Chronic B-Cell Leukemia (CLL): VA Presumptive Condition (Agent Orange)
VeteranHQ lists Chronic B-Cell Leukemia (CLL) as a presumptive condition in the Agent Orange and Other Herbicides group. The exposure it is tied to is: Herbicide Agent (Agent Orange/TCDD). This condition was added to the presumptive list effective October 16, 2003. That is the date the statute or final rule that added it took effect, not the effective date of any individual award, which VA decides claim by claim. It is governed by 38 CFR § 3.309(e); 38 USC § 1116; VA Final Rule, 68 FR 59540 (October 16, 2003); 38 CFR § 3.307(a)(6); 38 USC § 1116A; 38 USC § 1116B.
A presumption removes one requirement and one only: the veteran does not have to prove a medical link between the condition and service. Everything else still applies. There must be a current disability, which for most conditions means a diagnosis from a medical provider. The service has to meet the requirements below, and VA decides the claim on the evidence in the record.
What qualifies: Chronic B-Cell Leukemia (CLL)
- Service era
- January 9, 1962 to May 7, 1975 (Republic of Vietnam, including its inland waterways, and the separate 38 USC § 1116A(d) offshore area); September 1, 1967 to August 31, 1971 (service in or near the Korean DMZ); January 9, 1962 to June 30, 1976 (a United States or Royal Thai base in Thailand)
- Service location
- Republic of Vietnam (including inland waterways); the separate offshore area defined by 38 USC § 1116A(d), within 12 nautical miles seaward of the line in that subsection; Thailand (U-Tapao, Ubon, Nakhon Phanom, Udorn, Takhli, Korat, and Don Muang bases); Korean DMZ; Johnston Island; specific test and storage sites in the United States
- Exposure
- Herbicide Agent (Agent Orange/TCDD)
- Added to presumptive list
- October 16, 2003
- Filing deadline
- No statutory deadline
- Diagnostic code
- 7703
Service required for this presumption
Qualifying service includes service in the Republic of Vietnam between January 9, 1962, and May 7, 1975, or other qualifying herbicide exposure locations. Independently, 38 USC § 1116A covers active military, naval, or air service offshore of the Republic of Vietnam in the area defined by § 1116A(d) during the period beginning on January 9, 1962, and ending on May 7, 1975. Offshore service requires no in-country duty or visitation and no inland-waterway service. Section 1116A(a) makes service connection "subject to section 1113 of this title" and covers "a disease covered by section 1116 of this title becoming manifest as specified in that section". Section 1116A(b) states: A veteran who, during active military, naval, or air service, served offshore of the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975, shall be presumed to have been exposed during such service to an herbicide agent unless there is affirmative evidence to establish that the veteran was not exposed to any such agent during that service. Covers all chronic B-cell leukemias, most commonly Chronic Lymphocytic Leukemia (CLL) and its variant Small Lymphocytic Lymphoma (SLL). Each route has its own authority: the Republic of Vietnam route is 38 CFR § 3.307(a)(6)(iii); the Korean DMZ route is 38 USC § 1116B(a)(2), which covers a veteran who served in or near the Korean Demilitarized Zone (DMZ) between September 1, 1967 and August 31, 1971, and names no unit requirement (38 CFR § 3.307(a)(6)(iv) still reads April 1, 1968 and speaks of service in a unit that, as determined by the Department of Defense, operated in or near the DMZ, but 1116B was added by the Blue Water Navy Vietnam Veterans Act of 2019, Public Law 116-23, effective January 1, 2020, and the statute controls); and the Thailand route of January 9, 1962 to June 30, 1976 at any United States or Royal Thai base is 38 USC § 1116(d)(2). The Vietnam ERA of 38 CFR § 3.2(f) is a wider window than this presumption and does not set its bounds.
About this presumption
Chronic B-Cell Leukemias, primarily Chronic Lymphocytic Leukemia (CLL) and Small Lymphocytic Lymphoma (SLL), are presumptively service-connected for herbicide-exposed veterans. CLL is the most common leukemia in the Western world and is characterized by clonal expansion of mature, antigen-experienced B-lymphocytes. TCDD-exposed populations show significantly elevated CLL incidence. Note: This covers only B-CELL leukemias; acute leukemias fall under the Radiation presumptive category, not Agent Orange, unless also applying for Agent Orange. VA established the CLL presumption by final rule at 68 FR 59540, published and effective October 16, 2003. A later final rule, 75 FR 53202 (published and effective August 31, 2010), BROADENED the same listing to hairy cell leukemia and other chronic B-cell leukemias; it did not create the CLL presumption, which already existed. A veteran with CLL should read the 2003 date, not the 2010 one. The offshore area of 38 USC § 1116A(d), captured verbatim: Notwithstanding any other provision of law, for purposes of this section, the Secretary shall treat a location as being offshore of Vietnam if the location is not more than 12 nautical miles seaward of a line commencing on the southwestern demarcation line of the waters of Vietnam and Cambodia and intersecting the following points: Points Geographic Names Latitude North Longitude East At Hon Nhan Island, Tho Chu Archipelago Kien Giang Province 9°15.0′ 103°27.0′ At Hon Da Island southeast of Hon Khoai Island Minh Hai Province 8°22.8′ 104°52.4′ At Tai Lon Islet, Con Dao Islet in Con Dao-Vung Toa Special Sector 8°37.8′ 106°37.5′ At Bong Lai Islet, Con Dao Islet 8°38.9′ 106°40.3′ At Bay Canh Islet, Con Dao Islet 8°39.7′ 106°42.1′ At Hon Hai Islet (Phu Qui group of islands) Thuan Hai Province 9°58.0′ 109°5.0′ At Hon Doi Islet, Thuan Hai Province 12°39.0′ 109°28.0′ At Dai Lanh point, Phu Khanh Province 12°53.8′ 109°27.2′ At Ong Can Islet, Phu Khanh Province 13°54.0′ 109°21.0′ At Ly Son Islet, Nghia Binh Province 15°23.1′ 109° 9.0′ At Con Co Island, Binh Tri Thien Province 17°10.0′ 107°20.6′
Evidence still needed
A presumption does not remove the evidence requirement. VA still needs evidence of a current disability, which for this condition means a current diagnosis from a medical provider, and service records that show the qualifying service above. What it removes is the medical opinion connecting the two.
Service records; peripheral blood flow cytometry showing CD5+/CD19+/CD23+ monoclonal B-cell population (≥5,000/μL); CBC with differential showing lymphocytosis; bone marrow biopsy if needed for staging; hematologist records with Rai or Binet staging.
Controlling legal authority
38 CFR § 3.309(e); 38 USC § 1116; VA Final Rule, 68 FR 59540 (October 16, 2003); 38 CFR § 3.307(a)(6); 38 USC § 1116A; 38 USC § 1116B
Related on VeteranHQ
- Leukemia (except for chronic myelogenous leukemia): 38 CFR Part 4 rating criteriaThe percentage tiers VA applies once service connection is established, under DC 7703.
- VA presumptive conditions, explainedHow presumptive service connection works, and what it does not cover.
- All presumptive conditions by exposureAgent Orange, PACT Act, Camp Lejeune, Gulf War, and ionizing radiation.
Questions About Chronic B-Cell Leukemia (CLL) and Presumptive Service Connection
Is Chronic B-Cell Leukemia (CLL) a VA presumptive condition?
Yes. VeteranHQ lists Chronic B-Cell Leukemia (CLL) as presumptive in the Agent Orange and Other Herbicides group, added to the list effective October 16, 2003, under 38 CFR § 3.309(e); 38 USC § 1116; VA Final Rule, 68 FR 59540 (October 16, 2003); 38 CFR § 3.307(a)(6); 38 USC § 1116A; 38 USC § 1116B. A presumption removes the requirement to prove a medical link to service. A current disability (for most conditions, a diagnosis) and qualifying service are still required, and VA decides the claim.
What service qualifies for the Chronic B-Cell Leukemia (CLL) presumption?
Qualifying service includes service in the Republic of Vietnam between January 9, 1962, and May 7, 1975, or other qualifying herbicide exposure locations. Independently, 38 USC § 1116A covers active military, naval, or air service offshore of the Republic of Vietnam in the area defined by § 1116A(d) during the period beginning on January 9, 1962, and ending on May 7, 1975. Offshore service requires no in-country duty or visitation and no inland-waterway service. Section 1116A(a) makes service connection "subject to section 1113 of this title" and covers "a disease covered by section 1116 of this title becoming manifest as specified in that section". Section 1116A(b) states: A veteran who, during active military, naval, or air service, served offshore of the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975, shall be presumed to have been exposed during such service to an herbicide agent unless there is affirmative evidence to establish that the veteran was not exposed to any such agent during that service. Covers all chronic B-cell leukemias, most commonly Chronic Lymphocytic Leukemia (CLL) and its variant Small Lymphocytic Lymphoma (SLL). Each route has its own authority: the Republic of Vietnam route is 38 CFR § 3.307(a)(6)(iii); the Korean DMZ route is 38 USC § 1116B(a)(2), which covers a veteran who served in or near the Korean Demilitarized Zone (DMZ) between September 1, 1967 and August 31, 1971, and names no unit requirement (38 CFR § 3.307(a)(6)(iv) still reads April 1, 1968 and speaks of service in a unit that, as determined by the Department of Defense, operated in or near the DMZ, but 1116B was added by the Blue Water Navy Vietnam Veterans Act of 2019, Public Law 116-23, effective January 1, 2020, and the statute controls); and the Thailand route of January 9, 1962 to June 30, 1976 at any United States or Royal Thai base is 38 USC § 1116(d)(2). The Vietnam ERA of 38 CFR § 3.2(f) is a wider window than this presumption and does not set its bounds. Service era: January 9, 1962 to May 7, 1975 (Republic of Vietnam, including its inland waterways, and the separate 38 USC § 1116A(d) offshore area); September 1, 1967 to August 31, 1971 (service in or near the Korean DMZ); January 9, 1962 to June 30, 1976 (a United States or Royal Thai base in Thailand). Service location: Republic of Vietnam (including inland waterways); the separate offshore area defined by 38 USC § 1116A(d), within 12 nautical miles seaward of the line in that subsection; Thailand (U-Tapao, Ubon, Nakhon Phanom, Udorn, Takhli, Korat, and Don Muang bases); Korean DMZ; Johnston Island; specific test and storage sites in the United States.
What evidence is still needed for a Chronic B-Cell Leukemia (CLL) claim?
Service records; peripheral blood flow cytometry showing CD5+/CD19+/CD23+ monoclonal B-cell population (≥5,000/μL); CBC with differential showing lymphocytosis; bone marrow biopsy if needed for staging; hematologist records with Rai or Binet staging. A presumption removes the requirement to prove a medical link to service. A current disability (for most conditions, a diagnosis) and qualifying service are still required, and VA decides the claim.
Is there a filing deadline for Chronic B-Cell Leukemia (CLL)?
No statutory deadline
VeteranHQ publishes VA rules and the citations behind them. It does not prepare, file, or represent claims, and nothing here is legal advice or a prediction of what VA will decide.