1. What This Condition Is
Non-Hodgkin's lymphoma (NHL) is a cancer of the lymphatic system that begins in lymphocytes — the white blood cells that make up much of the immune system. Unlike Hodgkin's disease, which has a specific cellular pattern, NHL is an umbrella term covering more than 60 distinct subtypes, ranging from slow-growing (indolent) forms to aggressive, fast-spreading cancers. Symptoms include enlarged lymph nodes, fatigue, night sweats, unexplained weight loss, and recurrent infections.
Non-Hodgkin's lymphoma is one of the original 14 conditions listed as an Agent Orange presumptive under 38 CFR 3.309(e). Vietnam-era veterans exposed to tactical herbicides — including Agent Orange, Agent Blue, and Agent White — do not need to prove a direct medical connection between their exposure and their diagnosis. If you served in a location and time period that qualifies as herbicide exposure under VA regulations, service connection is presumed once you submit a confirmed diagnosis.
The presumptive also extends to veterans who served in certain locations beyond Vietnam: the Korean Demilitarized Zone (DMZ) between April 1, 1968 and August 31, 1971, Air Force veterans who handled or maintained aircraft sprayed with herbicides, veterans at specific stateside bases where herbicide testing occurred, and others identified under regulatory expansion under Public Law 117-168 (the PACT Act).
Blue Water Navy veterans — those who served on ships offshore rather than on Vietnamese land — are also covered under the Blue Water Navy Vietnam Veterans Act of 2019, which extended the presumptive to veterans who served in the territorial seas off the coast of the Republic of Vietnam.
2. VA Rating Criteria
Non-Hodgkin's lymphoma is rated under 38 CFR § 4.117, Diagnostic Code 7715. The rating schedule for lymphomas does not assign a single permanent disability percentage based on symptoms. Instead:
Active disease or treatment: NHL is rated as 100% during any period of active disease or during any treatment phase (chemotherapy, radiation, immunotherapy, or biological therapy). This 100% rating continues throughout the active treatment period.
Post-treatment evaluation: Following the completion of treatment, the 100% rating continues for a minimum of six months. After that period, the VA schedules a rating examination to assess residual disability. The veteran is then rated based on the functional impairment that remains.
Residual conditions: Common residuals after NHL treatment include fatigue, peripheral neuropathy from chemotherapy, immunosuppression, lymphedema, secondary organ damage, and secondary malignancy risk. Each residual is evaluated under the applicable diagnostic code. For example:
- Peripheral neuropathy from chemotherapy is rated under the appropriate peripheral nerve diagnostic codes based on severity of motor or sensory deficit.
- Lymphedema is rated under DC 7120 based on the degree of swelling and functional limitation.
- Fatigue and reduced stamina may be evaluated under the applicable systemic or general debility codes.
Veterans should not wait until all residuals stabilize before filing. The 100% rating during active disease and treatment begins from the date of diagnosis if claimed within one year of diagnosis, and effective dating is tied to the earliest date of claim or medical evidence supporting the diagnosis.
3. What to Expect at Your C&P Exam
For active disease or current treatment, the C&P exam confirms diagnosis, current treatment status, and prognosis. The examiner will review your oncology records and treatment history.
For a residual rating exam conducted after treatment, the examiner will assess your current functional status. Be prepared to describe the extent of fatigue, any neuropathy in hands or feet, any swelling in the limbs, immune system compromise, and the degree to which these residuals limit your daily function and work capacity. The examiner must document each residual condition separately and assign the appropriate diagnostic code.
If you were recently diagnosed and are actively receiving treatment, you do not need to wait until treatment ends to file. File immediately on diagnosis. The 100% rating is retroactive to the date of your earliest qualifying claim.
4. Evidence You Need to Win
Diagnosis: A pathology report confirming the NHL subtype, stage, and the treating oncologist's records. The diagnosis must be current — not simply a historical cancer that has been in remission for decades without ongoing residuals.
Service Record Evidence (Herbicide Exposure): Documentation establishing your service in Vietnam, the Korean DMZ during the qualifying period, or another location covered by the herbicide presumptive. For Vietnam service, the DD-214 showing service dates is generally sufficient. For Blue Water Navy veterans, ship logs or service records confirming vessel assignment to offshore waters are required.
No Nexus Letter Required for Presumptive Claims: If the herbicide presumptive applies, you do not need a physician to connect your NHL to Agent Orange exposure. The regulatory presumption substitutes for medical nexus. Document the diagnosis and the qualifying service and file.
Nexus Letter (Non-Presumptive Claims): Veterans who develop NHL through a different service-connected pathway — such as radiation exposure, occupational chemical exposure during service, or secondary to another service-connected condition — need a physician's nexus opinion. The letter must state "at least as likely as not" with a rationale.
DBQ Form: VA Form 21-0960C-8 (Hematologic and Lymphatic Conditions) or the cancer-specific DBQ for malignant tumors. Your oncologist should complete this form with current diagnosis, treatment status, and residual findings.
Residual Evidence: Medical records documenting current residuals after treatment: neuropathy evaluations, lymphedema measurements, fatigue assessments, and any secondary complications. These support separate ratings for each residual condition.
Personal Statement: Describe the functional impact of active disease and any residuals. For veterans in treatment, describe the effect of chemotherapy or radiation on your daily function, work capacity, and relationships. For veterans post-treatment, describe persistent residual limitations.
5. Secondary Conditions to Consider
Peripheral Neuropathy: Chemotherapy agents used to treat NHL — particularly platinum compounds and vinca alkaloids — cause peripheral neuropathy in the hands and feet. If you developed neuropathy during chemotherapy for NHL and the NHL is service-connected, the neuropathy qualifies for secondary service connection.
Lymphedema: Damage to lymph nodes during surgical biopsy, radiation, or lymph node dissection can produce persistent limb swelling. Secondary lymphedema is ratable under DC 7120 based on severity.
Depression and Anxiety: A cancer diagnosis and treatment course produce significant psychological burden. Secondary mental health conditions are ratable under 38 CFR 3.310.
Secondary Malignancy: Prior treatment with certain chemotherapy agents and radiation increases risk of secondary cancers. If a secondary malignancy develops and can be attributed to treatment for the service-connected NHL, secondary service connection may apply.
Immune System Compromise: Long-term immunosuppression from chemotherapy or the disease itself can result in chronic infections, secondary illnesses, and conditions that warrant separate evaluation.
Fatigue and Systemic Debility: Severe, persistent fatigue after cancer treatment can be evaluated separately if the general debility exceeds what is captured in any individual residual rating.
6. Common Mistakes That Kill Claims
Not filing immediately on diagnosis. The 100% rating during active disease is tied to the date of claim. A veteran who waits a year after diagnosis before filing loses retroactive benefits from the months between diagnosis and filing. File immediately.
Assuming presumptive service connection means the VA will automatically find you. The VA does not proactively identify veterans who qualify for presumptive conditions. You must file the claim yourself. Having served in Vietnam is not enough — you must submit the claim.
Failing to claim residuals separately. After treatment ends and the 100% rating is reviewed, many veterans receive a 0% residual rating without realizing they have compensable neuropathy, lymphedema, or persistent fatigue. Each residual is its own claim and must be documented separately.
Not pursuing Blue Water Navy coverage. Offshore Vietnam veterans who were denied claims before 2019 may be entitled to reopen those claims under the Blue Water Navy Vietnam Veterans Act. File a Supplemental Claim if you were previously denied under the old rule.
Failing to document herbicide exposure for locations beyond Vietnam. Veterans who served at qualifying stateside bases or in the Korean DMZ during the presumptive period must establish their location through service records. This is a documentation requirement, not a medical one.
7. FWD Assist Resources
The following FWD Assist HQ books are directly relevant to a Non-Hodgkin's lymphoma claim:
- Agent Orange: The Complete Vietnam Veterans Claims Guide — comprehensive coverage of every presumptive condition, herbicide exposure locations, Blue Water Navy provisions, and how to file a presumptive claim
- C&P Exam Prep Guide — covers what to expect at a cancer residual exam and how to document each residual condition for the rating evaluation
- Secondary Conditions Guide — walks through chemotherapy neuropathy, lymphedema, and secondary mental health chains from a service-connected cancer
- The PACT Act Playbook — covers the expansion of presumptives and exposure locations under Public Law 117-168
All titles are available at fwdassisthq.com.
8. Get Help Without a Claim Shark
Free, accredited help is available through Veterans Service Organizations including the DAV, VFW, American Legion, and AMVETS. County Veterans Service Officers (CVSOs) file and manage claims at no cost.
Charging upfront fees to assist with a VA claim is illegal under 38 U.S.C. § 5905. VA-accredited attorneys and claims agents may charge fees only after an initial VA decision, capped at 20% of past-due benefits under 38 U.S.C. § 5904. No legitimate representative asks for money before your first decision.
Verify accreditation at va.gov/ogc/accreditation.asp.