Decades after he deployed to Vietnam, Laos, Cambodia, and Thailand in the late 1960s, Army veteran Jim Scott developed urinary symptoms that bothered him enough to go to the doctor.
“He asked for a urine sample,” Scott said. “He came back into the room and he said, ‘Guess what? You’ve got some urine in your blood.’ Because the little vial was full of blood instead of urine.”
It was bladder cancer. More than 20 tumors required surgery and chemotherapy. Scott suspected Agent Orange, an herbicide the U.S. government used in Vietnam, was to blame. So he filed a claim with the Department of Veterans Affairs, which said he didn’t have enough proof that his military service caused his illness.
After his cancer was treated, Scott got involved with the Bladder Cancer Advocacy Network — sharing his story and counseling newly-diagnosed patients. He also lobbied Congress to recognize the link between bladder cancer and Agent Orange so that veterans could get VA disability benefits without specific proof.
It finally happened last year.
“I was ecstatic,” Scott said. “It was like: Are you kidding me? ‘Breaking news! VA expands benefits for conditions related to certain toxic exposures.’ That's what I remember most.”
Three new presumptive conditions were added: bladder cancer, hypothyroidism, and Parkinsonism. The VA is sending letters to eligible veterans and has pledged to revisit previously denied claims.
But Scott said the packet of paperwork he received didn't fully explain the process. Instead, it asked him for additional information about his service, medical conditions, and beneficiaries. He ended up confused about how the claims process will proceed.
"It's like, 'Okay, once I fill it out, am I done?'" Scott said. "Do I just wait, or is there something else that I should do?"
Veterans advocates say the VA’s communications are often boilerplate, and veterans can have a difficult time applying the information to their specific issues or claims.
“That leads to mass amounts of miscommunication and misunderstanding amongst veterans,” said Stacey-Rae Simcox, a law professor and director of the Stetson University veterans advocacy clinic.“It also means veterans run around trying to get information they don't need to get, because the VA already has it.”
Even if veterans submit all the right information, that doesn’t mean the money will start flowing any time soon.
The VA already has more than 70,000 claims to review stemming from Parkinsonism, bladder cancer and hypothyroidism. That's on top of a longstanding, massive claims backlog for other veterans and their families. As of the beginning of the year, the VA said it had a total of more than 260,000 claims that had been pending longer than 125 days.
While the VA has been struggling with a claims backlog for years, Secretary Denis McDonough told reporters last month that the pandemic made it worse.
“We stopped, for example, providing what we call Compensation and Pension Exams, during the pandemic," McDonough said.
Those medical exams are usually the first step after a veteran files a claim. The VA uses them to gather evidence about a veteran's condition before issuing a decision on his or her claim. McDonough said the exams have resumed, but VA is still catching up.
“Under our current plan, we’re having employees work overtime,” he said. “We will — between that added overtime, automation of records, digitization of records, and hiring of additional people — get that down under 100,000 claims by early 2024.”
But that’s still a long time for veterans who for years have been battling health conditions and the VA. Jim Scott, the bladder cancer survivor, worries that some of his comrades won’t follow through on such a drawn-out process.
“Some veterans may go in and apply and not hear anything for an extensive period of time, dismiss the fact that they are going to be considered, and not keep the claim active," he said.
Scott encourages vets to file claims, stay on top of them, and be proactive until they get their benefits.
This story was produced by the American Homefront Project, a public media collaboration that reports on American military life and veterans.Funding comes from the Corporation for Public Broadcasting.
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