Treading carefully in the footsteps of legislation passed earlier this year, the Veterans Administration has put out guidelines saying it's up to VA doctors to decide whether veterans who claim an illness was caused by exposure to Agent Orange in Vietnam or to radiation from nuclear blasts should get preferential treatment at VA hospitals. They say nothing about compensation--VA administrator Robert P. Nimmo says compensation payments could cost hundreds of millions of dollars annually. Nor do they approve treatment in non-VA facilities, which usually are more expensive. Some 10,500 Vietnam veterans have asked the VA to treat illnesses they say were caused by the toxic herbicide Agent Orange; about 2,450 vets have put in claims for treatment of cancer caused by radiation exposure suffered while on duty near Hiroshima, Nagasaki or testing sites.

The VA, embroiled in lawsuits over these issues, emphasized these are only guidelines; it hasn't decided whether to issue regulations. National Veterans Law Center attorney Ronald Simon says the guidelines are inadequate, because few VA doctors are trained to treat patients exposed to substances like Agent Orange. VA officials argue that their doctors are instructed "to interpret the guidelines as liberally as possible." If a Vietnam vet claims Agent Orange caused his condition, and if the illness could conceivably have been caused by the herbicide, doctors should give the vet preference, the VA says.