Parents usually assume any VA help for a child with a birth defect flows through the veteran's own rating. Chapter 18 works the other way: spina bifida and CWVV benefits are paid directly to the child, for life in most cases, and the veteran does not need to be rated, or even living, for the child to qualify. Qualifying service in the right place and window is the only veteran side requirement.
Who these benefits are for
Some of the veterans we hear from did not realize that VA recognizes a separate set of benefits for their children when the child was born with certain birth defects. The benefits are not part of the veteran's own disability rating. They are payable directly to the child (or to a guardian if the child is a minor or under a legal disability), they continue for the child's lifetime in most cases, and they cover monthly money, health care, and vocational training.
This article walks through the three big programs.: Agent Orange spina bifida, the Children of Women Vietnam Veterans (CWVV) program, and the Camp Lejeune Family Member Program. It ends with what to file and where to send it.
This is educational. It is not legal advice and not a recommendation.
Program 1, Spina bifida for children of Vietnam, Korean DMZ, and Thailand veterans
The rule: 38 CFR 3.814 and 38 USC chapter 18.
Who is covered: Biological children of veterans who served in:
- The Republic of Vietnam during the Vietnam War (Jan 9, 1962, May 7, 1975), or
- Certain units along the Korean DMZ between Sep 1, 1967 and Aug 31, 1971, or
- Royal Thai Air Force Bases (Ubon, Udorn, Nakhon Phanom, Korat, Takhli, U-Tapao, Don Muang) and certain perimeter assignments from Jan 9, 1962 to May 7, 1975.
What counts as spina bifida for VA purposes: All forms except spina bifida occulta. That includes meningocele, myelomeningocele, lipomyelomeningocele, and tethered cord. The "occulta" exclusion exists because that form is asymptomatic and very common.
What the child gets:
- Monthly monetary allowance at one of three levels (Level I, II, or III) depending on functional impairment. Level III is the highest and is paid for severe impairment.
- VA health care for any condition associated with the spina bifida.
- Vocational training with monthly subsistence, similar to Chapter 31 voc rehab for veterans.
How to file: VA Form 21-0304, Application for Benefits for Certain Children with Disabilities Born of Vietnam and Certain Other Veterans. Mail to the Denver, Colorado VA Regional Office (the Denver RO handles all chapter 18 claims for the country).
Important: The child does not need to be a dependent of the veteran to qualify, and the veteran does not need to be alive or service connected for any specific condition. Service in the qualifying location is the only veteran-side requirement.
Program 2, Children of Women Vietnam Veterans (CWVV)
The rule: 38 CFR 3.815 and 38 USC chapter 18.
Who is covered: Biological children of women who served in the Republic of Vietnam during the Vietnam War, born with one of the listed covered birth defects.
The 18 covered birth defects (paraphrased.; the regulation lists each by clinical name):
- Achondroplasia (a form of dwarfism)
- Cleft lip and cleft palate
- Congenital heart disease
- Congenital talipes equinovarus (clubfoot)
- Esophageal and intestinal atresia
- Hallerman-Streiff syndrome
- Hip dysplasia
- Hirschsprung's disease (congenital megacolon)
- Hydrocephalus due to aqueductal stenosis
- Hypospadias
- Imperforate anus
- Neural tube defects (other than spina bifida)
- Poland syndrome
- Pyloric stenosis
- Syndactyly (webbed or fused fingers or toes)
- Tracheoesophageal fistula
- Undescended testicle
- Williams syndrome
*What is not covered:* Conditions that are familial, hereditary, or that result from a known birth-related injury (other than the listed conditions). The presumption is that the listed conditions are connected to the mother's service.
What the child gets:
- Monthly monetary allowance at one of four levels based on functional impairment.
- VA health care for the covered birth defect and any associated condition.
- Vocational training, when feasible.
How to file: VA Form 21-0304a, Application for Benefits for Certain Children of Women Vietnam Veterans Born with Certain Birth Defects. Also goes to the Denver Regional Office.
Program 3, Camp Lejeune Family Member Program (CLFMP)
The rule: 38 USC 1787 and the VA's CLFMP regulations.
Who is covered: Family members who resided at, or were in utero while their mother resided at, Marine Corps Base Camp Lejeune or Marine Corps Air Station New River for at least 30 days between August 1, 1953 and December 31, 1987.
This includes children who were in utero during that window, which is why CLFMP frequently comes up in conversations about birth defects.
The 15 covered conditions (the same list the VA uses for veteran presumptives plus a few water-contamination-related conditions):
- Bladder cancer
- Breast cancer
- Esophageal cancer
- Female infertility
- Hepatic steatosis (fatty liver)
- Kidney cancer
- Leukemia
- Lung cancer
- Miscarriage
- Multiple myeloma
- Myelodysplastic syndromes
- Neurobehavioral effects
- Non-Hodgkin lymphoma
- Renal toxicity
- Scleroderma
What the family member gets:
- Reimbursement of out-of-pocket medical expenses for the covered conditions, retroactive in some cases to the date services were rendered, subject to VA being the payer of last resort (so private insurance, Medicare, and Medicaid pay first).
- This is not a monthly check. It is a medical-cost reimbursement program.
How to file: VA Form 10-10068, Camp Lejeune Family Member Program Application. Mail or upload to the Health Administration Center in Denver.
Camp Lejeune lawsuits (separate path)
The Camp Lejeune Justice Act of 2022 created a separate path for family members (including children in utero during the contamination window) to file a tort claim in the Eastern District of North Carolina federal court for compensation. The deadline window for filing was generally two years from the date of enactment, and family members should consult an attorney familiar with the Act for current deadlines and procedure.
This is separate from VA benefits. A child or surviving family member can pursue both, VA's Camp Lejeune Family Member Program reimbursement and a federal lawsuit, without the two paths offsetting each other in most cases.
What about CHAMPVA?
CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs) is a separate health-care program for the family members of a veteran who is:
- Permanently and totally service connected disabled,
- Rated permanent and total at the time of death,
- Died from a service connected condition, or
- Was killed in the line of duty.
CHAMPVA is not limited to birth defects, but it is the program that frequently pays health care for the children of severely disabled veterans, including children with congenital conditions that may or may not be connected to the veteran's service.
To apply: VA Form 10-10d, Application for CHAMPVA Benefits.
How to organize the claim
- Confirm qualifying veteran service (Vietnam, Korean DMZ, Thailand, or Camp Lejeune in the right window). Get the DD-214 and a unit history if needed.
- Confirm the diagnosis with current medical records. Spina bifida occulta is not covered for chapter 18 benefits.
- Pick the right form:
- Spina bifida (any veteran): VA Form 21-0304 - CWVV birth defect (women Vietnam veterans): VA Form 21-0304a - Camp Lejeune family member: VA Form 10-10068 - CHAMPVA: VA Form 10-10d
- Send to Denver. All chapter 18 claims and CLFMP claims are processed centrally in Denver.
- Keep copies of everything. Document the date you mailed or uploaded each form.
Important limitations to know
- Chapter 18 benefits go to the child. The veteran cannot collect them on the child's behalf as part of the veteran's own disability rating.
- Higher level allowances under spina bifida (Level II and III) require an updated medical-functional assessment. If the child's condition is severe, request the assessment.
- Camp Lejeune Family Member Program is reimbursement, not a monthly check.
- The Camp Lejeune Justice Act lawsuit path is separate and has its own filing deadlines.
Getting help with the claim
These claims can be complex, especially when more than one program is in play. A VA accredited attorney, claims agent, or VSO can help structure the claim. The Find Help directory on this site lists accredited representatives by state. Sponsorship of a listing does not imply endorsement.
Sources
- 38 CFR 3.814 (spina bifida monetary allowance)
- 38 CFR 3.815 (CWVV covered birth defects)
- 38 USC chapter 18 (statutory authority for both)
- 38 USC 1787 (Camp Lejeune Family Member Program)
- VA.gov, Children with Disabilities Born to Vietnam and Certain Veterans
- VA.gov, Children of Women Vietnam Veterans (CWVV) Program
- VA.gov, Camp Lejeune Family Member Program
- Camp Lejeune Justice Act of 2022 (Honoring Our PACT Act, sec. 804)