Court Opinion

ID: 9383886
Source: CourtListenerOpinion
Date Created: 2023-03-31 15:01:07.028458+00
Date Added: 2024-06-11T17:17:48.889937
License: Public Domain

Case: 20-1537   Document: 58     Page: 1   Filed: 03/22/2023

   United States Court of Appeals
       for the Federal Circuit
                 ______________________

      MILITARY-VETERANS ADVOCACY INC.,
                  Petitioner

                            v.

       SECRETARY OF VETERANS AFFAIRS,
                   Respondent
             ______________________

                       2020-1537
                 ______________________

    Petition for review pursuant to 38 U.S.C. Section 502.
                  ______________________

                Decided: March 22, 2023
                ______________________

      JEFFREY T. QUILICI, Orrick, Herrington & Sutcliffe
 LLP, Austin, TX, argued for petitioner. Also represented
 by MELANIE L. BOSTWICK, Washington, DC; MELANIE
 HALLUMS, Wheeling, WV; JOHN B. WELLS, Law Of-
 fice of John B. Wells, Slidell, LA.

     MEEN GEU OH, Commercial Litigation Branch, Civil Di-
 vision, United States Department of Justice, Washington,
 DC, argued for respondent. Also represented by BRIAN M.
 BOYNTON, ERIC P. BRUSKIN, MARTIN F. HOCKEY, JR.; BRIAN
 D. GRIFFIN, BRANDON A. JONAS, Office of General Counsel,
 United States Department of Veterans Affairs, Washing-
 ton, DC.
                  ______________________
Case: 20-1537     Document: 58      Page: 2    Filed: 03/22/2023

 2                            MILITARY-VETERANS ADVOCACY v.
                              SECRETARY OF VETERANS AFFAIRS

     Before NEWMAN, PROST, and CUNNINGHAM, Circuit
                       Judges.
 NEWMAN, Circuit Judge.
     Military-Veterans Advocacy Inc. (“MVA”) brings this
 petition pursuant to 38 U.S.C. § 502 and asks the court to
 review and revise certain instructions and practices of the
 Secretary of Veterans Affairs (“VA”), as set forth in the Vet-
 erans Affairs Adjudication Procedures Manual (the “M21-1
 Manual”). This Manual provides guidance and instruc-
 tions to the administrators of veterans’ benefits and claims,
 by interpreting and coordinating the application of stat-
 utes, regulations, policies, and judicial decisions. Thus the
 M21-1 Manual “limits VA staff discretion, and, as a practi-
 cal matter, impacts veteran benefits eligibility for an entire
 class of veterans.” Nat’l Org. of Veterans’ Advocates v. Sec’y
 of Veterans Affs., 981 F.3d 1360, 1374 (Fed. Cir. 2020) (en
 banc) (“NOVA”).
                         BACKGROUND
                Section 502 Judicial Review
      Direct judicial review of certain VA actions and prac-
 tices is authorized as follows:
     38 U.S.C. § 502. Judicial review of rules and
     regulations.— An action of the Secretary to
     which section 552(a)(1) or 553 of title 5 (or both) re-
     fers is subject to judicial review. Such review shall
     be in accordance with chapter 7 of title 5 and may
     be sought only in the United States Court of Ap-
     peals for the Federal Circuit.
 Section 502 establishes Federal Circuit jurisdiction for di-
 rect review of VA actions concerning “substantive rules of
 general applicability, statements of general policy and in-
 terpretations of general applicability” that must be pub-
 lished in the Federal Register, as provided by the
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 SECRETARY OF VETERANS AFFAIRS

 Administrative Procedure Act (“APA”) at 5 U.S.C.
 § 552(a)(1)(D). LeFevre v. Sec’y of Veterans Affs., 66 F.3d
 1191, 1196 (Fed. Cir. 1995). These administrative rules,
 policies, and interpretations are the substance of the M21-1
 Manual.

     Section 553(e) provides “the right to petition for the is-
 suance, amendment, or repeal of a rule.” 5 U.S.C. § 553(e).
 Judicial review is available when the right to petition for
 rulemaking is denied, as well as when the petition is denied
 on its merits. Preminger v. Sec’y of Veterans Affs., 632 F.3d
 1345, 1351–53 (Fed. Cir. 2011). However, the Secretary
 errs in stating that the court does not thereby have juris-
 diction to review the result when the agency grants a re-
 quest for rulemaking but does not provide the relief sought
 by the requester. See Sec’y Br. 39; Preminger, 632 F.3d at
 1352 (“Indeed, when Congress reported out § 502 it appar-
 ently contemplated that § 502 would provide for review of
 the Secretary’s decision not to issue a rule as well as the
 decision to issue a rule.”) (citing H.R. REP. NO. 100-963
 (1988), reprinted in 1988 U.S.C.C.A.N. 5782, 5786).
     The APA requires the reviewing court to “decide all rel-
 evant questions of law, interpret constitutional and statu-
 tory provisions, and determine the meaning or
 applicability of the terms of an agency action” to the extent
 necessary to reach a decision. 5 U.S.C. § 706. Section 502
 of Title 38 provides further oversight of agency actions with
 respect to veterans’ concerns. See 38 U.S.C. § 502.
  Legislation and Rules Relating to the Presumption
             of Exposure to Agent Orange
      MVA asks the court to review certain presumptions
 and procedures concerning Vietnam era exposure to the
 Agent Orange defoliant. MVA’s petition is directed to VA
 practices described in the M21-1 Manual (1) at Section IV
 (ii)(1)(H)(4)(a) and Section IV (ii)(1)(H)(4)(b) (the “Thailand
 Rules”), (2) at Section IV (ii)(1)(H)(1) (the “Blue Water
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                              SECRETARY OF VETERANS AFFAIRS

 Navy Rule”), and (3) at Section IV (ii)(2)(C)(3)(e) (the “Air-
 space Rule”). These rules are founded on legislation that
 arose as veterans of the Vietnam era developed illnesses,
 such as non-Hodgkin’s lymphoma and other cancers, that
 came to be understood as related to exposure to Agent Or-
 ange.
     Early legislative action concerning Agent Orange expo-
 sure is seen in the Veterans Health Programs Extension
 and Improvements Act of 1979, Pub. L. No. 96-151, § 307;
 93 Stat. 1092, 1097–98 (1979), in which Congress required
 the VA to conduct a study of long-term health effects on
 Vietnam veterans who were exposed to dioxins that were
 components of Agent Orange. After study by the Centers
 for Disease Control (“CDC”) in 1982, see H.R. REP. NO. 98-
 592 at 5 (1984), reprinted in 1984 U.S.C.C.A.N. 4449,
 4451–52, Congress enacted the Veterans’ Dioxin and Radi-
 ation Exposure Compensation Standards Act, Pub. L. No.
 98-542, 98 Stat. 2725 (1984) (the “Dioxin Act”). The Dioxin
 Act directed the VA to establish guidelines for diseases
 shown by “sound scientific or medical evidence” to be asso-
 ciated with herbicides, including Agent Orange, containing
 dioxins. Id. §§ 5(a)(1)(A), 5(b)(2)(B), 98 Stat. at 2727–29.
     The Dioxin Act also instructed the VA to presume that
 a veteran experienced toxic herbicide exposure “if the in-
 formation in the veteran’s service records and other records
 of the Department of Defense is not inconsistent with the
 claim that the veteran was present where and when the
 claimed exposure occurred.” Id. § 5(b)(3)(B). In 1986, the
 VA promulgated 38 C.F.R. § 3.311a, a regulation presum-
 ing exposure to herbicides containing dioxins for veterans
 who “served in the Republic of Vietnam.” 38 C.F.R.
 § 3.311a(b) (1986). This presumption applied to service in
 mainland Vietnam, as well as “service in the waters off-
 shore and service in other locations, if the conditions of ser-
 vice involved duty or visitation in the Republic of Vietnam.”
 Id. § 3.311a(a)(1).
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 SECRETARY OF VETERANS AFFAIRS

     In 1990, the CDC reported the results of a comprehen-
 sive study, showing a statistically significant relation be-
 tween service in Vietnam and illnesses such as non-
 Hodgkin’s lymphoma and other cancers. See The Associa-
 tion of Selected Cancers with Service in the U.S. Military
 in Vietnam: Final Study, I. Non-Hodgkin’s Lymphoma, 150
 ARCHIVES INTERNAL MED. 2473 (1990); see also Claims
 Based on Service in Vietnam, 55 Fed. Reg. 43123, 43124
 (Oct. 26, 1990) (38 C.F.R. pts. 3, 4).
     There followed the Agent Orange Act of 1991, Pub. L.
 No. 102-4, 105 Stat. 11. This Act established a presump-
 tion of service connection for veterans afflicted with desig-
 nated illnesses who “served in the Republic of Vietnam.”
 Id. § 2 (codified as amended at 38 U.S.C. § 1116). The leg-
 islative history records the congressional understanding
 that the VA could amend the list of diseases for which
 Agent Orange service connection would be presumed, after
 considering the advice of the National Academy of Sci-
 ences. See 137 CONG. REC. H719-01 (1991). The M21-1
 Manual provided instructions, forms, questionnaires, and
 other guidance for implementation by the VA’s regional of-
 fices throughout the nation, establishing “service in Vi-
 etnam” if a veteran received the Vietnam Service Medal.
 See M21-1 Manual § 4.08(k)(1) (Nov. 8, 1991) (citation
 omitted). However, in 2002 the VA amended the M21-1
 Manual, replacing the Vietnam Service Medal test for pre-
 sumptive “service in the Republic of Vietnam,” and instead
 requiring veterans to show a “foot-on-land” or “boots-on-
 the-ground” presence within Vietnam during their service.
 See M21-1 Manual, Pt. III, para. 4.24(e)(1) (Feb. 27, 2002).
      Studies of medical causation and service relation con-
 tinued as the nation’s experience with diseases associated
 with Agent Orange enlarged with an aging veteran popu-
 lation. See, e.g., Herbicide Exposure and Veterans With
 Covered Service in Korea, 74 Fed. Reg. 36640-02 (July 24,
 2009) (proposed rule).
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 6                            MILITARY-VETERANS ADVOCACY v.
                              SECRETARY OF VETERANS AFFAIRS

     Representative Bob Filner, the Chairman of the House
 Committee on Veteran Affairs, introduced the Agent Or-
 ange Equity Act of 2009 to clarify that 38 U.S.C. § 1116 in-
 cludes veterans who served in waters offshore of Vietnam
 or at any level of airspace above Vietnam, or who received
 the Vietnam Service Medal. See H.R. 2254, 111th Cong.
 § 2 (2009). The bill was not enacted, although it received
 hearings. See Vietnam Veterans Longitudinal Study, 2010
 WL 1785800 (May 5, 2010).
     Congressional attention continued in 2013, when the
 Blue Water Navy Vietnam Veterans Act of 2013 was intro-
 duced. See H.R. 543, 113th Cong. (2013). This bill would
 have extended the presumption of service connection to in-
 clude service on the territorial seas of Vietnam. Several
 versions of the bill were reintroduced over the next six
 years. See, e.g., S. 681, 114th Cong. (2015); H.R. 299, 115th
 Cong. (2018).
     Several states, including Hawaii, Alaska, and Arizona,
 urged Congress to assure the presumption of service con-
 nection to veterans who “served in the waters defined by
 the Combat Zone” and “in the airspace over the Combat
 Zone” in Vietnam. 160 CONG. REC. S3290-05, S2393 (May
 22, 2014) (“Congress is respectfully urged [by the House of
 Representatives of Hawaii] to restore the presumption of a
 service connection for Agent Orange exposure to United
 States veterans who served in the waters defined by the
 Combat Zone and in the airspace over the Combat Zone in
 Vietnam . . . .”); 160 CONG. REC. S6197-01, S6201 (Nov. 20,
 2014) (“[T]he Alaska State Legislature urges the United
 States Congress to restore the presumption of a service
 connection for Agent Orange exposure to United States
 Veterans who served in the waters defined by the combat
 zone and in the airspace over the combat zone . . . .”); see
 also 160 CONG. REC. S4217-01, S4423 (July 7, 2014) (“[T]he
 House of Representatives of the State of Arizona,
 prays . . . [t]hat the United States Congress restore the
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 SECRETARY OF VETERANS AFFAIRS

 presumption of a service connection between Agent Orange
 exposure and subsequent illnesses to United States Vi-
 etnam War veterans who served in the waters, which is de-
 fined as the combat zone, and in the airspace over the
 combat zone.”). Other states and localities urged Congress
 to apply the presumption for veterans who served in the
 “territorial waters” or “offshore waters,” and “airspace” of
 Vietnam. See 155 CONG. REC. E2166-04, E2167 (July 31,
 2009) (“The 81st Legislature of the State of Texas respect-
 fully urge [Congress] to restore the presumption of a ser-
 vice connection for . . . veterans who served on the inland
 waterways, in the territorial waters, and in the airspace of
 the Republic of Vietnam . . . .”); 160 CONG. REC. S3290-05,
 S3291 (May 22, 2014) (“The House of Representatives [of
 Pennsylvania] respectfully urge . . . Congress . . . to re-
 store the presumption of a service connection for . . . veter-
 ans who served on the inland waterways, territorial waters
 and in the airspace of Vietnam . . . .”); 159 CONG. REC.
 E1889-01, E1889 (Dec. 16, 2013) (“The United States Con-
 gress should . . . direct the [VA] to administer the Agent
 Orange Act under the presumption that herbicide expo-
 sure . . . includes [Vietnam’s] inland waterways, offshore
 waters, and airspace . . . .”).
      In Congressional hearings, the Congressional Budget
 Office provided data and estimated that 229,000 veterans
 were presumptively exposed to Agent Orange in the Vi-
 etnam Service Medal area, 55,000 more veterans than the
 Congressional Research Service estimated were serving in
 the territorial seas of Vietnam. See Veteran Benefits Leg-
 islation, 2015 WL 3378295 (May 13, 2015). The MVA par-
 ticipated in Congressional hearings and pointed out
 differences between various criteria used to determine
 “service in the Republic of Vietnam,” including the Vi-
 etnam Service Medal area, the territorial seas of Vietnam,
 and the “foot-on land” rule. See id. (“Historically . . . the
 M21-1 Manual[] allowed the presumption to be extended to
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 8                            MILITARY-VETERANS ADVOCACY v.
                              SECRETARY OF VETERANS AFFAIRS

 all veterans who had received the Vietnam service
 medal . . . . In a February 2002 revision to the M21-1 Man-
 ual, the VA . . . required a showing that the veteran has set
 foot on the land or entered an internal river or stream.”);
 Pending Legislation, 2017 WL 1281456 (Apr. 5, 2017)
 (“Prior to 2002, the VA granted the presumption of expo-
 sure to any ship that crossed the [Vietnam Service Medal
 demarcation line]. [The Blue Water Navy Vietnam Veter-
 ans Act] will restore the presumption only to a ship that
 crosses the [line demarcating the territorial seas].”).
     In 2015, an Institute of Medicine of the National Acad-
 emy of Sciences report led the VA to presume herbicide-
 agent exposure for veterans who “regularly and repeatedly
 operated, maintained, or served onboard C-123 aircraft
 known to have been used to spray an herbicide agent dur-
 ing the Vietnam era.” 38 C.F.R. § 3.307(a)(6)(v); see also
 Presumption of Herbicide Exposure and Presumption of
 Disability During Service for Reservists Presumed Ex-
 posed to Herbicide, 80 Fed. Reg. 35246-01, 35247 (June 19,
 2015) (interim final rule).
     A Senate resolution in 2017 “recognize[d] the intent of
 the Agent Orange Act of 1991 (Public Law 102-4) included
 the presumption that those veterans who served in the
 Armed Forces in the bays, harbors, and territorial seas of
 the Republic of Vietnam . . . served in the Republic of Vi-
 etnam for all purposes under the Agent Orange Act of
 1991.” 163 CONG. REC. S2219-03, S2220 (Apr. 4, 2017). In
 2018, the National Academy of Sciences issued its Veterans
 and Agent Orange: Update 11, stating that “there was in-
 adequate information to determine the extent of exposure
 experienced by Blue Water Navy personnel, but that there
 were possible routes of exposure,” including ships drawing
 contaminated seawater to distill for potable water. NAT’L
 ACAD. SCI, VETERANS AND AGENT ORANGE: UPDATE 11 at 36
 (The National Academics Press, 2018).
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 SECRETARY OF VETERANS AFFAIRS

     In 2019, this court held that the Republic of Vietnam
 includes its 12 mile territorial sea. Procopio v. Wilkie, 913
 F.3d 1371, 1380–81 (Fed. Cir. 2019). This was codified by
 the Blue Water Navy Vietnam Veterans Act of 2019, Pub.
 L. No. 116-23, § 2, 133 Stat. 966 (codified at 38 U.S.C.
 § 1116A), stating “[a] veteran who . . . served offshore of
 the Republic of Vietnam . . . shall be presumed to have
 been exposed.” The Act then defines the boundaries of “off-
 shore” service based on a list of geographical coordinates
 that represent Vietnam’s claimed territorial waters. See
 38 U.S.C. § 1116A.
      However, the airspace over Vietnam was not included
 in the scope of the Act, as Congressman Mark Takano sub-
 mitted that “an aircraft that passed in the airspace above
 the offshore waters would not have drawn water from the
 sea and therefore is not considered present within the off-
 shore waters for purposes of this legislation.” H.R. REP. NO.
 116-58, at 11–12 (2019), reprinted in 2019 U.S.C.C.A.N.
 279, 280–82. Still, Rep. Takano stated that “the Commit-
 tee intends that VA’s definition . . . be broad and compre-
 hensive.” Id. at 11. The House Report also referred to the
 Institute of Medicine’s conclusion that, given the passage
 of time and lack of data collected during the conflict, defin-
 itive answers concerning Blue Water Navy Veterans’ expo-
 sure to Agent Orange are not available, and are unlikely to
 ever become available. Id. at 10.
     Debate continued, along with legislative attention. On
 August 10, 2022, President Biden signed the Sergeant
 First Class Heath Robinson Honoring Our Promise to Ad-
 dress Comprehensive Toxics Act of 2022, Pub. L. No. 117-
 168, 136 Stat. 1759 (codified at 38 U.S.C. §§ 1116 and 1710)
 (“the PACT Act”), effective October 1, 2022. The PACT Act
 included provisions relevant to Agent Orange exposure for
 Vietnam era veterans who served in Thailand, as we shall
 discuss.
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 10                           MILITARY-VETERANS ADVOCACY v.
                              SECRETARY OF VETERANS AFFAIRS

                         DISCUSSION
     MVA’s 38 U.S.C. § 502 petition is directed to the desig-
 nated “Thailand Rules,” the “Blue Water Navy Rule,” and
 the “Airspace Rule,” with respect to presumptions of Agent
 Orange exposure and service connection, as administered
 by VA statutes, regulations, and M21-1 Manual provisions.
 Similar issues for other areas and additional background
 are reported in our decision in Military Veterans Advocacy,
 Inc. v. Secretary of Veterans Affairs, 38 F.4th 154 (Fed. Cir.
 2022).
     We review § 502 petitions to “decide all relevant ques-
 tions of law, interpret constitutional and statutory provi-
 sions, and determine the meaning or applicability of the
 terms of an agency action.” 5 U.S.C. § 706; McKinney v.
 McDonald, 796 F.3d 1377, 1383 (Fed. Cir. 2015). We will
 “hold unlawful and set aside agency action” that is “arbi-
 trary, capricious, an abuse of discretion, or otherwise not
 in accordance with law.” 5 U.S.C. § 706(2)(A).
                               A
                    THE THAILAND RULES
     The challenged Thailand Rules concern the scope of the
 presumption of exposure to Agent Orange for veterans who
 served on military bases in Thailand.
    The relief that MVA requested of the VA, and subse-
 quently this court, relating to the Thailand Rules has now
 been provided in part by the PACT Act as follows.
     In 2010, the Secretary responded to congressional con-
 cern and amended the M21-1 Manual to apply the pre-
 sumption of service connection to veterans who were
 stationed in Thailand during the Vietnam era. However,
 the presumption was limited to veterans whose duties
 placed them “at or near the base perimeter,” for defoliant
 use was primarily at the perimeter. M21-1 Manual, Sec-
 tion IV (ii)(2)(C)(10)(q) (Oct. 4, 2010). This provision had
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 SECRETARY OF VETERANS AFFAIRS

 not substantively changed since 2010, despite petitions for
 rulemaking, legislative hearings, and the filing of this
 § 502 petition. Then, in 2022 the requested change was
 partially made in the PACT Act, enacted while this case
 was pending:
     PACT Act § 403. Presumptions of service con-
     nection for diseases associated with expo-
     sures to certain herbicide agents for veterans
     who served in certain locations.—
                              ***
     (d) In this section, the term “covered ser-
     vice” means active military, naval, air, or space ser-
     vice— . . . . (2) performed in Thailand at any
     United States or Royal Thai base during the period
     beginning on January 9, 1962, and ending on June
     30, 1976, without regard to where on the base the
     veteran was located or what military job specialty
     the veteran performed . . . .
 136 Stat. 1759, 1780–81 (amending 38 U.S.C. § 1116).
     In view of this enactment, we requested briefing from
 the parties concerning its effect on MVA’s § 502 petition.
     The Secretary responded that “the PACT Act does not
 moot MVA’s ‘Thailand Rules’ challenge . . . . because it
 does not provide MVA with the full extent of the relief that
 it had sought from VA and this court,” referring to a dis-
 crepancy in the chronological period covered by the PACT
 Act (January 9, 1962–June 30, 1976), and the period used
 by the VA in the Thailand Rules context (February 28,
 1961–May 7, 1975). Sec’y Suppl. Resp. Br. 2–3, Sept. 14,
 2022, ECF No. 56. The Secretary stated that “there is [a]
 portion of MVA’s ‘Thailand Rules’ challenge that remains
 live even after the PACT Act.” Id. at 3–4.
     But the MVA wrote that “the PACT Act provides the
 full relief requested by MVA on behalf of its Thailand
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 12                            MILITARY-VETERANS ADVOCACY v.
                               SECRETARY OF VETERANS AFFAIRS

 veteran members, and any relief provided by this Court
 would not affect their legal interests.” MVA Suppl. Resp.
 Br. 7, Sept. 14, 2022, ECF No. 57 (citations omitted). MVA
 did not agree with the Secretary that any part of its chal-
 lenges to the Thailand Rules remained live, so it appears
 that the MVA has waived its challenges to the Thailand
 Rules to the extent that its challenges were not moot.
     The Thailand Rules portion of the petition is accord-
 ingly dismissed.
                               B
                 THE BLUE WATER NAVY RULE
     As an initial matter, the Secretary argues that MVA
 does not have associational standing to challenge the Blue
 Water Navy Rule, as well as the other M21-1 Manual pro-
 visions at issue. To establish associational standing, an or-
 ganization must show that:
      (a) its members would otherwise have standing to
      sue in their own right; (b) the interests it seeks to
      protect are germane to the organization’s purpose;
      and (c) neither the claim asserted nor the relief re-
      quested requires the participation of individual
      members in the lawsuit.
 NOVA, 981 F.3d at 1368 (citations omitted). The Secretary
 accepts that this § 502 action meets NOVA’s requirements
 as described in (b) and (c), but the Secretary argues that
 “[n]one of the manual revisions MVA disputes affect any of
 its members’ substantive rights.” Sec’y Br. 29.
      The MVA filed affidavits of two of its members, stating
 uncertainty as to whether their claims are covered by the
 current Blue Water Navy rule. Section 502 authorizes pe-
 titions for clarification of VA Rules when there is “an actual
 or potential claim [that] is sufficiently affected by the par-
 ticular challenged rule to meet the requirements of actual
 or imminently threatened concrete harm and the other
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 SECRETARY OF VETERANS AFFAIRS

 requirements for that member to have Article III stand-
 ing.” NOVA, 981 F.3d at 1370. Having reviewed the record,
 we do not agree with the Secretary that the MVA lacks or-
 ganizational standing here.
     With respect to the Blue Water Navy Rule portion of
 the § 502 petition, we do not share MVA’s view that the
 VA’s interpretation of the Blue Water Navy Vietnam Vet-
 erans Act of 2019 unduly narrowed the presumption of ex-
 posure and service connection as applied to shipboard
 service. MVA Br. 1–5.
      The initial regulations as adopted in 1993 stated that
 the presumption of service connection regarding Agent Or-
 ange exposure applied to shipboard veterans with
 “[s]ervice in the waters offshore and service in other loca-
 tions if the conditions of service included duty or visitation
 in the Republic of Vietnam.” 38 C.F.R. § 3.307(a)(6)(iii)
 (1993). As noted supra, in 2002 the VA began interpreting
 this regulation to require a veteran to show some service
 on land within Vietnam applying the “foot-on-land” or
 “boots-on-the-ground” policy. See M21-1 Manual, Pt. III,
 para. 4.24(e)(1) (Feb. 27, 2002).
     This court previously upheld that interpretation as
 within the Secretary’s discretion. See Haas v. Peake, 525
 F.3d 1168, 1193 (Fed. Cir. 2008) (“Drawing a line between
 service on land, where herbicides were used, and service at
 sea, where they were not, is prima facie reasonable.”).
 Thus naval service without foot-on-land presence did not
 create a presumption of service connection for veterans
 who became afflicted with the designated conditions.
     The foot-on-land rule was the subject of ongoing de-
 bate, and in 2019 we overruled Haas and held that the pre-
 sumption of service connection does not require presence
 on mainland Vietnam. Procopio, 913 F.3d at 1376 (“[W]hen
 the Agent Orange Act was passed in 1991, the ‘Republic of
 Vietnam’ included . . . its 12 nautical mile territorial sea.”).
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 14                            MILITARY-VETERANS ADVOCACY v.
                               SECRETARY OF VETERANS AFFAIRS

 The requirement for “duty or visitation” onshore was elim-
 inated. Id. at 1377–78. This decision led to the Blue Water
 Navy Vietnam Veterans Act of 2019, which provides:
      38 U.S.C. § 1116A(b). Exposure.— A veteran who,
      during active military, naval, or air service, served
      offshore of the Republic of Vietnam during the pe-
      riod beginning on January 9, 1962, and ending on
      May 7, 1975, shall be presumed to have been ex-
      posed during such service to an herbicide agent un-
      less there is affirmative evidence to establish that
      the veteran was not exposed to any such agent dur-
      ing that service.
 This presumption is implemented in the M21-1 Manual,
 Section IV (ii)(1)(H)(1)(g), referring to service on vessels op-
 erating in “eligible offshore waters.” The question as pre-
 sented in MVA’s § 502 petition relates to the definition of
 “eligible offshore waters.” The Blue Water Navy Vietnam
 Veterans Act of 2019 defines “offshore of Vietnam” as
 within the traditional 12 nautical mile limit of territorial
 sea:
      38 U.S.C. § 1116A(d). Determination of Off-
      shore.— Notwithstanding any other provision of
      law, for purposes of this section, the Secretary shall
      treat a location as being offshore of Vietnam if the
      location is not more than 12 nautical miles seaward
      of a line commencing on the southwestern demar-
      cation line of the waters of Vietnam and Cambodia
      and intersecting the following points . . . [longitu-
      dinal and latitudinal coordinates].
     MVA argues that the 12 nautical mile limit should not
 apply, for Procopio and 38 U.S.C. § 1116(d) did not limit
 Vietnam’s territorial waters to any specific nautical mile-
 age, nor did the court define offshore waters by longitude
 and latitude as in 38 U.S.C. § 1116A. MVA argues that
 these delineations are contrary to this court’s holding in
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 MILITARY-VETERANS ADVOCACY v.                             15
 SECRETARY OF VETERANS AFFAIRS

 Procopio and asks this court to assure that the presump-
 tion of service connection applies to all naval and air ser-
 vice “throughout the Vietnamese theater of combat.” MVA
 Reply Br. 32. MVA points out that “§ 1116A captures some
 360 square nautical miles of the sea that lie outside the
 territorial sea of the Republic of Vietnam.” MVA Br. 39.
 MVA also argues that “§ 1116A does not capture the entire
 territorial sea of the Republic of Vietnam,” such as the sea
 near the island of Phu Quoc, id., and states that those ar-
 eas should be deemed covered by the presumption in view
 of our ruling in Procopio, where we stated that “all availa-
 ble international law, including but not limited to the con-
 gressionally ratified 1958 Convention, confirms that, when
 the Agent Orange Act was passed in 1991, the ‘Republic of
 Vietnam’ included both its landmass and its 12 nautical
 mile territorial sea,” 913 F.3d at 1376.
     The Secretary states that it was Congress, not the VA,
 that defined the geographic scope of what “offshore” areas
 were included within the Blue Water Navy Vietnam Veter-
 ans Act of 2019. See Sec’y Br. 52. The Secretary argues
 that Phu Quoc is not within § 1116A and that, “[i]f MVA
 wishes to challenge the scope of the plain reach of the stat-
 ute, it must direct that grievance toward Congress.” Id. We
 agree with the Secretary that, if any changes are war-
 ranted, the legislative process is the appropriate forum.
     MVA also objects to the remand of authority from the
 regional offices to a centralized team of administrators for
 processing claims for Agent Orange exposure. In accord-
 ance with the Blue Water Navy Vietnam Veterans Act of
 2019, the M21-1 Manual was amended to state:
     ROs are no longer authorized to establish if a Vet-
     eran’s service qualifies for herbicide exposure in
     RVN claims. The centralized processing teams will
     be responsible for all adjudication activities in-
     volved in processing blue water Navy conten-
     tions . . . .
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 16                           MILITARY-VETERANS ADVOCACY v.
                              SECRETARY OF VETERANS AFFAIRS

 M21-1 Manual, Section IV (ii)(1)(H)(1)(a). MVA states that
 the 2019 “withdrawal of authority from the Regional Of-
 fices leaves Blue Water Navy veterans who served outside
 the area defined in § 1116A completely unable to obtain a
 presumption of service connection in the initial adjudica-
 tion of their claims.” MVA Reply Br. 19. MVA’s criticism
 appears to be unwarranted, and unresponsive to the notion
 that a centralized team of experienced claim administra-
 tors is a desirable step in the area of complex medical sci-
 ence.
    The petition with respect to review of the Blue Water
 Navy Rule is denied.
                              C
                     THE AIRSPACE RULE
     After the Agent Orange Act was enacted in 1991, ques-
 tions soon arose as to what should constitute service “in the
 Republic of Vietnam” under the Act. The VA’s general
 counsel issued an opinion that concluded, for purposes of
 the presumption of service connection regarding Agent Or-
 ange exposure under 38 C.F.R. § 3.313, “‘service in Vi-
 etnam’ does not include service of a Vietnam era veteran
 whose only contact with Vietnam was flying high-altitude
 missions in Vietnamese airspace.” VA Office Gen. Couns.,
 Prec. Op. 7-93 Service in Vietnam under 38 C.F.R. § 3.313
 (Aug. 12, 1993), https://www.va.gov/ogc/opinions/1993prec-
 edentopinions.asp. This position was reflected in the
 M21-1 Manual, Section IV (ii)(2)(C)(3)(e) (the “Airspace
 Rule”). Efforts to remove the “high-altitude missions” lim-
 itation have not succeeded, as summarized supra. MVA
 asks us to act under § 502 to “invalidate the Airspace Rule
 as contrary to the governing statute, international law, and
 [our] recent decision in Procopio.” MVA Br. 29. MVA states
 that our reasoning in Procopio that explained the Agent
 Orange Act should be interpreted consistently with inter-
 national law compels the conclusion that the “Republic of
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 MILITARY-VETERANS ADVOCACY v.                              17
 SECRETARY OF VETERANS AFFAIRS

 Vietnam” includes the airspace above its territory. Thus
 MVA states that a regulatory exception for “high-altitude
 missions” should be corrected by action under § 502.
     MVA provided the affidavit of Frederick Hinchliffe, a
 U.S. Navy veteran who flew bombing missions over Vi-
 etnam, but never landed in the country. Hinchliffe states
 that on one of his bombing runs over South Vietnam at
 3,000 feet, “the air was significantly thick with yellowish
 haze” and “all vegetation was defoliated.” Id. at A3–A4.
 However, flying at 3,000 feet is not a high-altitude mission,
 as admitted by MVA. Id. at 26–27.
     MVA states that “if the Airspace Rule were vacated,
 Mr. Hinchcliffe [sic] would be able to show that he should
 be granted the presumption of service connection under a
 correct interpretation of the governing statutes and case
 law.” MVA Reply Br. 11.
      The Secretary argues that MVA’s challenge to the Air-
 space Rule is time barred under 28 U.S.C. § 2401(a), for the
 exclusion of high-altitude missions from the presumption
 of service connection has been the rule since 1993, and that
 the December 2019 M21-1 Manual revisions merely repub-
 lished the Airspace Rule with a change to capitalization.
 See Sec’y Br. 34–37; 28 U.S.C. § 2401(a) (“Except as pro-
 vided by chapter 71 of title 41, every civil action com-
 menced against the United States shall be barred unless
 the complaint is filed within six years after the right of ac-
 tion first accrues.” (emphasis added)). We agree with the
 Secretary that MVA’s challenge to the Airspace Rule is
 barred by the six-year limit provided in § 2401(a) because
 the rule has been in full force and effect since 1993. See
 Sec’y Br. 34–35.
     However, even if the time bar did not apply, we also
 agree with the Secretary on the merits. The Secretary sup-
 ports the current Airspace Rule by citing the statement in
 H.R. REP. NO. 116-58, at 11–12 (2019), reprinted in 2019
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 18                           MILITARY-VETERANS ADVOCACY v.
                              SECRETARY OF VETERANS AFFAIRS

 U.S.C.C.A.N. 279, that “an aircraft that passed in the air-
 space above the offshore waters would not have drawn wa-
 ter from the sea and therefore is not considered present
 within the offshore waters for purposes of this legislation.”
 Because Congress is presumed to have had knowledge of
 the VA’s Airspace Rule, the Secretary argues this state-
 ment signals that Congress chose not to enlarge the pre-
 sumption of service connection with respect to high-
 altitude flights. See Sec’y Br. 44–45.
     The Secretary points out that Congress has consist-
 ently preserved the high-altitude exception since its adop-
 tion in 1993. See id. at 44–46. It appears that Congress
 has, again, not accepted the position that MVA requests of
 the court. In the recently enacted PACT Act, in which Con-
 gress broadened the Thailand Rules, Congress explicitly
 included airspace service in the toxic exposure presump-
 tion for certain designated locations, but not Vietnam. See
 PACT Act, 136 Stat. at 1778 (defining “covered veteran” for
 certain toxic exposure presumption purposes as “any vet-
 eran who . . . performed active military, naval, air, or space
 service while assigned to a duty station in, including the
 airspace above [the named countries]”).
    The petition with respect to the Airspace Rule must be
 denied.
                         CONCLUSION
     This petition under 38 U.S.C. § 502 is dismissed as to
 the Thailand Rules and denied as to the Blue Water Navy
 Rule and the Airspace Rule.
       DISMISSED IN PART, DENIED IN PART
                            COSTS
 No costs.