Introduction – You’re Not Crazy, and You’re Not Alone

If you’re reading this, there’s a good chance you’ve been fighting for years — filing claims, getting denied or deferred, watching your body break down piece by piece, and still not getting real answers.

You’ve probably heard things like:

• “There’s no chronicity in your service records”

• “This is just normal aging”

• “We need more evidence”

• Or worse… nothing at all. Just silence and another denial.

You’re not imagining this. And you’re not the only one.

A lot of veterans from our era — especially those who worked in motor pools, maintenance, recovery operations, ship engine rooms, aircraft or around heavy equipment — were exposed to a chemical called trichloroethylene, (TCE). It was the standard solvent used for cleaning parts, tools, and even our own hands and arms. Many of us also lived in base housing or nearby towns where the water was contaminated.

For decades, the connection between that exposure and the autoimmune diseases, joint destruction, neurological problems, kidney issues, and other conditions we’re now dealing with was hidden or ignored.

This chapter is for veterans who suspect there might be more to their story — or who are just now starting to wonder why their claims keep getting denied while their health keeps getting worse.

We’re going to walk through exactly how to investigate whether TCE played a role in your conditions, how to document it properly, how to get the medical evidence you need, and how to build a claim that actually gives the VA what it needs to approve it.

This isn’t about theory. It’s about what actually works.

If you’ve ever felt like the system is stacked against you… you’re right. But that doesn’t mean you can’t win. It just means you have to build your case smarter and stronger than before.

“Let’s get to work.”

Documenting Your Exposure

Before you can build a strong claim, you need to clearly show how you were exposed to TCE. The VA often denies these claims because veterans don’t connect the dots between their daily duties and the chemical they were working with every day.

TCE (trichloroethylene) was the standard solvent used across all branches of the military for cleaning parts, tools, engines, and even hands and arms. If you worked in maintenance, motor pools, recovery operations, engine rooms, aircraft or around heavy equipment, there’s a very good chance you had regular, direct contact with it.

When Was TCE Used?

TCE was widely used as a degreaser from the 1950s through the mid-to-late 1980s. During this time, it was common to see open vats or buckets of TCE in motor pools and maintenance shops. Many veterans cleaned parts by dunking them in the solvent or wiping them down with rags soaked in TCE. It was also common practice to wash grease and oil off your own hands and arms with the same solvent.

Even after the military began reducing the direct use of open TCE vats in the late 1980s and early 1990s, the damage had already been done. For decades, improper disposal practices — dumping used solvent on the ground, into drains, or into landfills — caused widespread contamination of soil and groundwater. This contamination often lasted for many years after active use slowed down.

A well-known example is Camp Lejeune, where TCE and other chemicals contaminated the drinking water from the early 1950s until the most contaminated wells were finally shut down in 1985 (with some continued use into 1987). Many other bases across the country had similar problems with long-term groundwater contamination from years of improper disposal.

This matters because even if you served later in the 1980s or early 1990s and didn’t personally use open TCE vats every day, you may still have been exposed through contaminated drinking water or by working in areas where the ground and water were already polluted from earlier years.

Occupational Exposure (What You Did at Work)

Start by asking yourself these questions:

• What was your MOS (job)?

• Did you work in a motor pool, maintenance shop, or recovery unit?

• Did you clean parts, tools, or vehicles?

• Was there a vat, bucket, or container of solvent that everyone used?

• Did you ever clean your hands and arms with the same solvent used on the equipment?

• Did you work around cosmoline (the heavy grease that covered new equipment and vehicles)?

Write down your answers. Be specific. Instead of saying “I was a mechanic,” try to remember details like:

• “I worked in the motor pool at Fort Lewis as a recovery vehicle operator and track vehicle mechanic from 1973 to 1975 and again from 1978 to 1979. We used an open vat of TCE daily to clean tools, parts, and our hands after working on vehicles.”

• “At Aberdeen Proving Ground during AIT in late 1972, we used TCE in open containers to clean equipment as part of our training”, etc.

Even small details matter. The more specific you can be about your daily duties and the years you served, the stronger your claim becomes.

Residential / Family Exposure

Many veterans were also exposed at home:

• Did you live in base housing or off-base housing near the base?

• Was your housing near a motor pool, maintenance area, or known disposal site?

• Did your family use well water or was the water supplied by the base?

• Did you bring work clothes home for your spouse to wash?

If your wife or children later developed autoimmune issues, joint problems, or other health conditions, this can also support your claim. Secondary exposure was real — TCE came home on your clothes and skin, and in some cases, it was in the drinking water where your family lived.

How to Find Evidence of Exposure

You don’t need to have an official document that says “TCE was used here.” Many veterans win claims without that. Look for:

• Your own service records and performance evaluations (sometimes they mention duties or locations)

• Old photos of your unit, shop, or equipment

• Buddy statements from others who worked with you

• Base environmental reports (many are now public)

• Any mention of “solvent,” “degreaser,” or “cleaning agent” in your records

Even if you can’t find official proof that TCE was used at your specific base, the fact that it was the standard military solvent for decades helps. Combined with a good description of your duties and the years you served, this can be enough.

Buddy Statements

A buddy statement from someone who worked with you can be very powerful. Ask them to write what they saw — not just “we used solvent,” but what it looked like:

• Was it in an open vat or bucket?

• Did people clean their hands and arms with it?

• How often was it used?

• Did it have a strong smell?

The more specific and honest the statement, the better.

Quick Summary of Documenting Your Exposure 

Write down your MOS, your actual daily duties, the places and years you served, and any details about cleaning solvents or chemicals. Add any residential exposure your family may have had. This becomes the foundation of your claim.

Getting a Strong Nexus Letter

A strong nexus letter is often the single most important piece of evidence in a TCE claim.

A nexus letter is a written statement from a medical professional that connects your current medical conditions to your military service — specifically to your exposure to TCE. Without a good nexus letter, even strong medical evidence can be denied because the VA needs a doctor to clearly link the two.

The legal standard the VA uses is “at least as likely as not.” This means the doctor does not have to be 100% certain. They only need to say that it is at least 50% likely that your conditions are caused by or aggravated by your TCE exposure.

What Makes a Strong Nexus Letter?

A good nexus letter for a TCE claim should:

• Clearly state your exposure history (what you did, where you served, how often you were exposed)

• List your current diagnoses

• Explain how TCE is known to cause or aggravate those conditions (autoimmune activation, chronic inflammation, impaired healing, etc.)

• Uses the correct legal language (“at least as likely as not”)

• Reference relevant medical and scientific studies on TCE

• Be signed by the doctor (MD or DO preferred)

A weak or generic letter that just says “this veteran has these conditions” without connecting them to TCE will usually get denied.

How to Get a Strong Nexus Letter

Most veterans have the best success when they prepare a clear, organized packet for their doctor before asking for the letter. Doctors are busy. The easier you make it for them, the more likely they are to write a strong letter.

Here’s what you should give your doctor:

• A short summary of your exposure (MOS, duties, locations, years)

• Copies of your key service records showing your duties

• Your current medical records and test results (especially autoimmune labs)

• A list of your diagnosed conditions

• Scientific references on TCE health effects (we can provide these)

• 6. A draft or bullet-point outline of what you would like the letter to include

Some doctors are willing to write the letter themselves once they have the information. Others prefer that you provide a draft they can edit and sign. Either way is fine — what matters is that the final letter is clear and well-supported.

Choosing the Right Doctor

Not every doctor is comfortable writing nexus letters, especially on toxic exposure cases. Here are your best options:

• Your primary care physician — Many veterans successfully start here. If your PCP already knows your history and is open-minded, they can be a strong choice.

• A rheumatologist, neurologist, or environmental medicine doctor (if possible)

• A doctor who is willing to review the science on TCE

Important reality check: Unfortunately, many doctors today — especially those working in large corporate or protocol-driven systems — are locked into strict guidelines and will only follow official VA or insurance protocols. They often refuse to consider toxic exposure connections or write nexus letters, even when the science is clear.

I was fortunate that my VA primary care physician was more of a naturalist and understood that my conditions were TCE-induced. That kind of doctor is becoming harder to find. If your current doctor is not willing to help, don’t take it personally — it’s often the system, not you. Many veterans have had to seek out private doctors who are more open to looking at the full picture.

Important Tips

• Be honest and accurate. Never ask a doctor to say something that isn’t true.

• The letter should focus on your specific conditions and exposure history.

• A well-written nexus letter can overcome weak or missing service treatment records.

• You can submit more than one nexus letter if you have support from multiple doctors.

Quick Summary of Getting a Strong Nexus Letter 

A strong nexus letter from a doctor who understands TCE is often the most powerful piece of evidence you can submit. Prepare a clear packet for your doctor and make it easy for them to help you. Be aware that many corporate/protocol-driven doctors will not assist with this type of letter.

Writing a Powerful Personal Statement

Your Personal Statement is one of the most important documents in your claim. While medical records and nexus letters provide the clinical evidence, the Personal Statement is where you get to tell your story in your own words. It’s often the first thing a rater reads, and it can make a big difference in how they understand your case.

A strong Personal Statement does three things:

• Clearly explains your exposure to TCE

• Connects that exposure to your in-service injuries and current conditions

• Shows how your life has been affected

The VA reads hundreds of claims. A well-written, organized Personal Statement helps your claim stand out and makes it harder for them to dismiss or lowball it.

What Makes a Strong Personal Statement for a TCE Claim?

For TCE-related claims, your statement should focus on these key points:

• Your exposure history — Be specific. Describe your MOS, your actual daily duties, the locations you served, and how often you were exposed to TCE (open vats, cleaning parts and tools, cleaning your hands and arms, working around cosmoline, etc.).

• Old injuries that never fully resolved — If you had injuries in service (neck, back, hips, knees, etc.) that were previously denied or rated low, explain them here. Describe how they never fully healed and how they have progressively worsened over the years.

• The TCE Effect — Explain how TCE exposure and the resulting autoimmune dysregulation and chronic inflammation have aggravated your old injuries and created new problems. Use clear, simple language.

• Current conditions and daily impact — Describe what you’re dealing with now (pain levels, mobility issues, limitations in daily activities, etc.) and how it affects your quality of life.

• Timeline — Show the progression. Many raters respond better when they can see that problems started in service and have steadily worsened over time.

Recommended Structure

Keep your statement organized and easy to follow. A simple structure works best:

• Introduction — Who you are, when and where you served, and a brief overview of your exposure.

• Exposure Details — Specific duties and how you were exposed to TCE.

• In-Service Injuries — Any injuries that occurred during service that never fully resolved.

• Progression Over Time — How your conditions have worsened, especially in recent years.

• Current Impact — How your conditions affect your daily life today.

• Closing — A short summary of what you’re asking for and why you believe it’s connected to your service.

Important Tips

• Be specific, not dramatic. Use facts and clear descriptions. Avoid overly emotional language.

• Use your own words. Don’t copy someone else’s statement. The VA can often tell when a statement sounds like it was written by someone else.

• Keep it organized. Use short paragraphs and clear sections if it helps readability.

• Be honest. Never exaggerate or include things that aren’t true. One inconsistency can damage your entire claim.

• Length — Most strong statements are 3–6 pages. Long enough to tell your story clearly, but not so long that it becomes repetitive.

Connecting Old Injuries to TCE

This is one of the most important parts for many veterans. If you had injuries in service that were previously denied, use your Personal Statement to explain how TCE exposure and autoimmune dysregulation have aggravated those old injuries over time. This is often the key to reopening or substantiating older claims.

Quick Summary of Writing a Powerful Personal Statement 

Your Personal Statement is your chance to tell your story clearly. Focus on your exposure, old injuries that never fully resolved, how TCE has aggravated your conditions over time, and how your life is affected today. Keep it organized, honest, and specific.

Organizing Your Evidence Packet

Once you have gathered your evidence and obtained a strong nexus letter, the next critical step is how you organize everything. A well-organized packet makes it much easier for the VA rater to understand your case and approve it.

Many veterans make the mistake of just throwing all their records together. This often leads to important information getting buried and the claim being denied or lowballed. A clean, logical structure helps the rater quickly see the connections between your TCE exposure and your conditions.

Recommended Organization (Proven Workflow)

Here’s the structure that has worked well:

1. Nexus Letter (Place this first)

Start with your strongest piece of evidence — the nexus letter from your doctor. This is often the most important document in the entire packet. Place it right at the front so the rater sees the medical connection immediately.

2. VA Claim Outline

Next, include a clear, well-organized Claim Outline of conditions you want rated. This document acts as a roadmap. It should list:

• All the conditions you are claiming

• Whether each is direct service connection, secondary, or aggravation

• The nexus for each condition

• Key evidence that supports it

This helps the rater understand the full picture quickly.

3. Personal Statement

Place your Personal Statement right after the Claim Outline. This is where you tell your story in your own words — your exposure, your in-service injuries, how your conditions have progressed, and how they affect your life today.

4. Scientific and Exposure Evidence

Next, include the documents that explain why TCE caused or aggravated your conditions:

• TCE Health Effects (scientific summary)

• Base-specific TCE Contamination Records/Records

• TCE Family Exposure (if applicable)

• Any other relevant scientific or environmental reports

5. In-Service Medical Records

Include the most relevant in-service treatment records, especially anything that shows symptoms or injuries while you were still exposed to TCE.

6. Condition-by-Condition Evidence

After the general evidence, organize the rest of your supporting documents in the same order your conditions appear in your Claim Outline. For each condition, group the relevant evidence together (labs, imaging, pathology reports, specialist notes, etc.).

This makes it easy for the rater to go through your packet condition by condition.

Quick Tips

• Use tabs or clear section dividers so the rater can easily find what they need.

• Put your strongest evidence near the front.

• Don’t overwhelm the packet with hundreds of repetitive pages — quality and organization matter more than quantity.

• Always keep a complete copy of everything you submit.

Quick Summary of Organizing Your Evidence Packet 

Organize your packet in this order:  

Nexus Letter → Claim Outline → Personal Statement → Scientific/Exposure Evidence → In-Service Records → Condition-by-Condition Evidence.

This structure is clear, logical, and has proven effective.

What to Expect from the VA – They Will Ask for More Evidence and Schedule C&P Exams

Here’s the hard truth: Even when you send them everything — a complete Nexus Letter, a detailed Claim Outline, your Personal Statement, scientific evidence on TCE, Base contamination reports, in-service records, labs, X-rays, and a 100+ page evidence packet — the VA will often come back and say they need more evidence or schedule additional C&P exams.

This is not because you did something wrong. It’s because most raters and examiners are not used to seeing a case built around the TCE Effect as a unifying cause. They are trained to look at conditions in isolation. When you present a full-body, multi-system case with one clear root cause (TCE exposure + resulting autoimmune dysregulation, neurotoxicity, and accelerated degeneration), it can feel overwhelming or unfamiliar to them. Many simply will not dig through thousands of pages of your medical records to connect the dots.

Why This Happens

• Your VA medical record can easily be thousands of pages long. They are not going to read it all.

• They often miss or ignore key documents even when they are clearly in the packet and your file.

• The concept that this exposure event (my 7 years of occupational + residential TCE) can drive dozens of conditions across multiple body systems is still new to many people working these claims.

How to Respond When They Ask for More Evidence

Stay calm and stay focused. Do not get discouraged or start over. Instead:

• Use dates from your VA Problems List  — This is one of the most powerful tools you have. The Problems List shows exactly when each condition first appeared in your VA records. Giving them the specific date and condition name points them straight to the right place without forcing them to hunt.

• Pull direct excerpts from your Nexus Letter — Your doctor already connected the dots for them. Quote the relevant sections that tie the condition to TCE exposure and autoimmune effects. You don’t need to rewrite the science — just point them to what your doctor already wrote.

• Reference the specific condition and how it fits the bigger picture — Briefly remind them that this condition is part of the overall TCE Effect pattern (immunotoxicity, neurotoxicity, accelerated joint degeneration, etc.).

• Add only what is truly new — If you have new labs, imaging, or a specialist note, include it. Otherwise, simply restate what you already provided with clearer references.

• Submit anyway — Just because they say they need more doesn’t mean they don’t already have it. Many veterans win on Higher-Level Review or Supplemental claims by simply organizing and highlighting what was already in the file.

Preparing for C&P Exams

This is where many veterans get caught off guard. Even when the examiner says “We have everything,” it does not mean they have read it.

Real example from my own cervical and shoulder exam:  

The examiner started with a question I wasn’t expecting:

“So tell me how this happened.”

I asked her if she had read my Nexus Letter and the related evidence I sent in. She said they have everything. But it became very clear she had not actually reviewed it. I had to walk her through the whole story — the 1973 in-service neck injury, the progression over decades, the TCE exposure, and how the autoimmune dysregulation and neurotoxic effects from TCE made everything worse and accelerated the degeneration.

Lesson: Be prepared to verbally walk the examiner through your case, especially the TCE connection. Do not assume they read your Nexus Letter or evidence packet. Keep it clear, concise, and focused on:

• How the condition started (in-service event or exposure)

• How it progressed

• How TCE played a significant role (use language from your Nexus Letter)

• How it affects your daily life now

Bring a short, one-page summary with you if it helps you stay on track. You are allowed to advocate for yourself during the exam.

Bottom Line

The VA claims process is not built for cases like ours. They are used to single-condition claims with obvious in-service events. When you show up with a lifetime of damage from TCE, they often don’t know what to do with it at first. That’s why they ask for more or schedule exams.

Your job is to make it easy for them to say yes. Use dates. Use your Nexus Letter. Stay organized. And be ready to explain it out loud when needed.

You already did the hardest part — figuring out what really happened to you and built the evidence. Now you just have to keep guiding them to see it.

Filing Strategy – Self-File vs. Using a VSO (Recommended)

When it’s time to file, you have two main paths: file it yourself or work with an accredited Veterans Service Officer (VSO) like the DAV. Both can work, but they are very different experiences.

Self-Filing (Do It Yourself)

Some veterans prefer to file on their own through VA.gov. This can work if:

• You are very organized and comfortable with paperwork

• Your claim is relatively straightforward (one or two conditions)

• You have already built a strong, well-organized evidence packet

Pros:

• You stay in full control of every word

• No one else is interpreting your story

• You can file quickly once your packet is ready

Cons:

• The VA will NOT automatically break your claim down into the proper separate ratable conditions and forms. That’s what a good VSO like the DAV does for you — they know how to expand it into the correct number of ratable items (pain, scars, range of motion, neuropathy in each extremity, etc.) and submit everything on the right forms.

• It is easy to miss conditions or how they should be properly rated if you’re not familiar with the VA’s specific rating structure.

• If they come back asking for clarification or more evidence, you are on your own to respond correctly and in the format they expect.

Self-filing is possible, but it requires you to think like the VA rater — and most of us don’t naturally do that.

Using a VSO (Strongly Recommended) – My Experience with the DAV

My strong preference is to run claims through the DAV. Here’s why:

When I built my claim outline, I had 17 issues. After the DAV reviewed everything and submitted it, they turned it into 29 ratable conditions.

That’s not because I missed things — it’s because the VA rates conditions in very specific ways. A good VSO knows exactly how to break these things down and how to present them so you get rated for everything you’re entitled to. They speak the VA’s language and use the right forms.

What working with the DAV looked like for me:

• I gave them my complete packet (Nexus Letter, Claim Outline, Personal Statement, all evidence)

• They reviewed it and expanded it into the proper number of ratable conditions

• They filed it correctly the first time using the right form

Important honesty: Even after going through the DAV and submitting a strong, well-organized packet, the VA can still come back requesting clarification on specific conditions. In my case, they asked for more information on several items (“please specify”). This is fairly common on complex, multi-condition claims — especially when the VA is not yet familiar with the TCE Effect as a unifying cause. That’s why having clear, organized responses ready (as discussed previously) is so important.

Another very important fact: If your claim is denied or deferred and you need to appeal, a VSO like the DAV will represent you in the appeal at no cost. I have personal experience with this — they fought for me and they won. Hiring a private attorney is not always necessary.

Practical advice: If you can, make an appointment with your local DAV (or other VSO) office. Take your full packet with you, show them your case, and ask for their help. Most offices are very willing to sit down with you and walk through everything.

A good VSO is worth their weight in gold on a complex TCE case like ours. They know how to protect you from the common mistakes that cause delays or lower ratings — and they will stay with you through appeals if needed.

My Advice

If your claim is simple and you’re very confident in your paperwork, self-filing is an option.

But if you have multiple conditions, a long history, or you’re building a TCE-related claim with a lot of secondary conditions, I strongly recommend going through the DAV or another accredited VSO you trust. They will almost always catch things you would miss, present your case in the way the VA is used to seeing, and represent you if an appeal becomes necessary.

You already did the hardest part — figuring out what TCE did to you and building the evidence. Let a good VSO help you get it filed and rated correctly.