C-123 AIRCRAFT AGENT ORANGE EXPOSURE CLAIMS

C-123 AIRCRAFT AGENT ORANGE EXPOSURE

The Department of Veterans Affairs (VA) has determined that a select group of Air Force and Air Force Reserve 

personnel were exposed to herbicides through regular and repeated duties as ground, flight, or medical crew

members on contaminated Operation Ranch Hand (ORH) C-123 aircraft that were used to spray Agent Orange 

in Vietnam. 

WHO IS ELIGIBLE? 

Any Air Force Veteran or Air Force Reservist who was assigned to one of the affected Reserve or active duty 

units as a ground, flight, or medical crew member on a contaminated aircraft and later developed a disability 

that has been linked to Agent Orange exposure should file a claim. VA has information indicating that few Air 

Force units (active duty and Reserve) had one or more of the contaminated aircraft during the period 1969 

through 1986 (depending upon unit of assignment). VA compiled a list of these units and the dates on which 

they had the aircraft, which is publicly available at

http://www.publichealth.va.gov/exposures/agentorange/locations/residue-c123-aircraft/index.asp

WHO TO CONTACT AT DOD FOR RECORDS?

If you are a Veteran or next-of-kin of a deceased Veteran, you may now use vetrecs.archives.gov to order a 

copy of your military records. For all others, your request is best made using a Standard Form 180. It includes 

complete instructions for preparing and submitting requests. Please Note: All requests must be in writing, 

signed and mailed to the following address:

National Personnel Records Center

1 Archives Drive

St. Louis, Missouri 63138

Disabilities determined by VA to be related to your military service can lead to monthly non-taxable compensation, enrollment in the 

VA health care system, a 10-point hiring preference for federal employment and other important benefits. Ask your VA 

representative or Veterans Service Organization representative about Disability Compensation, Pension, Health Care, Caregiver 

Program, Career Services, Educational Assistance, Home Loan Guaranty, Insurance and/or Dependents and Survivors’ Benefits.
HOW CAN YOU APPLY? 

Claimants are encouraged to apply online through the eBenefits portal. You can apply by filling out VA Form 

21-526, Veterans Application for Compensation and/or Pension, or VA Form 21-526EZ, Fully Developed Claim 

(Compensation). Please ensure that each C-123 related disability is specifically annotated (e.g., Diabetes/C123) on Part II, Block 14 of VA Form 21-526, or Section I, Block 11 of VA Form 21-526EZ. If you have any of the 

following material, please submit it with your application: 

If you have any of the following material, please attach it to your application: 

• Discharge, separation papers (DD214 or equivalent) 

• USAF Form 2096 (unit where assigned at the time of the training action)

• USAF Form 5 (aircraft flight duties)

• USAF Form 781 (aircraft maintenance duties)

• Dependency records (marriage & children's birth certificates) 

• Medical evidence (doctor & hospital reports) 

HOW DO ELIGIBLE SURVIVORS AND DEPENDENTS APPLY? 

Eligible survivors and dependents can apply by filling out VA Form 21-534, Application for DIC, Death Pension 

& Accrued Benefits by Surviving Spouse or Child. Or VA Form 21-534EZ, Fully Developed Claim (Survivors 

Benefits). Please ensure “C-123 claim” is annotated on Section I, Block 7 of VA Form 21-534 or Section I, Block 

16 of VA Form 21-534EZ.

Applications for benefits should be mailed to the following location (or faxed to 608-373-6694):

Department of Veterans Affairs

Claims Intake Center

Attention: C123 Claims

PO Box 5088

Janesville, WI 53547-5088

HOW DO I GET MORE INFORMATION?

All C-123 claims are processed at the St. Paul Regional Office. Veterans can call 1-800-749-8387, or email 

VSCC123.VAVBASPL@va.gov. 

Contact us: www.va.gov 1-800-827-1000 

Compensation Service – June 2015