Veterans exposed to contaminated water at Marine Corps Base Camp Lejeune face some significant challenges when it comes to collecting the disability benefits they deserve. Our military supplied up to one million Veterans, National Guard, and Reserve members with drinking water containing highly toxic organic compounds between 1953 and 1987. The U.S. Department of Veterans Affairs (VA) approved a meager 25 percent of the 5,792 Camp Lejeune water toxicity claims filed between January 2011 and June 2019.
Unfortunately, all involved parties may be missing out on some important legal avenues available for Camp Lejeune veterans. The VA may deny disability claims using the faulty rationale that the veteran’s disease isn’t on the Camp Lejeune presumptive list. Veterans and advocates often fail to recognize opportunities for disability compensation for non-presumptive diseases – or choose not to appeal a bad VA decision.
Despite these obstacles, we continue to win VA disability benefits for hundreds of Camp Lejeune veterans – whether or not their diagnosis is on the VA’s list of presumptive diseases. Let’s review how this works.
Toxins Found in Camp Lejeune Water
Between the 1950s and the late 1980s, Marines and their families living at Camp Lejeune in Jacksonville, North Carolina drank, cooked with, and bathed in water contaminated with chemical waste from a nearby dry-cleaning company and runoff from military equipment cleaning stations.
ABC Cleaners Inc. began operations in 1954. The dry-cleaning facility was located just 500 ft north of Camp Lejeune and discarded waste near the underground storage tanks and wells supplying water to Hadnot Point and Tarawa Terrace housing units.
On-base water sample tests conducted in the early 1980’s revealed over 70 toxins in the water supplied to Tarawa Terrace and Hadnot Point, the most concerning being the degreaser tetrachloroethylene (TCE), the TCE byproduct vinyl chloride, and the solvents benzene and perchloroethylene (PCE).
Levels of all four chemicals exceeded U.S. Environmental Protection Agency (EPA) maximums. For example, the EPA maximum for PCE and TCE in drinking water is five parts per billion (ppb). In 1982, tests measured TCE in Hadnot Point water at up to 1,400ppb and Tarawa Terrace water at up to 215ppb.
EPA classifies TCE, benzene, and vinyl chloride as known human carcinogens. PCE is a likely human carcinogen. As volatile chemicals, the major route of exposure is through inhalation of vapors coming from the water, though some will also enter the bloodstream through ingestion and touch.
The toxins in the water at Camp Lejeune were colorless and odorless. Someone who used the water regularly would not notice a problem – experiencing only mild symptoms (headache, fatigue, dizziness, skin irritation) if any. Most people do not notice any symptoms of disease from these toxins until decades after exposure.
Contaminated Hadnot Point wells were shut down in early 1985. The Tarawa Terrace water treatment plant continued operations until 1987. Since the toxic water was the only supply of water veterans and their families had for everyday use, VA presumes that any veteran who served at USMC Base Camp Lejeune or Marine Corps Air Station (MCAS) New River for at least 30 days from August 1953 to December 1987 was exposed to toxic levels of contaminated water.
8 Diseases on VA Camp Lejeune Presumptive List
After exposure, the body metabolizes the toxins into dangerous byproducts. TCE and PCE byproducts go on to invade the central nervous system, immune system, kidney, liver, and male reproductive system. Studies suggest these metabolic byproducts have DNA-binding capacity, causing DNA and chromosomal abnormalities that cause a variety of cancers and other diseases.
Vinyl chloride byproducts can bind protein, RNA, and DNA. It is mutagenic in humans, causing spontaneous DNA synthesis and chromosomal mutations that result in cancers of the liver, brain, lung, blood, and lymphatic system.
Byproducts of benzene metabolism can disrupt cell structures, create cancer-causing free radicals, induce DNA strand breaks, and alter gene expression control mechanisms. Exposure is known to cause bone marrow depression, aplastic anemia, and chromosomal damage leading to various diseases and cancers.
Based on the strength of the scientific evidence associating Camp Lejeune toxins with diseases, the VA established a Final Rule in January 2017 offering VA disability benefits to Camp Lejeune veterans diagnosed with any of the following eight conditions:
- Parkinson’s disease
- Non-Hodgkin’s lymphoma
- Multiple myeloma
- Liver cancer
- Kidney cancer
- Bladder cancer
- Aplastic anemia / myelodysplastic syndromes
- Adult leukemia
Under this Rule, the VA automatically grants service connection for disability compensation to veterans who:
- Served at USMC Base Camp Lejeune or MCAS New River for at least 30 days between August 1953 and December 1987 (“qualifying service”), and
- Did not receive a dishonorable discharge, and
- Have one of the eight diseases on the presumptive list.
Veterans who meet all three of these conditions do not have to prove a link between their disease and their service at Camp Lejeune to get disability benefits.
Unfortunately, many Camp Lejeune veterans and VA officials mistakenly assume that veterans do not qualify for service connection if their diagnosis is not one of the eight diseases on the disability benefits presumptive list. These common misunderstandings cause hundreds of Camp Lejeune veterans to miss out on thousands of dollars in disability compensation every year.
Camp Lejeune Diseases Not on VA Presumptive List
Many Camp Lejeune veterans are just now beginning to exhibit the debilitating health problems caused by toxin exposure that happened decades ago. Scientific evidence and medical opinions have expanded significantly since the VA made its Camp Lejeune presumptive list back in 2017. Today, veterans can link numerous non-presumptive diseases to their Camp Lejeune service to secure veteran disability benefits.
For example, male breast cancer is not on the Camp Lejeune presumptive list. But numerous veterans who served at Camp Lejeune during those critical years are calling us saying they’ve developed male breast cancer. These veterans know other Camp Lejeune veterans diagnosed with male breast cancer. An obvious common denominator here is exposure to the toxic water at Camp Lejeune. But because it’s not on the list, most veterans find it challenging to prove service connection.
In addition to the VA’s eight Camp Lejeune presumptive diseases, scientific research connects PCE, TCE, benzene, and vinyl chloride with the development of many serious health problems, including (but not limited to):
- Brain cancer
- Cervical cancer
- Ovarian cancer
- Prostate cancer
- Rectal cancer
- Esophageal cancer
- Lung cancer
- Soft tissue cancer
- Kidney disease
- Eye defects
- Hodgkin’s disease
- Impaired immune system function
- Liver disease (cirrhosis, hepatic steatosis)
- Neurobehavioral effects (low reaction times, short-term memory, low attention span, insomnia, low visual perception, dementia, fatigue, motor problems, color vision issues)
- Severe, generalized hypersensitivity skin disorder
Most volatile organic compounds found in Camp Lejeune water are known human carcinogens. Using the wide array of scientific studies associating various cancers with the toxins at Camp Lejeune, hundreds of Camp Lejeune veterans have won disability benefits for cancers that aren’t on the list.
For example, a 2014 study by the Agency for Toxic Substances & Disease Registry (ATSDR) found that Marines and Navy members stationed at Camp Lejeune had higher mortality rates for certain cancers than a similar veteran population stationed at a non-contaminated location. These cancers included
esophageal cancer, leukemias, Hodgkin lymphoma, cervical cancer, rectal cancer, pancreatic cancer, soft tissue cancer, lung cancer, and prostate cancer.
Both the American Chemical Society and U.S. Environmental Protection Agency have reported links between vinyl chloride exposure and brain cancer, soft tissue cancer, and nervous system cancer. A 2017 ATSDR review found positive associations between Camp Lejeune toxins and brain cancer, breast cancer, cervical cancer, leukemias, esophageal cancer, lung cancer, ovarian cancer, prostate cancer, rectal cancer, and soft tissue cancer.
A 2014 ATSDR evaluation of Camp Lejeune veteran mortality found evidence of association with Hodgkin’s disease. Other studies, particularly human epidemiological studies, have also reported a potential link between exposure to benzene and Hodgkin’s disease.
Impaired immune system function
Research has attributed various autoimmune diseases to TCE and PCE exposure, including scleroderma and systemic lupus erythematosus. Exposure to organic solvents is known to cause lymphopenia, and benzene is known to induce immunodeficiency diseases like pancytopenia and leukocytopenia.
Reports have associated cases of chronic liver disease, liver cirrhosis, portal hypertension, and fibrosis with vinyl chloride exposure. Organic solvents like TCE have been associated with hepatic necrosis and hepatitis. Some studies suggest vinyl chloride could be associated with steatohepatitis or fatty liver disease.
Currently, the VA’s presumptive list for Camp Lejeune disability benefits doesn’t include neurobehavioral problems like poor coordination, learning difficulties, chronic headaches, visual perception issues, confusion, poor concentration, delayed reaction time, depression, anxiety, or mood disorders. But a significant pool of scientific literature points toward a positive association between volatile organic compound exposure and neurobehavioral problems, including reports from the National Research Council, Institute of Medicine, Oregon Health and Science University, and others.
Severe skin disorders
We continue to push for expansion of the Camp Lejeune presumptive list for service connection for disability compensation. Multiple Camp Lejeune veterans are also reporting cases of diabetes mellitus, sleep apnea, depression, fibroid sarcoma, colon cancer, mesothelioma, prolactemia, gynecomastia, Crohn’s disease, hidradenitis suppurativa, amyloidosis, endocrine disorders, skin conditions, urinary tract conditions, and cardiovascular disorders.
Birth Defects in Children of Camp Lejeune Veterans
Scientific data also shows that the toxins in the water at Camp Lejeune can cause reproductive issues, pregnancy complications, and birth defects in the children of those exposed. These conditions include:
- Female infertility
- Small gestational size
- Oral cleft defects
- Neural tube defects
- Choanal atresia
- Major malformations
- Low birth weight
- Cardiac defects
Numerous studies support an associate between the toxins discovered in Camp Lejeune water and birth defects. To mention a few, prenatal exposure to volatile organic compounds has been associated with congenital male genital abnormalities, neural tube defects, and asthma in infants. Parents who lived or worked near vinyl chloride facilities have also reported high rates of birth defects, including fetal death, central nervous system defects, genitalia defects, and clubfoot. Other studies have associated TCE and PCE with cardiac defects, low birth weight, and fetal growth restriction.
How To Win Camp Lejeune VA Disability Benefits
As described above, Camp Lejeune veterans diagnosed with a health condition on the VA’s presumptive list don’t have to supply evidence proving a link between the diagnosis and their service at Camp Lejeune to get disability benefits.
These veterans only need to supply evidence showing that they served a total of 30 days between August 1953 and December 1987, received an honorable or other-than-honorable discharge, and were diagnosed with the disease.
While the above makes it sound easy to get a Camp Lejeune claim for a presumptive disease approved, the VA continues to deny these claims for several reasons, including:
- Lack of certainty regarding qualified service
- Uncertainty surrounding positive disease diagnosis
- Incomplete or faulty claim preparation
Remember, many veterans will win Camp Lejeune benefits only after several rounds of appeals. Don’t give up. An experienced veterans’ disability benefits lawyer can help you collect persuasive evidence, appeal the VA’s decision, and prove why you deserve Camp Lejeune disability benefits.
How to Win Non-Presumptive Camp Lejeune Disability Benefits
When your diagnosis is not one of the eight diseases on the VA’s list, it can seem impossible to win a disability claim. But never assume that you can’t secure a service connection for an illness because it isn’t on the Camp Lejeune presumptive list. And never lose hope if the VA has denied your claim. Appeal the decision or file a new claim.
Most non-presumptive disease Camp Lejeune claims can succeed, as long as you know how to construct your claim from the legal and medical angle the VA expects to see. Persuasive scientific evidence and a compelling medical nexus opinion are indispensable.
Above all, your Camp Lejeune disability benefits claim must prove that your time at Camp Lejeune was “at least as likely as not” the cause of your disease. Camp Lejeune veterans need enough evidence to show at least a 50% chance that their service caused their non-presumptive disease diagnosis.
We also advise veterans to pursue secondary connection for health problems that may have been caused or aggravated by a Camp Lejeune service-connected condition.
Many illnesses on the Camp Lejeune presumptive list can cause or aggravate secondary health problems. For example, radiation treatment for cancer may cause cataracts, secondary cancers, hearing loss, or radiation fibrosis. And 40-50 percent of people with Parkinson’s disease experience clinically significant depression. If you can prove that your direct service-connected diagnosis is “at least as likely as not” the cause of another, secondary health problem, you can enhance your disability benefits with a secondary service connection.
Getting a Quality Camp Lejeune Medical Nexus Opinion
Camp Lejeune medical nexus opinions that win claims for VA disability benefits use sound medical and scientific rationale to show that evidence of a link between service and disease is equal to (or outweighs) any credible evidence against an association.
Strong evidence of a dose-response relationship will provide convincing support for these claims. For example, citing studies showing that the incidence of prostate cancer increases with the level of benzene exposure.
VA also looks at the number of statistically significant findings. The more studies you cite in the medical nexus opinion, the better. Equally as important, the studies must be credible. For example, medical nexus opinions need to show that the studies used adequate controls for risk factors like age, sex, and patient population.
Evidence of a dose-response relationship using several credible, statistically significant findings could in itself be powerful enough to establish Camp Lejeune service connection. However, other types of evidence could further strengthen the medical nexus opinion, including studies showing the toxin’s mechanism of action in the body or linking a particular service activity at Camp Lejeune with the disease.
Vital to success in Camp Lejeune disability claims and appeals, medical experts preparing the nexus opinion must be familiar with the 50% standard of proof, include “at least as likely as not” in the language of the opinion, and understand what types of evidence will support Camp Lejeune service connection.
Unfortunately, most veterans and independent physicians or medical professionals conducting compensation and pension exams aren’t familiar with these important factors. So how does a veteran get a strong medical nexus opinion to support their claim?
The easiest and most affordable way is to hire an experienced veteran’s advocate. Access to the nation’s best medical experts and meticulous review of the scientific literature allows our veterans’ disability lawyers to prepare bulletproof medical nexus opinions for Camp Lejeune veterans with non-presumptive diseases. With decades of experience in preparing and winning Camp Lejeune VA claims, we know what works.
Importantly, these experts can be expensive. Our veterans’ disability lawyers pay for their services upfront. Our Camp Lejeune veteran clients don’t pay a penny until they win their claim.
Having litigated over 500 appeals at the U.S. Court of Appeals for Veterans Claims and recovered millions of dollars for disabled veterans, our attorneys at Gang & Associates, LLC fight to get veterans the benefits they deserve.