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VA adds to Agent Orange list

Effective May 7, the VA has finalized the proposed rule establishing AL Amyloidosis as a presumptive condition on the Agent Orange/herbicide list. In November 2008, VA had published this change as a proposed rule under the applicable procedures for public comment. As the public comment period has passed and VA has reviewed all comments received, the proposed rule has been accepted as the final rule without change.

The provisions of this revision apply to all applications for benefits pending before VA or received after May 7, 2009 as well as too review of certain previously denied claims to the extent provided in 38 CFR § 3.816.

As noted in VA&R Bulletin 36-08, dated November 4, 2008, an Institute of Medicine (IOM) report "Veterans and Agent Orange: Update 2006," released on July 27, 2007, IOM concluded that "there is limited or suggestive evidence of an association between exposures to the compounds of interest [found in the herbicide Agent Orange] and AL amyloidosis." The Secretary of Veterans Affairs, after considering all of the evidence, subsequently determined that there is a positive association between exposure to herbicide agents and the occurrence of AL amyloidosis.

Amyloidosis is a rare and potentially fatal disease that occurs when substances called amyloid proteins build up in your organs. Amyloid is an abnormal protein usually produced by cells in your bone marrow that can be deposited in any tissue or organ.

Amyloidosis can affect different organs in different people, and there are many types of amyloid. Amyloidosis frequently affects the heart, kidneys, liver, spleen, nervous system and gastrointestinal tract.

The exact cause of amyloidosis is unknown, and there's no cure for amyloidosis. However, therapies are available to help you manage your symptoms and limit the production of amyloid protein.

AL amyloidosis is a rare monoclonal plasma cell disorder that shares biological and patho-physiological features of multiple myeloma and some lymphomas that have been associated with herbicide exposure in previous IOM reports. Although there is relatively little direct epidemiological evidence concerning the relation of AL amyloidosis to herbicide exposure, the Secretary of Veterans Affairs noted that IOM considered the evidence linking AL amyloidosis to multiple myelomas and lymphomas to be significant, if indirect, evidence of an association.

Signs and symptoms of amyloidosis depend on the organs affected. The wide range of signs and symptoms often makes amyloidosis difficult to diagnose. You may even have no symptoms. Signs and symptoms may include:

• Swelling of your ankles and legs

• Weakness

• Weight loss

• Shortness of breath

• Numbness or tingling in your hands or feet

• Diarrhea

• Severe fatigue

• An enlarged tongue (macroglossia)

• Skin changes

• An irregular heartbeat

• Difficulty swallowing

Please see your local county veterans service officer if you have any questions. You can contact your local VSO at (218) 631-7617 or by e-mail at As always, have a great week.