posted in Miscellaneous Lupus Topics on February 23, 2024 by
Updated March 12, 2024
Some veterans have an increased risk of developing lupus. When grappling with the complexities of lupus, a pressing question for many is whether it qualifies for Veterans Affairs (VA) disability benefits. Let’s explore the intricacies to understand if and how lupus can make you eligible for VA disability.
This blog on “VA Disability for Lupus” was edited and contributed to by Donald Thomas, MD; author of “The Lupus Encyclopedia.” Parts of this blog post come from “The Lupus Encyclopedia: A Comprehensive Guide for Patients and Health Care Providers, edition 2“
Lupus, a chronic autoimmune condition, can profoundly affect one’s health. Its diverse symptoms, ranging from joint pain to organ inflammation, can also often raise questions about eligibility for disability benefits.
The VA determines disability eligibility based on the impact of a condition on a veteran’s ability to work and lead a fulfilling life. Lupus, with its potential to cause severe fatigue, pain, and organ damage, can significantly hinder daily activities.
The Department of Psychiatry, University of California, San Francisco, and the San Francisco Veterans Affairs Medical Center reported an increased number of veterans with autoimmune disorders in 2014. They evaluated the records of 666,269 veterans of Afghanistan and Iraq. Around one out of every three veterans suffered from PTSD. These veterans with PTSD were twice as likely to develop an autoimmune disorder (including lupus) compared to veterans who did not have a psychiatric disorder. Veterans with military-associated sexual trauma were also more likely to develop an autoimmune disease.
There is mounting evidence that also stress increases the chances of developing systemic lupus erythematosus (SLE). The risk is highest with severe stressors like natural disasters, sexual and physical abuse, and stress that leads to PTSD. Stress also increases the risk of SLE flares. The amount of research showing a link between stress and SLE is so strong that lupus experts recommend that SLE patients learn to practice stress reduction techniques, such as practicing daily mindfulness. People cannot eliminate stress from their lives, but they can improve how their body reacts to it. Exaggerated and unhealthy reactions to stress have negative effects on the immune system.
While 25% of the risk of developing SLE lies with is genetic, around 75% of the risk is thought to be related to environmental triggers. One well-known trigger is stress, as discussed above. However, there are others that veterans may have faced during their careers in the military:
One of the most well-known and publicized herbicides is “Agent Orange” previously used in the Vietnam War from approximately 1962 to 1971. It was used to kill the leaves of trees and other plants to allow the US military to see the enemy better. Unfortunately, many civilians and the U.S. military were exposed to Agent Orange.
The “Children of Vietnam Veterans Health Alliance” lists autoimmune diseases, such as lupus, in the children of veterans as a possible consequence of exposure.
However, autoimmune disorders (like SLE) have not occurred in higher than expected numbers thus far from agent orange exposure and are not listed as a known health consequence.
Disorders listed as “presumptive diseases associated with exposure to Agent Orange” include
Veterans should note that several of these disorders are common and should be considered as possible associated disorders:
The only autoimmune disease on this list is hypothyroidism (usually as a result of Hashimoto’s thyroiditis or Graves disease).
Although not autoimmune diseases, the following agent orange-associated disorders occur more commonly in people with autoimmune diseases, including with SLE:
However, lupus is an uncommon disease, and it is hard to prove causality by studies like those for Agent Orange. For example, large studies fail to prove any connection between vaccines and lupus. However, most lupus experts have patients with SLE who developed it after receiving a vaccine. Since herbicides are implicated as one possible trigger for SLE, Agent Orange could be a possible trigger. Some veteran disability lawyers list lupus as a possible result of agent orange. If you think you developed lupus due to Agent Orange, consider getting an attorney who specializes in veterans disability benefits.
Some veterans benefits groups advocate that autoimmune disorders like lupus occur more often in veterans exposed to burn pits during the Gulf War. However, there is no sufficient evidence showing a link between burn pit exposure and lupus. This does not definitively mean that burn pit exposure may not trigger lupus in some people. SLE is an uncommon disorder and it is difficult to prove causation, even when it exists.
Establishing a connection between lupus and military service is pivotal for VA disability claims. While lupus is not directly linked to specific military exposures, veterans must demonstrate how their service may have triggered or worsened the condition.
To strengthen a VA disability claim for lupus, meticulous documentation is crucial. Medical records outlining the diagnosis, treatment history, and the functional impact of lupus on daily life provide essential evidence for the claim.
A Nexus statement from a medical professional can be a game-changer. This statement establishes a link between the veteran’s lupus and their military service, reinforcing the case for disability benefits.
Initiating a VA disability claim for lupus involves a series of steps. Veterans must gather comprehensive medical evidence, submit a formal claim, and also potentially undergo a medical examination. Navigating this process can be intricate but is essential for a successful outcome. There is also an online tool you can use to view your disability rating.
While lupus and VA disability claims require careful navigation, veterans living with lupus have avenues for support. Understanding the criteria, documenting the impact of lupus, and seeking professional advice can enhance the chances of a successful disability claim.
For information about other disability benefits that may be available, you can also take a look at Can You Work with Lupus? Lupus patients and the Americans with Disabilities Act (ADA)
Read more in The Lupus Encyclopedia, edition 2
Look up your symptoms, conditions, and medications in the Index of The Lupus Encyclopedia
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Both of my children have autoimmune diseases. They are different in each child. We have no known history in either my family or my wife’s family. I have always believed my exposure to agent orange had something to do with it. Watching how it affects them is gut wrenching. It leaves me with a gilt complex. This article was very informative and I thank you for posting it
So Sorry to hear this, Hal. I’m sure it is hard to get rid of the guilt feelings, and I’m sure you’ve been told this many times, but it isn’t at all your fault! It is our fault for using Agent Orange in the first place.
I am also ex-Army… and I so much appreciate your service. My cousin saw a lot of Vietnam action, and I cannot imagine what it was like.
I also wish our nation had treated you guys better when you returned.
Donald Thomas, MD
Hi-I’ve been trying to learn more about this since you wrote this blog earlier this spring. I’m a veteran with lupus.
Lupus is on the list of presumptive disabilities for the VA.
https://www.va.gov/disability/eligibility/illnesses-within-one-year-of-discharge/
This is from the CFR 3.309
“3.309 Disease subject to presumptive service connection.
(a) Chronic diseases. The following diseases shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under § 3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of § 3.307 are also satisfied.”
According to the Schedule of Ratings in the ECFR 4.88b the lowest compensable rating for Lupus is 10% and is rated for “Exacerbations once or twice a year or symptomatic during the past 2 years.”
So if I understand that correctly that means if I was symptomatic during that time (either during active duty or the first year following service) but wasn’t formally diagnosed until later then lupus could be service connected.
Have you had any experience with this issue?
The reason I ask is because I have thrombocytopenia and anxiety that started within that time frame that continue to this day. The thrombocytopenia was one of the main things that led to my eventual diagnosis with lupus. Just wondering if those things would be considered “symptomatic” for lupus before I explore this further and waste the VA’s time.
Thank you for your thoughts, and thank you for all you do sharing your knowledge. I have both of your books and they have been a tremendous help. I’ve had so many health issues for years that I just chalked up to aging, but they kept getting worse. The lupus diagnosis was a shock and I knew absolutely nothing about it when I was first diagnosed other than it was not a good thing to have and it was something that people did charity runs for. Your books have educated me so much and something that I think every lupus patient should have.
Lynn: Very good question. If I were in your shoes, I would go for it. You absolutely had evidence of being symptomatic with SLE. You cannot get any better than the low platelet showing up early as part of your SLE.
However, the question will be, is that enough evidence for them to grant it, or do the symptoms that started during service had to have been the same ones that caused your disability (like severe fatigue, unable to concentrate well enough to do your job, severe joint pains making it impossible to do your job, etc.)
Thank you for the kind works about my books. They have been a labor of love, and it motivates me even more when I see they help others.
Good luck!
Donald Thomas, MD
I was diagnosed with Mixed Connective Tissue Disease (lupus, rheumatoid arthritis, Reynaud’s, and hypothyroidism) while serving in the Marine Corps Reserves. I was medically discharged due to this diagnosis. I have started the VA disability process and am currently attempting to connect my diseases with my service. Any suggestions as to service related factors that other vets have mentioned outside of what you already mentioned in your article. I definitely think it was the overexposure of sun (I have to stay out of the sun as much as possible now), extreme mental and physical stress I experienced in boot camp with multiple injuries and UTI’s (treated with Cipro). Along with trauma and stress during infantry training. I’ve never been diagnosed with PTSD as I never admitted it may be part of my issues. Also, what do you think about all the medical problems that my autoimmune disease as caused throughout my life. Do I document all of those too (which includes Hodgkin’s Lymphoma)? Any ideas would be greatly appreciated.
Jessica: I am not an expert on how to connect service-related activity and the onset of MCTD/SLE etc. If on active due when it begins, I would think it would be much easier. Reserves I suspect will be much harder since most of your time is spent away from duty (unless assigned to Afghanistan/Iraq, etc). It would certainly take medical documentation by a health care professional to support a case, I would suspect. So sorry to hear you have gone through so much and I wish you all the best (ex-reservist and active duty myself).
Donald Thomas, MD
Wow, so informative. I hope Im not too late to ask my question. My husband was at Camp Lejeune and was diagnosed with SLE 30 years ago. He now has RA and non alcoholic cirrhosis also. He was at Lejeune in the 70’s. We have always believed his Lupus was from the toxins in the water. Lupus was on the presumptive list and removed. We wanted to file for disability over 20 years ago and were told we couldn’t. I have read some mice tests on TCE and have read numerous articles of TCE, etc causing autoimmune diseases ( SLE included ). Is there more proof of this? Is the Lupus foundation pursuing this? We greatly appreciate your time, knowledge and any direction you may have.
Connie: So sorry to hear that. So many veterans have been exposed to health risks over the years.
Dr. Mara Richard specifically points out TCE exposure in her article in the journal “Lupus”, stating,
“Solvent exposure is thought to be a possible occupational risk factor for developing lupus. In particular, the degreasing solvent, trichloroethylene (TCE), has been most frequently implicated and most widely studied. TCE has been identified as a possible factor in studies of geographic lupus clusters in Arizona and North Carolina near military bases where high levels of TCE were found in drinking water.73–75″
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