Hypertension (Agent Orange, Blue Water/Brown Water Navy): VA Presumptive Condition (Agent Orange)

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. The presumption reaches every veteran with covered service, not only veterans who served aboard ship. THIS PRESUMPTION IS AVAILABLE NOW. VA.gov lists high blood pressure as a current Agent Orange presumptive condition added by the PACT Act and says that if you have not filed a claim yet for the presumptive condition you can file a new claim online now. Public Law 117-168 § 404(d)(2)(A) set a phased schedule (August 10, 2022 for claimants for dependency and indemnity compensation and for veterans VA determines are terminally ill, homeless, under extreme financial hardship, more than 85 years old, or capable of demonstrating other sufficient cause; October 1, 2026 for everyone else), but VA implemented the presumption ahead of that schedule, so no veteran needs to wait for October 2026 to file. 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

Congress added hypertension to the statutory herbicide presumptive list at 38 USC § 1116(a)(2)(M) in section 404(c) of Public Law 117-168, enacted August 10, 2022, following National Academy of Medicine review of the association with TCDD exposure. 38 CFR § 3.309(e) does not list hypertension, so the statute is the authority for this presumption. TCDD promotes hypertension through multiple mechanisms: increased angiotensin-converting enzyme activity, endothelial dysfunction, oxidative stress, and disruption of the renin-angiotensin-aldosterone system. How to file depends on your history, and the two routes are not interchangeable. A veteran who has never claimed hypertension files a NEW claim: VA.gov says you can file one online now. A veteran VA already denied files a Supplemental Claim, which by VA's own definition reviews a claim it has already decided. Retroactive awards under Public Law 117-168 § 404(d)(2)(B) go only to claimants for dependency and indemnity compensation described in § 404(d)(2)(A)(i), and the Nehmer rules at 38 CFR § 3.816 reach only the covered herbicide diseases listed in 38 CFR § 3.309(e), which does not include hypertension. That limits the special retroactive-award path; it does not remove the ordinary effective-date rules that apply to any granted claim. Hypertension is one of the most common service-connected conditions and also serves as a primary condition for secondary cardiovascular and renal disease claims. 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 confirming covered herbicide service; medical evidence of a hypertension diagnosis; blood pressure readings taken two or more times on at least three different days, which is what 38 CFR § 4.104, DC 7101, Note (1) requires; cardiology or primary care records documenting diagnosis and treatment; medication records (antihypertensives). Note (1) defines hypertension as diastolic pressure predominantly 90 or more, and isolated systolic hypertension as systolic pressure predominantly 160 or more with diastolic pressure under 90. The DC 7101 evaluations are 10 percent for diastolic predominantly 100 or more, or systolic predominantly 160 or more, or a history of diastolic predominantly 100 or more requiring continuous medication for control; 20 percent for diastolic predominantly 110 or more, or systolic predominantly 200 or more; 40 percent for diastolic predominantly 120 or more; and 60 percent for diastolic predominantly 130 or more. Service connection does not depend on reaching a compensable level.

Controlling legal authority

38 USC § 1116(a)(2)(M); Public Law 117-168, title IV, § 404(c) (August 10, 2022); 38 CFR § 3.307(a)(6); 38 USC § 1116A; 38 USC § 1116B

• 38 CFR § 3.307
• 38 USC § 1116
• 38 USC § 1116A
• 38 USC § 1116B
• Public Law 117-168

Related on VeteranHQ

• Hypertensive vascular disease (hypertension and isolated systolic hypertension): 38 CFR Part 4 rating criteriaThe percentage tiers VA applies once service connection is established, under DC 7101.
• 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 Hypertension (Agent Orange, Blue Water/Brown Water Navy) and Presumptive Service Connection