Monoclonal Gammopathy of Undetermined Significance (MGUS): VA Presumptive Condition (Agent Orange)
VeteranHQ lists Monoclonal Gammopathy of Undetermined Significance (MGUS) 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 August 10, 2022. 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 USC § 1116(a)(2)(L); Public Law 117-168, title IV, § 404(b) (August 10, 2022); 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: Monoclonal Gammopathy of Undetermined Significance (MGUS)
- 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
- August 10, 2022
- Filing deadline
- No statutory deadline for Agent Orange presumptives
- Diagnostic code
- 7712
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. No minimum service duration required. Applicability under Public Law 117-168 § 404(d)(1)(A): 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, 2022 for everyone else. 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
MGUS (Monoclonal Gammopathy of Undetermined Significance) is a pre-cancerous blood plasma condition recognized as presumptive for veterans exposed to Agent Orange/tactical herbicides under the PACT Act of 2022. MGUS is characterized by a small monoclonal immunoglobulin protein (M-protein) in the blood produced by abnormal plasma cells, without meeting criteria for multiple myeloma, Waldenström macroglobulinemia, or other plasma cell dyscrasias. MGUS can progress to multiple myeloma, lymphoma, or other blood cancers at a rate of approximately 1% per year. Veterans with MGUS should undergo regular surveillance (SPEP, CBC, creatinine, calcium) and be monitored for progression. 38 CFR § 4.117 DC 7712 (Multiple myeloma) names this condition in its own criteria: the 0 percent evaluation reads asymptomatic, smoldering, or monoclonal gammopathy of undetermined significance (MGUS), and symptomatic multiple myeloma is 100 percent. A 0 percent evaluation still establishes service connection, which is what opens secondary claims and other benefits. 38 CFR § 3.309(e) does not list MGUS, so the statute is the authority for this presumption. 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 qualifying herbicide exposure location; serum protein electrophoresis (SPEP) showing M-protein spike; immunofixation electrophoresis confirming monoclonal immunoglobulin type; serum free light chain ratio; bone marrow biopsy showing <10% plasma cells (to exclude myeloma); CBC, creatinine, and calcium within normal limits; hematologist records with MGUS risk stratification.
Controlling legal authority
38 USC § 1116(a)(2)(L); Public Law 117-168, title IV, § 404(b) (August 10, 2022); 38 CFR § 3.307(a)(6); 38 USC § 1116A; 38 USC § 1116B
Related on VeteranHQ
- Multiple myeloma: 38 CFR Part 4 rating criteriaThe percentage tiers VA applies once service connection is established, under DC 7712.
- 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 Monoclonal Gammopathy of Undetermined Significance (MGUS) and Presumptive Service Connection
Is Monoclonal Gammopathy of Undetermined Significance (MGUS) a VA presumptive condition?
Yes. VeteranHQ lists Monoclonal Gammopathy of Undetermined Significance (MGUS) as presumptive in the Agent Orange and Other Herbicides group, added to the list effective August 10, 2022, under 38 USC § 1116(a)(2)(L); Public Law 117-168, title IV, § 404(b) (August 10, 2022); 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 Monoclonal Gammopathy of Undetermined Significance (MGUS) 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. No minimum service duration required. Applicability under Public Law 117-168 § 404(d)(1)(A): 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, 2022 for everyone else. 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 Monoclonal Gammopathy of Undetermined Significance (MGUS) claim?
Service records confirming qualifying herbicide exposure location; serum protein electrophoresis (SPEP) showing M-protein spike; immunofixation electrophoresis confirming monoclonal immunoglobulin type; serum free light chain ratio; bone marrow biopsy showing <10% plasma cells (to exclude myeloma); CBC, creatinine, and calcium within normal limits; hematologist records with MGUS risk stratification. 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 Monoclonal Gammopathy of Undetermined Significance (MGUS)?
No statutory deadline for Agent Orange presumptives
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.