PFF Insights

Benefits and care for veterans with pulmonary fibrosis and interstitial lung disease

by Jennifer Simokaitis, Manager, PFF Help Center, and Kate Gates, Vice President, Advocacy and Programs
September 08, 2023
Army soliders in uniform

Veterans whose illnesses are connected to their military service may be eligible for care and benefits from the United States Department of Veterans Affairs. Since it was passed in 2022, the PACT Act has expanded benefits for many veterans who were exposed to burn pits or other toxic exposures, especially those who served during the Gulf War and post-9/11 eras. However, this expansion in care and benefits from the PACT Act does not extend to Vietnam-era veterans who have been diagnosed with pulmonary fibrosis (PF) and interstitial lung disease (ILD).

What does this mean if you are a veteran living with pulmonary fibrosis?

Gulf War and post-9/11 eras: PF and ILD are considered presumptive conditions

In order to get a Veterans Affairs (VA) disability rating, your condition must be connected to your military service. Your VA disability rating is used to determine your level of benefits.

For many illnesses, you must prove that your illness is a result of your service. But some illnesses are presumed to have been caused by your military service. The PACT Act of 2022 added pulmonary fibrosis and interstitial lung disease as “presumptive conditions” for veterans who meet the following criteria:

  • You served during the Gulf War or post-9/11 eras
  • You were exposed to burn pits or other toxic substances

    If you meet the criteria for a presumptive condition, you don’t have to prove that your service caused your condition in order to get a VA disability rating.

    Use this link to learn more and apply for PACT Act benefits.

    Vietnam era: PF and ILD are not considered presumptive conditions

    While the PACT Act added PF and ILD to the list of presumptive conditions for Gulf War-era and post 9/11 veterans, it did not include PF and ILD as presumptive conditions for Vietnam-era veterans. PF and ILD are not currently considered presumptive conditions for veterans who served during the Vietnam era.

    Unfortunately, it has been difficult to establish a connection between PF and ILD and Agent Orange exposure, a toxic exposure experienced by many military personnel during the Vietnam era.  There are various reasons that it is difficult to make this connection, such as the age of Vietnam veterans when PF is diagnosed, a high likelihood of smoking among veterans who served during the Vietnam era (which is a risk factor for PF), the length of time from Agent Orange exposure to diagnosis, and difficulty in measuring exposure levels to Agent Orange.  

    Until recently there had not been research that found a statistical association between PF and Agent Orange exposure. A study published in 2022  reviewed Veterans Health Administration data to look for evidence of an association between Agent Orange and a diagnosis of idiopathic pulmonary fibrosis (the most common type of PF, also known as IPF). The study found that veterans who had been exposed to Agent Orange may have a slightly greater risk of developing IPF than those who were not exposed. The study conclusion also states that additional research is needed to confirm the association between Agent Orange and IPF, and to learn about the disease processes involved. This study, which includes two members of the PFF medical team among its authors, was published in one of the journals of the American Thoracic Society, the preeminent medical society for respiratory health in both the U.S. and worldwide, and received funding from the National Heart, Lung, and Blood Institute of the National Institutes of Health.

    My illness is not considered a presumptive condition. Now what?

    When an illness is not considered a presumptive condition, you can present evidence of direct causation to try to show that your PF is connected to your military service. A service connection may be granted if you are able to provide sufficient evidence to show "it was at least as likely as not" that your disease is related to a toxic substance you were exposed to during your military service. Therefore, evidence that supports the link between a diagnosis of PF or ILD and Agent Orange or other harmful exposures is critical if you would like to seek VA coverage for your medical care.  This page on the VA website provides information about applying for compensation for illness due to Agent Orange exposure. 

    The VA provides an online, searchable database of individual decisions by the Board of Veteran Appeals regarding veterans’ benefits claims. Reading through some of these appeal decisions may help you gain an understanding of the types of reports, medical records and evidence that other veterans have provided when appealing the denial of their initial claim. 

  • This link will take you to an example of an appeal decision that granted a service connection to a veteran who was successful in linking his diagnosis of idiopathic pulmonary fibrosis (the most common type of pulmonary fibrosis, also known as IPF) to his exposure to Agent Orange.  
  • This link will take you to a search tool on the U.S. Department of Veterans Affairs website where you can search the archive of individual decisions by the Board of Veterans Appeals. If you search for "pulmonary fibrosis" and "Agent Orange" you can review numerous decisions, some of which have granted a service connection for pulmonary fibrosis due to Agent Orange exposure. 

If your claim is denied, it may be helpful for you to contact a local VFW chapter, the Disabled American Veterans, the National Veterans Legal Services Program, or other veterans' advocacy groups, who may be able to assist you by providing guidance or securing legal representation if your initial claim is denied.  

The PFF invites veterans to join us for a dedicated session at the PFF Summit

During the PFF Summit 2023, the PFF will be hosting a session for veterans, their caregivers, and healthcare providers who work with veterans. This session will provide networking opportunities, an overview of current research, and educational resources. The session will take place on November 11 from 6:45 a.m. – 7:45 a.m. ET.

The PFF Summit is the world’s largest conference focused on pulmonary fibrosis (PF) and interstitial lung disease (ILD) research and education. The PFF Summit 2023 is being held in Orlando, Florida from November 9 – 11, 2023. Registration for patients and caregivers is $135. To learn more and register, use this link.

Other Resources

The Deployment-Related Lung Disease Center at National Jewish Health conducts research on lung injury related to exposures experienced during military service.

The VA's War Related Illness and Injury Study Center provides post-deployment clinical care, education, and ongoing communication to veterans, and conducts research into service-related health concerns.  The Center's clinical program provides comprehensive multidisciplinary evaluations and environmental exposure assessments for veterans who believe their health issues are related to their deployment.