CHATTANOOGA, Tenn. --- A Department of Veterans Affairs letter pledges free medical care and treatment for former patients who have tested positive for HIV or hepatitis since being exposed to endoscopic cleaning mistakes at three VA hospitals in the Southeast.

But advocates for veterans contend the VA should also be quickly pledging disability and damage payouts for some of the former patients and their families.

National Organization of Veterans' Advocates President Richard Cohen said the VA pledge of no-cost medical care -- included in a letter received Wednesday by a Tennessee congressman -- promises nothing "that the VA wouldn't do if these veterans were not subjected to unsanitary devices."

The VA's Web site shows seven veterans have tested positive for HIV among former patients exposed to mistakes with rigging or cleaning endoscopic equipment at VA hospitals in Murfreesboro, Tenn.; Augusta; and Miami.

Another 12 veterans among about 10,000 who have gotten follow-up blood checks have tested positive for hepatitis B and 36 others have tested positive for hepatitis C.

The VA and independent doctors say those rates of infection are far below what would normally be found among similar populations and a top VA doctor has said there is no way to trace the infections to VA mistakes he described as human error. Some medical experts disagree.

John R. Gingrich, the chief of staff to VA Secretary Eric Shineski, said in the letter to Democratic U.S. Rep. Bart Gordon of Tennessee that VA hospitals will provide plans of medical care and treatment at no cost to the veterans.

An aide to Mr. Gordon wrote in an e-mail that before Wednesday, "it was unclear if infected veterans would have to pay the $50 co-payments each time they received treatment as they are normally required to do."

VA spokeswoman Katie Roberts did not return messages.

Some other veterans' advocates agreed with a statement by Mr. Gordon, whose district includes the VA hospital at Murfreesboro, that the letter answering his request that former veterans who are infected get free medical care was "one step in the right direction."

Paul Sullivan, the director of Veterans for Common Sense, said that while the letter "appears to be good news because VA agrees to cover medical testing and treatment, the question of long-term disability compensation for veterans infected by VA remains open."

Mr. Cohen said the VA is saying they will provide continuing medical care for folks already receiving medical care.

"They are not giving them anything there," Mr. Cohen said. "The issue down the line in the case of somebody who has contracted hepatitis C or HIV or something else, the question is are they going to make these folks jump through hurdles in order to get" benefits or compensation.

"Somebody who receives negligent medical treatment and ends up with permanent disability is entitled to benefits," he said.