26 August 2014

President Announces Executive Orders to Address Veterans' Issues

Speaking today at the American Legion's 2014 National Convention, President Obama announced nineteen steps he is taking through executive orders to address the ongoing scandal in the Department of Veterans Affairs. Unfortunately, nothing was mentioned about the claims or appeals process. (CLICK for complete speech)

Yesterday, the VA itself released an Inspector General report which indicates no deaths can be positively attributed to the delays in patient care in Phoenix, despite whistle-blower allegations.

Among the key points in the President's orders are:

• A new recruiting campaign to fill shortages of doctors and nurses at VA hospitals.

• Automatically enrolling military personnel receiving mental health care into mental health treatment programs by the VA.

• A partnership with five national banks to help veterans get lower rate mortgages easier.

• New efforts to better understand traumatic brain injuries, including a $34.4 million VA suicide prevention study involving 1800 veterans at 29 VA hospitals, and more suicide prevention training for military and VA personnel.

• Automatic enrollment of separating service personnel in transition programs.

In recent weeks the VA has also trumpeted grants for homeless veterans throughout the country, dedicating millions towards this serious need.

The VA scandal erupted in April when a retired doctor at the VA hospital in Phoenix disclosed that long wait times may have contributed to the deaths of as many as 40 veterans. A preliminary investigation found that delays and falsified records were widespread through the VA system.

The President assured the Legionnaires, "We are going to fix what is wrong. We are going to do right by you and your families, and that is a solid pledge and commitment I’m making to you here.”

The American Legion has long been a supporter of C-123 veterans' Agent Orange exposure claims, for which we continue to express our gratitude.

Dave Zamorski Retires!

We note with respect and affection the upcoming retirement of Lieutenant Colonel David Zamorski, ART Administrator of the 439th Aeromedical Evacuation Squadron, Westover AFB, MA.

When I was Technical Sergeant, I watched David first come to the squadron, get oriented by Vinny McCrave, and advance to Senior Airman while earning his aircrew wings as an Aeromedical Evacuation Technician. In 1980 he was selected for a commission as a Medical Service Corps officer.

David's service includes OIF, and he is the longest-serviing member of the squadron (originally the 74th Aeromedical Evacuation Squadron.)

It will be hard to replace him!

Happy trails,

      Wes

25 August 2014

VA Attorneys Create New False C-123 Claims Barrier

Under the leadership of James Ridgeway, Chief Counsel for Policy and Procedure with the VA Board of Veterans Appeals, new and creative anti-veteran strategies have been introduced by his attorneys specifically to prevent C-123 exposure claims.

BVA attorneys are responsible for prevention of appealed claims, and represent their client, the VA Veterans Benefits Administration with gusto, creativity and zeal.

But not with accuracy. Or ethics. Or honesty. In 2007 LtCol Aaron Olmsted's exposure claim was denied when VA attorneys withheld, or pointedly did not seek or provide Olmsted's representative) proof that the C-123s he piloted for thousands of hours had sprayed Agent Orange in Vietnam. Even when that Air Force evidence was provided after the fact, BVA attorneys (even their association's ethics chairman) insured his widow Diane's claim remained denied. After all, to BVA counsel, success is found only in a denied claim, or at least one delayed past the veteran's death.

To prevent C-123 veterans' claims from approval, BVA attorneys have begun citing completely non-existent "scientific studies" by Veterans Health Administration. Please note: these proofs don't exist – VA made them up! 

The only scientific studies ever done concluded the opposite – that C-123 veterans were exposed and have a greatly increased cancer risk (CDC/ATSDR.) The only peer reviewed study reached the same conclusion...veterans were exposed.

In fact, VA's references to "scientific studies" amount to nothing more than several web pages which mention carefully selected (and most pointedly, carefully avoid) references, and a one-page policy statement VA Issue paper authored by Dr. Terry Walters in 2011.  There have been no scientific studies completed which found the veterans were not exposed – even the 2012 USAF C-123 Consultative Letter and follow-on explanations to the Senate said VA should not use for rejecting C-123 veterans' claims and that individual exposures could not be calculated. This report has since been repudiated by some of its contributors.

Clearly, it is important, indeed Job One, for BVA attorneys opposing veterans to appease VBA and prevent helpful documentation falling into the hands of opposing representatives. So much for the legal requirement, but phony pro-veteran, non-adversarial and veteran-friendly VA treatment of veterans' claims. Faced with the possibility of a defeat by veterans having the full facts and by reference to actual scientific studies, Mr. Ridgeway's victories against the veteran trumps the profession's expectations of his staff.

Dr. Walters' (Deputy Chief Consultant at VHA's Post Deployment Health Public Health section) single page was in preparation to oppose veterans' concerns in an upcoming teleconference with non-VA scientists and C-123 veterans. Together with her colleagues (Dr. Wendi Dick, Dr. Theresa Irons, Dr. Michael Peterson, and VBA's Mr. James Sampsel) they explained in the October 2011 teleconference that none of the C-123 veterans' claims would likely be approved.

Then on February 28, 2013, Mr. Tom Murphy (Director VBA Compensation & Pension, who denies claims on the basis that "TCDD hasn't been shown to be harmful") explained to me and Major Marlene Wilson USAF NC that none of the C-123 claims would ever be approved because Dr. Walters and her associates had already determined that none of the veterans were ever exposed. Thus VHA Post-Deployment Health overruled the Secretary's and General Hickey's assurances to veterans that all C-123 claims would be handled on a "case-by-case" basis.

This opposition to C-123 veterans claims was based on a theory VHA and VBA accepted in 2011 and formed upon the writings of Dr. Al Young. Apparently, he was the scientist who apparently first insisted that none of the Vietnam ground troops were exposed in his 2004 article for Dow and Monsanto  (manufacturers of Agent Orange,) and his July 2011 article in Military Medicine. Young expounded on his theories which were music to the ears of VBA and VHA executives who, as reported in the Associated Press, were determined "to draw the line somewhere" regarding claims of exposed veterans. Young did so by disputing the more current research presented to the IOM and instead citing work decades old. Young argues that the !991 Agent Orange Act was an inappropriate response to veterans' needs, even dismissing statistical evidence of Vietnam veterans' illnesses.

Perhaps Mr. Ridgeway isn't aware of the fact that VA's entire foundation for opposing C-123 veterans relies on its Agent Orange consultant, Al Young. Dr. Young in 2011 described us, the veterans Ridgeway seeks to keep out of VA hospitals, as "trash-haulers, freeloaders looking for a tax-free dollar. I have no respect." Apparently BVA is okay with such distain from its experts but not with experts whose opinions are respectful and in favor of our exposure claims.  Dr. Young's $300,000/year no-bid, sole-source Agent Orange consulting contract has created such useful information for Ridgeway's case work.

Ridgeway's team seems to have begun deceiving judges at the Board of Veterans Appeals with citations of VHA's non-existent "scientific studies" approach in 2013. A search of BVA decisions shows the frequent reference, and reliance by BVA judges upon these non-existent references. This is despite numerous truly scientific studies which conclude the C-123 veterans were indeed exposed.

Ridgeway's staff clearly ignores, and of course prevents informing the veterans' representatives, similar findings by other federal agencies which have reached the same conclusion that C-123 vets were exposed...National Institutes of Health, the Agency for Toxic Substances and Disease Registry, and the US Public Health Service. Proofs of veterans' exposure claims are ignored or dismissed by Ridgeway's skilled attorneys.

BVA also ignores the Yale Law C-123 conclusion that the veterans are presumptively service connected for recognized Agent Orange illnesses. BVA's motivated staff of attorneys finds it best to dismiss any such legal or scientific proofs arguing for the veteran.

The first BVA citation below is for a Navy, not C-123 veteran, but the inclusion of such language is terrifically wrong! VBA did not "review all available scientific evidence" but instead VHA Post Deployment Health selected references it felt best blocked exposure claims to fulfil VHA policy. This can be seen from their cited references, paid-for opinions, Dow/Monsanto opinions but avoidance of unpaid and independent expert input from ATSDR, NIH, USPHS, Columbia, OHSU, etc., all of which argue in the C-123 veterans' favor.

Further, this policy by BVA defies statements from VA leaders, including Secretary Shinseki and Under Secretary Hickey, that each claim will be considered on a case-by-case basis, as instead VA automates the denials not only at BVA but directs RO denials as well.

Examples:
"Citation Nr: 1426689: the Department of Veterans Affairs did address residual Agent Orange exposure concerns by post-Vietnam crews that later flew C-123 aircraft that had previously sprayed Agent Orange. VA's Office of Public Health is noted to have reviewed all available scientific information (?) regarding the exposure potential to residual amounts of herbicides on the C-123 aircraft surfaces. It was concluded that the potential exposure for the post-Vietnam crews that flew or maintained the aircraft was extremely low and therefore it was concluded that the risk of long-term health effects was minimal. See http://www.publichealth.va.gov/exposures/agentorange."
And from an April 2014 BVA decision, also reflecting VBA's damage. (Actually, these studies and findings have repeatedly been brought to VA's attention.)
"Citation Nr: 1413377: there are no studies that VA is aware of showing harmful health effects for any such secondary or remote herbicide contact that may have occurred."
From others:
 "An undated Compensation Service Memorandum indicates  that there was no presumption of secondary exposure based upon being near or working on aircraft that had flown over Vietnam or handling equipment once used in Vietnam, noting that the aerial spraying of tactical herbicides in Vietnam did not occur everywhere and that it was inaccurate to think that herbicides covered every aircraft and piece of equipment with Vietnam.  Additionally, the undated Memorandum notes that the high altitude jet aircraft stationed in Thailand generally flew far above the low and slow flying UC-123 aircraft that sprayed tactical herbicides over Vietnam during Operation Ranch Hand.  The Memorandum also reflects a comment that there were no studies showing harmful health effects for any such secondary or remote herbicide contact that may have occurred. "
"Citation Nr: 1337387: note, the Department of Veterans Affairs did address residual Agent Orange exposure concerns by post-Vietnam crews that later flew C-123 aircraft that had previously sprayed Agent Orange.  VA's Office of Public Health is noted to have thoroughly reviewed all available scientific information regarding the exposure potential to residual amounts of herbicides on the C-123 aircraft surfaces.  It was concluded that the potential exposure for the post-Vietnam crews that flew or maintained the aircraft was extremely low and therefore it was concluded that the risk of long-term health effects was minimal.  (See www.publichealth.va.gov/exposures/agentorange.)  Otherwise, other than his unsubstantiated allegations, there simply is no evidence that the Veteran was exposed to Agent Orange or other herbicides based on his contact with any military vehicle that may have once been used in Vietnam."
Mr. Ridgeway, together with VBA/VHA, has institutionalized the C-123 non-exposure position, citing totally  non-existent "scientific" studies on VBA web pages which were policy statements and not scientific studies, and which are contradicted by VA's Federal Register publications and statements by VA leadership. These unscientific positions then become cited by BVA in refusing care to exposed veterans.

Nothing supporting the veterans' claims, although proofs are present in the files of VA's Office of General Counsel, VBA Under Secretary Allison Hickey, and VHA's Dr. Victoria Daveys, is made available to veterans by the VA during claims, appeals or cases before the US Court of Appeals for Veterans Claims. According to FOIA responses from VA, nothing about C-123s even exists, other than its web pages.

It seems to BVA and Mr. Ridgeway's staff that VHA web pages citing non-existent "scientific studies" by Post Deployment Health trump repeated VA Federal Register publications addressing non-Vietnam herbicide exposures.

As the President said before the American Legion today, " That's how we will uphold the sacred trust with all who've served in our name." 

BVA sees upholding the "sacred trust" much differently.

Court of Appeals for Veterans Claims Sees Trouble Ahead With Caseload

In its current condition, the U.S. Court of Appeals for Veterans Claims can handle its caseload. But a judge on that court with close ties to The American Legion told Legionnaires at the 96th Annual National Convention in Charlotte, N.C., that things are changing.
Past National Commander Alan Lance, Sr., a judge on the U.S. Court of Appeals for Veterans Claims, told the Legion’s Veterans Affairs & Rehabilitation Commission on Aug. 24 that staffing issues facing the court – along with an increase in appeals coming before it – could put the court in a precarious spot.
“Right now, we have nine judges, and we’re adequately staffed and prepared to deal (with the current caseload),” said Lance, the Legion’s national commander from 1999-2000 and a former Idaho attorney general. “Very soon, we’re going to start losing judges. Unless Congress reauthorizes the maximum strength of nine judges, that strength will be reduced to seven judges at about the time (the court’s caseload will increase).
“In addition to that, we have judges whose terms of service will expire, and it takes a while to get a judge nominated, confirmed and through the process. So … we’re going to be pretty busy, we think. I’m sure we’ll have some suggestions at the appropriate time, but right now we’re just watching it come down the mountain, trying to figure out when it’s going to hit and how much it’s going to be.”
In 2002, the Court of Appeals for Veterans Claims handled more than 17,000 cases. That caseload could approach more than 50,000 this year. “We’re prepared to deal with it right now, but as circumstances change, we may be coming back and explaining our problems to you,” Lance said.
An understaffed Department of Veterans Affairs’ Group 7 – attorneys tasked with more or less prepping cases to go before the Court of Veterans Appeals and then argue cases on behalf of VA – will impact the court, Lance explained. “They’re going to be requesting more time … and they’re going to slow up the appellate process if they’re not properly staffed,” Lance said. “Our court has no control over this. It’s the (VA) secretary’s bailiwick. But if (Group 7’s) processes slow down, then our processes will slow down. That’s my concern.”

Deceptive VBA Freedom of Information Act Response!

On July 29, 2014, in partial response to my suit in the US District Court of Washington DC for information due me under the Freedom of Information Act, VBA sent a letter. It seems inaccurate and incomplete....in the extreme!

VBA stated, in effect, they had no records relating to the C-123 issue except the three or four Internet pages on the VA web sites.  They denied knowing anything about the current IOM study, other than that it is underway.

Their denial is so broad, they even denied their VBA staff preparing the letter Secretary Shinseki sent to Senator Burr regarding the C-123 veterans. Good thing, because the letter was riddled with errors. A perfect example of how Secretary Shinseki was torpedoed by his staff as they went about their personal agendas.

As for the information which surely exists, VBA insists there were no notes taken before, during or after any of our meetings. No knowledge of the hundreds of pages of letters and forms and source documents the C-123 veterans provided. No knowledge, no records, no recordings, no emails, no correspondence, Nada.

But how can VBA deny the existence of the September 27, 2012 $600,000 contract they let to A.L. Young Consultants? How can they deny existence of documents approving the contract, arranging the funding, receiving the reports, correspondence, distribution within VBA and VHA...how can they honestly evade answering the FOIA in a formal response? How can they deny correspondence between VBA and Joint Services Records Research Center? How can they deny ordering VAROs, such as Portland, to deny C-123 veterans' claims and then deny existence of the emails which were already provided the claimants?

Because this is the VA. What can you do? Appeal?

They do as they wish, as there are no individual penalties for deception or evasion. And they take their sweet time about their inaccurate and incomplete response – the FOIA was given them in October. Instead of responding in the 20 days FOIA requires, VBA opted to ignore it and take until the end of July to respond. So much for VBA adherence to the President's own directives, and statements from the President about FOIA being a fundamental element of American democracy.

This fits in perfectly with the overall VA policy of delay, delay until we die. That's not just a phrase...they mean it.

What the VA Doesn't Want the Institute of Medicine C-123 Post-Vietnam Agent Orange Exposure Committee to Know:

VA gathered the Institute of Medicine this spring and summer to study the post-Vietnam C-123 transports and the aircrews' Agent Orange exposures. Their report on what the VA should do will be submitted to the Secretary of Veterans Affairs by the end of September 2014. C-123 veterans notified IOM staff and the VA we consider this an an unethical step by VA to prevent currently qualified exposure veterans from receiving care the law now provides, with VA seeking to use IOM to construct a specific barrier in our situation.

But the committee doesn't have all the facts before it. The C-123 veterans wish to make known the various reports, studies, and other relevant documents, because the end of June was the committee's cut-off date for formal submission and many new items have been uncovered in the last two months.

Here are new developments or materials not previously submitted to the committee:

1. USAF has withheld hundreds of pages of its post-Vietnam C-123 Agent Orange study from release to veterans and the public, but provided everything to the VA. 
The USAF, through suits filed in the US District Court of Washington DC, has released some of the too late for the IOM, USAF released only heavily redacted materials, with nearly every page of the 380 completely blank. The only useful item was a single paragraph in which the USAF research team on post-Vietnam C-123 exposures grouped our exposures with those of Operation Ranch Hand. They then concluded because Ranch Hand veterans are reasonably healthy, the C-123 veterans were somehow not exposed to harmful amounts of Agent Orange. Actually, the AF should have likened our degree of bioavailability to the Vietnam ground troops or even more, according to Dr. Jeanne Stellman of Columbia.
materials sought under the Freedom of Information Act request we first filed in 2012. Last week, years late and

2. VA withheld most pages of its post-Vietnam C-123 Agent Orange activities from release to the veterans and the public.
VA promised through the US District Court requested documents by the end of May, but continues to request postponements and releases nothing except the request for the next postponement. VA references "scientific studies" on its web pages which even the VA Board of Veterans Appeals cites as authority for denying C-123 exposure claims, yet apparently no such studies exist...only the VHA collection of references and selection of those best aimed at preventing veterans' claims. Subsequently in July 2014, VBA officials even denied knowledge of the A.L. Young Consultants $600,000 contract let in 2012, and of all reports, correspondence and other information.

3. Other Federal agencies have concluded the C-123 veterans were exposed and suffered harmful results.
At one point the Secretary of Veterans Affairs told the Senate that "many independent scientists voluntarily came forward" to argue against C-123 veterans' exposure claims, but it turns out there were only three, and each was paid to offer their opinions, one by VA and the other two by Dow and Monsanto. The Secretary dismissed the dozens of "Concerned Scientists and Physicians" who'd written him through Dr. Stellman as their corresponding scientist, and all of whom were unpaid. The Secretary, writing Senator Burr, dismissed these experts with a minimizing adjective as "some."
Please note that three voices against the veterans are termed "many" but dozens confirming the veterans' exposures are termed, "some."

He ignored input from the National Institutes of Health/NEISH and the CDC/Agency for Toxic Substances and Disease Registry in explaining to the Senate why VA refuses C-123 claims. The Secretary's misleading letter to the Senate, perhaps an example of what the Secretary meant when he resigned because of poor staff work, was prepared by Mr. James Sampsel in VBA who has opposed C-123 veterans' claims since we first began submitting them in 2011.

4.  VA's spokesperson to the IOM C-123 committee was paid $600,000 for his services, but did not reveal this to the committee.
VA was represented at the June 16 IOM C-123 committee meeting by Dr. Al Young of A.L. Young Consultants LLC. He did not inform the committee that he enjoys a $600,000 two year no-bid sole-source consulting contract to help VA prevent post-Vietnam exposure claims. The Dow and Monsanto-sponsored reports properly noted their chemical industry sponsorship. Young works out of his home office.  All six major veterans service organizations have demanded the VA cease contractual relationships with this firm.

5. As I told told the committee, the legal issue for the benefits claimed by C-123 veterans is exposure itself, and not bioavailability.
The law, regulations, US Code and Federal Register simply specify exposure to be eligible for what VA terms "presumptive service connection" for recognized Agent Orange illnesses. We've established our exposure to the satisfaction of legislators and Yale Law School as well as other federal agencies. Agencies with the actual statutory authority and expertise in exposure issues such as CDC, NIH and the US Public Health Service have informed VA that we've been both exposed and harmed by it. VA currently orders all C-123 exposure claims denied but the Board of Veterans Appeals almost always overturns and awards benefits to the veteran. To address this, VA's office of General Counsel has opined that VA can redefine exposure in any unique manner it wishes to prevent exposed veterans from being able to meet the law's requirement which only states "exposure."

6. VA did not reveal that its spokesperson at the June 16 IOM was personally involved in ordering destruction of the toxic C-123s in 2010 (and as he stressed, to prevent potential veterans' claims), and had a background making him an inappropriate decision-maker regarding these veterans' health.
In a 2009 series of "Decision Memoranda" to Air Force leaders, the consultant, in his capacity as Senior Consultant to the Office of Secretary of Defense, recommended cessation of all further testing and the immediate destruction of the toxic C-123s, then in quarantine storage at Davis-Monthan AFB, AZ. Citing the consultant's unique authority from the Office of Secretary of Defense, Mr. Wm. Boor requested and received from the Air Staff approval for destruction.

This has provided the consultant a unique historical role over four decades:
A. In the '60's he helped develop Agent Orange as a military herbicide and tactical weapon employed from the modified C-123K (which became the UC-123K.)
B. After the war, he provided scientific background to the Department of Veterans Affairs and the Office of Secretary of Defense, as well as the Executive Office of the President, in which roles he formulated the Administration's firm resistance to veterans' Agent Orange claims. He received the Legion of Merit in 1985 for this (the citation can be read if enlarged)
Source: USDA AL Young Library
C. The 1991 Agent Orange Act resolved most struggles and greatly deflated the consultant's role at VA significantly as exposure questions were resolved by legislation and VA's continued obstruction was tempered. The consultant's continued opposition of claims by his assertion of the innocence of Agent Orange, simply became irrelevant. Anybody in Vietnam was considered presumptively exposed, and any other veteran able to prove exposure, was also considered to have presumptive service connection. The battle against Vietnam veterans' claims lost, the consultant moved on. His Legion of Merit citation even stressed how valuable he was to the VA in working their Agent Orange program, and was presented by VA leadership in a special ceremony.
D. To continue having a voice in opposing exposure claims, in 2004 the consultant began publishing articles continuing to assert the innocence of Agent Orange and his proposition that none of the Vietnam War veterans were ever exposed...this argument being the development of his idea of bioavailability. Bioavailability was proven for the Operation Ranch Hand veterans who continued in relative fair health, but never tested for the ground troops whose exposures would have been less intense...therefore they weren't exposed or harmed, was his theme. This is contrary to IOM and VA findings as well as the generally accepted scientific conclusion. But it was welcomed by VA VHA Post-Deployment Health as the foundation for their obstruction of post-Vietnam claims.
E. In 2006 he apparently worked a subcontract through Battelle in which he specified to the Department of Defense which non-Vietnam Agent Orange sites were to be recognized. That list is used by VA to deny all claims for not specified by the consultant.
F. In 2008 he was recommended to the Air Force by the Office of Under Secretary of the Army when questions arose about the C-123 fleet then retired to special HAZMAT quarantine storage at Davis-Monthan AFB, Arizona.
G. In 2009, using three separate "Decision Memoranda" he recommended immediate destruction of the toxic airplanes and all associated equipment because of the need to prevent future exposure concerns, agreeing that the airplanes, even if decontaminated, exposed the Air Force to liability. Because of the cost of testing, he recommended all tests be terminated. He advised the Air Force that post-Vietnam C-123 veterans might learn of the contamination (at that time, all information was withheld from the public under "Official Use Only" per the USAF Office of Environmental Law attorneys') and apply for VA treatment of Agent Orange illnesses, because the laws provided that exposed veterans were to be granted "presumptive service connection." Citing his authority the destruction was approved by USAF.
H. In July 2011 he denigrated the post-Vietnam C-123 veterans, many of whom are veterans of Vietnam, the Gulf War, Somalia, Panama and other combat situations, as "trash-haulers, freeloaders looking for a tax-free dollar from a sympathetic congressman. I have no respect." This should have disqualified him from any further official or unofficial role in C-123 veterans' benefits.
I. In 2012 he approached the VA with an unsolicited proposal for post-Vietnam Agent Orange studies and catalogue operations. He immediately provided a report on how to prevent C-123 veterans' exposure claims with several that followed.
J. In 2014 he provided additional barriers for VA to employ blocking C-123 veterans' claims, and appeared before the June 2014 IOM C-123 Agent Orange committee hearing to "explain" the VA perspective which he formed with them for $600,000.  This gave him a complete historical role regarding C-123 veterans.

7. VA Expenditures Regarding C-123 veterans' exposure claims:
    -Support Veterans' Claims: $0.00
    -Prevent Veterans' Claims: $600,000 plus contractor expenses, VA staff salaries, travel & benefits
    -Contract extension with Institute of Medicine: unknown but language of the charge is considered to direct a negative response regarding the legal question of exposure and to force an inconclusive response regarding degree of harm, as this has been the result of previous IOM, unless the committee opts to exceed its charge and act with independence. Dow & Monsanto also sponsored opposition to C-123 veterans at the June 16 2014 Institute of Medicine hearing.

8. In 2013 the USAF Assistant Surgeon General informed the Senate Veterans Affairs Committee that the USAFSAM C-123 Consultative Letter should not be used by VA in denying C-123 veterans' claims.

Still, VA cites it as the foundational document in preventing all C-123 veterans claims. VA further cites its own "scientific study" which is actually only a single page point paper typed in 2011 in preparation for the initial teleconference between VHA, VBA,C-123 veterans, and several scientists. The VA "scientific study" pointedly ignored every finding and opinion supporting C-123 veterans' claims...only publications which could be interpreted to argue against exposure were cited. This "scientific study" was thus only a policy statement.

In its response to the Senate, the AF illogically also reported that its conclusion aircrews were not exposed was "consistent" with the ATSDR finding that aircrews were exposed, and AF simply disregarded the ATSDR finding that the aircrew cancer risks were greatly increased.

9. The Air Force Ranch Hand Study considered non-Ranch Hand C-123 aircrews as potentially exposed from flying converted spray airplanes.
From the early study:
"Another possible control group, the non-Ranch Hand C-123 population, is known to be too small (approximately 3000) to provide flexibility and replacement under the proposed best match variable concept (see below and Section VI,A). Many of the Ranch Hand aircraft were reconfigured for transport and insecticide missions and thus, non-Ranch Hand crews responsible for these other missions, may have been exposed to Herbicide Orange residues in these aircraft. This group may not be considered truly unexposed to herbicides..."

24 August 2014

The Army Proved the C-123 Exposures, Despite VA Dismissal

It was heavily downplayed by VA and USAF in their C-123 reports. The Army's Technical Guide (TG) 312, considered the "gold standard' in its treatment of surface contaminations was dismissed as irrelevant regarding implications for C-123 post-Vietnam veterans.

It had to be. TG 312 was too accurate, and too spot-on to simply ignore, as VA and USAF had ignored the expert input from other federal agencies. VA's agenda was, and is, to "draw the line somewhere" (Dr. Terry Walters, VHA to the Associated Press 2014) and prevent any further Agent Orange exposure claims (Dr. Terry Walters to Major T. Rudd, US Army Chemical Corps 2012.) Because it helped establish C-123 veterans' exposures, the Army's TG 312 was a hurdle before VA in blocking claims, so they simply tipped it over and went around. VA's stated policy objective regarding post-Vietnam claims was, as they've stated since the beginning, to prevent approvals.

The Air Force Times itself did a complete explanation of the whole mess, and VA's intransigence, with a full-page article and also its editorial echoing that of other major publications.

By careful selection of which references to use and which experts and other federal agencies to ignore, VA VHA formed their arguments to prevent claims, and against the veterans, rather than letting the full body of evidence be evaluated to form their policy.

VA dismissed TG 312 as having no relevance for the C-123 interior and the aircrews' exposure. The complex interior of the C-123, mind, is of aviation grade aluminum, painted aluminum, wood, canvas, leather, glass, adhesives, other metals, canvas, fiberglass, wrapped electrical cables...many different surfaces upon which Agent Orange and its contaminant, dioxin, penetrated over the Vietnam years and then began to degrade.

The slow degrading was through weak UV exposure, as well as dioxin's half-life, different on different surfaces. But it was there, for decade after decade following Operation Ranch Hand in Vietnam, through the decade we flew them (1972-1982,) through the next decade while Patches (#362) sat at the USAF Museum, until Patches was tested "heavily contaminated on all test surfaces" in 1994.

TG 312, along with the USAF toxicologists who actually tested Patches, clearly showed these former spray aircraft a toxic threat to the crews who'd flown them. So VA dismissed both. VA said the AF tests were not applicable to the rest of the C-123 fleet (which hadn't been decontaminated but was determined with repeated tests to be contaminated with Agent Orange,) and TG 312 was based on wipe samples which disturbed the surfaces testing tested and therefore was inaccurate.

TG 312 is the "gold standard" of the US Army, respected by virtually every government, university and independent toxicologist, but VA's goal was to insure it somehow did not apply to the C-123 because tests on the C-123s, evaluated against TG 312, supported the veterans' exposure claims, even VHA's unique redefinition of "exposure" to require bioavailability. And wipe tests prescribed by TG 312 had adjustments calculated for physical disturbance in the testing procedures, a critical point mischaracterized by VA.

But most tellingly, the bioavailability is addressed in the TG 312  equations.  The surface and airborne concentrations are multiplied by various factors to yield an estimated dose by the various routes of exposure. For example,  by the direct dermal contact route, specific to dioxin, TG 312 notes the dermal absorption factor is 0.001, perhaps less significant unless exposed to large amounts over longer periods  However, the major routes of exposure are dermal to oral and inhalation which bypass the dermal barrier.  So VHA Post Deployment Health and its VA/Dow/Monsanto consultant Dr. Al Young were only partially correct positing that via direct dermal contact dioxin is not readily bioavailable.*

Exposure by ingestion and inhalation, exposure and yes...also bioavailability. Less so by dermal contact which was still intensive over the decade working on these transports, but it was there, too. We were exposed, and there was bioavailability. As Yale Law and other legal scholars agree, C-123 post-Vietnam veterans who flew former Agent Orange spray aircraft met the legal and regulatory standards to present vet's exposure claims. In 2001, 2008 and 2010, VA even said so, but this was before the C-123 vets grew concerned about our exposures, so VA had to redefine the word "exposure" used in several Federal Register promises to treat exposed veterans, so that they could better pretend we weren't exposed.

But VA says, "NO." VA orders regional offices to deny claims, has its C&P Agent Orange Inquiry Desk return "recommend disapproval" responses to claims forwarded IAW VA 21-1MR,  and create web pages alluding to non-existent "scientific studies" which were merely selective literature reviews to form words around VA's "we cannot permit any C-123 claims," as per Dr. Terry Walters, Deputy Chief Consultant, VA Post Deployment Health. "VHA has told us no C-123 veterans were ever exposed," according to Mr. Tom Murphy's statement on February 28, 2013 in his office conference with C-123 veterans.

The recent non-release of the FOIA'd USAF C-123 records, in which only a handful of hundreds of white pages had copy left on them after nearly all information was redacted, a line showed that the point-of-contact the Army for TG 312 would like to follow and assist the USAF C-123 investigation – but all such information was redacted and we don't know any more.

Neither do we know much about the VA's $600,000 sole-source, no-bid two year contract with A.L. Young Consultants LLC for post-Vietnam Agent Orange exposure claim prevention...so many pages of the contract were redacted when released by VA. Amazing: the US government opts not to release information about Agent Orange studies it pays to conduct to the veterans who have been exposed and who need that information to accept, or to challenge its conclusions.

One final observation: the VA sought out the US Army Public Health Command for input regarding its TG 312 and the two organizations communicated regarding the C-123s. We veterans also wrote the Army with questions, but our inquiries were ignored, both the formal letters and the emails. The Army Public Health Command has in its mission statement the duty to assist in this regard, but withheld that assistance except to the VA.

* email, Dr. Peter Lurker to Major Wes Carter, 23 August 2014

23 August 2014

Obama Nominee for Ass't Secretary for Policy & Planning Schwartz Says, "U.S. must find 'better ways' to get medical care to veterans."

Retired Col Linda Schwartz, PhD.
(note: Dr Schwartz once flew with the 74AES from Westover AFB, MA)
Linda Schwartz, the commissioner of Veterans' Affairs in Connecticut, gave the keynote speech at the Community Mental Health Summit hosted by the University of Alabama at Birmingham (UAB) on Fri., Aug. 22, 2014.
Jesse Chambers | jchambers@al.com
Print Jesse Chambers | jchambers@al.com By Jesse Chambers | jchambers@al.com

BIRMINGHAM, Alabama – A recently passed federal law should be good news for veterans seeking to get access to health care through the Veteran's Administration (V.A.), according to Linda Schwartz, the commissioner of Veterans' Affairs in Connecticut.

The Veterans' Access to Care through Choice, Accountability and Transparency Act – signed by Pres. Obama about two weeks ago – is "massive" and contains "sweeping changes to call the V.A. to be accountable," Schwartz said today at the Doubletree Hotel downtown just prior to her keynote speech at a Community Mental Health Summit hosted by UAB.

As part of the new law, "we are going to see if some of these things that the V.A. has been doing... are effective or not," Schwartz said.

A U.S. Air Force nurse during the Vietnam War, Schwartz has a doctorate in public health from the Yale School of Medicine.  She is also Obama's nominee as assistant secretary of Veterans Affairs for Policy and Planning at the U.S. Department of Veterans Affairs.

BVA Cites Non-Existent VHA "Scientific Studies" to Deny Exposure Claims

The first BVA citation below is for a Navy veteran and not C-123, but the inclusion of such language is
terrifically wrong! VBA did not "review all available scientific evidence" but instead VHA Post Deployment Health selected references it felt best blocked exposure claims to fulfil VHA policy. This can be seen from their cited references, paid-for opinions, Dow/Monsanto opinions but avoidance of unpaid and independent expert input from ATSDR, NIH, USPHS, Columbia, OHSU, etc.

Further, this defies statements from VA leaders, including Secretary Shinseki and Under Secretary Hickey, that each claim will be considered on a case-by-case basis, as instead VA automates the denials not only at BVA but directs RO denials as well.
"Citation Nr: 1426689: the Department of Veterans Affairs did address residual Agent Orange exposure concerns by post-Vietnam crews that later flew C-123 aircraft that had previously sprayed Agent Orange. VA's Office of Public Health is noted to have reviewed all available scientific information (?) regarding the exposure potential to residual amounts of herbicides on the C-123 aircraft surfaces. It was concluded that the potential exposure for the post-Vietnam crews that flew or maintained the aircraft was extremely low and therefore it was concluded that the risk of long-term health effects was minimal. See http://www.publichealth.va.gov/exposures/agentorange."
And from an April 2014 BVA decision, also reflecting VBA's damage. Actually, these studies and findings have repeatedly been brought to VA's attention.
 "Citation Nr: 1413377: there are no studies that VA is aware of showing harmful health effects for any such secondary or remote herbicide contact that may have occurred."
From others:
 " An undated Compensation Service Memorandum indicates  that there was no presumption of secondary exposure based upon being near or working on aircraft that had flown over Vietnam or handling equipment once used in Vietnam, noting that the aerial spraying of tactical herbicides in Vietnam did not occur everywhere and that it was inaccurate to think that herbicides covered every aircraft and piece of equipment with Vietnam.  Additionally, the undated Memorandum notes that the high altitude jet aircraft stationed in Thailand generally flew far above the low and slow flying UC-123 aircraft that sprayed tactical herbicides over Vietnam during Operation Ranch Hand.  The Memorandum also reflects a comment that there were no studies showing harmful health effects for any such secondary or remote herbicide contact that may have occurred. "
"Citation Nr: 1337387: note, the Department of Veterans Affairs did address residual Agent Orange exposure concerns by post-Vietnam crews that later flew C-123 aircraft that had previously sprayed Agent Orange.  VA's Office of Public Health is noted to have thoroughly reviewed all available scientific information regarding the exposure potential to residual amounts of herbicides on the C-123 aircraft surfaces.  It was concluded that the potential exposure for the post-Vietnam crews that flew or maintained the aircraft was extremely low and therefore it was concluded that the risk of long-term health effects was minimal.  (See www.publichealth.va.gov/exposures/agentorange.)  Otherwise, other than his unsubstantiated allegations, there simply is no evidence that the Veteran was exposed to Agent Orange or other herbicides based on his contact with any military vehicle that may have once been used in Vietnam."
VBA/VHA have institutionalized the C-123 non-exposure position, citing non-existent "scientific" studies on its web pages which were policy statements on VA web pages, contradicted by VA's Federal Register publications and statements by VA leadership. These unscientific positions then become cited by BVA in refusing care to exposed veterans.

It seems to BVA that VHA web pages citing non-existent "scientific studies" by Post Deployment Health trump VA Federal Register publications addressing non-Vietnam herbicide exposures.

Can't this be corrected or is it too late?

19 August 2014

$600,000 VA Contract to "Help" Agent Orange-Exposed Veterans With Claims

Not the contractor. Do Not Try This At Home!
Really? VA spent the money only to "help" us?

No.

 Veterans Benefits Administration spent $600,000 on a no-bid, sole-source unsolicited consulting contract to "help" veterans with post-Vietnam Agent Orange claims...by getting the claims denied and reducing subsequent appeals. He even emphasized his work would help VA assure veterans of assistance in researching their claims, meeting that statutory requirement.

In his proposal, the consultant wrote:
"Although the Department presumes exposure for Vietnam veterans and US Korean  veterans, this is not the case for veterans potentially exposed outside of Vietnam or Korea. For these cases, the Department of Veterans Affairs has been placed in a  very difficult position, because without appropriate record identification, the Department has had to rely upon minimal documentation, and often only on the unsubstantiated documentation, to determine the validity of the veteran’s claim. Clearly, it would have been beneficial to all parties to have had all the available records related to the allegation or incident."
Beneficial? Hardly. This consultant consistently defends the innocence of Agent Orange, and insists that no veterans of Vietnam were actually exposed. That consistent view, that predictable view, that anti-veteran mentality made this consultant the go-to expert to help VA prevent C-123 Agent Orange exposure claims.

And just a moment...he even dismisses our claims by calling them "allegations." For years, at least since 2011 as best we can tell, he has led the VA in redefinition of exposure to require bioavailability. That is because redefining exposure is the only "out" VA has available to deny our claims.

Three times VA assured Congress and veterans via the Federal Register that exposed veterans in situations other than Vietnam will be treated with the same presumptive service connection as Vietnam veterans. The only requirement was proof of exposure. Now that contamination of the C-123s has been well-established, the consultant helped VA redefine the whole issue which apparently was first stated by Dr. Terry Walters of VHA's Post Deployment Health Section in her preparation for the October 2011 teleconference with C-123 veterans.  In her "VHA Issue Brief" she echoed the consultant's toxic logic from his 2011 article appearing in the journal of the Association of Military Surgeons of the United States.

Then, with her colleagues, they presented a poster at the Society of Toxicology in which they repeated the redefinition of exposure to prevent exposure claims: "exposure = contamination field + bioavailability." That was just a little line inserted in the poster's C-123 section, but it has become the foundation of VA's scheme to deny all C-123 claims. Every single one of them. Only Paul Bailey's claim, denied at first but approved over a year ago on reconsideration, has been okay'd, and since then VA has kept Dr. Walter's public promises to "draw the line somewhere" because "VA cannot permit a C-123 claim."

And VA certainly doesn't permit any claims. Rating officials even cite non-existent regulations or publications or scientific studies. There's no such thing1 One of the most recent claim denials stated:
"The VA and DOD have specifically provided guidance that such secondary exposure cannot be granted service connection, to include working on planes that carried or sprayed, or being stationed on vessels which transported the herbicide."
We should restate one terrific reason VA selected this consultant for the juicy no-bid contract: he holds C-123 aircrew veterans in terrible destain. Although he himself is a retired USAF officer, in 2011 he wrote a correspondent that C-123 veterans are "trash-haulers, freeloaders looking for a tax-free dollar from a sympathetic congressman. I have no respect." He offered no respect for our combat tours, or our Purple Hearts, our Distinguished Flying Crosses, our Air Medals, our POW Medals...no respect for our wings. Obviously VA, eager to prevent C-123 exposure claims, chose the right guy with the right attitude to help trash those claims. VA knew about the consultant's comments because the veterans had brought the issue to the department's attention several times.

Imagine, however, if this guy was a consultant on VA employee health coverage. Imagine how unhappy VA employees would be if the same consultant had called government employees "trash-haulers, freeloaders" for whom he had no respect. They wouldn't tolerate it...they'd scream bloody murder!

But VBA feels it was a bargain, just $600,000 to help prevent C-123 exposure "allegations."

VA Releases Details on Post-Vietnam Agent Orange Consulting Contract – $600,000 Spent to Block Claims

Today VA released a redacted version of its contract let to A.L. Young Consultants of Cheyenne, Wyoming. Its principal, Dr. Al Young, is a retired USAF colonel and has over four decades of experience developing Agent Orange as a military herbicide, and helping VA and DOD prevent veterans' claims for Agent Orange exposures. Young's is one of the most lucrative consulting contracts ever issued by VA, at $300,000 per year for two years, an unusual sum for two researchers. The contract was for an unsolicited proposal, was sole-source and no-bid. Sweet!

Dr. Young's views are well-known, consistent over the decades, and likely the reason he was sought  out by VA...the results of the work are quite predictable...no Agent Orange exposures to anybody. His perspective on Agent Orange exposure is well-summarized in his 2011 article carried in AMSUS, the journal of the Association of Military Surgeons of the United States.

Although I over-simplify, his view is that because the most exposed population of veterans in Vietnam was the Operation Ranch Hand aircrews, since they show no greatly significant differences in illnesses from the general population, and since ground troops were sprayed less than the aircrews, therefore no exposures occurred to the ground troops. VA caring for Agent Orange illnesses is a waste of money.

The failure in this logic is the decision to ignore decades of findings by the Institute of Medicine, as well as other researchers. Exposure to Agent Orange results in statistically higher risk of a long list of illnesses recognised by the Institute of Medicine, and exposure to Agent Orange is supposed to provide a veteran presumptive service connection for those illnesses.

But VA wants to use Young to backtrack on Congress. Young's definition of Agent Orange exposure requires bioavailability...the veteran must prove the presence and harm caused by the Agent Orange exposure. VA also wants to actually redefine "exposure" to its own version, being "exposure = contamination field + bioavailability." This is unique to VA, because other federal agencies accept the CDC/Agency for Toxic Substances and Disease Registry's definition, "exposure = skin (or eye) contact with a chemical (of any type) or its ingestion or inhalation."

Dr. Young is well-known to the C-123 veterans, and apparently, he feels well-informed about us. He wrote a correspondent that C-123 veterans are "trash-haulers, freeloaders looking for a tax-free dollar from a sympathetic congressman. I have no respect." As one can expect, C-123 veterans are uncomfortable having VA led to its anti-C-123 veteran decisions by a person who denigrates us so soundly. VA should have sought a consultant who hadn't already announced his conclusions and who hadn't expressed distain for the patient population involved.

If VA gets away with this, veterans of all types of exposure are threatened, because VA can redefine away their proven exposures. Burn pits, radiation, dirty water, biohazards, immunizations, bugs...any exposure not provided for by law, as with the 1991 Agent Orange Act, leaves VA free to create impossible barriers for any veteran seeking medical care.

Latest Senate Version of Veterans Toxic Exposures Act of 2014

Provided by Vietnam Veterans of America headquarters this afternoon:

Actual title: S.2738 - "Toxic Exposure Research Act of 2014:
https://beta.congress.gov/113/bills/s2738/BILLS-113s2738is.pdf

VA Ups Their Opposition – Claims Are Now Denied On VA & DOD "Specific Guidance"

The VA in Montana has shot down another C-123 veteran's claim. This vet, with more problems than I
want to type, received his claim denial in March and it has Compensation and Pension attitude all through it.

What is chilling is the justification for denying the Agent Orange-related illnesses of this former mechanic who worked on Patches:
"The VA and DOD have specifically provided guidance that such secondary exposure cannot be granted service connection, to include working on planes that carried or sprayed, or being stationed on vessels which transported the herbicide."
So much for empty assurances from the Secretary on down that each claim is considered on a case-by-case basis. They should have assured us instead, and more honestly, "each claim is denied on a case-by-case basis, regardless of justification."

How can they promise pro-veteran, non-adversarial claims processing? They ought to simply put a paragraph that C-123 veterans need not apply.

We have no idea where the DOD "specific guidance" comes from, unless it is the 2006 list Batelle and Al Young were paid to prepare for DOD.

17 August 2014

C-123 Exposure & Health Studies Withheld by USAF in Defiance of Freedom of Information Act

Subject: August Release of Freedom of Information Act materials by the USAF Surgeon General's Office – USAF Defied the Law But Accidentally Let Vital Information Leak*

The C-123 Veterans Association had requested information about the May 2012 USAF C-123 Consultative Letter and how its conclusions were reached, and details about the scientific studies performed. Nothing secret, nothing personal. Stuff we're entitled to!

Instead, the USAF released two sets (Release One and Release Two) of documents last Friday, each a duplicate of the other, and each redacted past the point of honesty and respect for the law. The only information not redacted was an irrelevant EPA document on radiation assessment....nothing was revealed about the C-123 study of post-Vietnam exposures.

What the heck? President Obama assured the American people on his first public act that a citizen's right to access to information is "a fundamental element of American democracy." The Air Force, perhaps, missed that press release, and also the one where the President ordered Federal agencies to be as open as possible.

Here, in their response to my 2012 FOIA request, and to my October lawsuit filed in the US District Court of Washington DC, the Air Force sent me blank pages, devoid of meaning. Remember – these are publicly-funded studies by the USAF Surgeon General's Office and the USAF School of Aerospace Medicine, about whether or not 2100 veterans were exposed to Agent Orange. Further, the Air Force study is the foundation of the VA refusal to permit a single C-123 veteran's Agent Orange claim to be considered. So...VA refused to permit us to have our cancers treated because of a secret Air Force study...not classified in any way, but still hidden from public view, and denied us as we seek VA benefits, by the USAF Surgeon General.


What arrogance and abuse of discretion. This "Freedom" of Information Act response was anything but freedom! Virtually every line of every page released was redacted, denying C-123 veterans access to USAF School of Aerospace Medicine in May 2012.
the studies completed about our Agent Orange exposure by the Air Force after they agreed to look into our concerns with scientific integrity. That study, however, failed to meet the true definition of scientific integrity, with command interference, unnecessary JAG interventions, and close cooperation with the VA but not with CDC/ATSDR nor NIH.

The AF C-123 study meekly concluded that individual exposure assessments were impossible, but then illogically also concluded that because of that impossibility, the C-123 veterans were probably not exposed to harmful amounts of Agent Orange. What an amazing twist of logic!

* But there was a single paragraph, truly golden hidden among the pages of white, a paragraph that they missed redacting and which perfectly explains our eligibility for Agent Orange exposure care:

"USAFSAM concludes that there is not enough data to evaluate or model individual exposures and performing an epidemiological investigation would not be possible.   They then looked at the results that were available from a general population and occupational perspective and conclude that although dried residuals of dioxins were present, the exposures to anyone encountering the Aircraft either occupationally or from the general public should be within the exposures experienced by the Ranch Hand personnel that were exposed in Vietnam.   The Air Force conducted an extensive epidemiological study of the Ranch Hand personnel (referred to as the Air Force Health Study) and to date the results do not provide evidence of disease in the Ranch Hand veterans caused by elevated levels of exposure to Herbicide Orange."

Read the paragraph's middle carefully, especially the fact that USAFSAM considered post-Vietnam C-123 exposures

"within the exposures experienced by the Ranch Hand personnel that were exposed in Vietnam." That confirms our exposure which is the only issue under the law to be eligible for Agent Orange illness care and benefits. The exposures were not hypothetical, not imaginary, not remotely possible...but "within the exposures experienced by Ranch Hand." There was no conclusion that we were not exposed, only that harm had yet to be proven by the exposures.

The USAFSAM study illogically concluded that because the Ranch Hand spray veterans have not evidence elevated illnesses, then the C-123 veterans must not be harmed either.

The logic failure is in failing to note that post-Vietnam C-123 vets were never tested, as was the Ranch Hand population. Further, our exposures were long term/low dose exposures, and over a ten year period versus a Ranch Hand eleven month tour in Vietnam. We were older, with more women, and during the decade we flew our sick crew members were removed from service when they presented developing Agent Orange illnesses, such as cancers, diabetes, and IHD.

Both groups of aircrews remain distinct from the "general population" in that we had flight physicals, everyone was a high school graduate (or more) if enlisted and a college graduate if commissioned. We had enlistment or commissioning physicals, which separated many who were already ill, used illicit drugs, had significant arrest records, or who did not meet education, physical or mental requirements. We had excellent medical and dental care, constant drug testing, weight control, excellent prospects of post-military graduate education and employment, and in so many ways were healthier and fortunately likely to stay healthier than the general population, Agent Orange issues not withstanding.

Conclusion: both Ranch Hand and post-Vietnam aircrews should be in better health than their contemporaries, and it seems they are. But, the overall group of Vietnam veterans, a large enough population for meaningful epidemiological studies, continues to show the ravages of Agent Orange-releated diseases.

VA even prohibits the kind of testing on us for the presence of dioxin which the Ranch Hand vets have had for decades. Ranch Hand remains the only studied population, one made up of under 2,000 veterans, similar in size to the post-Vietnam C-123 group of about 2,100. Both, too small for meaningful examination. Which is why Congress, in frustration with VA foot-dragging, simply directed with the 1991 Agent Orange Act that all Vietnam veterans, and those veterans able to prove their exposure to Agent Orange, will be treated for recognized illnesses.

Three times the VA "more clearly" explained the agency's policy toward non-Vietnam Agent Orange exposures in the Federal Register. VA stated that exposed veterans would receive the same presumptive service connection for recognized Agent Orange illnesses, providing exposure itself was established. We've done that.

As can be read above, the Air Force established our exposure. ATSDR confirmed the exposure, as did the NIH/National Institute of Environmental Health Sciences and the US Public Health Service. There is a pro-veteran requirement in the VA claims process....we'd like to see some!

USAF and VA: A great partnership in denying responsibility along with denying medical care for the harm done.

By the way, below is an example of the Air Force perspective on what they feel veterans are permitted to see in military studies about us, paid for by the public, requested by the veterans. It is the first page of what AF sent out last week following two years of our actions to compel release of material which should be in the public domain:



13 August 2014

Senate Staffer Support!

They're still working hard for us! Senators and their staffs, from both parties, have given countless hours to the C-123 problems. We're not forgotten. There seem to be weekly meetings and conferences between the senators and VA, their staffs and VA, anybody and everybody who is involved. Before his confirmation, now-Secretary McDonald had the C-123 issued briefed by Senator Merkley's staff.

So they know we're here, and they know full well we're not getting younger and we're not getting better. This is the plain situation, and the years VA is taking seem to be a tactical approach on their part....wait us out, given our life expectancies, and the fact that the only thing potentially lost is the catch-up disability check.

In the interim, for every day VA delays a claim and for every year a denied claim sits awaiting BVA attention, both VBA and VHA save millions by ordering our vets out of their hospitals, telling us seek care elsewhere as best we can. Waiting lists for appointments are gamed this way, too, by keeping our eligibility delayed as long as possible.

VA pays no penalty, regardless of how illegal or outrageous their claims decisions
. VA raters face no criticism or correction...the claims sit on desks for years, get denied for improper reasons following orders from C&P or VHA that they be denied, and then years pass before the widows get a big brown envelope long down the road.

But we have highly motivated staffers working for our senators (particularly Senators Merkley, Bennet, Burr, Udall, and Chambliss.) In the House, it seems to be only Congresswoman Bonamici, although others have signed her joint letter to the Secretary, and Congressman Neal wrote a letter himself just this year, although we've been detailing the problem to his office for three years without response.

As for VA employees, including SES, there have been changes and start-up orientations, but while smiles are friendly and they are mostly our fellow veterans, their oft-stated mission seems unchanged: they want to "draw a line somewhere," "VA cannot permit any C-123 claims," etc.

Anything that they can do to prevent C-123 exposure claims, including wording the charge to the Institute of Medicine to avoid asking the relevant question, "were they exposed," and instead asking IOM to decide "how much harmful exposure was there" to which they've responded in several studies that individual assessments just cannot be made, especially with such a small population.

10 August 2014

Corrections Gladly Accepted

My most recent post was improved when a scientist offered clarification. Thank you. Much of what this
blog and our web site address involves scientific information for which I try to draw inferences relevant to our C-123 issues. But as a layman, I don't have the background to make the right interpretation all the time, of course.

This is not a platform for debate, but I have tried to correct every error or misstatement that has been explained to me, or to defend a post when challenged and I think I'm right. I may not be friendly towards every perspective in this issue but within my ability everything here is as accurate and honest as possible.

I'll remind readers that most of the leaders in our C-123 Veterans Association are not affected by any VA changes we advocate. Most are like me... retired military and either Vietnam veterans or have other VA disabilities, meaning we as individuals aren't affected by VA recognition of C-123 exposure claims.

We're doing this for our crew mates who need the VA care and benefits appropriate for Agent Orange exposures.

PLEASE: corrections and suggestions gladly accepted.

08 August 2014

AF May 2012 C-123 Exposures Report Differs from 1978 Draft of AFHS re: Aircrew Exposure: Command Interference?

(corrected with thanks)
Found in a 1982 report (covering Oct 78-Dec 82) of  USAF School of Aerospace Medicine report on Epidemiological Investigation of Health Effects in Air Force Personnel Following Exposure to Herbicides." The report is available in full at the USDA A.L. Young Collection, Item # 01570. Ranch Hand issues, to include comments on C-123 Ranch Hand veterans and non-Ranch Hand veterans, "
No. 01570, pages 21-22

The important observations to make are:
1. The C-123 non-Ranch Hand aircrews are acknowledged as "may have been exposed to significant Herbicide Orange residue in these aircraft. Therefore, this group may not have been truly unexposed to herbicides..."
2. No distinction is made as to routes of exposure
3. The May 2012 USAFSAM C-123 exposure report concluded the AF was unable to determine the amount of exposure post-Vietnam veterans had, and illogically then concluded there was too little exposure to consider them exposed. In VA-speak, this is equipoise, or "as likely to as not."
4. The Ranch Hand study addressed only Ranch Hand personnel. Only RH veterans had serum levels tested, at $1000 per test. As a small population, studies such as have but little epidemiological, especially for want of a proper control group.  The only real cohort to study is the larger body of Vietnam veterans of all services.
5. The Air Force Chief Medical Research Officer, Dr. Richard Albanese*, testified under oath that about 10% of his reports were modified by his supervisors and that about 10% of all reports he was aware of, such as the Ranch Hand Study of which he was principal investigator, also had command interference for policy objectives.
6. Ranch Hand and post-Vietnam C-123 crews are similar only in flying the same toxic airplanes and being exposed to the same military herbicide. They differ in amounts of exposure, duration of exposure, short vs. long term exposure, ages, years flying the toxic airplanes, gender (post-Vietnam crews began including many more female medical technicians and flight nurses, and some maintenance workers.) But again...both cohorts were exposed to the same military herbicide, Agent Orange, although VA policy prohibits testing the post-Vietnam veterans. 

Conclusion: USAFSAM is shown in their 1982 report to have opined that C-123 crews may have been exposed but changes it mind even in the face of additional exposure evidence in their 2012 report, and contradicts itself for reasons of command interference.

* Dr. Albanese later detailed the multitude of failures in the USAF Ranch Hand study.  He went into specifics regarding the interference by a  White House science committee (White House Working Group "WSWG") made up of military and VA representatives...and they don't seem to have changed anything in the last 22 years!

Additional Conclusion: USAFSAM again proved susceptible to command interference with their 2012 C-123 report. "Look
again" was the order from above when preliminary conclusions favored the possibility of aircrew exposures. "Drop it" was the order when one analysis supported the veterans' assertions. This called for an IG complaint to the 75th Air Wing Inspector General. I filed it in person in early 2013, but without any action or response...they dropped it.

No wonder the Air Force has refused to release the 2012 USAFSAM C-123 report materials, despite two years of FOIA requests and our suit in the US District Court of Washington. At least, AF has promised to allow "some" documents to flow by the end of September. 

Like VA, the AF is keeping source documents locked up until after the Institute of Medicine completes its study and report to the Secretary. Neither agency wants any materials likely to help support the veterans' claims to be made available.

07 August 2014

My Most Recent Claim Denied – For Want of VA Records

Typical VA Claims Result
My latest claim for various VA disabilities (not the Agent Orange-related ones) was denied last week, mostly because the VA regional office in Denver maintained I had no new information to submit against earlier denials, thus the original denials were final.

VBA was especially clever in this response: the adjudicator avoided addressing several elements of the claim (different injuries,) knowing that once the claim reaches the Board of Veterans Appeals they don't have jurisdiction, and the claim will be remanded. That will mean more time at the regional office, and then back in line for more years of waiting for BVA to decide.

They don't do this stuff without strategy, you know! What looks like an oversight is meant to provide VA with several more years of stalling, waiting for the vet to lose interest, or die.

For some reason, eBenefits has been accepting electronic documents for several months, at least since the end of April, but not showing them in the list of either requested or unrequested materials. Things get posted on eBenefits only if mailed or if a vet calls IRIS. Thus all my responses to VA inquiries for the last ten weeks have disappeared, so VA denied my claim.

That's one problem. The other is that the FOIA I submitted in April, which was acknowledged, still hasn't been fulfilled. That was where I'd expected to find the Air Force line-of-duty determinations for the specific injuries in the claim. Originally VA had somehow failed to even note the LODs and denied the claim because the LOD-specified injuries "did not occur during service nor in one year after." Heck, I was even hospitalized in Bethesda Naval Hospital on AD and they missed that.

I should have asked the Denver FOIA office about this earlier, because from their response letter I had no idea their current backlog is actually between six to nine months for a "C" file FOIA response. I'd gone in to see my files but they could only let me see a few pages on their computer, so a trip to Denver was wasted.

Yesterday, Denver FOIA offered to move my request for a copy of my records up and get them here in about a week because I'm so sick. Great. Now I can face two to five years in an appeal but that's way, way past my life expectancy.

Nice folks. Lousy system. Everybody at VA solves claim problems with a vet by telling us to "just appeal."

That's like a kiss of death. They know it. Perhaps their greeting at the 800-number should be "sorry for your loss" instead of "thanks for your service."