specific questions about your disability. When he is finished he will write a summary of his findings. The rating specialist in the regional office will transfer these findings to what is called a Rating Decision, and assign a percentage evaluation for each disability granted. You will then be notified in writing as to the decision. The rating decision, if done properly, will consider service connection for diabetes, for example, on a direct basis, and then again on a presumptive basis. That is, the rating specialist will peruse your service medical records to see if you had a diagnosis of diabetes while on active duty. Most likely, there was none. Then, the rating specialist will consider a grant of diabetes secondary to Agent Orange exposure. Ratings for diabetes, prostate cancer, and non-Hodgkin’s lymphoma seemed to be the most prevalent conditions among Vietnam veterans, though this is not meant to downplay the significance of the other eight disabilities. They are all serious conditions for anyone who has them. Specifics of compensation A grant of service connection for diabetes associated with herbicide exposure is usually a straightforward grant of benefits based on a medical doctor’s diagnosis of that condition. Usually, a 20% evaluation is given when the veteran is on a restricted diet and taking insulin or using an oral medication such as Metformin or Glucotrol. A word of caution: Even though a veteran served in Vietnam and has a diagnosis of diabetes, service connection could still be denied. Your doctor must state that you have Type 2 diabetes in order for benefits to be granted. Having Type 1 diabetes will result in a denial because it is not one of the disabilities associated with herbicide exposure, as stated above. Common complications of diabetes may be found in medical journals and treatises, such as the Merck Manual and the Physician’s Desk Reference. Such conditions are rated separately from the grant of diabetes. For example, if the veteran complains of partial paralysis, pain, or numbness below the knee, an evaluation of 10% might be granted for left leg peripheral neuropathy. If the same condition is present in the other leg, a separate 10% evaluation might be given for that condition. Other conditions arising from the diabetes might include nephropathy with hypertension, and hypertensive retinopathy. Renal insufficiency secondary to diabetes, in particular, is another example of an extremely serious condition resulting from diabetes. It is diagnosed from laboratory tests showing elevated blood urea nitrogen (BUN) and/or other such tests. A VA rating of 30% or 60% for service connection would not be uncommon, depending on the severity of symptoms. Amputation of a lower extremity is another serious side effect of diabetes. For example, a veteran might have diabetic ulcers on his feet which could conceivably turn into gangrene. A subsequent amputation of both feet might result in a bilateral grant of service connection for the feet, rated 40% each, with the additional benefit of Special Monthly Compensation (SMC) being paid for the loss of both feet. Prostate cancer, another of the presumptive conditions associated with Agent Orange exposure, is a very serious, and life-threatening, condition. This condition is usually first diagnosed when there is evidence of an enlarged prostate or a rise in your Prostate Specific Antigen (PSA). Treatment with radiation and chemotherapy is standard. Treatment with surgery is another alternative. This procedure is called a radical prostatectomy, and such cases qualify for what is called Special Monthly Compensation K for loss of a creative organ (in this case for impotency resulting from the surgery). While undergoing treatment for prostate cancer, a temporary 100% evaluation is granted. Six months following cessation of treatment a mandatory VA examination is required to determine any residuals. This means that your claim will be rated on residuals of voiding dysfunction or renal dysfunction, whichever is predominant. Usually, this means the 100% evaluation will be terminated and replaced with another evaluation, 30% for example. However, this reduction from 100% to 30% will not take place until 60 days has elapsed. Another serious condition which arises as a result of Agent Orange exposure is non-Hodgkin’s Lymphoma. The same procedure is followed as stated above: while undergoing treatment a temporary 100% evaluation is granted. Six months after treatment ends, a mandatory VA examination will be given to determine any residuals. | Page 1 | Page 2 | Page 3 | Page 4 |