Since the late 1970s, Vietnam-era veterans have voiced concerns about how exposure to Agent Orange may have affected their health and caused certain disabilities, including birth defects in their children, and now their grandchildren. The Department of Veterans Affairs (VA) received the first claims asserting conditions related to Agent Orange in 1977. Likewise, the Department of Veterans Affairs (VA) consistently took the position that because the long-term exposure to Agent Orange was unclear, and because of scientific uncertainty of the evidence linking Agent Orange to specific illnesses, it could not compensate veterans who alleged that exposure to Agent Orange had caused their diseases. In December 1979, Congress passed the Veterans Health Programs Extension and Improvement Act of 1979 ( P.L. In 1981, Congress passed the Veterans' Health Care, Training, and Small Business Loan Act of 1981 ( P.L. 97-72 ). The Veterans' Dioxin and Radiation Exposure Compensation Standards Act of 1984 ( P.L. 98-542 ) required the VA to develop regulations for disability compensation to Vietnam veterans who may have been exposed to Agent Orange. P.L. In 1991, the Agent Orange Act ( P.L. 102-4 ) established a presumption of service connection for diseases associated with herbicide exposure (see text box "What is Presumption of Service Connection ?"). In making this determination, P.L. 102-4 authorized the VA to contract with the Institute of Medicine (IOM) of the National Academy of Sciences (NAS) to review and summarize the scientific evidence concerning the association between exposure to herbicides used in support of military operations in Vietnam during the Vietnam era and each disease suspected to be associated with such exposure. P.L. Within 90 days of issuing the proposed regulations, the VA must issue final regulations establishing a presumption of service connection for any disease for which there is scientific evidence of a positive association with herbicide exposure. Based on the most recent IOM report, "Veterans and Agent Orange: Update 2012," the VA decided not to establish any new presumptions. Both the VA Regional Office and the Board of Veterans' Appeals (BVA) denied Mr. Haas the presumption of service connection, stating that a veteran must have actually "set foot on land in the Republic of Vietnam" to qualify for a presumption of service connection for exposure to Agent Orange. Current Issues

Currently, three major issues pertain to Vietnam-era veterans and their exposure to Agent Orange: (1) providing presumptive service-connected disability compensation for those who served in the waters surrounding Vietnam and in other areas that Agent Orange may have been stored or used; (2) providing disability compensation and health care for paternally mediated birth defects; and (3) researching and providing disability compensation and health care services to biological grandchildren and later generations of Vietnam-era veterans. As discussed under the " Blue Water Veteran Litigation " section, some veterans of the Vietnam era who served aboard deep-water naval vessels off the coast of Vietnam—referred to as "Blue Water Navy" veterans—have been pressing Congress and the judicial system to expand the definition of service in Vietnam, thereby qualifying this group to receive disability compensation for diseases or conditions presumed to be associated with Agent Orange. The VA is reviewing all these claims on a case-by-case basis. However, some veteran service organizations have asserted that more research should be done regarding paternally mediated birth defects and that eventually disability compensation policies should be developed for disabilities and health conditions that appear in later generations. However, beginning with the 2010 review, the IOM extended its focus to include all types of medical conditions occurring in Vietnam-era veterans' children, regardless of age, and to include such conditions in successive generations.
The U.S. Armed Forces used a variety of chemical defoliants to clear dense jungle land in Vietnam during the war. Agent Orange (named for the orange-colored identifying stripes on the barrels) was by far the most widely used herbicide during the Vietnam War. Many Vietnam-era veterans believe that their exposure to Agent Orange caused them to contract several diseases and caused certain disabilities, including birth defects in their children, and now their grandchildren.
The Department of Veterans Affairs (VA) received the first claims asserting conditions related to Agent Orange in 1977. Since then, Vietnam-era veterans have sought relief from Congress and through the judicial system. Beginning in 1979, Congress enacted several laws to determine whether exposure to Agent Orange in Vietnam was associated with possible long-term health effects and certain disabilities. The Veterans' Health Care, Training and Small Business Loan Act (P.L. 97-72) elevated Vietnam veterans' priority status for health care at VA facilities by recognizing a veteran's own report of exposure as sufficient proof to receive medical care, absent evidence to the contrary. The Veterans' Health Care Eligibility Reform Act of 1996 (P.L. 104-262) completely restructured the VA medical care eligibility requirements for all veterans. Under P.L. 104-262, a veteran does not have to demonstrate a link between a certain health condition and exposure to Agent Orange; instead, medical care is provided unless the VA determines that the condition did not result from exposure to Agent Orange. This authority was permanently authorized by the Caregivers and Veterans Omnibus Health Services Act of 2010 (P.L. 111-163).
Likewise, Congress passed several measures to address disability compensation issues affecting Vietnam veterans. The Veterans' Dioxin and Radiation Exposure Compensation Standards Act of 1984 (P.L. 98-542) required the VA to develop regulations for disability compensation to Vietnam veterans exposed to Agent Orange. In 1991, the Agent Orange Act (P.L. 102-4) established a presumption of service connection for diseases associated with herbicide exposure. P.L. 102-4 authorized the VA to contract with the Institute of Medicine (IOM) to conduct scientific reviews of the evidence linking certain medical conditions to herbicide exposure. Under this law, the VA is required to review the reports of the IOM and issue regulations, establishing a presumption of service connection for any disease for which there is scientific evidence of a positive association with herbicide exposure. Based on these IOM reports, currently 15 health conditions are presumptively service-connected.
Under current regulations, a servicemember must have actually set foot on Vietnamese soil or served on a craft in its rivers (also known as "brown water" veterans) to be entitled to the presumption of exposure to Agent Orange. Those who served aboard deep-water naval vessels (commonly referred to as "Blue Water Navy" veterans) do not qualify for presumption of service connections for herbicide-related conditions unless they can prove that the veteran's service included duty or visitation within the country of Vietnam itself, or on its inland waterways.
Recently, Vietnam-era veterans have increasingly expressed concerns about all types of medical issues occurring in their children, regardless of age, and in successive generations. Furthermore, they have asserted that more research should be done on paternally mediated birth effects, so that compensation policies might be developed similar to those that address maternally mediated birth effects of Vietnam-era progeny.