VA final ruling for presumptive Peripheral Neuropathy due to AO Exposure

The VA final ruling effective September 6, 2013 follows the Institute of Medicine recommended changes of 2010, as published in the VA proposal.

The ruling does note the veteran’s legal right to file after September 6, 2013 on a DIRECT basis rather than on the presumptive ruling.  There is nothing in law that prevents the veteran from making reference to the new ruling of a presumptive relationship between PN and AO exposure, as another substantiating fact to support their claim!  What this in effective does is negate the need of the veteran to prove in general that AO does cause peripheral neuropathy.

The VA final ruling, while acknowledging and responding to public comments, ignores the FACT that PN symptoms were seldom recognized or diagnosed during the years following the Vietnam and Korean Wars.  Even in 2015 diagnosis is still difficult in many situations due to the failures to fully recognize the symptoms of neuropathy, insufficient research for decades and lack of tools to diagnose PN.

While the medical system failed to diagnose the veteran to establish the ‘early onset’ (symptoms at 10% disabling within a year of exposure), this left the veteran at a loss, as many veterans did not understand their strange symptoms, let alone the medical system.  There is sufficient proof that this failure of the medical system is fact and even in 2015 diagnosis of the neuropathies is still in its infancy and most difficult for most practitioners given the lack of training in the clinical diagnosis and treatment of the neuropathies.

I am pleased that the VA has noted that patients can submit cases and prove on a direct basis rather than on the presumptive ruling, as this is what I was able to do, working for six years.

Too many case workers trying to help veterans dismiss the veteran when they do not met the presumptive criteria forgetting that the veteran can and many have proven their case on a direct basis.

While this is more difficult, much of the same information must still be submitted under the presumptive ruling.   This is exactly what our references and logic in our guidance for veterans does for the veteran who does not fit into the presumptive VA law.  Our guidance has hit the nail right on the head for years with regards to Agent Orange and Peripheral Neuropathy.   The claim that a Veteran must have early on-set at the 10% disability level is bogus based on medical facts.  Cases approved on a direct basis for years include those where early on-set was not proven, but medical authority dismissed the claim from the very start.

For a shorter summary of the guidance and what you should submit on your claim or appeal, it is highly recommended that you send an E-Mail to and he will send you this information.

NOTE: Copyright 2010-15 Network For Neuropathy Support, Inc. dba Neuropathy Support Network.. This article may be reprinted or published for educational purposes as long as the printing or publishing is not for profit and acknowledgement is granted the author. Contact him at E-mail:

PATIENT TO PATIENT – Disclaimer: Patient to Patient articles are intended to be educational, not diagnostic or prescriptive, nor legal advice and the patient is encouraged to seek help from their own private physician or advice from a qualified lawyer.




About the Author

LtCol Eugene B Richardson, USA (Retired) BA, MDiv, EdM, MS

Col Richardson has suffered with severe neuropathy for over 45 years. A 27 year military veteran and veteran of the Vietnam War, he was diagnosed with a progressive chronic peripheral neuropathy resulting in severe disability. This diagnosis has been confirmed as due to exposure to Agent Orange. It was not until 2010, 42 years after his exposure to Agent Orange, that his diagnosis was recognized by Veterans Affairs as service connected.

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