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Last updated: August 04. 2014 10:07AM - 260 Views
Thomas Crisp Contributing Columnist



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The major media has covered this story for years. The health effects on Marines, their dependents and civilian workers are tragic reminders of what happens when toxic chemicals are dumped into the ground and find their way into the aquifer and the tap water.


The main chemicals involved were volatile organic compounds (VOCs) such as perchloroethylene (PCE), a dry cleaning solvent, and trichloroethylene (TCE), a degreaser; however, more than 70 chemicals have been identified as contaminants at Lejeune, including benzene and vinyl chloride.


The last contaminated well was shut down in 1987. Providing VA health care to those injured from the toxic water took another 25 years. In August 2012, President Obama approved presumptive health care for 15 medical conditions for Camp Lejeune Marines and their dependents.


The Janey Ensminger Act requires the VA to provide health care for Lejeune victims of the contaminated water who suffer from cancer of the esophagus, lung, breast, bladder or kidney; leukemia; multiple myeloma; myleodysplasic syndromes; renal toxicity; hepatic steatosis; female infertility; miscarriage; scleroderma; and/or neurobehavioral effects or non-Hodgkin’s lymphoma.


The law doesn’t provide for VA disability compensation to veterans injured by the contaminated water and veterans can’t sue the government for injuries linked to active duty. Their only recourse is to file a VA disability and compensation claim. Claims for Camp Lejeune water contamination are processed by the VA in their Louisville, Ky., office.


At the VA’s Louisville office, the VA reviews all available evidence concerning the veteran’s service at Camp Lejeune, family history and exposures prior to and post-service, and all scientific and medical literature related to the particular claimed disabilities, according to an informed Congressional source.


This same source provided information that supported the critical need for an acceptable VA medical nexus opinion. Camp Lejeune Marines have better odds at a blackjack table than winning a VA disability claim, according to data provided by the Congressional source: The VA’s statistics as of January 31, 2014, showed that the VA’s Louisville office had processed 9,703 medical claims, approved 349 (3.6 percent), and denied 9,354 (96.4 percent).


According to the VA, Camp Lejeune Marines failed to provide a “credible medical opinion” (nexus opinion) and medical evidence to support VA disability claims. Without an independent audit by the VA Inspector General or the GAO, it’s impossible to tell whether the fault lies with the veterans or the VA.


It’s not unusual for veterans who suffer from cancers to be unemployed and desperate for ways to support their families. Most Americans would agree that when diseases are caused by exposure to toxic chemicals in military service, the government has a moral obligation to provide compensation to the veterans.


The legal argument for presumptive disability compensation for Camp Lejeune veterans was published in the Veterans Law Review in January 2012. It fell on deaf ears. Should the Congress have approved presumptive disability compensation for Camp Lejeune veterans? The short answer is yes. But, this is only wishful thinking at this point in time.


It doesn’t matter if the veteran has one of the 15 medical conditions listed in The Janey Ensminger Act (Public Law 112-154). No nexus opinion is the fastest track to a VA denial of disability. VA regulations require that Marine and Navy veterans who served at least 30 days at Camp Lejeune during the period 1957 until 1987 and have one or more of the medical conditions listed in the The Janey Ensminger Act must file a VA disability compensation claim supported by a doctor’s medical nexus opinion.


The nexus opinion makes the connection between an in-service event (e.g., contaminated water) and an existing medical condition. The doctor’s nexus opinion must state that the veteran’s medical condition is “at least as likely as not” due to exposure to toxic chemicals.


In simple terms, this means that there is a 50% subjective probability that the medical condition was caused by exposure to Lejeune’s contaminated water. In other words if half the evidence supports the contaminated wells were the cause of the disease, the veteran wins.


Filing a VA disability compensation claim is a legal process. Although there’s nothing to prevent VA doctors from writing nexus opinions, there is a possibility that VA doctors would be unwilling to risk criticism from VA management by writing a nexus opinion that results in a successful disability claim against the government. Thus veterans often need to nexus seek opinions from other sources to support their claims.


Since doctors normally charge a fee for reviewing a veteran’s service and medical history, a Marine veteran of Camp Lejeune with terminal cancer and unemployed may not have the financial resources to pay for a nexus opinion. An alternative may be medical doctors employed by city and county health departments.


Info on writing nexus opinions and the VA disability process is available online from the College of William and Mary’s Lewis B. Puller, Jr. Benefits Clinic. The mission of the clinic is to provide current and former military service members with knowledge of and assistance with pursuing available disability benefits resulting from their military service.


The Lewis B. Puller Jr. Benefits Clinic provides an excellent series of videos on the veteran’s disability claim process, including the critical nexus opinion. Check http://law.wm.edu/academics/programs/jd/electives/clinics/veterans/For%20Veterans/youtube/index.php


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