Vietnam Vets need to know: Agent Orange effects can come 30 years or more after exposure; hard-fought for benefits available

Vietnam Defoliation Mission, 7/26/69/National Archives

A dozen diseases, from multiple myeloma to prostate cancer to Type 2 diabetes, have been deemed presumptive for Agent Orange exposure.

Photo caption: Vietnam Defoliation Mission. A UH-1D helicopter from the 336th Aviation Company sprays a defoliation agent on a dense jungle area in the Mekong delta., 07/26/1969/National Archives photo

In 2000, three decades after serving in Vietnam, Minnesota veteran Jim Fiebke of Rochester, Minn., then 52, was diagnosed with multiple myeloma.  A chance encounter in a parking lot led him to the VA where he learned he qualified for funds allocated for Vietnam veterans for diseases considered "presumptive" for Agent Orange exposure.

Fiebke is one of about 2.4 million Vietnam veterans who were exposed to Agent Orange sprayed by airplanes, helicopters, boats and soldiers on the ground between 1962 and 1975. About 20 million gallons of the herbicide were sprayed in Vietnam to kill foliage. 

A dozen diseases, from multiple myeloma to prostate cancer to Type 2 diabetes, have been deemed through lengthy studies and statistical analysis to be presumptive for Agent Orange exposure. In addition, health care, compensation and vocational rehabilitation services are provided to Vietnam veterans' offspring with spina bifida, a congenital birth defect of the spine which is also a risk factor related to Agent Orange exposure. But many Vietnam veterans aren't aware of the benefits available to them. Some don't realize that exposure to the dioxin in Agent Orange can manifest in illnesses decades after contact with the chemical. Unlike most VA-related health benefits, there is no time limit for claiming illness related to Agent Orange exposure. That has not always been the case. Major court decisions in 1979, 1985, and 2007, national legislation and huge ongoing epidemiological studies by the National Academies of Sciences and others have made it possible for Vietnam veterans to file Agent Orange-related claims for benefits, sometimes retroactively.

Fiebke hopes that his story will capture the attention of other Vietnam veterans and their family members, alerting them to the types of diseases considered presumptive for Agent Orange, and encourage them to apply for the benefits won over a 40-year battle.

Interview with Jim Fiebke, March 17, 2008:

Jim Fiebke

Why is it so hard to get the word out about the Agent Orange-related benefits?

I think the word gets out to Vietnam veterans pretty readily if they’re members of organizations like American Legion, VFW, or Disabled American Veterans.  They all do a good job of letting vets know, but for the most part, when guys got back from Vietnam, they didn’t necessarily join those organizations. If they're not in one of those organizations, they may never get the information that the disease they have may get them some compensation and medical help from Veterans Affairs.

It was a hard-won benefit, if I recall. What was the turning point?

I don't know the history very well on it. I was one of these people that were just in the dark about it.  And, frankly, like most people, when I got back from Vietnam, I just wanted to put it in my rearview mirror as quick as I could and get away from it.  But I know there was a fight, and it probably culminated in the 1990s. And the late '90s is when things started to come into place and the government acknowledged that, yeah, these diseases more likely than not were the result of Agent Orange exposure.  It's a dioxin.  It was an herbicide used to kill off foliage to deny the enemy cover, basically. The reason it was called Agent Orange is it was stored in barrels that had an orange stripe on them.

Was it in the air, the water, maybe even in the food supply?

In my case I'm sure it was in the water that we used, and I presume it was on the foliage and in the dirt.  Yeah, it was just there, and it was a lot of chemicals.  I read it can stay around for years.  I don't know if there was any one source attributed to how you come in contact with it. I think they mixed fuel oil or diesel fuel in with it so it would not evaporate and would adhere to foliage and things. A few times when I was in the field, I could actually smell what I thought was diesel fuel, and I never had any idea what that was all about.  It was very faint, but it was very clear.  It smelled like being around the pumps at a gas station with diesel fuel.

After you got back, you didn't have any immediate problems.  How long was it before your disease appeared?

It was exactly 30 years after I got back that I was diagnosed with multiple myeloma.  I was diagnosed very early.  The reason we caught it early was that I got pneumonia twice and that surprised the doctors. They dug a little deeper and found out there was something wrong with my antibodies. The diagnosis was multiple myeloma.  They were surprised by that, too. This is usually a disease that strikes men in their 70s and older, and I was 52. They didn't speculate on where it had come from, but I always wondered after that.  Some people when they get cancer ask, "Well, why me?"  I got it, and I just couldn't understand why now.  I had that on my mind.  That was in 2000, and it wasn't until 2003 that someone said, 'You know, you should go talk to your county Veterans Service officer.'  My claim was approved as 100 percent service-connected 

What was the story on that?  Did you run into somebody in a parking lot?

Yeah, it was quite by chance that I learned about it, and it just happened to be somebody that took the initiative to point it out to me.  I was waiting in the parking lot to pick up my car at the mechanic’s.  This lady looked at me because I didn't have any hair. I had just finished some chemo with my stem cell transplant.  Then she looked at the car, and it had Vietnam veteran license plates. She came up and told me her husband had died of a disease that was associated with Agent Orange exposure.  She told me I should talk to my Veterans Service officer.  I didn't do it right away, but I thought about it for a week or two, and realized I should check into this. I probably would have learned about it sometime, but I don't know when.  The benefits don't start until you submit the claim, so it was helpful that I learned sooner rather than later.  So that's my interest in getting the word out to people.  Maybe they know somebody that's a Vietnam veteran and I’m trying to give them a nudge to check into this and see if it takes them somewhere. 

What are some other possible ways to get the word out? What if there were intake forms or something in doctors' offices where they could ask if you are a Vietnam veteran?

I know physicians have a lot on their minds, but if there was a way that physicians, say in hematology, would be alerted by patients who are 60-ish with chronic lymphocytic leukemia or multiple myeloma to ask the patient if they’re a Vietnam veteran.  And if they say yes, they should refer them to their Veterans Service officer.  In large medical places like Mayo I was told that's something that social workers do.  I was interviewed by a social worker as one of the steps along the way to getting the stem cell transplants and all they said was, "Oh, there's a number of resources" and they hand you a booklet and — 

You're on your own.

Yeah.  There's a folder in there with about 100 one-line entries of Leukemia Lymphoma Association, American Cancer Society, all that, and I don't even know if Veterans Affairs is listed.  I'm sure there's a whole lot of competing things in physicians' minds, but if they could — even if a few of them -- kind of perked up to an article like this and catch somebody, that's all the better. 

Do people apply through Veterans Affairs, or through their local VA office?

Eventually the application for benefits is to Veterans Affairs, but one of the easiest ways to apply is through the county Veterans Services office. Every county has one and that office will help them gather up the information they need.  It's pretty easy to apply.  It eventually does end up with Veterans Affairs, but it's probably a little easier to get a Veterans Service officer to help you out. 

What do you think the time frame is going to be?  Should people get started early if they want to file a claim?

Yeah, probably.  If somebody applies, if they have what's called a DD-214 -- a form that  documents their military service -- and dates of marriage and children's birth dates, things like that, it's pretty straightforward.  I think in my case it only took two or three months to get approval. It could be that they're required to take a physical or something, but it doesn't take very long.  If the person can demonstrate that they were in Vietnam, either on the ground or in what's called “the brown water Navy,” you know, there in the inland waters, and that they have one of these diseases on the list, it goes pretty quickly. 

What’s the best site for looking up the diseases?

It’s in my email signature.  That's the official VA list of the diseases that are presumptive.  There are different percentages of disability.  Some diseases are considered 100 percent disabled.  If they have type 2 diabetes, they're probably going to come in somewhere around 20 percent disabled.   

Could you tell me a little bit more about what you've gone through as part of this experience?  Didn’t you have your second stem cell transplant recently?

Yes. There's no known cure for the disease, but it's quite treatable.  The disease was fairly stable for about a year where it didn't need treatment. Since then I've had a number of treatments.  The two most notable ones were stem cell transplants in August of ‘02 and in January of this year.  In between I've been treated by a number of different drugs -- dexamethasone, prednisone and two new drugs that were not even in existence when I was diagnosed. The new drugs are quite effective on the disease. I was treated with Velcade in 2005, and the other is called Revlimid, and I was treated with that in 2007.  The good news is that this disease is highly treatable, and there are new drugs coming to market regularly.  At one point the average life expectancy after diagnosis was five years, and I was diagnosed nearly eight years ago, so I'm pretty happy about the way it’s gone. 

I was so glad to hear that your comeback after the latest transplant was better than the first one. 

I was surprised.  I thought it would be worse.  You know, I'm five years older, and I thought, 'Oh, this is going to be really tough.'  And it was tough during the transplant, but once I got going, I really bounced back well. In fact, I'm getting fat again.

That's good.  You want that.   

Resources:

Cyber Sarge’s Agent Orange Pages

Veterans and Agent Orange: Update 2006, The National Academies Press

(Some content is free)

Vietnam Veterans Benefit From Agent Orange Rules, US Department of Veterans Affairs