Even if the National Academy of Medicine’s forthcoming report does find definitive evidence of a link between Agent Orange and esophageal cancer, that’s no guarantee the disease will be added to the list of approved service-related illnesses.
Though the academy’s past reports have recognized 50 diseases that fall under the “limited or suggestive” evidentiary category, the VA has only approved 14. Hypertension and bladder cancer are two examples of diseases the academy listed in its 2016 report as having some research suggesting a link with service exposure, but which the VA has thus far not added.
In some cases, the resistance to adding more to the list has not been the VA but rather the Office of Management and Budget. The federal agency, known as OMB, controls the VA’s purse strings and has in the past been hostile to the idea of adding costs to the budget for veterans services. In March, now-dismissed VA Secretary David Shulkin told the Senate Veterans Affairs Committee that he had recommended adding a handful of conditions to the list in a request to OMB last fall, but the agency was still looking at data and reviewing financial estimates.