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FACT SHEET: Supporting Veterans Experiencing Financial Hardship and Addressing the Harmful Effects of Military Environmental Exposures

March 01, 2022

The President believes that our Nation has a sacred obligation– to properly prepare and equip the troops we send into harm's way, and to care for them and their families when they return home. Far too often military service comes with a cost, and we owe it to our veterans and their families to address the consequences comprehensively. This means helping veterans build lives of opportunity when they leave military service by helping them to find employment, providing pathways to home ownership, and providing financial support and relief for those who are struggling.

Our veterans are the best of America and supporting the women and men who wear the uniform is a commitment that unites all of us. Throughout history, Democrats and Republicans have been working together to ensure access to world-class health care and benefits for our veterans. And, while our nation's longest war is over, our commitment to support our veteran continues.

To honor those who have worn the uniform of the United States, and to ensure we address the needs of veterans in financial hardship or those who have encountered environmental hazards, the Biden-Harris Administration is:

Reducing Financial Hardship

The President's American Rescue Plan provided $17 billion to help veterans, ensuring the Department of Veterans Affairs (VA) had funding to provide health care services for veterans, including funding for homelessness programs, and to implement a rapid retraining assistance program to help veterans impacted by the pandemic. The American Rescue Plan also eliminated all out-of-pocket medical cost for veterans and provided much needed financial relief to veterans experiencing economic hardship during the COVID-19 pandemic.

Veterans in financial hardship who get treatment through VA are entitled to get their medical debt forgiven. But currently, they can only apply for that medical debt relief through a complex, paper form with complicated eligibility requirements. Veterans may be deterred from applying for much-needed relief because the application process is too confusing and time-consuming. To address this barrier, today the President is announcing that VA is:

Simplifying the process for claiming medical debt forgiveness. VA will streamline the request process and set a simple income threshold for receiving medical debt relief. The request process will include an online option for veterans and reduce the effort required by veterans to access relief. These changes will go into effect in the next 90 to 120 days. This change comes on top of the approximately $1 billion in medical debt the VA has already forgiven for veterans under the American Rescue Plan, which eliminated all out-of-pocket medical cost for veterans and provided much needed financial relief to veterans experiencing economic hardship during the COVID-19 pandemic. It also comes on top of a final rule VA issued in February 2022, under which it will virtually cease reporting unfavorable debt, including medical debt, to consumer reporting agencies.

Addressing Harmful Effects of Environmental Exposures

Too often, military service results in increased health risks and other consequences for our veterans. Some of these injuries and illnesses may take years to manifest. Some are visible and some are invisible. This can make it difficult for veterans to prove in-service exposure and establish a direct connection for disabilities resulting from military environmental exposures such as burn pits.

To mitigate the difficulty in establishing entitlement to benefits, the Department of Veterans Affairs (VA) has established the presumption of exposure and service connection for various chronic conditions when the evidence of a military environmental exposure and the associated health risks are strong in the aggregate but hard to prove on an individual basis.

To further advance efforts to address the harmful effects of exposures during military service, the Biden-Harris Administration is:

Proposing to establish presumption for rare respiratory cancers. Based on a focused review of scientific and medical evidence related to exposure to fine particulate matter and the subsequent development of rare respiratory cancers, the Secretary of VA plans to propose a rule that will add presumptive service connection for several rare respiratory cancers for certain veterans. These cancers under consideration include squamous cell carcinoma (SCC) of the larynx, SCC of the trachea, adenocarcinoma of the trachea, salivary gland-type tumors of the trachea, adenosquamous carcinoma of the lung, large cell carcinoma of the lung, salivary gland-type tumors of the lung, sarcomatoid carcinoma of the lung and typical and atypical carcinoid of the lung.

Supporting legislation to better care for veterans with environmental exposures. The Administration strongly supports ongoing legislative efforts to expand access to health care services and benefits for veterans impacted by environmental exposures. We are committed to ensuring we are able to quickly and fairly recognize additional presumptions of service-connected disabilities by modernizing the processes for evaluating the relationship between exposure and health outcomes. The President looks forward to signing legislation that addresses the toxic legacy of environmental exposures sustained by veterans during their military service.

These actions build on ongoing efforts the Administration is taking to ensure timely access to services and benefits for veterans who experience service connected disabilities from military environmental exposures, including:

Processing claims for new presumptive conditions. In August, VA began processing disability claims for asthma, rhinitis, and sinusitis based on presumed exposure to particulate matter. Veterans who served in the Southwest Asia theater of operations and other areas and who developed these conditions within 10 years of military service are now eligible to apply for disability benefits and access to VA health care. This rulemaking was based upon application of the new presumptive model and involved careful review of a study conducted by the National Academies of Science, Engineering, and Medicine, as well as other evidence assessed by VA subject matter experts. Since August, VA has completed 16,537 claims, granting over 12,000 veterans and their survivors benefits for one or more conditions, leading to over $36 million in retroactive benefit payments.

Applying a new model to review evidence of service connection for constrictive bronchiolitis. VA continues to test and refine a new decision-making framework to determine whether to establish presumptions of service connection based on exposure to military environmental hazards during active military service and other purposes. The new model is evidence-based, transparent, and allows VA to make faster policy decisions on crucial exposure issues. This new model will fundamentally change how VA makes decisions on environmental exposures. VA continues to test the model, solicit feedback from internal and external stakeholders, and evaluate its effectiveness.

Raising awareness of VA benefits related to military exposures. Many veterans were unaware of their eligibility for benefits and services related to potential military exposures. In addition, some claims adjudicators may not have up-to-date awareness of recent policies related to conditions newly presumed to be service-connected. Beginning in November 2021, VA launched a proactive campaign to inform and encourage veterans to file claims related to military environmental exposures. In December 2021, military environmental exposures were featured in the VA Benefits Newsletter, reaching nearly 5 million subscribers. VA continues to share information via its social media platforms weekly.

Requiring training for VA and non-VA providers. Veterans often find that their providers and compensation and pension examiners are not well-trained to understand or treat veterans' exposure concerns. To address this, VA directed compensation and pension providers and Veterans Health Administration clinicians to complete a training module on assessing deployment related to environmental exposures. This is the first module in a series of five essential trainings. VA is also encouraging all providers who care for veterans outside of VA through the Community Care Network contract to complete training on the TRAIN Learning Network, VA's publicly available training site. Furthermore, VA employees and community care providers have been directed to utilize the Exposure Ed App to help providers provide information to Veterans on health effects associated with certain exposures during military service. More information on the app is available here.

Implementing a network of specialized providers and call center. Veterans with concerns about the health outcomes of military exposures experience inconsistent care to address these specific issues, especially outside of VA. Earlier this year, VA launched VET-HOME, The Veterans Exposure Team-Health Outcomes of Military Exposures. VA plans to hire a total of 73 health professionals, including physicians, nurse practitioners, and physician assistants who will specialize in conducting patient assessments regarding the health effects of military exposures. By January 2023, VA expects to have a fully operational call center and network of experts to help veterans concerned about environmental exposure and provide consultative services to veterans in primary care clinics.

Joseph R. Biden, FACT SHEET: Supporting Veterans Experiencing Financial Hardship and Addressing the Harmful Effects of Military Environmental Exposures Online by Gerhard Peters and John T. Woolley, The American Presidency Project https://www.presidency.ucsb.edu/node/354694

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