A Marine veteran dying of cancer is stuck in limbo as the Department of Veterans Affairs mulls his claim for disability benefits, even though his condition is recognized by law as connected to his service.
Juan Santiago, 61, has a terminal cancer known as multiple myeloma.
Congress approved legislation in 2012 granting VA medical treatment -- but not automatic disability benefits -- for multiple myeloma and other conditions to veterans who served in Camp Lejeune, N.C., from 1957 through 1987 because of the water contamination.
The government also recognizes multiple myeloma as caused by exposure to Agent Orange, which Santiago encountered on trips to Vietnam to pick up military equipment for repairs.
But his claim for disability benefits has lingered unresolved by the VA for 10 months.
The last time he heard from the VA was in January, when he received a letter asking for proof the cancer is service connected, and for medical records. Santiago has been treated at a VA hospital since the cancer was diagnosed.
A Washington Examiner investigation published earlier this year - "Making America's Heroes Wait" - found VA processing errors often make veterans endure long delays after applying for disability benefits.
More than 1 million veterans have pending VA claims and appeals. The average wait for an initial rating decision is nine months, but delays often exceed a year or more.
Santiago knows he will die soon. Before that day comes, the former Marine hopes to resolve his stalled claim to ease his wife's financial burden when she becomes a widow.
The cancer in his blood nearly killed him once since he filed his disability claim in May.
"Nobody wants to talk about death, but I know it's going to happen," Santiago said. "I pray that letter comes giving me the award so I can say to my wife, 'Hon, you're going to be OK. You're going to be fine.' "
Santiago was 17 years old when he volunteered for the Marines, at the height of the Vietnam War in 1968. Though he did not see combat, he spent two years at Camp Lejeune, at a time when the water there was contaminated with deadly industrial solvents linked to the type of cancer now killing him. He also served in Okinawa, and on occasion flew into Vietnam to pick up equipment needing repair.
For most of his life, Santiago had no serious health issues. After the service, he became a general contractor in Florida. Then he blacked out while driving one day in Texas in 2005 and woke up in an emergency room. Doctors said his kidneys failed but they weren't sure why.
Santiago lost his job and health insurance when the blackouts continued. So he sought treatment for what he thought was kidney disease at a VA medical facility in 2009.
He also filed a disability claim then, but the VA denied it after agency doctors couldn't prove it was connected to military service. Then in May 2012, they found the cancer.
He nearly died last December because of internal bleeding. Eighteen pints of blood saved him.
VA officials say they're studying the links between the water contamination at Camp Lejeune and medical conditions including multiple myeloma. The agency opposed the legislation recognizing service connection for medical care. Veterans still must prove their medical conditions are directly related to military service to receive disability benefits.
So Santiago waits.
He draws strength from helping other veterans with cancer he sees at chemotherapy sessions. The new patients are easy to spot, he says.
"You can see the terror in his eyes," Santiago said. "You can hear the fear in his voice."
He comforts them, helps them understand what's ahead.
"What makes you stay alive and what makes you strong is you try to encourage him to stay strong," Santiago said. "I don't like to face it. I know it's coming. But for my family, I stay alive. For my loved ones, I stay alive. For the Marine that needs me, I stay alive."
Mark Flatten is a member of The Washington Examiner's Watchdog investigative reporting team. He can be reached at firstname.lastname@example.org.