Initial Release Date:  February 11, 2011             SUBJ:  Training Guide for the readjudication of Claims for Ischemic Heart Disease (IHD), Parkinson’s Disease (PD), Hairy Cell Leukemia (HCL) and other Chronic B-cell Leukemias, and other Diseases Under Nehmer              On October 13th, 2009, Secretary Shinseki announced his intent to establish presumptive service connection for IHD, PD, and HCL for Veterans who served in the Republic of Vietnam.  This decision was based on the Institute of Medicine’s seventh biennial update, “Veterans and Agent Orange:  Committee to Review the Health Effects in Vietnam Veterans and Exposure to Herbicides.”  Under the court order of the U.S. District Court for the Northern District of California (the “Court”) in Nehmer v. U.S. Department of Veterans Affairs, 712 F. Supp. 1404, 1409 (N.D. Cal. 1989), VA must readjudicate previously denied claims for IHD, PD, or HCL filed by Nehmer class members (Vietnam Veterans and their survivors) and provide retroactive benefits pursuant to 38 C.F.R § 3.816.  This requirement involves claims filed or denied from September 25, 1985, to August 31, 2010, the date VA published the final regulation establishing a presumption of service connection for the foregoing diseases. Such claims may not be finally adjudicated until VA’s regulation change at 38 C.F.R. § 3.309(e) is final, which will add these three diseases to the list of diseases associated with herbicide exposure.                   Accountability Resource Centers and Regional Offices, who are responsible for the adjudication /readjudication of Nehmer claims, must strictly comply with the instructions set forth in this letter and the attached Training Guide.  It is critical that Nehmer claims be handled expeditiously and correctly.  The processing of Nehmer claims requires VA to operate under court-imposed deadlines.  Failure to comply with instructions could result in court-ordered sanctions against VA and/or VA officials.                            Regulatory Guidance A proposed regulation was recently published in the Federal Register Vol. 75, 14391 (March 25, 2010) that would amend 38 C.F.R. § 3.309(e) by adding IHD, PD, and HCL to the list of diseases presumptively associated with exposure to herbicides in Vietnam.  Publication of the final rule is expected in the near future.                             Whom to Contact for Help  If you have questions or need additional information, send your inquiry to your Veterans Service Officer (VSO). Click Here to Download Training Guide

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