On 10 MAR Sen. John Boozman, (R-AR) introduced S.657 to modify the presumption of service
connection for veterans who were exposed to herbicide agents while serving in the Armed Forces in
Thailand during the Vietnam era, and for other purposes. It was read twice and referred to the Committee
on Veterans' Affairs who held hearings on it on 28 APR. It currently has 14 cosponsors. During the Vietnam
War, more than 40,000 gallons of Agent Orange were used in Thailand, yet the Department of Veterans
Affairs (VA) does not automatically recognize all veterans who served there as being exposed to this toxin.
VA’s adjudication manual only acknowledges herbicide exposure for veterans with specific military
occupational specialties who served on the perimeter of eight specific Thai Bases.
S. 657 would automatically concede herbicide exposure for all veterans who served at military
installations in Thailand, regardless of the base, duty on the perimeter or military occupational specialty.
These veterans would be eligible for VA health care and presumptive service-connected benefits due to
their Agent Orange exposure. Readers can support this bill by clicking on DAV’s take action site
https://dav.quorum.us/campaign/33432 and forwarding DAV’s prepared editable letter to their Senators
asking for their support of this bill.

Study Finds Increased Risk to Exposed Vietnam Vets
A study that used stored blood samples from U.S. Air Force personnel who conducted aerial
herbicide spray missions of Agent Orange during the Vietnam war found a more than 2-fold
increased risk of the precursor to multiple myeloma known as monoclonal gammopathy of
undetermined significance (MGUS), according to an article published online by JAMA Oncology.
While the cause of MGUS and multiple myeloma (plasma cell cancer) remains largely unclear,
studies have reported an elevated risk of multiple myeloma among farmers and other agricultural
workers and pesticides have been thought to be the basis for these associations, according to study
background.
Ola Landgren, M.D., Ph.D., of Memorial Sloan Kettering Cancer Center, New York, and
coauthors examined the association between MGUS and exposure to Agent Orange during the
Vietnam War in a study sample of 958 male veterans, including 479 Operation Ranch Hand
veterans who were involved in aerial herbicide spray missions and 479 comparison veterans who
were not. The study found the overall prevalence of MGUS was 7.1 percent in the Operation Ranch
Hand veterans and 3.1 percent in the comparison veterans, which translates to a 2.4-fold increased
risk for MGUS in Operation Ranch Hand veterans.
The authors noted limitations to their study, including a lack of women in the study group and
the potential for unknown confounding factors such as family medical history and civilian
occupation. “Our findings of increased MGUS risk among Ranch Hand veterans support an
association between Agent Orange exposure and multiple myeloma,” the study concludes. In a
related editorial, Niklhil C. Munshi, M.D., of the Dana-Farber Cancer Institute, Boston, wrote:
“The study by Landgren et al has brought clarity to the risk of AO [Agent Orange]
exposure and plasma cell disorder. It also highlights the importance of tissue banking that
allows investigation of a number of unanswered questions using modern methods. The
emphasis now is to store samples from almost every major study with correlative science
in mind, and this is essential if we are to understand disease biology, mechanism of
response and resistance to therapy in the era of targeted therapy and precision medicine.”

Are You Eligible To File For Benefits?
Were you exposed to hazardous materials while serving in the military, such as from Agent
Orange or burn pits? Did you serve in Vietnam, Thailand or Southwest Asia? If so, you may be
eligible to file for service-connected benefits based on presumptive exposure. Over the course of
the last six months VA has begun processing service-connected disability claims for six new
presumptive conditions related to exposure to hazardous materials.
In May 2021, VA started implementing provisions of the William M.Thornberry National
Defense Authorization Act for Fiscal Year 2021 (NDAA), adding bladder cancer, hypothyroidism
and Parkinsonism to the list of medical conditions presumptively associated with exposure to
Agent Orange. A few months later, VA added asthma, rhinitis and sinusitis (to include
rhinosinusitis) on a presumptive basis based on particulate matter exposures during military
service in Southwest Asia and certain other areas. Any Veteran who was previously denied
service-connection for any of these six conditions but had symptoms manifest within 10 years of
military service would need to file another claim.
Be sure to use VA Form 20-0995, “Decision Review Request: Supplemental Claim” when
filing. An online fillable one is available at
 https://search.yahoo.com/search?p=va+for...UTF-8&fp=1
The claim form should include the name of the
medical condition and also specify that the medical condition is being claimed due to in-service
exposure to environmental hazards. VA is committed to assisting Veterans who may have been
exposed to hazardous materials during their military service. Be sure to stay plugged in to
www.va.gov for the most recent developments around environmental hazards; VA is constantly
conducting research and surveillance, as well as reviewing scientific literature for conditions that
may be related to exposure during military service.
If you feel you have a chronic condition attributed to an in-service exposure, we highly
encourage you to file a claim.

Veterans Benefits for Dementia
Over five million Americans over age 65 currently have Alzheimer’s disease or another type of dementia diagnosis. This staggering number represents approximately 10 percent of the senior population. In a 2017 report, the VA released data that suggests cognitive impairment like Dementia, Alzheimer’s Disease, and more are twice as common among veterans over 65 than their civilian counterparts. A previous traumatic brain injury (TBI) or diagnosis of depression or post-traumatic stress disorder (PTSD) have an increased risk of veterans developing symptoms of dementia; it also could mean they have eligibility for veterans disability benefits, VA health care services, and more.

Alzheimer’s disease slowly destroys memory, makes it difficult for people to care for themselves, and eventually leads to death. Alzheimer’s disease is the third-leading cause of death among Americans over age 65, with only cancer and heart disease claiming more lives.

VA Disability Ratings for Dementia
The VA assigns a rating between 0 and 100 percent for Alzheimer’s disease, Parkinson’s disease, TBI, Lewy Body dementia, FTD, mixed dementia, and all other types of cognitive impairment. The rating scale is as follows:

0 percent for Dementia: Veterans may be in the early stages of dementia at this point, but the health condition does not interfere with work or social obligations, nor does it require taking medication on an ongoing basis.
10 percent for Dementia: A 10 percent rating means that the veteran’s dementia diagnosis only rarely interferes with work or social obligations.  Veterans who must take medication continually to control the symptoms of dementia may also receive a 10 percent rating if the medication makes it possible to live a normal life.
30 percent for Dementia: This rating is most appropriate for veterans in the early stages to moderate stages of dementia. Common symptoms of dementia displayed at this point include depression, anxiety, panic attacks, and sleep disruption.
50 percent for Dementia: Veterans with a 50 percent disability rating for dementia typically demonstrate reduced ability to meet work and social obligations. Mood and behavior shifts are also common at this point.
70 percent for Dementia: The effects of dementia are apparent in most areas of life. The typical symptoms of dementia that veterans with a 70 percent disability rating demonstrate are neglecting personal care, irritability, and mood changes.
100 percent for Dementia: The dementia has taken over the veteran’s life at this point, causing hallucinations, permanent disorientation, and the inability to care for themselves.

Definition and Symptoms of Dementia
The National Institute on Aging (NIA) describes dementia as the progressive loss of cognitive functioning related to reasoning, thinking, and remembering. The most common symptoms of dementia include:

Balance and movement problems
Confusion
Delusions
Describing familiar objects with unusual words
Difficulty speaking and expressing thoughts
Difficulty with reading or writing
Getting lost and wandering away in familiar settings
Hallucinations
Ignoring personal care
Impulsivity
Lack of concern about the feelings of others (can sometimes include loved ones )
Loss of interest in relationships, work, and hobbies
Memory loss
Paranoia
Poor judgment
Repeating questions even after receiving an answer
Taking a longer time to complete everyday tasks
The NIA indicates that dementia comes in at least four unique forms. These include:

Alzheimer’s disease is the most common type of dementia diagnosis among older adults. The condition develops due to an abnormal buildup of protein and other changes in the brain. Symptoms are often subtle in the early stages but eventually become impossible to ignore.
Frontotemporal dementia (FTD) is the rarest type of dementia diagnosis, and it typically occurs in people under 60 years old. People with FTD have abnormal amounts of the TDP-43 and tau proteins.
Lewy body dementia occurs due to abnormal deposits of alpha-synuclein, also known as Lewy bodies.
Vascular dementia forms after a TBI or a health condition that causes damage to blood vessels in the brain or interrupts the flow of oxygen and blood into the brain.
The VA considers veterans who have two or more of these types of dementia as having mixed dementia. 

Service Connection for Dementia
To receive disability compensation from the Department of Veterans Affairs, veterans must submit a disability claim that connects the dementia diagnosis with military service. The dementia diagnosis must be service-connected in that the veteran developed dementia while completing military service or the military service worsened an existing condition.

When applying for VA benefits, veterans must have a current dementia diagnosis and describe a specific event or occurrence that caused or exacerbated the condition. The VA refers to this as a medical nexus.

Traumatic brain injury is a common example of a medical nexus. A veteran who suffered a TBI in combat could easily link that incident to a later dementia diagnosis. Veterans with mental health challenges, such as depression or post-traumatic stress disorder, may need to provide more medical evidence to demonstrate how their health condition developed into dementia. Some VA benefits that veterans with dementia may be able to receive upon approval of their disability claim include:

Assisted living care
General dementia care
Home based primary care
Homemaker services
Hospice care
Memory care
Nursing home care
Respite care for caregivers

Secondary Service Connection for Dementia
The term secondary service connection describes a new medical condition related to the original dementia diagnosis that the veteran developed during military service. The secondary health condition may be pre-existing if its development or progression is service-connected.

In the example of the traumatic brain injury above, a dementia diagnosis could be secondary to the TBI. Whether a dementia diagnosis is a primary or secondary service-connected condition, veterans must demonstrate a medical nexus when applying for VA benefits.


Service Connection by Aggravation
Veterans already in the early stages of dementia when they signed up for military service may be able to file a disability claim due to service connection by aggravation. The veteran applying for disability compensation must be able to prove that military service aggravated the progression of dementia and that the progression did not occur due to the normal course of aging. Medical test results and notes from doctor appointments typically provide proof the VA needs to approve disability compensation under this special category. This is an extremely unlikely scenario since early symptoms of dementia don’t typically start until much later in life.

Compensation & Pension Exams for Dementia
The VA requires some people who have filed a disability claim to undergo a medical exam known as C & P. The purpose of this exam is for the doctor to gather additional information to help the Department of Veterans Affairs approve or deny your request for VA benefits. Since the symptoms of dementia occur due to disturbances in the brain, claimants can expect to undergo a psychiatric evaluation and skills demonstration during their appointment. Veterans may also need to undergo additional medical tests such as an MRI or CT scan.

Most C & P exams take less than one hour to complete. Veterans should try to relax and go in being as honest and transparent as possible regarding their worst symptoms. The exam should hopefully uncover physical, emotional, and cognitive changes associated with dementia.

Total Disability Based on TDIU for Dementia
Total disability based on individual unemployability (TDIU) is another type of VA disability compensation available to veterans who meet certain qualifications. Applicants must have a single service-connected disability with a rating above 60 percent or two or more service-connected disabilities with a combined rating of at least 70 percent. People approved for this benefit must prove they cannot work at all due to a dementia diagnosis.

Contact Hill & Ponton for Additional Help
Dementia is a devastating neurological disease that affects the entire family. Due to the nature of the health condition, family members and caregivers are welcome to contact Hill & Ponton for a free case evaluation if you have received a VA decision you are not satisfied with.


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PDF available in DOWNLOAD Resources area. Good information to become familiar with

Servicewomen and military working dogs were honored with a new sculpture that was unveiled at Arlington National Cemetary in Virginia on 17 OCT. Titled "The Pledge," the sculpture is part of the Women In Military Service For America Memorial located at the cemetery's entrance. Created by sculptor Susan Bahary, the life-size bronze statue shows a female dog handler kneeling alongside her working dog and was commissioned by the U.S. War Dogs Association National Headquarters, reported the Associated Press. The unveiling took place during a closed ceremony, due to health concerns stemming from the ongoing novel coronavirus COVID-19 pandemic, but it was live-streamed on Facebook by The Women's Memorial. According to the Associated Press, one side of the 6 | P a g e statue includes a quote from Anne Sosh Brehm, who served in the Army as a nurse during World War II. It reads: “Let the generations know that women in uniform also guaranteed their freedom. That our resolve was just as great as the brave men who stand among us. And with victory, our hearts were just as full and beat just as fast — that the tears fell just as hard for those we left behind.”

VA’s Office of Small and Disadvantaged Business Utilization (OSDBU) interacts with businesses in all industries whose products or services support VA’s and Veterans’ needs. In honor of Breast Cancer Awareness Month, we’re shining a spotlight on a Woman-Owned Small Business (WOSB) that supports breast cancer fighters and survivors: Le’Host Hair & Wigs. After a close friend was diagnosed with breast cancer, owner Haith Johnson realized there was an underserved market for women struggling with severe illnesses who faced plummeting self-confidence when they lost their hair. Among women, hair loss before their chemotherapy began was patients’ primary fear, according to a 2001 study published in the Journal of Pain and Symptom Management. “When you look better, you feel better,” Johnson said. “Which is why I developed the motto: ‘Fight pretty with a wig.’” Sadly, her friend lost her battle to breast cancer, but Johnson’s journey inspired her to help other women going through cancer treatment. What started out as selling bundles of hair online from a basement in 2002 has now blossomed into a community of #BeautyCuties throughout #WigNation. “We reached out to the American Cancer Society, and they designated our business as a wig bank. We were [able] to distribute these wigs free of charge, but we also took care of these women − they got a free wig and free services.” Le’Host Hair & Wigs also partnered with VA medical centers to provide wigs to those in need, free of charge. Even with many American Cancer Society wig banks closing down due to the COVID-19 pandemic, Le’Host Hair & Wigs has remained committed to their promise to continue providing free, custom cranial prosthesis wigs. Johnson understands that choosing a wig is a very personal process. Le’Host Hair & Wigs’ “Wigs for Vets” program allows the company to provide products and services to all Veterans experiencing hair loss, and it specializes in custom-fitted hair prosthesis units for medical hair loss conditions, such as cancer, alopecia, burns, diabetes, lupus, thyroid conditions, and PTSD-related stress. When asked about her experience working with Veterans, Johnson said it’s been amazing. “We understand their needs, the dimensions, so it fits perfectly and naturally… which gives them confidence.” Le’Host Hair & Wigs was recently recognized as the 2020 Great Lakes Women’s Business Council’s (GLWBC) Women’s Business Enterprise of the Year. GLWBC represents more than 1,400 woman business enterprises in Michigan. Johnsons provides ongoing support and contact with her business’s clients. They hope this restores a sense of normalcy to those undergoing medical treatments, such as scalp injections, radiation and chemotherapy. Readers can learn more about Le’Host Hair & Wigs at http://www.lehosthair.com and if in need of their assistance make their request in a message at https://www.lehosthair.com/store-q-a

With women now serving on the front lines like never before in our nation's history, the military faces the new challenge of understanding the toll combat takes on the female psyche. Combat trauma is common in women; five out of ten women experience a traumatic event. Women tend to experience different traumas than men. While both men and women report the same symptoms of PTSD (hyperarousal, reexperiencing, avoidance, and numbing), some symptoms are more common for women or men.

What is the Difference?
Women are more likely to be jumpy, to have more trouble feeling emotions, and to avoid things that remind them of the trauma than men. Men are more likely to feel angry and to have trouble controlling their anger then women. Women with PTSD are more likely to feel depressed and anxious, while men with PTSD are more likely to have problems with alcohol or drugs. Both women and men who experience PTSD may develop physical health problems.

Why do Women Experience PTSD?
Women in the military are at high risk for exposure to traumatic events, especially during times of war. Although men are more likely to experience combat, a growing number of women are now being exposed to combat. Women in the military are at higher risk for exposure to sexual harassment or sexual assault than men. Future studies are needed to better understand the effects of women's exposure to both combat and sexual assault.

Do More Women than Men Experience PTSD?
Women are more than twice as likely to develop PTSD than men (10% for women and 4% for men). There are a few reasons women might get PTSD more than men:

Women are more likely to experience sexual assault.
Sexual assault is more likely to cause PTSD than many other events.
Women may be more likely to blame themselves for trauma experiences than men.
Not all women who experience a traumatic event develop PTSD. Women are more likely to develop PTSD if they:

Have a past mental health problem (for example depression or anxiety)
Experienced a very severe or life-threatening trauma
Were sexually assaulted
Were injured during the event
Had a severe reaction at the time of the event
Experienced other stressful events afterwards
Do not have good social support

Help and Treatment
The VA has established a Women Veterans hotline 855-VA-WOMEN (829-6636) to receive and respond to questions from women Veterans, their families, and caregivers across the nation about available VA services and resources. If you or a loved one are experiencing symptoms contact the 24 hour Veterans Crisis Line: 800-273-8255, press 1 ( or text 838255 for immediate help.) You can also use the VA's  Confidential Veterans Chat to seek assistance online.  You can also check out the VA's PTSD website for more information.

Transitioning servicewomen and recently separated women Veterans have access to information about VA women’s health services through the Women’s Health Transition Training course.

The online, self-paced instruction is available at http://TAPevents.org/courses/182 and is designed to complement VA’s Transition Assistance Program (TAP). found here https://benefits.va.gov/TRANSITION/tap.asp

Women Veterans can learn about VA’s gender-specific health care services. Women can also learn how to enroll in VA health care as quickly as possible after separation. This helps women Veterans better manage their post-military health care.

“VA has presented the Women’s Health Transition Training content to hundreds of women and refined it based on their feedback,” said VA Office of Transition and Economic Development Acting Executive Director, Lawrencia Pierce. “By expanding course availability online, servicewomen and women Veterans worldwide are better able to learn about VA health care designed for their needs and empowered to make informed decisions about their future.”

Background information on the program
Women are the fastest-growing segment of the U.S. Veteran population, but only 40% of eligible women Veterans enroll in VA health care. VA and the Department of Defense collaborated in 2017 to study women Veterans’ barriers to care. This led to establishing a pilot training program to address these barriers.

In 2018, VA began offering the Women’s Health Transition Training at select installations. Since then, hundreds of transitioning servicewomen accessed both instructor-led course in person and online. Feedback from pilot participants shows the course increases awareness of women’s health services available through VA, and the on-demand course makes this important information readily available to all.

The 2.5-hour on-demand Women’s Health Transition Training can be accessed at http://TAPevents.org/courses/182 . Learn more about future course opportunities here https://www.va.gov/womenvet/whtt/

Service members can register for a course using a CAC or entering a DOD ID and ALL the required information to receive credit. Veterans can choose the appropriate user type and complete the course registration to enter the course.
The course offers a certificate of completion.

A California lawmaker has introduced a bill that would require the Government Accountability Office to
investigate the involuntary discharge of thousands of women from military service from the 1950s to the
1970s due to pregnancy or motherhood -- something that could end up restoring benefits to those who lost
them through unwarranted dismissals. Democratic Rep. Julia Brownley on 8 APR introduced the "Justice
for Women Veterans Act," which would commission a study to identify "irregularities in discharges that
may have left these women without the veterans' benefits that they earned," according to a release.
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"The unfair practice of discharging women from the military because they became pregnant or became
a mother was not only wrong but it perpetuated a harmful cycle of gender prejudice," Brownley said in the
release. "My goal is to identify disparities in access to care and benefits for women veterans and, where
necessary, introduce, advocate for, and pass legislation that fixes those gaps." The study would look at
involuntary discharges between 1951 and 1976, when Executive Order 10240 was in effect. Signed by
President Harry Truman on April 27, 1951, it stipulated that women could be removed "regardless of rank,
grade, or length of service." During that time, the Pentagon granted discretionary authority to the service
branches to discharge women due to pregnancy, childbirth or becoming parents or stepparents through
adoption.
Brownley's office said the policy was prejudiced against "thousands of women who became pregnant,
regardless of whether the pregnancy was planned, unplanned, or the result of sexual violence." Women
were not given the courtesy of separation benefits, counseling or any type of assistance despite their removal
from the armed forces, the release states. The GAO will look at the executive order's impact, including how
women of a particular race or ethnicity may have faced other discrimination. The congressional watchdog
will make recommendations on the best ways to potentially restore those benefits, the release adds. "This
bill is the first step in assessing the impact of this discriminatory practice against servicewomen and will
provide recommendations on how to restore fairness for these women veterans," Brownley said.
The review would be similar to an investigation released in May 2017 into other-than-honorable
discharges of veterans with post-traumatic stress disorder or traumatic brain injury. The GAO found that,
of roughly 92,000 service members discharged for misconduct between 2011 and 2015, two-thirds "were
diagnosed with PTSD, TBI or other conditions such as adjustment, anxiety, bipolar or substance abuse
disorders within two years before leaving the service." That GAO study also said the military services were
inconsistent in considering whether service-connected medical issues contributed to the misconduct.