Veterans Affairs officials are now accepting claims for all presumptive illnesses included in the massive toxic exposure legislation signed into law last month, including cases concerning burn pit smoke and carcinogenic chemicals that were not scheduled to go into effect for several more years.

The move will likely result in a spike in backlogged claims in coming months, potentially opening department leaders to criticism that they are overworking staffers and underdelivering on promises to veterans.

But senior VA staff say they believe the move will get veterans and their family members new benefits and health care faster, some as soon as early 2023.

“We’ll bring generations of new vets into VA health care and increase the health care benefits of many more,” VA Secretary Denis McDonough said during a speech before the American Legion’s national convention on Aug. 31.

“That will result in better health outcomes, across the board. We’ll deliver benefits to more survivors of vets who passed away from toxic exposure. And we’ll invest in our workforce and our infrastructure to deliver those additional services.”

PACT Act presumptives

When President Joe Biden signed the Promise to Address Comprehensive Toxics Act (better known as the PACT Act) into law on Aug. 10, he directed VA officials to treat all of the presumptive conditions included in the measure “as applicable the moment I sign this bill.”

Presumptive status for service-connected illnesses cuts down on the paperwork veterans are required to file to receive monthly disability benefits, which can total several thousand dollars a month.

In recent days, VA officials have clarified that the new presumptives covered include 12 types of cancer and 12 other respiratory illnesses linked to burn pit exposure in the Gulf War, the War in Afghanistan, and the War in Iraq; hypertension and monoclonal gammopathy of undetermined significance (MGUS) for veterans who served in Vietnam; and radiation-related illnesses for veterans who served in several new locations in the 1960s and early 1970s.

The full list of illnesses and areas covered is available on the VA website.

When Congress wrote the sweeping veterans toxic exposure legislation, they included a staggered timeline over the next three years for VA officials to phase in all of those claims, because of their potential to overwhelm staff.

For example, officials have estimated that the Agent Orange hypertension claims alone could affect as many as 500,000 Vietnam veterans. Under language in the legislation, VA did not need to begin processing those claims until October 2026.

But Joshua Jacobs, senior VA advisor for policy who is currently overseeing the department’s benefits operations, said officials determined that waiting years to begin work on those claims — and the other presumptives that were not scheduled for immediate implementation — would be confusing and potentially harmful for veterans.

“This is an opportunity for us to deliver more benefits and more health care to veterans,” he said in an interview with Military Times.

“We assumed going in that the staggered implementation timelines would enable us to more effectively manage the workload and get benefits to war veterans more quickly. However, the challenge that we quickly realized was that as we worked through multiple layers of analysis, we couldn’t fully put them on hold.

“We would have to go in and review the claims. We would be unable to grant them. But we would be unable to deny them. They’d just have to wait.”

Backlog increases coming

Now, the plan is to begin processing all new claims on Jan. 1, 2023. Jacobs said officials are currently putting in place the regulations needed to handle the cases, as well as training and hiring staff to deal with the upcoming workload.

He would not commit to when veterans will start seeing payouts arrive, but indicated that officials hope to move quickly to deliver the money in early 2023.

“We’re working very quickly and thoroughly to make sure that we do this right, as quickly as possible,” he said.

But Jacobs also acknowledged that the decision on PACT Act presumptives will likely cause an uptick in VA’s claims backlog, the number of first-time claims that take more than 125 days to finalize.

That number has been a point of controversy for the department in past years. It ballooned to more than 600,000 in 2013 after VA officials struggled to process other presumptives related to Agent Orange exposure in Vietnam, fell to around 70,000 after years of reforms, and jumped above 264,000 in 2021 because of pandemic-related problems.

McDonough has promised additional hiring, training and overtime work to return the number to its pre-pandemic levels in coming years. As of this week, the backlog was at about 154,000 claims, and has been improving steadily since the start of 2022.

In his American Legion speech, McDonough said that Aug. 11 (the day after the PACT Act signing) was “our all-time high for online disability compensation claims.” VA officials said they are up about 10% now, potentially adding tens of thousands more cases in coming weeks.

Whether VA has enough staff to process the new claims within the four-month deadline remains to be seen.

File claims now

Jacobs said he is optimistic that staff will be ready. And VA officials are actively encouraging all veterans eligible for the new claims to file immediately, even if it means more work in the short term.

“We know it’s going to be more work, but it’s what we’re here to do,” he said.

“This is a monumental law. It is big, it is complex, and it’s incumbent upon us to work with others to make sure that people know what’s in the law, what they may be entitled to, and then how to access those benefits.”

As many as one in five veterans living in America today could see some benefit from the legislation in coming years. VA officials have been working with veterans advocacy groups to publicize the measure and encourage veterans who believe they may be eligible to apply.

“We want every veteran — every single one — to get the care they need and the benefits they deserve,” McDonough told the American Legion crowd this week. “And we won’t rest until they do.”

Veterans who file claims in the next few months will be eligible for disability payments retroactive to the Aug. 10 date, once they are deemed eligible.

Veterans and survivors can contact VA about eligibility rules and filing procedures through the department’s PACT Act website or by calling 1-800-MY-VA-411 (1-800-698-2411).

Leo covers Congress, Veterans Affairs and the White House for Military Times. He has covered Washington, D.C. since 2004, focusing on military personnel and veterans policies. His work has earned numerous honors, including a 2009 Polk award, a 2010 National Headliner Award, the IAVA Leadership in Journalism award and the VFW News Media award.

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