Conference Coverage

Malignant Pleural Mesothelioma (MPM): Analysis of Military Occupation Related to Asbestos Exposure and Subsequent VA Disability Entitlements in Veterans at the Boston VA (VABHS)

Abstract 57: 2016 AVAHO Meeting


 

Objective: Retrospective review of Veterans diagnosed with MPM looking at history of exposure to asbestos, military occupation, active duty service branch, and compensation for disability or ‘service connection’ (SC).

Background: Malignant Pleural Mesothelioma (MPM) is a rare disease that disproportionately affects Veterans. Untreated, this is a rapidly fatal disease with a 6 month median survival. Traditionally, an association between Navy service and MPM in veterans is well established. The Veterans Healthcare Administration (VHA) rewards a full, 100%, compensatory benefit known as SC disability for pleural neoplasms in the setting of asbestos exposure during military service. In 2012, Kuschner et al. from the Palo Alto VA reported that 6% (1/16) of MPM patients at their VA were even told about the possibility of compensation.

Methods: We offer open access, in-network, advice and therapy for Veterans within VHA nationally. After initial phone triage or e-consult, qualified Veterans register at the VABHS. A multidisciplinary team, including experienced MPM thoracic surgeons, pathologists and radiologists, reviews each case and tailor individual treatment plans.

Results: Between 2011 and 2016, we phone-triaged 73 Veterans with suspected MPM. 56 had confirmed MPM and half (50%) served in the U.S. Navy. 39% (16 Army, 3 Marines, 3 Air Force) served in ground or air combat units. There were 2 Veterans from the Coast Guard (4%) and 4 Veterans with unknown service branches (7%). 43 Veterans travelled an average of 1,031 miles to VABHS. 38 of these Veterans have biopsy-proven MPM, which the VHA defines as a disease rewarded 100% SC disability compensation. 3 Veterans are currently being processed by the VHA. There are still significant numbers of Veterans with MPM without SC (see Table 1.)

Conclusion: The majority of Veterans evaluated at the VABHS served in the Navy or Coast Guard, however 39% served in branches not traditionally associated with MPM. Surprisingly, many did not serve in traditional military occupations associated with asbestos exposure. There is an opportunity for improvement in recognizing a ‘service connection’ for veterans with MPM.

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