23 July 2014

Why C-123 Veterans Are Affected by Institute of Medicine C-123 Agent Orange Study

In what turned out to be a critical change in VA Agent Orange policy, Public Law 102-4, the Agent Orange Act of 1991, transferred the advisory function regarding dioxin and herbicides from the VACEH to the National Academy of Sciences (NAS). The NAS, an independent and highly regarded scientific body, then took the responsibility of reviewing the scientific literature concerning the association between herbicide exposure during Vietnam service and each health outcome suspected to be associated with herbicide exposure. Since responsibility for a scientific review was formally passed to the NAS, VA terminated publication of the scientific literature review mentioned in the previous paragraph.

Following receipt of the NAS reviews, the Secretary has 60 days to determine which, if any conditions evaluated will be recognized as service-connected. The legal standard that the Secretary of Veterans Affairs must use to evaluate what conditions should be presumptively recognized for service connection is described in Chapter 6 – Disability Compensation. The standard differs from the cause-and effect.

Further, the Agent Orange Act removed the requirement that veterans of the Vietnam War must prove both exposure and medical nexus...these are now presumed to have been proven. For veterans who've been exposed to Agent Orange in situations other than Vietnam's "boots on the ground," they must prove exposure. Once exposure to Agent Orange is established, they need not prove medical nexus for any of the Agent Orange-recognized illnesses.

Thus, the IOM study is only tangentially of interest to C-123 veterans because VA carefully chose the assignment wording to avoid asking whether nor not C-123 vets were exposed.

Instead, careful wordsmithing by VA's Post Deployment Health Section gave the IOM an assignment which asks whether or not "excess" risk can be proven. So they IOM can return a finding that the risk is excessive, yet VA continue their present refusal to acknowledge our exposure and thus exclude us from coverage. If IOM returns a finding that our risk cannot be established, VA will seize upon that as definitive "proof" that we are not eligible at all.

The deck is stacked – against us! No wonder Professor Peter Kahn called the whole process unethical, despite the sincere efforts by dedicated scientists on the IOM C-123 committee. At the June 16 2014 IOM meeting, the C-123 Veterans asked the committee to exercise its independence and report back an additional answer to an unasked question...were the C-123 veterans exposed or not?

That is the only question under the law. Besides, we have already established that exposure through juried scientific articles, opinions from dozens of scientists and physicians, as well as opinions from federal government agencies such as the CDC.

We were exposed. We are barred from VA care today because of the personal preferences of VA staff in Post Deployment Health...nothing more.

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