When a service member prepares for deployment overseas, there is an understanding they are going to a hostile territory, to engage a hostile enemy. They have no illusions as to if it will be dangerous or not and they continually prepare for battle against ambushes, fire fights, IED’s, RPG’s, landmines amongst others. These are all things that can cause a service member to become severely injured or even worse in a matter of seconds. When service members go off to war, they are worried about the obvious threats such as these, but they do not put any thought into all of the environmental hazards they could encounter along the way during their deployments.

Veterans that served in certain places, during certain time periods were exposed to certain environmental hazards such as Agent Orange, radiation, and burn pits. These toxic environments have numerous long-term health effects on many of the veterans that were exposed to these types of environments while serving. This brings me to the genre of service-connected illnesses that are referred to as presumptive illnesses. A “Presumptive Illness” is an illness the VA concedes was caused by your military service even if the illnesses symptoms begin after your military service has ended. When an illness is added to the presumptive illness list on the federal register, it means that such illness has been medically proven to be caused and associated to exposure to whichever hazard list it has been added to. Having an illness added to the presumptive list can take years if not decades to happen. This addition requires the assistance of Congress who approves the illness and then directs the Secretary of the VA to add the illness to the Federal Register which effectively changes the law on the day it’s added to the register. From the point of the addition forward, veterans can file for that illness with many of the barriers removed.

The fact a presumptive illness is listed on the federal register only wins half of the fight for a veteran. This is because, when it comes to disability claims, there are two basic parts.

  1. a) Proof a service connection exists
  2. b) Severity, which is the extent to which the injury/illness keeps you from working.

It is not just enough to prove a service connection exists because that can easily get a veteran 0% rating.  There is a need to prove the illness/injury impacts your daily life in an adverse way, reduces your work efficiency and hinders your ability to become and stay gainfully employed. Presumptive Illnesses are NOT the only way to get a claim approved through the VA. It just simplifies things in instances when veterans have certain illnesses that are on the presumptive illness lists.


Over the years many veterans have been lost because of Agent Orange. Most were young men and women when they joined the military just out of high school. Many volunteered while others were drafted into service. These were the lucky ones that made it home after surviving the war, and many of them went to work and started families. These became our neighbors our best friends and in many cases our parents. They have been our aunts and uncles for our entire lives, and each day many of them find themselves being added to “The Wall” as they pass away due to Agent Orange Exposure.

There are lists of presumptive illnesses for exposure to Agent Orange and also the places it was used or stored. This list continually grows as ships and locations are added to this list fairly frequently. Now, in a case where a veteran files a claim for an Agent Orange Presumptive Illness, assuming both the illness are on the list, and where they served matches up with the list as well, then a service connection will happen. This only establishes the service connection though and it still leaves the question of severity which must now be answered. This buttresses the fact that it’s not just enough to establish a service connection but you also have to be able to show it hinders your ability to maintain gainful employment as well.

There are instances where groups of veterans are left off the Presumptive Illness Exposure list. This happens from time to time, such as with ships that served off of the coast of Vietnam, those that served in Okinawa, Panama, etc. The only way these veterans can get their exposures recognized is by getting it added to the Federal Register which will effectively change the law to recognize their exposures. Otherwise, they would remain in an uphill battle in trying to prove they were exposed.


Vaccinations for Yellow Fever, Typhoid, Cholera, Meningitis, Hepatitis B, Whooping Cough, Tetanus and Polio are standard vaccinations for service members going overseas to the Gulf – Afghanistan and Iraq. In many cases those vaccinations are given to service members in anticipation for deployment. You may never go down range and suffer illness in having received them. Many service members receive Anthrax and Botulinum toxoid vaccines as well. I have known many veterans that have had long-term illnesses that are consequence of these vaccinations. While the VA is usually quick to point out there is NO definitive link between vaccinations and many different long-term illnesses, I would also point out there is a reason they call them “Medically Unexplained Illnesses” although science may not have made the medical link yet, it doesn’t mean the medical illnesses many veterans have contracted from them are any less real. While vaccinations are the first major long-term health risks service members encounter before deployments to Afghanistan and Iraq, they are also usually sent into the field for intensive training that simulates the extreme conditions they will encounter overseas. I have known and served with many service members who were injured and extremely ill from these extreme conditions. While some had frost bite & hypothermia from the extreme cold at Fort Dix in the winter, others paralyzed, some with broken arms or legs from injuries that happened during their training in the field. These are just examples of some of the things that can happen while preparing for deployments.


When the first Gulf War began, the Iraqi army set oil fields on fire in hopes of obstructing our attack abilities from both land and by sky. This created giant clouds of toxic soot, black rain, and numerous respiratory issues that led to many veterans having respiratory issues and lung cancer at very young ages. Here in the United States, we have the Environmental Protection Agency, the EPA which regulates how materials are disposed of, recycled, and destroyed. In the United States we recycle used tires into fuel, rubber and even the chips used on playgrounds. This is done to abate the long-term environmental issues that will be caused if tires are not properly disposed of, and the health hazards created by just throwing them into landfills or burning them. Over in Iraq and Afghanistan, there is no such environmental regulatory system, and many things such as tire burning (which here in the US are illegal because of the health and environmental hazards they pose) went almost completely unchecked throughout the entire war! Have you ever wondered why we have environmental laws in place? Now, how many pounds of waste do you think were burned per day in the Burn Pits at Joint Base Jalad in Iraq in 2007?  Paint, chemicals, rubber, wood, Styrofoam, plastics, discarded food, lubricant products, petroleum, metal/aluminum cans, munitions

Do you know that: In 2007, Joint Base Jalad burned an average of 400,000 pounds of waste per day in the burn pits? That’s 146,000,000 pounds of human, medical, chemical, tire, ordnance, plastics and many other types of waste

and other unexploded ordnance, medical and human waste are all things that have been burning in burn pits for the last decade in both Iraq and Afghanistan. In June of 2003 a giant sulfur mining plant near Mosul in Iraq caught fire. The sulfur fire took close to a month to contain and thousands of service members especially from the 101st Airborne Division that served in the 52nd, 326 and the 887 Engineer Battalions fought the blazing sulfur fires. Since that time many of these veterans in particular have experienced several major respiratory problems such as constrictive bronchiolitis and reactive airway dysfunction syndrome.

Over 10 years ago the war began with tanks, strikers, and billions of pounds of heavy equipment rolling across the desert which we often call the sandbox. Even though calling it the sandbox makes it sound like a playground and seems to lessen the magnitude of events, it is quite ironic the sand plays an active role in causing many of these illnesses once veterans get home. A grain of sand on its own isn’t deadly, but when it gets run over by heavy equipment all day long for a decade it becomes finer and finer over time. Then we have the burn pits which presents its own set of issues from burning both medical and human wastes, plastics, rubber, Styrofoam, lead, copper, and anything else you can imagine. Fire makes smoke, and smoke settles back on top of that sand which gets run over again by another tank, gets blown up with an IED which makes even smaller particles with even more toxic metals inside of each particle of dust. Then the sand storms pick it all up, and eventually it goes into the lungs of our service members. X-Rays and traditional testing doesn’t show it, and only through biopsies can it be seen. What, you ask? Constrictive Bronchiolitis!


Deployed service members are commonly exposed to many pesticides. One of these is diethyl toluamide (C12H17NO), commonly known as DEET. DEET is the active ingredient in “Deep Woods Off” which has 25% pure DEET in it and is used for keeping insects away. Anything over 30% pure DEET can have long-term side effects and for this reason it was not for sale in stores for many years here in the US and you had to purchase it online to get 99% pure DEET if you were an avid hunter or fisherman. Years ago, selling DEET became legal and it is possible to get 99% pure DEET which is not to be placed on the skin but instead on clothes. Which makes you wonder how many service members knew this when they sprayed it all over themselves.

Lindane is another pesticide the military uses to treat deployed service members’ uniforms to prevent lice. Although highly effective, it is now banned by the EPA because of its toxicity, ability to cause seizures, propensity to weaken the immune system, damage the nervous system, and possibly cause cancer and disrupt the hormone systems as well. Service members that served in the Gulf were also potentially exposed to Pyrethroid (Ermethrin) which primarily kills fleas and Organophosphorus which is primarily a pesticide but if used in high doses can have lasting medical effects through poisoning of the person spraying it.


For more than twenty years, the military has widely used depleted uranium as both armor for tanks and for depleted uranium rounds that penetrate enemy vehicles on the battle field. This presents its own problems because once a depleted uranium round penetrates a vehicle, small pieces of the depleted uranium can become scattered and become embedded in the service member.


While on deployments, Iraq and Afghanistan veterans were also exposed to infectious diseases and some came home with them. These diseases include Malaria, Brucellosis, Campylobacter jejuni, Coxiella burnetti (Q fever), Non-typhoid Salmonella, Shigella, and West Nile Virus. Each of these diseases has to be diagnosed within 1 year of military separation. Mycobacterium, Tuberculosis, and Visceral Leishmaniasis are also infectious diseases veterans were exposed to but they do not have to be diagnosed within 1 year of separation.

Apart from the common exposures veterans who served in Iraq & Afghanistan faced while on deployments, there are also issues a smaller number of service members faced while serving in each of these places. One of these issues is cold injuries like frostbite, hypothermia and immersion foot (trench foot) which are all caused by prolonged exposure to freezing temperatures. This often applies to those deployed to Afghanistan, received training or were stationed in places like Alaska or Fort Dix in the wintertime. Long-term cold injuries can cause numerous problems such as:

  1. Skin cancer in the frostbite scars.
  2. Vascular injuries with Raynaud’s phenomenon that has symptoms such as arms and legs becoming painful and white or discolored when they become cold.
  3. Changes in skin, muscles, ligaments, bones and nails.
  4. Neurological injuries with symptoms such as bouts of pain in arms and legs, hot and cold tingling sensations, and constant numbness.

Years ago, I was made aware of some serious environmental hazards that exist at Bagram Air Base in Afghanistan. Bagram was originally built back in 1976 by the Soviet Union’s military during their war with Afghanistan. Back then it was common place to use things such as Asbestos, and to improperly dispose of hazardous materials which at times were just sealed into rooms within the facilities that are now occupied by service members and which at times can cause exposure to these hazardous materials. Many times, in speaking with post deployed veterans, they tell me about the strange illnesses/symptoms they have had since returning from the war. After they list 2-3 illnesses, I often stop them and begin reading the list of illnesses that are presumptive, meaning that the VA presumes are linked to service in Iraq & Afghanistan. A prominent condition affecting Gulf War Veterans is a cluster of medically unexplained chronic symptoms that can include fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, and memory problems. The VA prefers not to use the term “Gulf War Syndrome” when referring to medically unexplained symptoms reported by Gulf War Veterans because the symptoms vary widely and therefore, do not meet the definition of a syndrome. A syndrome is a group of symptoms that usually occur together and characterize a certain disease or abnormal condition. For this reason, the VA uses the terms “medically unexplained chronic multi-symptom illnesses” and “undiagnosed illnesses” instead of “Gulf War Syndrome.”

VA presumes certain chronic, unexplained symptoms existing for 6 months or more are related to Gulf War service without regard to cause. These “presumptive” illnesses must have appeared during active duty in the Southwest Asia theater of military operations or by December 31, 2016 and be at least 10 percent disabling. Gulf War Veterans who meet the criteria below do not need to prove a connection between their military service and illnesses in order to receive VA disability compensation. These illnesses include:

■Chronic Fatigue Syndrome, a condition of long-term and severe fatigue that is not relieved by rest and is not directly caused by other conditions.

■Fibromyalgia, a condition characterized by widespread muscle pain. Other symptoms may include insomnia, morning stiffness, headache, and memory problems.

■Functional gastrointestinal disorders, a group of conditions marked by chronic or recurrent symptoms related to any part of the gastrointestinal tract. Functional disorder refers to an abnormal function of an organ, without a structural alteration in the tissues. Examples include irritable bowel syndrome (IBS), functional dyspepsia, and functional abdominal pain syndrome.

■Undiagnosed illnesses with symptoms that may include but are not limited to: abnormal weight loss, fatigue, cardiovascular disease, muscle and joint pain, headache, menstrual disorders, neurological and psychological problems, skin conditions, respiratory disorders, and sleep disturbances.

Sometimes with veterans that have mysterious illnesses, one of the first questions to ask is to list all the names of every military base they were ever at while in service. This is because many bases had different chemicals that were later found in the soil. When we have strange illnesses as veterans, sometimes we merely need to look at where we have been in the past to figure out how we became this way.

A friend of mine went to fire school some ages ago at the old Treasure Island Naval Base in San Francisco, CA. Years ago a veteran told me of the numerous chemicals that were in the soil and the US Navy spent millions to clean it up. There was silver in the ground underneath where the Dental Offices were, and there were PCB’s in the ground which can cause a wide array of cancers and non-Hodgkin Lymphoma. Many of the PCB contamination in the soil were directly underneath on-base housing! This veteran shared hundreds of pages of documentation that proved that this happened at Treasure Island.

There have been “Light bulb moments” with veterans, while talking together they realized that “As likely as not their injuries were caused by their military service” (to use a VA term). This often happens when a veteran states how they feel and then go down the list of PTSD symptoms, or if they say they have 1 or 2 illnesses that I know are presumptive to those who served within that certain area, then you begin going down the list and after reading it they mention that they had 4 or 5 illnesses that had just been listed. No matter where you served, you really need to look at all the possible illnesses that are associated with serving there and if you become ill, do a few Google searches using the illness name along with words such as Army, Navy, Vietnam, Iraq, Fort Lewis, and other keywords.

Many veterans end up getting into a game of semantics with the VA over their injuries. A common example is Ischemic heart disease. Most times, many medical professionals refrain from using the words “Ischemic Heart Disease” but use such terms as myocardial ischemia, hardening or narrowing of the arteries, coronary artery disease, atherosclerosis of the coronary arteries, angina, myocardial infarction, unstable angina, acute coronary syndrome, etc. The truth is when the words Ischemic Heart Disease is used, most veterans will automatically realize that it’s associated with Agent Orange exposure but if it is called by another name then most veterans will not make the connection. This is why you should use a simple trick with veterans who think they could have been exposed to Agent Orange. If they mention they served in a place that used Agent Orange, if they mention a heart problem by any name, do a Google search of the words they used plus the words Agent Orange. Often you find that whichever name the doctors gave them for the heart problem is usually connected to Ischemic Heart Disease which is presumptive for Agent Orange exposure. The same holds true for many other illnesses. Therefore, you might have to demand clarification from the doctors or make complaints to get the disease name changed so that the claims can go forward. At other times, veterans have had to submit a private doctor’s statement that ‘A’ according to VA doctors is in fact B in order for their claims to go forward.

The words used to describe a disease or injuries are very important. The rating decision team comprises of administrative officers who are simply looking for the buzz words and are not in the medical profession, consequently they could fail to make the connections. So often, veterans that have an illness the VA recognizes but unless they know it’s presumptive, the VA can easily get away with denying a service connection exists! It is vital to find the nexus between the illness a veteran has and the presumptive illnesses that the VA recognizes.

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Hosts Mike and Tricia Marino are a retired military family with three children. They retired from the Navy with just over 20 years of service in 2011 and returned from Japan serving as civilians on a Navy base.

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