Acinic Cell Carcinoma, a Presumptive Condition Under the Pact Act

Military service often comes with the devastating possibility of toxic exposure. While most people understand that men and women of the armed forces are at greater risk than the civilian public they protect, the fact that they may face toxic exposure during service is, most of the time, a vague concept. Moreover, exposure to toxins in their daily work environment or living conditions is often a hidden risk for most enlistees.

Some occupational specialties carry particular risks, including exposure to dangerous toxins in proximate environments, laying the base for some veterans' health-related hardships upon returning to civil life. It only adds to the situation's severity that some former service members may have been exposed to more than one type of toxins deriving from:

• asbestos
• chemical weapons agents
• silica dust
• nuclear radiation
• contaminants in the water, air, or soil
• firefighting foam or AFFF

Exposure to these hazardous elements may result in illnesses with immediate symptoms, or they could cause long-term signs that go unnoticed until significant health concerns arise, such as cancers. One of the conditions related to toxic exposure and only recently declared malignant is acinic cell carcinoma (ACC), or tumor of the salivary glands. ACC is also a head and neck tumor, an adenocarcinoma occurring in the submandibular gland and minor salivary glands of the palate. Even if it represents only 1-3% of salivary gland tumors, ACC drew the medical world's attention due to its high rate of recurrence, particularly in military personnel. These illnesses are categorized based on location, histology, and the type of cell where the cancer began:

• mucoepidermoid carcinoma
• adenoid cystic carcinoma
• polymorphous adenocarcinoma

The most common type is mucoepidermoid carcinoma, which accounts for 30-40% of all cases. ACC often develops in the major salivary glands in the front and below the ears (parotid glands), but it can also develop in the:

• submandibular gland below the jawline
• other minor salivary glands dispersed throughout the mouth
• sublingual gland under the tongue

Although medical professionals consider ACC low-grade cancer that doesn't tend to be aggressive, this malignancy has a more aggressive form that spreads rather rapidly through the bloodstream, producing metastases in the:

• bone
• liver
• brain
• thyroid
• spleen

However, due to its slow development, people often receive the diagnosis before it spreads, and it's treatable with surgery alone in most cases. Potential signs and symptoms of salivary gland cancers, including ACC, are:

• muscle weakness on one side of the face
• numbness in part of the face
• ongoing pain near a salivary gland
• trouble opening the mouth widely
• trouble swallowing
• lump or swelling on or near the jaw or in the neck or mouth

The exact cause of ACC is unknown, but healthcare professionals have identified some factors that raise the risk of salivary gland tumors:

• airborne hazards exposure in the military, like the toxic burn pits
• workplace exposure to certain substances
• radiation therapy for cancer
• smoking

Occupational exposures potentially leading to salivary gland tumors include hazards such as:

• asbestos
• lead
• rubber and plastics manufacturing materials

Rare Cancers Warrant Presumption of Service Connection

After reviewing scientific and medical evidence, the VA determined a plausible link between airborne hazards and the development of respiratory tract cancers, and found that the unique circumstances of rare cancers call for a presumption of service connection. Similarly, the rarity and severity of specific head and neck cancers warrant service connection.

By VA definition, airborne hazards refer to any contaminants or potentially toxic substances that veterans are exposed to through inhalation. While on active duty, military service members may have been exposed to a large variety of hazardous particulate matter, including:

• asbestos from old building materials
• smoke and fumes from open burn pits
• sand, dust, and particulate matter
• general air pollution in certain countries
• fuel, aircraft exhaust, and other mechanical fumes
• smoke from oil well fires

Veterans diagnosed with ACC can apply for disability benefits under the PACT Act because the VA includes this illness under the presumptive conditions for head cancers - malignancies located in the:

• scalp
• face
• mouth
• aural areas
• lips
• hard or soft palate

Consequently, rare cancers included in the mouth, neck, and throat category are:

• hypopharyngeal cancer - a rare throat cancer that forms in the lower part of the throat
• jaw cancer - several types of cancer that develop in the mouth's jawbone, teeth, or soft tissues.
• laryngeal cancer - a rare type of throat cancer, a malignancy that affects the voice box or larynx
• oral cavity squamous cell carcinoma - or floor of the mouth cancer
• oropharyngeal cancer - affects the oropharynx, the middle part of the throat
• pharyngeal cancer - develops in the hollow, cone-shaped tube between the nose and esophagus.
• salivary gland cancer - including ACC
• thyroid cancer - forms from the tissues of the thyroid gland
• tongue cancer - also known as oral cavity cancer

Additionally, the VA also considers the following skin cancers of the mouth and neck presumptive:

• basal cell carcinoma of the skin
• squamous cell carcinoma of the skin
• melanoma

Qualifying For VA Disability Under the Pact

As of March 2024, the Vietnam War, the Gulf War, Iraq, Afghanistan veterans, or those who fought in the Global War on Terror or other combat zones after 9/11 qualify to apply directly for VA health care without first applying for VA benefits. Moreover, veterans who never deployed but suffered toxic exposure while training or on active duty in the U.S. can also enroll.

Additionally, any veteran of any era, even service members still on active duty, can apply and qualify for VA health care while a claim is pending. Eligibility for VA health care is determined separately from disability claims, and many veterans qualify based on their service history, income level, or service-connected disabilities. To be eligible for VA disability under the PACT Act, veterans should meet the following criteria:

• have a diagnosed condition caused by exposure to a specific toxic contaminant in the air, soil, or water
• have served on active duty in a location that caused his exposure
• have not received a dishonorable discharge

Furthermore, to ensure a successful claim, veterans are advised to prepare before starting a VA disability application by:

• finding out information about their qualification for VA disability compensation by checking eligibility
• filling out the claim entirely
• gathering any supporting documents and sending in all the evidence along with the claim at the same time
• checking before filing if there's a need to turn in any additional forms with the claim

Offering Help for Veterans Injured by Toxic Exposure

The new legislation known today as the PACT Act guarantees care and benefits for former service members who suffer the impacts of their exposure to contaminants like asbestos and other toxins while serving America, helping improve the lives of veterans or their survivors.

One of the greatest things about the PACT Act is that there's no time limit for filing a claim for presumptive service connection under this law. However, to ensure all necessary criteria are met and to secure all possible retroactive payments, the help of a legal specialist is highly recommended.

Besides collecting all necessary papers and crucial information for a smooth filing process, a toxic exposure attorney will ensure that your claims meet VA regulations. We can help you contact legal experts ready to represent your case.