply for Social Security Disability. You can receive both SSDI and VA disability compensation.

There is no time limit after leaving Vietnam until being diagnosed with WM or submitting a VA claim. However, you should apply as soon as possible after you are diagnosed, even if you have not had symptoms. If you have already completed a course of treatment, you should still apply. The effective date of a claim is usually the date the VA receives the claim, not the date symptoms began, as is usually so for SSDI.

You do not have to be treated by the VA in order to qualify for disability benefits, although the VA may require that you be examined by a VA health care provider. However, qualifying may entitle you to free VA medical care. You also may be eligible for other VA benefits such as dental care, eyeglasses, no cost life insurance and commissary and base exchange privileges.

The disability claim process can be initiated by phoning the VA at 1-800-827-1000 or online at http://vabenefits.vba.va.gov/vonapp/main.asp. You must complete an application, which can be completed on the VA website, downloaded and printed from the VA website, or you may request the VA representative to mail one to you. Although it is not required, it is best to consult with a Veteran’s Service Officer (VSO). Many States have county VSO’s in some counties. The phone number should be available in the local phone directory or from Directory Assistance. You may also seek assistance from a veteran’s service organization, such as the Disabled American Veterans, at http://www.dav.org. Their services are free. You should not need a lawyer for your initial application. You should submit the application as soon as possible, because the effective date of the benefits is usually the date that the VA receives your application. There are no application fees or any other fees.

If your claim is denied by the VA, you should appeal. It is best to use a VSO or an attorney. Free legal assistance is available from the National Veteran’s Legal Assistance Program (NVLAP), http://www.nvlsp.org/.

You should also apply for rating of all disabilities which may have originated or may have been aggravated by active service at any place or time. It will be necessary to consent to the VA obtaining your medical records for care from non-VA providers. Obtaining your medical records and letters yourself from treating physicians and sending them to the VA may expedite the process. It may take from several months to more than a year before you receive the approval. Benefits are usually retroactive to the date the VA received your claim.

The VA will determine a rating, which is expressed as a percentage of disability. The criteria for the 100% disability rating for NHL (and therefore for WM) are that the disease must be active and/or the patient must be in active treatment. You will meet the treatment criterion if a treatment recommendation has been made, even if you have deferred or declined treatment. The compensation for the 100% rating for 2009 for a single veteran is $2,673 per month, tax free. Additional compensation is paid if you are married and/or have minor children.

If the disease is not considered active or you are not in active treatment, a disability rating will still be given, although it may be at a lower level. If the rating is 0%, there is no disability compensation. However, this establishes that you have the service-connected disability and the rating may be upgraded if you develop symptoms, you are treated, or treatment is recommended. However, you should claim that, since WM is currently incurable, it is always active, as evidenced by elevated IgM.

There are additional ratings for disabilities which are the consequence of WM or its treatment, such as peripheral neuropathy, and there are additional allowances if you have dependents, including dependent parents, for other disabling conditions and for certain other circumstances including being unable to work, being housebound, or requiring aid and attendance.

If you retired from a US Uniformed Service, your retired pay will be reduced by the amount of your disability compensation. When you are awarded VA disability compensation, you should file amended income tax returns for the years for which your retired pay has been reduced. The
IRS may limit this to the last three tax years, so you should submit your amended tax returns before the end of the year. You should also apply to your Uniformed Service for Combat Related Special Compensation (CRSC). See http://www.defenselink.mil/prhome/mppcrsc.html. It should be approved and will replace the forfeited retired pay. It is also tax free, so it will not affect your amended tax returns.

A lawsuit against the manufacturers of AO was settled out of court in 1985 with a payout to the plaintiffs. The fund was depleted by 1997. An attorney subsequently filed suit on behalf of plaintiffs who had not been able to participate in the original case. A lower court ruled against the plaintiffs. The attorney appealed twice to the US Supreme Court. The Supreme Court denied the last appeal. There is no further recourse through the courts. The only remaining possibility is legislation through the US Congress. For further information, see http://www.agentorangelaw.net.

This article was written by Jerry Fleming, Vietnam vet, retired military and VA Disability Compensation and CRSC recipient.

DISCLAIMER: The contents of this article are believed to be accurate at the time it was written, but are not guaranteed by the VA or the IWMF. Check with the VA the concerning your case.

Tips, Suggestions and Reminders:

1. Apply as soon as possible. The effective date of your benefits will probably be the date the VA receives your application, so try to get it to the VA by the end of the current month. Also apply for Social Security Disability Insurance (SSDI), if you are unable to work and you are under the full Social Security retirement eligibility age. You can receive both VA disability compensation and SSDI. Even if you do not qualify for VA disability compensation, you may qualify for a VA pension.

2. State that you have been diagnosed with Waldenstrom’s Macroglobulinemia, which is a type of non-Hodgkin’s lymphoma. Ask your oncologist to prepare a letter stating that you have WM and that it is a type of NHL. The VA does not have a separate classification for WM. NHL is one of the diseases presumed to be the result of exposure to AO in Vietnam. The VA claims analyst will probably never have heard of WM, but NHL is in their rating manual. Go to the VA web site at http://www1.va.gov/agentorange/docs/D3AOBRIEF82005.doc. Print page 2. Highlight where it says, “Does VA recognize non-Hodgkin's lymphomas as service-connected for Vietnam veterans? Yes.” Include this with your claim. Go to the American Cancer Society’s web site page, “What is Waldenstrom’s macroglobulinemia?”, at http://www.cancer.org/docroot/CRI/content/CRI_2_4_1x_What_Is_Waldenstroms_Macroglobulinema.asp?mav=cri. Print the page. Highlight the statement, “Waldenstrom's macroglobulinemia is a type of non-Hodgkin's lymphoma…” Attach this to your claim.

3. If you are a US Navy veteran who served offshore of Vietnam, but you did not actually set foot in Vietnam, you still qualify for VA disability benefits. The VA may erroneously reject your claim because of policies and court decisions, referred to as Haas v. Nicholson, which require veterans with other AO related diseases to have actually set foot in Vietnam. However, non-Hodgkin lymphoma (NHL) (and therefore WM) is covered by a different federal regulation than the other AO related diseases. In order to avoid the VA erroneously rejecting your claim, attach to your claim a copy of the letter at http://bluewaternavy.org/NHL/gillibrand.PDF .

4. Submit a copy of your non-VA medical records and letters from your treating physicians. This may expedite the process. However, don’t delay submitting your claim while waiting to get them. You will have to sign a release for the VA to obtain your records. You can reduce the
processing time by helping the VA get the records as soon as possible, especially if you obtain the records and submit them to the VA. Review your record to insure that they include the diagnosis of WM and the treatment recommended. If your physician uses another diagnosis, such as Lymphoplasmacytoid lymphoma or Lymphoplasmacytic lymphoma, ask him to prepare a statement that you have Waldenstrom’s Macroglobulinemia to attach to your claim. Or you may go to http://www.thedoctorsdoctor.com/diseases/waldenstrom.htm, print
the page, highlight where it says, “…this disease is best viewed as a lymphoplasmacytic lymphoma…” and attach it to your claim.

5. Attach a copy of your Certificate of Release or Discharge from Active Duty (DD Form 214) if you have it. It should have your Vietnam service and medals listed on it. Highlight wherever the word Vietnam appears. You may obtain a copy of your DD Form 214 by applying online at www.archives.gov. Click on “Military Service Records”. Follow the instructions. You will have to download the signature verification form, sign it, and fax it to the fax number indicated. You should receive your DD 214 within about three weeks. Do not delay submitting your VA disability claim while waiting for your DD Form 214. You may send it after submitting your claim.

6. Describe how the disease is active (IgM level, bone marrow biopsy, blood test results, and symptoms). State if you are in active treatment. Having active disease, being in active treatment, or having a treatment recommendation meets the criteria for the 100% disability rating. However, still apply even if you have not had symptoms or if you have already completed a course of treatment. You should still get a disability rating, although it may be at a lower level. Print a copy of the IWMF home page, www.iwmf.com and highlight where it states that WM is incurable. Include it with your claim. State in your claim that, since WM is incurable, it is always active. Request that they designate your disability as Permanent and Total (P&T). If they do, you will receive the benefits for life and you will not be required to be re-examined periodically.

7. Describe any consequential or residual disabilities, such as peripheral neuropathy. They may qualify for additional disability ratings and possibly additional disability compensation.

8. Claim any other disabling conditions which may have originated during or been aggravated by active service at any place or time. They do not have to be AO related. It is the burden of the VA to determine whether they are service-connected. Ratings are combined to increase the amount
of disability compensation. However, the ratings are not added together directly. The VA has a complex formula for combining ratings.

9. Describe any other circumstances, such as those that may cause you to be unemployable, to be housebound, or to require aid and attendance. These may qualify for additional allowances. However, you do not have to have any of them in order to qualify for disability benefits.

10. List all dependents, including dependent parents. They warrant additional allowances.

11. Use a Veteran’s Service Officer (VSO), if available. They should be familiar with the requirements, although they probably are not familiar with WM. But don’t delay submitting your claim awaiting an appointment. You can always submit additional information later.

12. Check with the VA every couple of months to make sure your application hasn’t gotten lost. It will take months and maybe more than a year for the VA to completer processing your claim. The disability compensation will be retroactive, probably to the date of your application. You will get one big check and then monthly checks or direct deposits.

13. If you are retired from a US Uniformed Service, after approval of your VA Disability claim, submit amended income tax returns for the retroactively forfeited retired pay. Attach a copy of your VA Award letter. You will receive a refund for the taxes you paid on that amount, with interest. Apply to your Uniformed Service for Combat Related Special Compensation (CRSC). It will return the portion of your retired pay which was forfeited because of the VA disability compensation and which is determined to be for combat related disabilities. It is tax free.

14. The VA may call you back for re-examination and review of your case every few years. When they do, provide them current information to substantiate continuing your benefits. (Remember: Since WM is incurable, it is always active, even if your symptoms are in remission.)

15. When you receive your VA disability compensation, please make a generous donation to the IWMF. Attach a note stating that you are a veteran. (This is just for statistical purposes only.)