The following instructions were given to VA adjudication personnel in the last few days. Encourage veterans to file claims if they served in Vietnam and have been diagnosed with hypertension. Please ensure that the veteran understands that it may be months before VA makes a decision as to whether to grant a presumption. Explain that should VA decide to establish a presumption it may still be another 6-12 months after that date before VA can decide their claim.

Note: if a Vietnam veteran is already service connected for diabetes and is newly diagnosed with hypertension, file the claim alleging that it is secondary to the diabetes.

Jerry Manar

The Institute of Medicine (IOM) of the National Academies recently published its biennial update, entitled Veterans and Agent Orange: Update 2006. In the report, the IOM found only limited or suggestive evidence of an association between exposure to Agent Orange and the subsequent development of hypertension. The Secretary of Veterans Affairs (VA) must now determine whether a presumption of service connection is warranted. If the Secretary determines that such a presumption is warranted, VA will propose the appropriate regulations. If the presumption of service connection is not warranted, VA must publish a notice to that effect in the Federal Register.

In the interim, VA will not adjudicate or develop a claim for high blood pressure based on exposure to herbicides. Instead, VA will establish end product (EP) 695 with a diary of 120 days (4 months).

At a later date, VA will provide sample language for an acknowledgement letter to send to the veteran and, if any, his/her representative.

VA will develop and adjudicate as normal other issues received with claims of hypertension related to herbicide exposure.