Study finds ALS risk varies by military service branch

A comprehensive study examining nearly 10 million veterans in the VA medical system has found that the risk of developing ALS varies significantly depending on which branch of the military a veteran served in. Researchers from Harvard T.H. Chan School of Public Health and the Department of Veterans Affairs analyzed records from 2000 to 2024 and identified 14,419 patients with ALS diagnoses, revealing notable differences in diagnosis rates across service branches and ranks.

Amyotrophic lateral sclerosis, commonly known as ALS or Lou Gehrig's disease, is a fatal progressive illness that attacks motor neurons, causing them to lose connectivity and die off. The disease affects roughly 5,000 Americans each year, making it relatively rare even though military personnel are diagnosed at nearly twice the rate of civilians. The VA already presumes ALS to be service-connected given this heightened occurrence in the veteran population, meaning veterans with ALS diagnoses generally qualify for VA disability benefits without needing to prove a direct connection to their military service.

The study found that Air Force veterans had a 29 percent higher rate of ALS compared to Army veterans, who served as the baseline for comparison. Coast Guard veterans showed a 26 percent higher rate, while Navy veterans had a 15 percent higher rate. Marines had the lowest rate among all branches, coming in at 22 percent below the Army baseline. These findings were adjusted for sex, race, and ethnicity to ensure accurate comparisons.

Rank also played a significant role in ALS risk, with officers experiencing a 64 percent higher rate than enlisted personnel overall. Women officers faced an even steeper increase, with a 72 percent higher rate compared to their enlisted counterparts. The differences among branches were most pronounced in men aged 61 and younger, while veterans older than 75 showed less variation across service branches.

Researchers theorize that exposure to hazardous environments and substances during military service may contribute to the elevated ALS risk, including burn pits, jet fuel, exhaust, heavy metals, dioxins, and other toxic materials. However, no direct scientific connection has been proven. Study author Marc Weisskopf noted that officers and those serving in the Air Force, Navy, or Coast Guard may have been exposed to military environments that increase ALS risk, calling for future research to identify these specific exposures. Despite the statistical differences, the researchers emphasized that ALS remains rare, affecting less than 0.2 percent of the 9.9 million veteran records reviewed.

For disabled veterans, this research reinforces the importance of the VA's presumptive service connection for ALS, which removes the burden of proving causation for benefits eligibility. Veterans diagnosed with ALS are entitled to expedited claims processing and full disability compensation regardless of when symptoms appeared after service. The study's findings may eventually lead to better understanding of environmental hazards and improved prevention strategies for service members currently on active duty.

Veterans who develop symptoms associated with ALS, including muscle weakness, difficulty speaking or swallowing, or progressive loss of motor function, should seek medical evaluation promptly and file for VA disability benefits as soon as a diagnosis is made. Working with a Veterans Service Officer can help ensure claims are processed quickly and that all available benefits, including special monthly compensation and caregiver support programs, are accessed without delay.