The Department of Veterans Affairs has approved nearly 80% of the 570,000 claims it has adjudicated under the PACT Act, distributing more than $2.2 billion in disability compensation to veterans or survivors since it began accepting claims last year.
Of the total claims, however, 34% have received a 0% disability rating, meaning that affected veterans have at least one service-connected condition under the law that is not disabling -- for example, hypertension, which has been linked to Agent Orange exposure, that is controlled by medication.
The VA is now reviewing its ratings schedule to determine whether it can revise it to address medically controlled conditions such as hypertension, VA Under Secretary for Benefits Joshua Jacobs told reporters Thursday.
With veterans service organizations and many affected veterans raising concerns about the 0% disability ratings they have received, Jacobs asked his staff "to explore whether we have the flexibility to consider revising the ratings schedule."
The review will include examining medical research and published studies and working with the Veterans Health Administration to determine how to proceed, Jacobs said.
The VA has received more than 1 million PACT Act-related claims and has processed roughly 570,000, according to Jacobs. Nearly 1.3 million additional claims not related to the PACT Act also have been filed this fiscal year, and together with PACT Act claims, they represent a 40% increase over the record-setting number of claims in fiscal 2022.
"Thanks to the largest outreach campaign in VA history, what we're seeing is that veterans and survivors are applying for their earned benefits at record rates," Jacobs said.
Still, veterans who fought to have illnesses such as hypertension recognized as service-connected are frustrated that they aren't among those receiving disability compensation.
According to VA, 82.1% of PACT Act-related claims for hypertension have received a 0% disability rating.
Former Army Spc. Jeff O'Malley, a Vietnam veteran whose Freedom of Information Act requests exposed an internal fight within the VA over including hypertension as presumptive condition for Agent Orange, noted that many survivors of cancers included in the PACT Act receive compensation even if their cancer is in remission, but those with hypertension aren’t receiving any.
"I'm proud of the PACT Act," O'Malley said in a text message to Military.com. "I think we need to rethink minimum ratings for approved claims."
Jacobs said many veterans have more than one health condition that qualifies for VA disability compensation, so their total disability ratings are usually higher than the rating for any one illness. He noted that a 0% disability rating entitles veterans to benefits that include health care, prescriptions, co-payment waivers and federal hiring preferences.
Also, Jacobs said, a 0% disability rating can lead to "secondary service-connected conditions."
In the case of hypertension, if the condition causes heart disease, the veteran would get service connection for that illness and "would likely have a higher rating," Jacobs said.
That response doesn't sit well with veterans like O'Malley, whose blood pressure is difficult to manage.
"I will have a stroke and it will be too late," O'Malley said.
The PACT Act expanded health care and disability benefits to up to 6 million veterans exposed to burn pits and other environmental pollution while serving in the Middle East, Southeast Asia and elsewhere, including post-9/11, Persian Gulf War and some Vietnam-era veterans -- the largest expansion of VA benefits in three decades.
It removed a requirement that veterans or their survivors, depending on where the military member served, prove service connection for more than 23 health conditions, including respiratory diseases, several types of cancer, high blood pressure and more.
The VA has not provided a list of PACT Act-related conditions that have received the 0% disability rating. Based on anecdotal information from veterans service organizations, hypertension appears to be at the top of the list, but some conditions such as asthma, rhinitis and hypothyroidism also can be medically managed.
According to data from the VA provided to Military.com, the average total disability rating for veterans with granted PACT Act claims is 70%.
Jacobs said he expects the review to yield information on any ratings change in the coming months, adding that a decision must work within "a very clear framework of legal authorities."
Jacobs said he has heard stories that some veterans have considered going off their medications so that when they receive their compensation and pension exam, their "numbers are off the charts."
He had strong words for any veteran contemplating such a move.
"Do not do that. That is a significant health risk to you," Jacobs said.
Editor's note: This story was updated with additional statistics on claims for hypertension and overall average ratings.
– Patricia Kime can be reached at Patricia.Kime@Military.com.