MemberMarch 24, 2023 at 6:49 pm
Talked with a Law Firm today. One of two that I have contacted.
The Lawyer that we spoke with will take our case and feels confident that we will win. They will appeal the previous decision and file for 100% service connected disability. If we don’t get 100% they will file again based on TDIU for 100%.
He understands the situation and says he has won like cases. They have numerous relationships with medical professionals that can write a Nexus Letter if they feel it’s necessary.
I have one more firm to hear from before we make our decision as to representation.
The attorney that we talked to answered all of our questions and understood the process.
Their fee: 20%.
MemberMarch 24, 2023 at 7:13 pm
What is a NEXUS letter?
MemberMarch 24, 2023 at 8:05 pm
“Nexus Letters are letters written by medical professionals detailing the connections … List (exposure to radiation, Agent Orange, Camp Lejeune water, etc.) …”
These letters are somewhat hard to come by. They can be purchased on line from $400.00 to $2000+. Most Medical Doctors do not want to write them as they have to say…the person “more likely than not” got the disease from exposure to Agent Orange. Most Drs. are not aware of the studies and cases, so they can not make “the” statement in good conscience. Neither my VA PCP or Neurologist was willing to make that statement.
These letters are supposed to be written by professionals/experts after a complete review of the medical records and the patient.
In my case the Appeal was Denied because I did not have this letter. I supplied a couple of studies from the NIH that showed linkage between herbicide exposure and gMG, but the Regional Office did not accept them because a Dr. did not say…”More likely than not this patient got gMG due to the Agent Orange exposure”.
MemberMarch 27, 2023 at 7:27 pm
Signed with an attorney today.
Denial below –
1-The available scientific and medical evidence does not support the conclusion that the condition is associated with herbicide exposure. (38 CFR 3.303, 38 CFR 3.307, 38 CFR 3.309)
2-The evidence also does not show that your disease developed to a compeusable degree within the specified time period after release from service to qualify for the presumption of service
connection. (38 CFR 3.307, 38 CFR 3.309)
3-The medical record shows that you were diagnose with myasthenia gravis in 2019.
4-The evidence does not support a change in our prior decision. -Therefore, we are confirming the previous denial of this claim.
5-Favorable Findings identified in this decision:
You have Vietnam Service from March 2,1971 through September 3,1971. Therefore, exposure to Agent Orange is conceded.
6-The claimed disability is a chronic disease which may be presumptively linked to your military
-Myasthenia gravis is a chronic disease subject to presumptive service connection.
-You have been diagnosed with a disability. You were diagnosed with myasthenia gravis on August 14, 2019.
You have sufficient service to meet the minimum requirements for presumptive service connection. You served 90 days or more during a war period or after December 31,1946.
The VA has acknowleged that I have MG and there is a presumptive Connection to my service in Vietnam but Denies the claim because it did not manifiest itself to 10% within 1 year from date of discharge.
You might see conflicting statements: Paragraph 1. ..scientific and medical evidence does not support the conclusion that the condition is associated with herbicide exposure. Paragraph 5: The claimed disability is a chronic disease which may be presumptively linked to your military service.
So Nexus letter might state…”Neurological disorders, due to herbicides/Agent Orange do not always expose itself within the time period allowed – 1 year after discharge. The statement must be supported by scientific papers and studies from professional people.
I guess we shall see what they have to say.
MemberMay 24, 2023 at 2:46 pm
I was stationed at an Army Depot 1972-74. 3 months before I was discharged, I was prescribed glasses with prisms, a treatment for double vision and a symptom of MG. Note – Nerve Gas was stored there.
First I asked for my medical records from the national archives three times and got a few none relevents pages. I then asked the VA for my “C-file”, claims file. It took a year to get because Covid had just started. It contained every VA record from military service, military health, VA education records, etc. After 2 hours of searching the 1,600 pdf pages, I found my 3 visits for colds and my “Army Eye Exams”. The exams showed the prisms being added to my glasses, after none for 21 months.
I have found that no one evaluating MG at the VA knows what it is, though it is on the original service connected presumptive list. When I appealed to the higher level reviewers, I finally got a chance to explain to someone and they didn’t know, but were good listeners and se5tup C&P exams.
I was rated for MG because I had a symptom within 1 year of discharge. In October, at the age of 72, I received 100% pay for TDIU (unemployability).
MemberJune 24, 2023 at 11:20 am
I was in Cu Chi Vietnam in 1967, I was w/a Gunner on a Huey chopper, I took some pictures of the area around us, it looked like the “Surface of the Moon”. I have some pics if you like. The spray was called a “DEFOILIANT”! None of us thought twice about that, all my VN service friends are mostly dead, dying, crippled, (from AO) or suffering. I had 4 sons, one died, my three sons have 8 children and my deceased son left me one Grandson, 9 in total. I worry about my 3 sons getting AO health problems and my 9 Grandchildren and others down the line. I hope there’s an extensive study on our DNA and passing on AO diseases to our Children.
respond if you like.
MemberJune 24, 2023 at 1:31 pm
Jodi, read the “New” Pact ACT,.I posted on anther’s page here.
Here is something else on immune disorders, (I was in VN 2/67 to 1/68)
“Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam” <<Link<<
MemberJuly 17, 2023 at 5:26 pm
The VA has Docketed my Appeal. My Attorneys have 90 days to get my documents recorded. The required Nexus Letter has been completed and am looking forward to seeing it. From there it’s up to the VA Appeals Board. I haven’t been able to get timing on this but could be anywhere between 90 days and two years.
We shall see.
MemberJuly 18, 2023 at 1:14 pm
I’m following your post. Vietnam 1967 Macong Delta. Mg diagnosed 5 years ago. Had signs undiagnosed for years. It’s sad that most Doctors won’t write a letter saying 50 50. When they really don’t know. To me if I don’t know, that’s 50 50.
MemberJuly 18, 2023 at 1:30 pm
Hi D Evans –
Actually the phrase is not 50/50, it is More Likely Than Not. That is 51/49 or greater.
Neither my VA PCP or Neurologist would write a Nexus letter for me because they did not know. The law group that has taken my case has a number of specialists that review health records and provide expert opinions to the VA for consideration. I am hopeful that my Appeal filed by this law group will be successful.
When the VA denied my first appeal that said that I “May” have contracted the disease during my Tour not More Likely Than Not.
Have you filed for Service Connection for you MG?
MemberJuly 31, 2023 at 9:03 am
Hi all, I just wanted to say it is possible to get approved for service connection for MG from Agent Orange. I was just granted the service connection last month at 50%. Maybe my circumstances are a bit unusual in that I was Army Special Forces, and in Vietnam (and Cambodia) from Nov. 1966 to Jan. 1969, for a total of 26 months. I saw lots of combat, and do to the nature of my missions, ended up in areas being sprayed while I was on the ground below the spraying.
I was able to get two nexus letters, one from my MG doctor, the foremost expert on MG in California, who is at UC Davis, and also a letter from the critical care neurologist who originally diagnosed me with MG after VA put me in the hospital for a complete work up after my unusual symptoms related to MG.The C&P examiner agreed with their “likely as not” diagnosis, and about a month after the the exam, I received my 50% award letter. Unfortunately, when one is awarded a service connection for MG, it isn’t common knowledge because of the privacy issue. Only when there is an appeal does it become open for review, as for the legal appeal publishing. So, it is possible. Thank you all for your service, and paying the price for our government’s defoliation tactics.
MemberAugust 1, 2023 at 11:25 am
Congrats Bob W –
My 2nd appeal, with a Law Firm, has been Docketed which means all of my Appeal docs, including Nexus letter, are due before Sept 30th, 2023. From there it is up to the VA to review the Appeal Docs and make a decision. Current review time is about 12 to 18 months.
I originally filed for Service Connection in 2019 and Appealed in 2021 and my 2nd Appeal in July of 2023.
It is a long process.
MemberAugust 2, 2023 at 3:23 pm
Hi all, I meant to add in my post that I did a fair amount of research on the impact of toxins and their impact on being the potential cause of autoimmune diseases. I presented both the doctors with that information, and they were willing to write my “nexus” letters. One Dr. Was even to go beyond “likely as not”, to say Agent Orange was likely the cause of my MG. I now believe it’s much better to submit a claim “with both guns blazing”, than to wait for a denial then try to change the opinion of a VA examiner. Just my opinion.
MemberAugust 2, 2023 at 4:19 pm
I got back in January ’68, was at Cu Chi. A lot of things happened to me medically, Bladder cancer 1980, Thryoid cancer 1982, Peripheral Neuroprathy plus other problems. My Vet friends never talked about Nam. I finally went to the VA when a friend died of Bladder cancer. His wife talked me into going to VSO, American Leigon, that was in 2018, now mor things have popped up like MG!!!
MemberSeptember 28, 2023 at 7:21 pm
Hi All – Follow-up –
My Appeal to the Appeal Denial has been filed and the case is Docketed, as I shared above. Next month I should be able to see where I lie on the Docket and when it might be reviewed. As of today, the decision could be made in as little as 90 days, but it has been said that the review could take as many as 525 days. We are hopeful.
All Appeal docs have been filed including a Nexus Letter from an independent MD/PHD specializing in, among other things, Toxins and their effect on the human body. He also explains how this disease can lay dormant for decades.
The Letter looks very strong and is quite descriptive in how this disease effects me and provides the link between MG and AO and other Auto-immune disorders in Medical jargon with numerous References.
We, our attorney and us, decided when we filed this Appeal, that the best way to address the Compensation Rate was to wait to receive this VA Decision Rating, see what their Rating is and Appeal the Rating Decision if the Rating not appropriate.
This is a long process……
MemberSeptember 29, 2023 at 3:50 pm
Thought I’d place interesting stuff….
From my Nexus Letter
“Multiple lines of evidence suggest that ADs have an environmental component. In some
individuals, disease improves after removing a suspected environmental agent and/or
worsens or reoccurs after re-exposure to the suspected agent. In addition to their role as
possible initiators of autoimmunity, environmental factors might alter the rate of
progression to clinical disease, the specific manifestations of disease expression, and/or the
course of illness. After certain disease-initiating exposures, decades can pass before
autoimmune disease manifests, and there can be a progression of stages from autoimmunity
to preclinical disease with immune alterations to classifiable autoimmune disease. Despite
the difficulties in defining environmental risk factors that lead to immunopathology, the
number of candidates proposed for specific ADs is continuously growing. A significant
body of research has pointed out that for autoimmunity to occur, the genetic background
warrants to be combined with environmental injuries and novel associations have been
described as the cause of the air pollution. Pollution and contaminants, such as AO
contaminants are hallmark toxicants which have been noted to be putative toxicants.
Solvents are liquids that dissolve a solid, liquid or gas. Organic solvents (AO) are
compounds whose molecules contain carbon. They may be broken down further into
aliphatic-chain compounds, such as n-hexane, and aromatic compounds with a 6-carbon
ring, such as benzene or xylene. One must review and understand the inherent component
of AO involved to make a nexus between ADs and AO (2-20).
Benzene or dioxin, which is an inherent chemical of AO, is a putative disease-causing
agent. Dioxin, also called polychlorinated dibenzodioxin, is a group of aromatic
hydrocarbon compounds known to be environmental pollutants that are generated as
undesirable by-products in the manufacture of herbicides, disinfectants, cleaning products
and other agents. It is generally synonymous with one specific dioxin: 2,3,7,8-
tetrachlorodibenzo-para-dioxin (2,3,7,8-TCDD). It is characterized chemically by the
presence of two benzene rings connected by a pair of oxygen atoms. Whether going by the
name dioxin, benzene, or TCDD, it is a highly toxic chemical, and a putative diseasecausing agent. As dioxin is a compound of benzene, the words will be used interchangeably
in this discussion (21-23).
Benzene and many similar contaminants are retained in some body tissues for a long time
(even decades), so target organ exposure continues even after external exposure ceases.
Even a brief external exposure, can involve protracted exposure of many organs. Disease
induction, the point at which initiation of the disease occurs (the disease might not be
apparent or detectable at this point), might even occur after external exposure ceases (20).
Dioxin/benzene and its inherent properties have the propensity to stay dormant in the
6 Siebert, D.
human body for decades before symptoms are apparent. Thus, one can clinically
extrapolate his exposure to AO, which has an inherent component of dioxin/benzene,
manifested in MG years later for this Veteran.”
MemberOctober 2, 2023 at 11:01 am
Thanks for sharing.
My dad served during the Vietnam era in Guam and he says that AO was sprayed all the time for foliage control. He said he would often follow the truck spraying it not knowing what it was, now he has developed MG. With the PACT Act they have said that AO was used in Guam, however, before the passing of the act when he saw the doctor in the VHA the doctor wrote in his medical file that the MG was likely probably AO related.
In my research I could not find any conclusive links to AO and MG. The VA says there is no link between AO and MG and has denied his claim for disability. MG is not a presumptive under the PACT Act nor is it a presumptive under 39 CFR 3.309 (e). It is a presumptive under 39 CFR 3.309 (a) however it has to be rateable within a year of separation (which is hard to prove with out medical evidence).
I do have some questions about your NEXUS however, I did not notice any references to studies from your doctor unless I missed them. Would you have references that your doctor used to write the nexus to come to their conclusion.
MemberOctober 6, 2023 at 9:00 am
What about Ataxia? Anything on that?
MemberNovember 5, 2023 at 7:34 am
My VSO showed me a letter that states “Jet fuel and other fuels are linked to many Diseases”!
MemberOctober 2, 2023 at 11:47 am
I received 100% P&T a year ago. I was in the Army 50 years ago for 2 years. Luckily, I found my Army Eye Exam and a Prescription for prisms in my glasses, 3 months before separation, in my VA claims file (C-file). Sometimes they don’t give you your Eye Exams when you request medical records, or raters don’t review them because they don’t know the significance.
I filed for double vision and MG. After denials by raters who didn’t know anything about MG, The Higher Level Reviewers (HLR) would get me C&P exams, after a phone call with them (check the box). Since 85% of the time the first symptom of MG is double vision, the C&P examiners said I had MG in the service. File for double vision in order to have an optometrist as a C&P examiner. Mine noted the reason for double vision was because of have MG.
MemberNovember 5, 2023 at 7:41 am
How did you find your eye exam? I had a back injury in basic training, 1966, and I’ve had surgeries and injections from the time I had insurance in 1973. They don’t give any help in finding your old Army health records. TIA
MemberOctober 2, 2023 at 12:00 pm
Hi Doug –
If you view the text from the Nexus Letter above, there are a number of Parentheses’ “()” in the text. For example: “…<i style=”font-family: inherit; font-size: inherit; color: var(–bb-body-text-color);”>a nexus between ADs and AO (2-20).” The References are in the “()” ie: (2-20). There are numerous References in that text.
1. Myasthenia Gravis: A Review. Autoimmune Dis. 2012; 2012: 874680.
2. Miller FW in The Autoimmune Diseases Vol. 4 (eds Rose NR & I. R. Mackay) Ch.
23, 297–308. (Elsevier, 2006).
3. Anaya JM (2010) The autoimmune tautology. Arthritis research & therapy 12: 147
4. Anaya JM, Corena R, Castiblanco J, Rojas-Villarraga A, Shoenfeld Y (2007) The
kaleidoscope of autoimmunity: multiple autoimmune syndromes and familial
autoimmunity. Expert review of clinical immunology 3: 623–635
5. Selmi C, Leung PSC, Sherr DH, Diaz M, Nyland JF, et al. (2012) Mechanisms of
environmental influence on human autoimmunity: A national institute of
environmental health sciences expert panel workshop. Journal of autoimmunity
6. Rook G (2011) Hygiene Hypothesis and Autoimmune Diseases. Clinical reviews in
allergy & immunology: 5–15.
7. Youinou P, Pers J-O, Gershwin ME, Shoenfeld Y (2010) Geo-epidemiology and
autoimmunity. Journal of autoimmunity 34: J163–7.
8. Pigatto PD, Guzzi G (2010) Linking mercury amalgam to autoimmunity. Trends in
immunology 31: 45–48
9. Finckh A, Cooper GS, Chibnik LB, Costenbader KH, Watts J, et al.
(2006) Occupational silica and solvent exposures and risk of systemic lupus
erythematosus in urban women. Arthritis and rheumatism 54: 3648–3654.
10.Kiyohara C, Washio M, Horiuchi T, Tada Y, Asami T, et al. (2009) Cigarette
smoking, N-acetyltransferase 2 polymorphisms and systemic lupus erythematosus
in a Japanese population. Lupus 18: 630–638.
11. Shoenfeld Y, Aharon-Maor A, Sherer Y (1997) Smoking and immunity: an
additional player in the mosaic of autoimmunity. Scandinavian Journal of
Immunology 45: 1–6.
12.Cooper GS, Gilbert KM, Greidinger EL, James JA, Pfau JC, et al. (2008) Recent
advances and opportunities in research on lupus: environmental influences and
mechanisms of disease. Environmental health perspectives 116: 695–702
13.Chang C, Gershwin ME (2010) Drugs and autoimmunity A contemporary review
and mechanistic approach. Journal of autoimmunity 34: J266–75
14.Barbara G, Cremon C, Carini G, Bellacosa L, Zecchi L, et al. (2011) The immune
system in irritable bowel syndrome. Journal of neurogastroenterology and
motility 17: 349–359.
15. Shoenfeld Y, Agmon-Levin N (2011) “ASIA” – autoimmune/inflammatory
syndrome induced by adjuvants. Journal of autoimmunity 36: 4–8
16. Shoenfeld Y, Selmi C, Zimlichman E, Gershwin ME (2008) The autoimmunologist:
geoepidemiology, a new center of gravity, and prime time for
autoimmunity. Journal of autoimmunity 31: 325–330
17.Chighizola C, Meroni PL (2012) The role of environmental estrogens and
autoimmunity. Autoimmunity reviews 11: A493–501
18.Farhat SC, Silva CA, Orione MA, Campos LM, Sallum AM, et al. (2011) Air
pollution in autoimmune rheumatic diseases: a review. Autoimmun Rev 11: 14–21
8 Siebert, D.
19.Gourley M, Miller FW (2007) Mechanisms of disease: Environmental factors in the
pathogenesis of rheumatic disease. Nature clinical practice Rheumatology 3: 172–
20.High Prevalence of Myasthenia Gravis Among Rural Adult Populations. J Cli
Neuromuscul Dis, 16 (2), 47-50 Dec 2014
21.Institute of Medicine, Committee to Review the Health Effects in Vietnam Veterans
of Exposure to Herbicides (1994). Veterans and Agent Orange: Health Effects of
Herbicides Used in Vietnam. National Academies Press
In my argument made to the VA, by my Attorneys:
“One of the reasons the Court has found a VA medical examination or opinion
to be inadequate is where the physician does not address all legal theories of entitlement
to service connection. “A medical examination is adequate where it is based upon
consideration of the veteran’s prior medical history and examinations and also describes
the disability in sufficient detail.” El-Amin v. Shinseki, 26 Vet. App. 136 (2013). A medical
opinion is inadequate if it is based on inaccurate factual premise. See Reonal v. Brown, 5
Vet. App. 458, 460-61 (1993).
In the case at hand, the VA examiner and the adjudicators relied solely on
myasthenia gravis not being a presumptive Agent Orange related condition to deny
service connection without meaningful analysis on the veteran’s exposure and
individual medical history, including his lack of alternate risk factors for developing the
Later in the Argument:
Baber pointed out that dioxin/benzene and its inherent properties have the propensity
to stay dormant in the human body for decades before symptoms are apparent. Dr.
Baber further noted that one can clinically extrapolate Mr. Seibert’s exposure to AO,
which has an inherent component of dioxin/benzene, manifested in myasthenia gravis
I am neither a MD or Attorney and really do not understand how all of this fits together. I am hopeful that the documents submitted, to the Board, will be sufficient to Rate my gMG as a Service Connected disability. The VA has Rated gMG as Service Connected in many claims long after their stated 1 year requirement.
My previously submitted claim Appeal that was Declined, and did show many of the References that Dr Baber uses. However, my previous Appeal did not have a recognized/qualified MD making a written statement that My gMG was more likely than not Service Connected.
The VA also wrote in my second Appeal that I did not have a Nexus Letter from a Qualified/Recognized MD.
I hired and Attorney to handle this Appeal as I did not have the Language or Resources to address the VAs Denials.
MemberOctober 11, 2023 at 6:45 pm
This is really really interesting!
I was diagnosed with MG Ocular back in 2007. I recently found out my father was exposed to Agent Orange after being in the Vietnam War! Please Please keep us updated if they start doing research on the possible connection!
MemberOctober 11, 2023 at 7:10 pm
Sorry to hear about both of you. Does your Dad have gMG as well?
I guess you might have an argument for getting it from Him but the Nexus between you and your Dad’s service in Vietnam will be difficult to document.
I have placed an address that will give you some more information.
– BTW – I have no idea why the web page is being displayed. –
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