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A Cruel Joke From The VA and Congress

At least with a real joke, you get to laugh. Here, the government seem to laugh at you.

At least with a real joke, you get to laugh. Here, the government seem to laugh at you.


Veterans cheered! The “Honoring the  PACT Act” passed in 2022!  

Finally, a law that cements the presumption that their high blood pressure was caused by Agent Orange, the toxic defoliant that was sprayed liberally and carelessly, especially in Vietnam. After decades of fighting for the inclusion of Agent Orange as a presumptive cause of hypertension, the vets would get their due, a disability rating and a disability payment. Hoorah!

But there was a catch in that PACT Act. As always, it's in the fine print. As a veteran, you could apply for disability under the Act if you had high blood pressure, even if you were medicated for it. But veterans who are already being treated for high blood pressure are evaluated for disability ON THEIR BLOOD PRESSURE READINGS AS CONTROLLED BY MEDICATION, almost guaranteeing a disability rating of 0%. 

“Your hypertension must be rated at 10 percent or higher to receive monthly compensation— though a 0 percent rating still qualifies you for health care and other ancillary benefits.”   (Source: Joye Law Firm)

Therefore, at a disability rating of 10% (refer to the chart above), you can receive a disability check of about $165/month in 2023. Hypothetically, a Vietnam veteran who had never been treated for hypertension, may well qualify based upon a worsening condition that was unknown or ignored for decades. If you took care of yourself and got treatment, your “disability,” according to the VA, is valid but not enough for compensation. As such, I do not qualify. As a Veterans Service Officer wrote to me recently about my own situation, “You were in the wrong place at the wrong time and have hypertension.”  

I do not need the money. What I can say is that there are tens of thousands of very deserving veterans, maybe more, who will not be getting even the $165/month because of this bureaucratic mumbo jumbo. Therein lies the cruel joke; yet another corollary to Catch-22.  

American Heart Association Blood Pressure Chart

Qualifying for a VA disability due to hypertension is already a difficult climb, as you have seen by the chart at the top of this article. If you have those numbers while already receiving treatment, you are likely to soon be dead, or you have an incompetent doctor, or both. At left is a chart by the American Heart Association that recently LOWERED the readings for having high blood pressure and being at increased risk of BP related diseases. The Heart Association numbers fly in the face of the VA chart, whose astronomical PB readings are necessary in order for it to be considered a disability.  

If all of this makes your head want to explode, you can do further reading here which goes into diagnostic codes and other such argle-bargle. Your teeth may itch as you read this:

“In general, a rating for a disability will not be based on whether or not medication is helping the disability.  However, the Court has stated that a Veteran may not be denied entitlement to a higher rating on the basis of relief provided by medication when “those effects are not specifically contemplated by the rating criteria.” So, if the rating criteria considers whether or not medication helps with the disability, the rating will only be determined based on the evidence of the disability after medication, not based on non-medicated symptoms.  Hypertension is rated under 38 C.F.R. § 4.104, under diagnostic code 7101. The Court has stated that diagnostic code 7101 DOES contemplate the effects of medication.”

Not sure which “Court” decided this but the logic mirrors decisions I have seen regularly on Judge Judy.

In spite of all this, I encourage all my fellow veterans to apply to the VA for this disability rating under the PACT Act. You can also write to your senator or representative in the U.S. Congress. Write letters to your local newspaper and call out the VA and Congress on this bait and switch. Unless you call them out, they will continue to crow about their great but phony accomplishments, like this one, in supporting the troops.  

[Disclaimer:  I am a member of the Whatcom Veterans Advisory Board but am speaking solely for myself in this article. ]

Comments by Readers

David A. Swanson

Feb 27, 2023

You nailed the paradox as well as Doc Daneeka nailed it for Yossarian.


Dick Conoboy

Feb 27, 2023


I did actually attempt to rewrite the famous Catch 22 paragraph using the Agent Orange presumption, which turns out to be bogus for its stated purpose, however, the concept did not lend itself to the re-write. I was reminded however of Schroedinger’s Live/Dead Cat.  Essentially hitting the send button on the VA site to claim a hypertension disability is comparable to collapsing the wave function.  But with the VA and hypertension, the “disability cat” is almost always dead.  


Dick Conoboy

Feb 27, 2023

My apologies to my readers out there in the science community who may percieve, with reason, that my “cat” analogy is imperfect or worse.  But I fall back on the use of the many versions of hyperbole, a known writers gimmick to get the point across. 


M. Lynda Hanscome

Feb 27, 2023

Paradox is an excellent use of the word, David.


Thomas R. Scott

Feb 27, 2023

Frankly, typical.

I am grateful that a defoliant was used to open fields of fire around the bases my father inhabited rather than have folks undetectable “right up to the wire”, regardless of some of the ill health effects to Dad.

However, that does not change the debt our country owes to those who served, including doing our best to treat any and all injuries and ill effects they received while in our service, especially those stemming from a function of their services provided.  That includes friendly fire, Agent Orange, et cetera.

This bait and switch is not out of the norm for Congress.  While everyone I have come into contact at the VA are stellar folks, that has not meant that structures put up by Congress to avoid fulfilling their/our side of the contract has been stellar as facilitated by the VA.  (Luckily, for my Dad, we have not had to deal with some of the craven among some VA hospital administrators.)

Anecdotal case in point:  Dad broke his arm near the shoulder.  No cast was feasible, only a sling.  Fair enough.  Further, at first, the break while crazed (such as in pottery) looked reasonably OK for a couple weeks.  However, it then rapidly started disintegrating as Dad’s body had a calcium issue.

The BAD / FRUSTRATING part was that his bone Doc prescribed a bone generator, which all the docs involved felt was the best / only chance for Dad’s body to repair the bone.  Tricare for life would have paid the paultry $700-$800 for the bone generator, except Dad was/is old enough for Medicare.  Even though Medicare serves as his “secondary” insurance, Tricare goes by Medicare standards wherever they are more restrictive than Tricare’s.  Medicare requires that a bone break exist for 90 days BEFORE a bone generator may be purchased and applied.  That is several (6+) weeks AFTER which the break would have “healed” in whatever condition it would be in, and on a path to amputating his left arm.

Dad lucked out, no thanks to his military retirement “guaranteeing” medical for life (after multiple wars and “police actions”), we found a food and supplement based method to boost his body’s failing ability to process calcium as a long shot that ... worked.

Another issue:  Tricare used to cover his dental.  While he was hospitalized, Tricare split that off to another government carrier but did not get Dad enrolled.  He has been paying his “covered” dental ever since and they will not allow enrollment outside a brief window regardless that his effective disenrollment was performed by them without his knowledge.


Dick Conoboy

Feb 27, 2023


When I received my commission in the Army in 1965,  Congress was already meddling in a system wherein retired military had care for life in military hospitals that you allude to.  Then space in these hospitals was declared “inadequate” but instead of making the military hospitals adequate, several pieces of legislation in the 50s and 60s started the “contracting out” of medical service for retirees with CHAMPUS and then Tricare.  Private health insurance corporations have now infiltrated the medical care for retired military as is happening with Medicare and its privatization under Medicare Advantage and ACO Reach.  It is apparent to all but the deliberately disinterested or unconscious that the US Government is absolutely committed to privatization of all health care in the US.  Democrats and Republicans are equally complicit in this wretched scam.   


Thomas R. Scott

Feb 28, 2023

Nothing privatized for Dad at the moment.  It’s all Grade-A Congressional Health Uncare.

You reminded me of another fun bit (Champus) with the medical for life promised to Dad and his dependents.  Our family retired to Anacortes in 1973, partially because NAS Whidbey was nearby and we could use Dad’s full medical, vision and dental benefits for him, medical for Mom and I until I would age out in college.

It did not work out that way, however, a few years later, like many other base and camp hospitals, Whidbey ceased taking dependents then retirees somewhere around 1980-1982.

We were directed to Champus.  However, Dad was not eligible for Champus because we BARELY lived within 40 or 42 (I forget which was the regulation distance) miles of the Naval Hospital.  We were less than a mile in side that radius at that.  While that was technically true “as the crow flies” the distance by road was actually farther.  Bottom line, Champus refused Dad because we lived too close to a hospital that would not provide any services.

Thus, Dad and Mom were out of pocket for all their medical, vision and dental until they aged out of Champus and into Tricare for Life and Medicare.


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