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Longtime exposure to asbestos, even decades ago, carries the risk of esophageal cancer,a malignancy of the esophagus, the muscular tube that connects the throat to the stomach.
According to more and more emerging studies, a precursor of veterans developing severe illnesses of the gastrointestinal tract is Barrett's esophagus (BE). This condition occurs when stomach acid refluxes into the lower esophagus for an extended period, causing damage to the inner lining.
BE is a precancerous condition, and veterans exposed to asbestos during their service should be aware that this illness may be associated with their exposure. Even so, the VA does not currently recognize BE as a presumptive condition related to asbestos exposure. While medical research suggests a link, a direct causal relationship hasn't been definitively proven.
What has been scientifically cleared is that BE increases the risk of esophageal adenocarcinoma, and veterans should be mindful of the potentialities and symptoms, including GERD. However, medical evidence shows a clear biological connection between asbestos exposure and subsequent chronic inflammation and cell damage, which potentially accelerates the path from BE to cancer.
Linking asbestos exposure to esophageal cancer, including the veterans with conditions like BE, has important implications not only for health monitoring but also for VA disability claims. In recognition of these risks, the VA updated its rating criteria, effective May 19, 2024, and introduced Diagnostic Code (DC) 7207, specifically mentioning BE, allowing veterans to receive a direct service connection rating for this illness. It's a significant update because previously, BE was generally rated only as a secondary condition to gastroesophageal reflux disease, also known as GERD.
However, not everyone with BE will develop cancer, and the majority of veterans diagnosed with the disease do not progress to cancer. Regular monitoring and treatment of GERD are practical tools to reduce the risk of cancer and manage symptoms.
New VA Rating Criteria for Barrett's Esophagus
Under the new update, the VA may combine BE with other digestive conditions, such as other esophageal diseases. The severity of the illness, as documented by pathology reports (high-grade vs. low-grade dysplasia), determines the rating:
- With Esophageal Stricture rated under DC 7203, ratings can vary between 0% and 80%, depending on the severity and associated symptoms, such as difficulty swallowing (dysphagia), the need for dilation procedures, or significant weight loss.
- Without Esophageal Stricture rated under the new DC 7207: 30% when documented by pathologic diagnosis with high-grade dysplasia; 10% when documented by pathologic diagnosis with low-grade dysplasia.
If BE progresses to cancer, it's rated under DC 7343 for malignant neoplasms of the digestive system.
How Veterans Can Get VA Disability for Barrett's Esophagus
BE isn't currently listed as a presumptive condition under the PACT Act. However, veterans can still apply for disability benefits for BE by establishing a direct service connection or a secondary service connection.
Vets can cite secondary service connection for BE if they already receive VA disability for GERD, hiatal hernia, or another gastrointestinal disorder. For a direct service connection, former service members must show that :
- were diagnosed with BE while in service, or
- had symptoms in service that later were diagnosed as BE
Generally, veterans exposed to burn pits, jet fuel, toxic chemicals, or asbestos tend to develop gastrointestinal illnesses. If there is medical evidence linking such exposure to BE, it may support an exposure-related claim. However, the VA doesn't currently recognize a direct link between asbestos exposure and BE. Consequently, claims based solely on asbestos exposure without supporting medical evidence may not be successful. Documentation needed to support a claim:
- A current diagnosis of BE, which must be confirmed by biopsy (pathology report)
- Dysplasia level, if known: it can be low-grade or high-grade
- Nexus letter (medical opinion) linking BE to the military service or a service-connected condition like GERD.
- Service medical records showing symptoms or treatment during service, if claiming a direct connection.
- Treatment records from VA or private doctors.
You can file claims:
- Online at VA.gov Disability Compensation
- By mail after completing VA Form 21-526EZ
- In person at any VA Regional Office
Tips for a strong claim:
- If you file secondary to GERD, make sure GERD is already service-connected or apply for it in the same claim.
- Include a nexus letter from your doctor linking BE to GERD or military service - it can significantly strengthen your claim.
- Use a DBQ: if your doctor is willing, have them complete the Esophageal Conditions Disability Benefits Questionnaire for your claim. It's not mandatory if you have other substantial evidence.
Trust funds don't currently compensate for BE alone, but if the disease eventually progresses to esophageal cancer, that could qualify them for compensation, especially with supporting evidence of their asbestos exposure.
Statistically, Navy personnel exposed to asbestos, toxic fumes, or solvents in poorly ventilated engine rooms or boiler rooms aboard ships built before the 1980s have increased chances of developing:
- Lung disease or chronic cough from asbestosis or pleural plaques
- GERD due to chronic coughing or strain
- BE, as a secondary progression from GERD
To prevent a cancer diagnosis in advanced stages, veterans with known asbestos exposure should undergo routine procedures such as:
- endoscopies if they have chronic GERD symptoms
- esophageal and laryngeal cancer screenings
We Offer Assistance to Navy Veterans and Their Families
Navy personnel in service onboard ships made before the 1980s and diagnosed with service-related cancer may file for compensation from the asbestos trust funds and the VA. To do so, they'll need proof of asbestos exposure and medical records of their malignant disease, such as:
- pharyngeal cancer
- colorectal cancer
- mesothelioma
- laryngeal cancer
- esophageal cancer
- urogenital cancer
- bronchial cancer
- lung cancer
- gastrointestinal cancer
It's vital to remember that filing claims is subject to a statute of limitations, so it's advisable to contact a lawyer as soon as possible after receiving a diagnosis of one of these diseases. By doing so, you can ensure that your claims are submitted on time and avoid payment denials.
If you are unsure whether or what type of indemnification you qualify for, we can help you gain a deeper understanding of your benefits. If you wish to take legal steps, we can connect you with experienced asbestos attorneys who will assist with the necessary documentation and represent you throughout the process.