VA: All veterans with ALS eligible for benefits

Late last month the U.S. Department of Veterans Affairs (VA) published new regulations granting military veterans diagnosed with amyotrophic lateral sclerosis, also called ALS or Lou Gehrig’s Disease, full access to health and disability benefits. The new rule went in effect immediately and covers all veterans serving at least 90 consecutive days no matter where or when they served. ALS is a progressive neuromuscular disease that affects about 20,000 to 30,000 people of all races and ethnicities in the United States, according to the National Academies of Science.  It causes degeneration of nerve cells in the brain and spinal cord that leads to muscle weakness, muscle atrophy, paralysis, and eventually the patient may lose the ability to swallow or breathe. Life expectancy after diagnosis is generally two to five years after diagnosis. However, there have been cases where ALS stops progressing and where symptoms have reversed.  

“Veterans living with Lou Gehrig’s Disease now have one less hurdle to face on an already difficult road,” said Steve Gibson, the ALS Association’s vice president of government relations and public affairs.

Citing the high incidence of ALS among Persian Gulf War veterans who were diagnosed with the disease at younger ages than had been typical, the VA granted service connected benefits to veterans of the 1990-91 war. Veterans with ALS, advocacy groups including the ALS Association, and some members of the military and Congress continued to push to designate ALS as a presumption of service connection and to expand benefits for all war veterans.

The VA cited a compilation of medical studies, Amyotrophic Lateral Sclerosis in Veterans: Review of the Scientific Literature, in concluding that “there is limited and suggestive evidence of an association between military service and later development of ALS.”  The report, completed by the National Academies of Science at the behest of the VA, was released in November 2006.

According to the studies, military veterans within the last century are nearly twice as likely to develop ALS as those with no history of military service, regardless of where or when they served in the military.

“Veterans are developing ALS in rates higher than the general population, and it was appropriate to take action,” VA Secretary James Peake said in a written statement. “ALS is a disease that progresses rapidly, once it is diagnosed.  There simply isn’t time to develop the evidence needed to support compensation claims before many veterans become seriously ill. My decision will make those claims much easier to process, and for them and their families to receive the compensation they have earned through their service to our Nation.”

The VA said it will try to identify and contact veterans with ALS, including those whose claims were previously denied.  

Why ALS occurs more often in veterans is unclear but anthrax vaccine may play a role

Bob Evans, a reporter with the Daily Press, wrote about the anthrax vaccine-ALS connection in a December 2005 article (‘Young’ men got Lou Gehrig’s disease, Navy officers Denis Army and Brody Prieto were hit by amyotrophic lateral sclerosis soon after their shots). Evans wrote: “Both died thinking that their anthrax shots triggered - or caused - this always-fatal illness, despite military doctors’ refusal to consider the possibility, their widows say.”

Both veterans also received anthrax from vaccine batches containing squalene, which, while boosting the potency of vaccines, caused symptoms consistent with “Gulf War Syndrome,” according to a 2002 study. Squalene is also known to cause severe autoimmune problems in laboratory animals. The Army experimented with vaccines containing squalene for 50 years, Evans found.

Todd Sanders of Kingsport, TN, told a reporter last year that he and his friend, another among the nearly 2 million Gulf War soldiers to receive the anthrax vaccine, believed their illness was caused by the vaccine. ”Sanders said he believes — and that Robertson believed — their condition was caused by the anthrax vaccine, which made him sick and almost caused him to pass out when he first received it,” wrote Rick Wagner.

Other studies have looked at the possible role of genetics, physical activity, environmental toxins, trauma, chemical and alcohol use, or a combination of these factors, to explain the high incidence of ALS in military veterans. Aside from determining that 5 to 10 percent of cases are inherited, these study results have been, for the most part, inconclusive.

National ALS Registries

The VA discontinued the National Registration of Veterans with ALS in September 2007. Between 2003 and 2007 the registry collected data, including DNA samples to be made available for ALS research, from 2,090 ALS patients or their survivors.  However, a national ALS registry bill was signed into law on Oct. 8 of this year. The registry is to be maintained by the Centers for Disease Control and Prevention. The law requires that an advisory board for the registry include at least one member from the VA, and that the CDC share and “coordinate with” state, local and federal registries, including the VA. 

Recommended reading:

Afflicted with Lou Gehrig’s disease, they fight for military benefits as science hunts the cause , Josh Mitchell, Baltimore Sun, May 19, 2008 

ALS in the Military: Unexpected Consequences of Military Service, ALS Association, May 13, 2008  

Department of Veteran’s Affairs disability compensation program 

Gulf War veteran believes illness related to anthrax vaccine, Rick Wagner, Kingsport (TN) Times-News, Sept. 3, 2007 

Presumption of Service Connection for Amyotrophic Lateral Sclerosis, Final Ruling, Federal Register 

‘Young’ men got Lou Gehrig’s disease, Bob Evans, Daily Press, December 5, 2005

Kathlyn Stone

Kathlyn Stone is a Twin Cities, Minnesota-based writer who has covered general news, and business, international trade, and health care news and policies for public and professional audiences.