Revised April 13, 2020
XIII.i.3.F.1.aDescription of NRI
Nasopharyngeal radium irradiation (NRI)** is a technique developed in the 1920s that used radium to treat hearing loss caused by repeated ear infections. This technique was also used for treating other conditions including
- sinusitis
- tonsillitis
- asthma
- bronchitis, and
- repeated viral and bacterial infections.
XIII.i.3.F.1.bBackground on NRI Use in the Military
Because NRI was effective in treating otitis media, military physicians used NRI to treat aerotitis media (barotrauma) in submariners, aviators, and divers due to enlarged tissue in the throat combined with rapid pressure changes.
XIII.i.3.F.1.cPolicy on Services Provided to Veterans
The Department of Veterans Affairs (VA) is authorized to provide Veterans with a medical examination, hospital care, medical services, and treatment for any cancers of the head or neck found to be associated with the Veteran’s receipt of NRI treatment during active service. Reference: For more information on NRI, see 38 U.S.C. 1720E.
XIII.i.3.F.1.dEligibility Requirements for Medical Care
To be eligible for VA medical care under 38 U.S.C. 1720E, the Veteran must have
- documentation of NRI treatment in active military, naval, or air service
- served as an aviator in the active military, naval, or air service before the end of the Korean Conflict, or
- undergone submarine training during active naval service before January 1, 1965.
Notes:
- Eligible Veterans may receive this care whether or not they are enrolled for VA healthcare.
- No co-payment is required for medical care associated with NRI treatment.
XIII.i.3.F.1.eTypes of Examinations and Care Offered
Veterans with head or neck complaints or who are concerned about the possible adverse effects of their NRI treatments will be offered the opportunity to receive an Ionizing Radiation Registry examination. Examination by an ear, nose, and throat specialist and additional studies, such as biopsies, will be performed if clinically indicated. Provision of other services for Veterans receiving medical care due to NRI treatment is dependent on eligibility, as determined by the medical facility.
XIII.i.3.F.1.fRO Involvement in Verifying Eligibility
If a VA medical facility cannot verify eligibility for medical care under 38 U.S.C. 1720E based on the information of record, it may send a request for verification of eligibility to the regional office (RO). The RO must then
- review the Veteran’s records to determine whether one or more of the eligibility criteria stated in M21-1, Part XIII, Subpart i, 3.F.1.d, have been met
- enter Eligibility to medical treatment under 38 U.S.C. 1720E [is/is not] established in Block 10 (Remarks) of Part II of VA Form 10-7131, Exchange of Beneficiary Information and Request for Administrative and Adjudicative Action , and
- return the form to the VA medical facility.
End of Part XIII, Subpart i, Chapter 3, Section F