On March 14, 2017, the VA established a presumption of service connection for certain diseases associated with contaminants found in the early 1980’s at Camp Lejeune, the Marine Corps Base in Lejeune, NC. Two on-base water supply systems were contaminated with the volatile organic compounds trichloroethylene (TCE), a metal degreaser; perchloroethylene (PCE), a dry-cleaning agent; benzene; and vinyl chloride.
Here is what you need to know about the Toxic Exposure at Camp Lejeune
What benefits is a Veteran eligible for that served at Camp Lejeune?
Evidence shows a link between several health conditions and exposure to chemicals found in the drinking water at Camp Lejeune and Marine Corps Air Station New River between 1953 and 1987. You may be eligible for disability compensation benefits if you served at Camp Lejeune or MCAS New River, North Carolina, for at least 30 days total between August 1, 1953, and December 31, 1987, and you didn’t receive a dishonorable discharge when you separated from the military. If you have one of the following eight presumptive conditions, you don’t need to prove that your service caused the condition:
These benefits arise from the same entitlement for those exposed to Agent Orange, burn pits, and other toxins and contaminants. Under 38 CFR § 3.307, qualifying Veterans are entitled to presumptive service connection for chronic, tropical, or prisoner-of-war related disease, disease associated with exposure to certain herbicide agents, or disease associated with exposure to contaminants in the water supply at Camp Lejeune; wartime and service on or after January 1, 1947.
Background of Contaminated Water
Congress mandated the Navy to request a review by the National Research Council (NRC) of adverse health effects associated with the Camp Lejeune water supply contamination. (Public Law 109-364, Section 318). The NRC found that from the 1950s to 1980s an off-base dry-cleaner and on-base industrial activity contaminated groundwater with the volatile organic compounds trichloroethylene (TCE), a metal degreaser; and perchloroethylene (PCE), a dry-cleaning agent; benzene; and vinyl chloride. National Research Council (US) Committee on Contaminated Drinking Water at Camp Lejeune. This contaminated groundwater fed into the wells of water systems supplied by Tarawa Terrace and Hadnot Point water treatment plants. These treatment plants served enlisted-family housing, barracks for unmarried service personnel, base administrative offices, schools, a hospital, industrial areas, and recreational areas. NRC found that “exposure” in this case refers to contaminated water used for drinking, but also bathing, showering, or washing dishes or clothing because TCE and PCE can evaporate into the air and can then be inhaled.
What are the Dates of Service for Eligibility?
38 CFR 3.307(a)(7)(iii) provides that a Veteran, or former reservist or member of the National Guard, who had no less than 30 days (consecutive or nonconsecutive) of service at Camp Lejeune during the period beginning on August 1, 1953, and ending on December 31, 1987, shall be presumed to have been exposed during such service to the contaminants in the water supply, unless there is affirmative evidence to establish that the individual was not exposed to contaminants in the water supply during that service. The last date on which such a Veteran, or former reservist or member of the National Guard, shall be presumed to have been exposed to contaminants in the water supply shall be the last date on which he or she served at Camp Lejeune during the period beginning on August 1, 1953, and ending on December 31, 1987.
In limiting the presumption to the exact dates of August 1, 1953 to December 31, 1987, the VA based the dates on earliest assessments of the water supply in the National Research Council report and the Agency for Toxic Substances and Disease Registry (ATSDR) best estimate of the period of contamination.
In enacting the 30 days of service requirement, the VA reviewed numerous comments arguing against the requirement, including comparing this exposure to other exposures that do not have a minimum exposure during service. The VA noted that other exposures have varying different requirements based on the scientific evidence supporting them. The VA further explained that the 30-day minimum requirement “will help to avoid public confusion and inconsistent results, for example where some Camp Lejeune Veterans would be eligible for a presumption for purposes of disability compensation, but not the statutory presumption for health care benefits.”
What is the Exact Location of Service?
Under 38 CFR 3.307(a)(7)(iii), service at Camp Lejeune means any service within the borders of the entirety of the United States Marine Corps Base Camp Lejeune and Marine Corps Air Station New River, North Carolina, during the period beginning on August 1, 1953, and ending on December 31, 1987, as established by military orders or other official service department records.
In proposing this definition, VA found MCAS New River falls under a separate command than Camp Lejeune despite being located within the borders, and thus service records may specifically denote service or assignment at MCAS New River. It does not include MCAS Cherry Point since MCAS New River has a separate water source and separate command structure than MCAS Cherry Point. It also does not include those who served aboard vessels that docked at Camp Lejeune unless military orders or other official service records reflect service at Camp Lejeune.
What are the Presumptive Conditions?
Under 38 CFR 3.309(f) effective March 14, 2017 the VA established a presumption of service-connection for eight conditions associated with exposure to contaminated water at Camp Lejeune.
(f) Disease associated with exposure to contaminants in the water supply at Camp Lejeune. If a Veteran, or former reservist or member of the National Guard, was exposed to contaminants in the water supply at Camp Lejeune during military service and the exposure meets the requirements of § 3.307(a)(7), the following diseases shall be service-connected even though there is no record of such disease during service, subject to the rebuttable presumption provisions of § 3.307(d).
(Authority: 38 U.S.C. 501(a) and 1112(b))
VA's presumptive conditions for benefits contains fewer and different conditions than the 2012 Camp Lejeune Act, which identified 15 conditions. The Camp Lejeune Act of 2012 provides health care for Veterans and family members for additional conditions, including: esophageal cancer, breast cancer, renal toxicity, female infertility, scleroderma, lung cancer, hepatic steatosis, miscarriage, and neurobehavioral effects. After a more recent review of the evidence, including hazard evaluations on the chemicals that failed to consider risk exposure, the VA cited to insufficient scientific evidence in the decision to not include presumptions for several conditions, including esophageal cancer, lung cancer, breast cancer, neurobehavioral effects and scleroderma. Additionally, the VA distinguished diseases from “general health effects” in not including conditions such as renal toxicity or hepatic steatosis, and female infertility and miscarriage.
Presumptive Conditions’ Residuals and Secondary Conditions
Equally important as the presumptive conditions are the residuals and secondary conditions that require separate claims. A residual effect is one caused by a treatment of a condition, and can include any form of lingering disability that is the result of a previous injury or treatment. Secondary conditions include non-service-connected conditions that are the direct result of the presumptive condition or permanently worsened beyond normal progression by the presumptive condition (medical evidence must establish the baseline and current level of severity). For example, cancer treatments may lead to side effects and residuals that continue into remission. Examples of some residual conditions following cancer and treatment include scars, disfigurement, loss of motion, incontinence and/or frequent urination, voiding dysfunction, renal dysfunctions, erectile dysfunction, neuropathy, osteoporosis, anemia, chronic fatigue syndrome, and fertility issues.
What if I don’t have a presumptive condition? Direct Service Connection
Even if an individual may not be eligible for presumptive service-connection, he or she may be eligible under direct service connection with a medical nexus connecting exposure of contaminated water at Camp Lejeune to a current disease or disability.
The Agency of Toxic Substances and Disease Registry has identified additional health effects where the evidence may be sufficient to conclude a causal relationship is at least as likely as not: end-stage renal disease, scleroderma, Choanal atresia (nasal passages blocked with bone or tissue), Eye defects, Low birth weight, Fetal death, Major malformations, Miscarriage, Neural tube defects, Oral cleft defects (including cleft lip), Small for gestational age, Breast cancer, Cervical cancer, Esophageal cancer, Lung cancer, Hodgkin's disease, Ovarian cancer, Prostate cancer, Rectal cancer, brain cancer, soft tissue cancer, liver cirrhosis, Impaired immune system function, Neurological effects (delayed reaction times problems with short-term memory, visual perception, attention, and color vision), Neurobehavioral performance deficits (i.e., delayed recall and deficits in visual perception), decreased blink reflex, and mood effects (i.e., confusion, depression and tension), Severe, generalized hypersensitivity skin disorder (an autoimmune-related disease).
VA has established presumptive service connection only for qualifying Veterans, Reservists, and National Guard members. Outside of disability benefits, family members of Veterans who also resided at Camp Lejeune during the qualifying period are eligible for reimbursement of out-of-pocket medical expenses related to the 16 covered health conditions in the Camp Lejeune Families Act of 2012. However, for disability benefits, it is common for family members to assist Veterans with the claims process, and there are VA benefits for spouses, dependents, survivors and caregivers. A surviving spouse, child or parent may be eligible for Dependency and Indemnity Compensation (DIC). If a claimant dies while the VA is processing this claim, a qualifying family member has one year to substitute in as claimant and be eligible for accrued benefits.
The CLJA provides a tort federal cause of action for both Veterans and non-Veterans. They must file an administrative claim with US Navy JAG by August 10, 2024. For Veterans, any CLJA award may be offset by VA benefits awarded. Under the CLJA, Veterans and civilians may bring an action in the United States District Court for the Eastern District of North Carolina to obtain appropriate relief for harm that was caused by exposure to the water at Camp Lejeune (Section 804 of PACT Act). Claims under this Act must first be filed with the Department of the Navy, and may be filed concurrently with claims filed with the VA. Pre-suit administrative claims may be filed until August 10, 2024.