27 July 2014

Secretary-Designate McDonald Not in Step with Post Deployment Health – Big Mistake Under Oath

VA Secretary-Designate McDonald
Post Deployment Health in VA's Veterans Health Administration had better get the word to the Secretary-Designate! According to those folks, Mr. McDonald's uncle was never exposed to Agent Orange while serving in Vietnam. His uncle's present care from the VA is only provided because VA is forced to by the Agent Orange Act of 1991.

In his confirmation hearings before the Senate Veterans Affairs Committee last week, Mr. McDonald described his service, and the service of his family, in the military from World War II, where his dad was a POW, to Vietnam, where his uncle was "exposed" to Agent Orange for which he now receives VA care. He said it, under oath. His uncle was exposed to Agent Orange in Vietnam.

...and under oath, too!
Careful there with your sworn testimony, Mr. McDonald. Big, big mistake!

You really should have run your testimony past your experts at Post Deployment Health. They have carefully explained to us, and to the Institute of Medicine, that none of the Vietnam ground troops was exposed to Agent Orange. Because your uncle can't prove bioavailability, he was never exposed! Give your uncle a call with the good news!

Forgive the sarcasm, please. We're on your side of the truth, but Post Deployment Health isn't.

What's the basis for this? Following the lead of their $300,000 per year consultant, Dr. Al Young, VA Post Deployment Health has redefined exposure to require veterans also prove bioavailability...the presence of dioxin in the body. Like all other Vietnam vets, Mr. McDonald's uncle can't prove that, just as C-123 veterans can't prove such a thing three decades after our last flights.

Because of such an impossible barrier which VA used to deny their disability claims for decades, in 1991 Congress simply provided presumptive exposure for Vietnam veterans. For non-Vietnam vets like C-123 folks, we have to prove an exposure situation, and then the presumptive eligibility for Agent Orange benefits applies.

At least, that's the law. Its not the way the VA sees it, in their determination to "draw the line somewhere."

VA unscientifically redefined exposure to skip out on its own commitments made in the Federal Register regarding post-Vietnam Agent Orange exposures..."exposure = contamination field plus bioavailability."

We wish Mr. McDonald great success in leading the VA to new levels of excellence. We certainly wish his
uncle well in the care he receives from the VA for his Agent Orange exposure. We wish VA would not reinvent "exposure" as their tactic to prevent giving us the same vital care.

26 July 2014

C-123 Veterans Charge to the Institute of Medicine C-123 Committee, June 16 2014


The IOM web site, and staff emails, end in “.edu.” and not “.gov.” The Institute of Medicine is independent, say both the Department of Veterans Affairs and the IOM. We ask for that independence to be exercised.

But the VA charge restricted your independence, and gave rise to confusion when instead VA should have sought useful answers. We listened to the confusion and attempts to clarify the charge back on May 15 at the first public meeting.

Back on May 15, you weren’t briefed by VA that the report of this committee, if strictly in response to the VA’s charge, still won’t affect C-123 veterans’ access to VA care. The wording on the charge was chosen most carefully.

Yale Law, and other legal scholars, and the VA itself through publications in the Federal Register, have made it abundantly clear that the sole qualifier for Agent Orange illnesses to be treated by the VA is a veterans’ proof of exposure, or proof of service in Vietnam or on the Korean DMZ.

The real question is not how much harm. The real question is not how much exposure. The real question is not about bioavailability.

The answer to the real question is vital, yet the real question itself wasn’t even raised in the charge to the committee.

That question, one you are asked by us to answer more fully, is whether or not we were exposed and are thereby due care. Last month we discussed the “as likely to as not” decision point for medical claims. The level of proof, by veterans’ law, is only equipoise. We’re far past that.

The charge, as worded, avoided the real question of simple exposure. The reason for that has become clear: By not directly asking IOM to determine C-123 veterans’ exposure on a yes or no basis, there is no response to the challenges raised in our disability claims.

The C-123 contamination has been repeatedly proven over the decades by the military. The harm from our exposure, although the law frees us from having to prove it, has also been established. Please consider that the findings supporting our exposure claim were all offered by experts without compensation. If we’d paid as much to support our claims as the VA to oppose, we’d certainly have even more to offer.

Stretch the boundaries of your charge, to answer the real question before this committee, which is simply whether our C-123 crews were exposed and are due the care for ailments already identified by the IOM as Agent Orange-presumptive illnesses.

Certainly, your work on this committee to address the fullness of the VA charge is important and there are important answers you’ll uncover. But you must go further for the real problem to be resolved. Three years of this misery is enough.

I say there must be no barrier, no evasion, no acceptance of rigid blindfolds disguised as a committee charge. As worded, the charge which takes from you the independence needed to meet the real mission of the IOM and the National Academies, fulfilling what President Lincoln sought in 1863, a body of distinguished scholars “charged with providing independent, objective advice to the nation on matters related to science and technology.”

Please: Independently answer the real question the veterans and the Department of Veterans Affairs are contesting, and form an effective as well as scientifically accurate report.

C-123 veterans, the focus of all your work, ask you to provide the nation your advice in the fullest way with a more complete, responsive answer to the real question at hand: QUESTION – In fulfilling our duty to fly this transport for a decade, were we, more likely than not, exposed and are thereby due VA care for illnesses previously associated by the IOM with Agent Orange exposure?

That should have been the real charge to this committee.

VA Designs Institute of Medicine C-123 Study to Prevent Exposure Claims

Skillful folks, the staff at VA Post Deployment Health. And they're not there to let any more veterans onto the Agent Orange disability lists! As they told the Associated Press, "We have to draw the line somewhere."
But three years of their policy of simply telling us "no" began to face some opposition in early 2014 with publication in Environmental Research of the article, "Post Vietnam Military Herbicide Exposures in C-123 Spray Aircraft." While VA could, and would prefer to, ignore that and all other evidence of veterans' exposures, at about the same time Yale Law School released a detailed white paper confirming the C-123 veterans' rights to presumptive service connection for Agent Orange exposures.
Together, these developments added to political suggestions that VA pretend, at least, to follow the law. After all, VA had repeated three times via the Federal Register their commitment to treat non-Vietnam Agent Orange exposures the same as vets exposed in Vietnam. Those repeated commitments needed to be skirted somehow, which VA has successfully done by having reinvented the basic word, "exposure." Simply put, VA decided to redefine the word to include bioavailability, or the proven impact of Agent Orange on the body. Perfect solution...just change the words around so that nobody exposed to anything qualifies for any exposure claims. With Agent Orange, many decades after exposure, the bioavailability of dioxin is impossible for us to prove...and VA even prohibits the test anyway.
But VA had continuing pressure to comply with the 1991 Agent Orange Act, which is to refer fundamental disputes or inquiries about Agent Orange to the Institute of Medicine. Here VA excelled! They complied, yet insured that the IOM process will defeat veteran's exposure claims.
VA gets to make up the ground rules in this game. One is that VA issues a "charge," or assignment, to the IOM to investigate. Since the only question under the law regarding non-Vietnam exposures is exposure, the VA skillfully avoided tasking the IOM with deciding whether we'd been exposed. Instead, VA asked IOM to address fairly irrelevant issues, of interest of course, but irrelevant in terms of whether VA should be treating our Agent Orange illnesses.
Here's their "charge" to the IOM which is currently investigating C-123 issues:
This committee will determine whether there is an excess risk of adverse health among crew members who, after the Vietnam War ended in 1975, flew and/or maintained C-123 aircraft that had been used to spray Agent Orange in Vietnam. The committee will: 
Evaluate the reliability (including representativeness, consistency, methods used) of the available information for establishing exposure; and, 
Address (qualitatively as a degree of certainty, rather than in a quantitative fashion) whether any documented residues represent potentially harmful exposure (i.e., consider biological availability of dioxin), by characterizing the amounts available and the degree to which absorption might be expected.
You see it, don't you? The second bullet item specifically asks for an IOM conclusion about bioavailability, which isn't a requirement for any veteran, Vietnam or non-Vietnam, to prove in order to seek care for exposure to Agent Orange. But VA sneaks in the term, knowing in advance that forty years after the last spray missions and thirty years after our last flights in 1982, no such proof is possible.
The IOM committee can't but help to repeat conclusions about bioavailability from earlier IOM reports...that it can't be established for this population.
When the C-123 veterans spoke before the IOM C-123 committee on June 16, we asked them to act independently of their charge from the VA. They have that authority and responsibility. We have, however, repeatedly been told that the committee is interested only in the scientific data required to form a response to the VA charge.
If they do this, they play the VA's game. The IOM avoids meeting its responsibility to us, and avoids answering the only real question on the table: 
Were C-123 vets exposed and, if so, are they to be treated as per law?

25 July 2014

Earliest VHA Reference to Bioavailability in Exposure Definition Found

Yesterday, the Air Force released some of the documents requested by the C-123 Veterans Association...back in 2012! So much for the 20-day response provided for in the Freedom of Information Act laws. While most of the requested materials were simply not included at all. one of interest was Dr. Terry Walters' 1 August 2011 "VHA Issue Brief."

As readers know, VA has redefined exposure to prevent exposure claims. We thought the earliest reference to this was the VHA Post Deployment Health poster display presented at the 2012 Society of Toxicology. Yesterday's USAF set of papers included Dr. Walters' VHA Issue Brief on the C-123. We don't know the genesis of the brief but it, and its insertion of bioavailability, showed up in the Air Force document set. We find that very disappointing.

The reason? The USAF Surgeon General's office was emphatic from the start...the USAF School of Aerospace Medicine was to conduct its research on the C-123 independently, without cross-pollination of opinions or perspectives between USAF and the VA. This high-minded approach failed immediately, with Dr. Terra Irons and Dr. Terry Walters providing carefully selected materials to provide (shall we say, guide?) the Air Force researchers.

Both agencies had relevant materials directly supporting C-123 veterans' exposure...so both agencies made sure those were suppressed. VA's set of materials mailed to the Air Force included the Blue Water Navy IOM Report (why?) and the usual copies of Dr. Al Young's Agent Orange apologies.
How to block Agent Orange exposure claims

And why Al Young? First, because he's so dang dependable! After losing the "Agent Orange is harmless" battle, his campaign against veterans shifted to claiming that none were ever exposed, not even the Vietnam War ground troops. In case that argument fails to convince, Young also insists that even if Agent Orange was present, it couldn't expose via dermal, inhalation or ingestion.

Second reason for VA's love affairs with Al Young is his evolution of the bioavailability dodge. Young tells his readers that Ranch Hand veterans have tested highest in dioxin levels yet seem to have reasonable health. He suggests that "logically" other veterans' body levels of dioxin (bioavailability) are necessarily lower and thus proof that they weren't exposed. And certainly, in appreciation for the VA no-bid $600,000 contract he was issued, he insists that no C-123 exposures occurred because we have never been tested for bioavailability. And he blends bioavailability into exposure so as to deny exposure.

Get it? No matter what, no problems with Agent Orange. Ever. Young and VA realize that the law simply demands non-Vietnam vets establish exposure, so together they blend the two words into one – 'exposure'– in a scheme to block any and all exposure claims.

This is illogical, and even labeled "unscientific" by toxicologists. "Ludicrous" is Dr. Wayne Dwernychuck's appraisal of the VA definition. And because of the impact of VA refusing C-123 veterans vital medical care, "unethical" was also an accusation.

Exposure is defined as "skin (or eye) contact with a chemical (of any type) or its ingestion or inhalation." Simple definition from the CDC/Agency for Toxic Substances and Disease Registry, and one generally accepted in science and medicine. VA's weird definition, which Young's writing's suggested, is "exposure = contamination field + bioavailability."

Remember that our only problem with the VA is their gate keepers, not the clinicians. Their objective since Day One of our C-123 problem, as shown by Dr. Walters' brief, was to insure all C-123 claims are denied. They had to redefine "exposure" to do this, and at some point in our struggle they'll get caught in the deception.

24 July 2014

House Blocks Veterans Health Care Bill..."Collapsed" Says Senator Bernie Sanders

In its move to prevent improved veterans' access to vital medical care, the House today rejected plans for a conference committee to meet and resolve differences between House and Senate versions of legislation. By waiting until virtually the last moment before Congress adjourns, this effectively destroys any hopes for addressing the core problems so well revealed in the current scandals involving the Department of Veterans Affairs.

The budget-focused House, and the veterans-focused Senate, now look at veterans with a "blame the other fellow" grin, both proud of saving money on the backs of, and at the expense of, disabled veterans who will continue to be refused care. It seems only the veterans committees of each house truly wanted to help...everyone else gleefully took advantage of the problem and made political capital.

from the Washington Times, July 24:

Negotiations on the VA reform bill imploded Thursday morning as House negotiators planned to introduce their own bill rather than work with senators in a conference committee.
Sen. Jon Tester, Montana Democrat, said six weeks of negotiation have been stalled by GOP posturing in an election year.
“Republicans today will announce that they’re foregoing the veterans conference committee and introducing a bill of their own,” Mr. Tester said on the Senate floor. “I had real hopes that this conference committee could rise above the political process.”
The House and Senate both passed bills that would allow veterans waiting too long for an appointment or living too far from a VA facility to seek private care. The bills cost about $44 billion and $35 billion respectively, and negotiations stalled over if and how to offset the huge cost after one meeting weeks ago.
The House Veterans Affairs Committee announced that lawmakers involved with negotiating the compromise veterans reform bill would meet Thursday at noon. But a spokesman for Sen. Bernard Sanders, Vermont independent and chair of the Senate Veterans Affairs Committee, said the meeting would not involve Senate negotiators. Instead, the meeting is a chance for Rep. Jeff Miller, Florida Republican, to introduce his “take-it-or-leave-it gambit,” the spokesman said.
“This is a sad indication that the House leadership is not serious about negotiations. We don’t need more speeches and posturing. We need serious negotiations – 24/7 if necessary – to resolve our differences in order to pass critical legislation,” Mr. Sanders said in a statement.
Mr. Sanders offered Mr. Miller a $25 billion compromise bill last week, that would include private care and increased firing authority for the secretary, as well as other provisions in the Senate bill like hiring more doctors and changing the G.I. bill.
The disagreement does not bode well for finalizing a bill to send to the president before Congress leaves Washington at the end of next week for the whole month of August.

Read more: http://www.washingtontimes.com/news/2014/jul/24/veterans-affairs-reform-bill-collapses-capitol-hil/#ixzz38PdbO8gY

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, clever 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.

22 July 2014

Military/Veterans Affairs Writer Tom Philpott Details VA Budget Issues

by Tom Philpot, Military Update:
A report by the Department of Veterans Affairs' inspector general and a separate "access audit" of appointment scheduling practices across VA health care facilities confirm system-wide abuses to distort wait times for care, which have put patients at risk and shaken confidence in how VA hospitals and clinics are staffed, managed and resourced.
Yet even as the acting IG and another senior VA official confirmed the depth of the patient wait-time scandal at hearing Monday of the House veterans affairs committee, as well as possible criminal activity by some administrators, they cautioned irate lawmakers against sending thousands more VA patients into the private sector for health care needs.
The caution flags haven't slowed Congress. On Tuesday, the House unanimously passed the Veterans Access to Care Act (HR 4810) from Rep. Jeff Miller (R-Fla.), VA committee chairman. It would require VA to offer non-VA care to enrolled veterans who cannot get an appointment within VA wait time goals or who live more than 40 miles from a VA medical facility.
On Wednesday, the Senate voted 93 to 3 for similar language as part of a more comprehensive bill, the Veterans' Access to Care through Choice, Accountability and Transparency Act of 2014 (S 2450), from Sens. Bernie Sanders (I-Vt.), VA committee chairman, and John McCain (R-Ariz.).
Veterans are right to worry that multiple schemes to address the VA's problems will all blend together into sticker shock or fast-fixes going nowhere. Much depends on the Secretary-Designate and his immediate mastery of budget issues and creation of an effective upper and middle-level management team.

VA Backlog Down - VA Appeals Through the Roof!

While Backlog Drops for Disability Claims
Backlog for Appeals Jump Dramatically

And now another serious problem facing the VAWhile there are clearly some doubters most people think that the backlog for disability adjudications has dropped dramatically. Indeed, this week the VA proudly announced that they had just adjudicated their 1,000,000th claim for this fiscal year. However, this is predictably leading to another backlog increase. There is now a backlog for pending appeals of denied claims… as well as increased delays in other claims matters.

One of the areas that have suffered while most of the VA’s focus has been on adjudicating initial disability claims is the simple job of changing the number of dependents that is covered by a claim. The VA’s own figures show that the number of claims to change the status of a dependent has risen from 35,734 at the start of 2012 to 191,464 on June 28 of this year.

As of June 28th the number of pending appeals has reached
279,435. This has been seen as a growing problem since 2012 when the VA’s Inspector General (IG) suggested that the VA "revise productivity standards" to ensure review officers get credit only for work that moves an appeal forward, according to the most recent IG report to Congress. That has not yet happened.

Laura Eskenazi, Principal Deputy Vice Chairman Board of Veterans' Appeals U.S. Department of Veterans Affairs and this the executive in charge of the Board of Veterans' Appeals, said appeals rates have held steady for nearly 20 years, but the total number has risen as more claims have been filed. "If the expectation is a short time frame [to get a decision on an appeal] that would require some trade-off in the due process," she said.

The average time for a denied claim to work its way through the VA’s appeals process shot up to more than 900 days last year After staying between 500 and 750 days for the past decade, what the VA refers to as its “appeals resolution time” hit 923 days in fiscal 2013. That is a 37% jump in one year, from 675 in fiscal 2012. The VA’s long time goal is for an appeal to take 400 days to resolve.

It should be remembered that veterans have a provision in our appeals process that almost no one else has. It permits all appellants (veterans, survivors or their representatives) to submit at any time in the appeal new evidence or information. That triggers a fresh review of the entire appeal. The Board of Veterans’ Appeals can grant, deny or remand the case to one of the VA’s regional offices for additional review. This of course slows appeals down but it is a terrific advantage for the veteran and his/her family.

C-123 Webmaster: It should also be noted that claims can take a year or more from a veteran already ill with cancer or heart disease to be approved, or denied. Submitted then to the BVA the issue can sit on somebody's desk for three or more years, and the veteran's cancer isn't going anywhere in the meantime and VA will continue to refuse to treat the illness unless the vet is eligible for some other reason or injury. Years pass with no pharmacy, no rehab, no prosthetics, no counseling, no pension, no medical care at all. Board of Veterans Appeals make sad reading as claim after claim is resolved in one way or another for the survivors because the veteran has died waiting for the VA.

21 July 2014

Retired Enlisted Association Confronts VA, But Stall Continues Blocking C-123 Claims

TREA Meets With Undersecretary for VBA

Last week TREA (The Retired Enlisted Association,) represented by Deputy Legislative Director Mike Saunders, met with Undersecretary for Veterans’ Benefits Allison Hickey to discuss the claims backlog and other claims-related issues. This was unrelated to all of the recent news surrounding the lack of access veterans have been dealing with related to the Veterans’ Health Administration (VHA).

·         The C-123 issue is currently being actively reviewed by VBA. This is the issue about the planes that were contaminated by carrying Agent Orange toVietnam; crew members who worked on those planes years later are suspected to have been exposed to dioxin from Agent Orange. No final decisions have been made yet.

Actual Result: Stall. Stall until we die. Amazing that VBA wants to "actively review" the C-123 issue. To us, not an issue but a threat to our lives, and amazing that VBA feels it must "review," instead of following the law the way it is written today.

New VA Scandal Revealed ... Veterans Under Secretary for Memorial Affairs Critcized

from Steve Straehley, AllGov.com
Timing is everything. Steve Muro, the VA’s Under Secretary for Memorial Affairs, retired June 20 after more than 35 years with the agency. A month later, the Department of Veterans Affairs’ Inspector General issued a report (pdf) criticizing Muro for improper personnel practices.
The report charged that Muro created a job for a friend in violation of civil service regulations; that he had an improper relationship with a contractor for the National Cemetery Administration (NCA), which he managed; and that he improperly gave that contractor business for educational services that were already available through VA channels.
Muro’s friend, whose name is redacted in the report, originally planned to retire in 2003. Muro gave the friend retention incentives and other raises over several years to dissuade him from retiring. Eventually, Muro created a job at a higher civil service rank and ensured it would go to his friend, thus enhancing the friend’s pension by $400 a month.
Muro’s relationship with contractor Patricia Noonan was deemed improper by the IG. He continued contacting Noonan after being advised to stop, he used his position improperly in giving her a letter of recommendation and improperly supported her efforts to win VA contracts. The IG report tersely described it as "less than arms-length relationship."
In addition, NCA gave Noonan contracts to provide over $374,000 for services for recently promoted NCA employees or those who were seeking promotions. The services involved professional coaching in giving presentations and completing individual development plans. Noonan received $250 an hour for providing that coaching, which was already available internally through VA’s Learning University.
This isn’t the first time problems have been found in Muro’s domain, according to The Washington Post. A 2012 VA review discovered that sets of remains were buried in incorrect graves and some grave markers were missing or incorrect. Muro worked to correct those issues by the following year.
Since Muro has retired, the recent IG report recommended no punitive action against him. The report urged that VA to investigate whether corrective action should be taken in regards to two applicants who did not get the job given to Muro’s friend, and to review any contracts still in force with Noonan to ensure there is no conflict of interest or other problems.

note: he may be beyond the VA IG, but certainly not beyond the US Justice Department!!

VA Contractor Contradicts Himself Regarding C-123 Dioxin Deterioration? Determined to Block Exposure Claims?

A big controversy has come up about VA deception with test results for C-123 dioxin contamination, as all such tests were taken well after the veterans flew the former Agent Orange spray aircraft. It seems VA/USAF use whatever interpretation or arguement best fits the situation to prevent veterans' exposure claims. VA freely switches back and forth on fundamental issues of exposure and personnel hazard. This is simply deceptive, with veterans paying the price for the deception.

Basically, VA and USAF maintain that the lower test results from 2009 investigations offer accurate retrospective views of contamination levels for the years the C-123s were flown by the veterans, 1972 to 1982. Both the USAF and VA rely on their consultant, A. L. Young Consultants of Cheyenne, Wyoming for this conclusion because it best argues against any possible exposures of those veterans., and this consultant historically insists on the harmlessness of Agent Orange exposure, a reliable perspective quite attractive to the VA and USAF as they seek to prevent veterans' exposure claims. 

He's the go-to-guy for exactly what the VA needs whenever claims need to be blocked. No wonder that on June 27 2014 the six major veterans organizations objected to the harm done and demanded that the Acting Secretary of Veterans Affairs investigate this contractor's input immediately, especially VA awarding $600,000 to block exposure claims.

Very few others have that mistaken viewpoint and thus A.L. Young Consultants can be used to block all input from the EPA, NIH, CDC, National Toxicology Center, WPA, US Public Health Service, universities, VA and private physicians, independent toxicologists and others who submit evidence supporting veterans' claims, which in the VA's view justifies their no-bid award of $600,000 to that firm, at $300,000 per year running through the last days of the IOM project...just to make sure the IOM report is properly worded to block claims also. 

VA also welcomes paid input from Dow and Monsanto to argue against the veterans...but that's not news and their input no surprise. Maybe the VA feels the government can't trust expert testimony unless they pay for it and select the input from someone whose views are already formed and inline with VA policy. Otherwise, VA wouldn't be buying policy reinforcement and veterans might get clean science instead.

So A.L. Young informed the IOM that 2009 test results represent non-existent 1972-1982 test
results and therefore no harm was possible to the aircrews at that time.

But the consultant five years ago told the Air Force exactly the opposite! It seems his firm will tell VA whatever helps VA deny exposure claims. 

The problem has two components, and a side issue:
I. The consultant, the VA and the USAF together insist in testimony to the Institute of Medicine C-123 Agent Orange committee that low to moderate dioxin contamination test results in 2009 prove that veterans who flew the C-123s earlier had no possibility of exposure. This position is best summarized in the report A. L. Young Consulting/Veterans Benefits Administration submitted to the Institute of Medicine for its current C-123 exposure studies. Young insists that dioxin in UV-restricted situations, on metallic and other surfaces, would degrade very slowly if at all, thus 2009 test results showing low dioxin contamination means veterans in 1972-1982 encountered similar low levels and were thus not exposed and suffered no health effects and are due no care for any Agent Orange-associated illnesses.  Disregarding the multiple source documents detailing base efforts between 1972-1982 to clean the aircraft which gradually removed contamination significantly before the 2009 tests, Young informs the IOM that a retrospective conclusion can be made that 2009 test results roughly equal what tests would have shown in 1972-1982, had such tests been made.

Young insists that the dioxin shown present in 2009 was the same low toxicity as when the veterans flew during the decade 1972-1982, and thus no exposure or health effect.

II. But the same consultant in 2009 assured the Air Force exactly the opposite: that decades of harsh desert storage of the quarantined  C-123 fleet greatly degraded its dioxin contamination. A. L. Young repeatedly assured, via several memoranda to different Air Force officials that the dioxin remaining on the aircraft had degraded significantly from earlier tests and represented no hazard to recycling personnel given their brief exposure.  He was credited by the Air Force as the strongest proponent for immediate destruction of the airplanes with no further testing, but he also warned the Air Force following regular procedures increased the risk of public attention. The CDC/Agency for Toxic Substances and Disease Registry also reached this conclusion, with its Director stating, "TCDD levels on-board contaminated aircraft were likely higher in 1972-1982 than in 1994 when samples were taken. 

Oh, and the CDC also concluded the C-123 veterans had a 200-fold greater cancer risk because of our exposures!

The truth: more likely than not, contamination of the former Agent Orange spray aircraft was more intense, and more dangerous, in 1972-1982 than tests performed decades later would suggest. This is the generally-agreed upon consensus, disputed only by Young, the Dow/Monsanto writers, and some of the contributors to the 2012 USAFSAM report...other contributors to that report agree with the ATSDR, and without any facts to substantiate that perspective.

The side issue: After the C-123s were destroyed in April-June 2010, every official involved seems to have forgotten one of the principal reasons cited for their elimination: the threatened $3.4 BILLION fine from the EPA for illegal HAZMAT storage. The aircraft were considered HAZMAT material until eventually shredded, at which point EPA loopholes no longer applied that label. The Air Force JAG calculated the EPA fine to continue at $30,000 a day until the destruction, and mentioned the good fortune the AF had thus far in preventing Arizona or Federal EPA from learning of the storage scheme of quarantined C-123s in that remote part of the Boneyard, out of sight from inspectors.

19 July 2014

C-123 Veterans Seek Investigation by Office of Special Counsel

On behalf of the 2100 men and women veterans of the C-123 Veterans
Association, we have asked that Senators Bennet, Udall, Merkley and Burr forward the attached request for inquiry to the Office of Special Counsel.

The VA National Center for Ethics in Healthcare, the VA Inspector General, the VA General Counsel and VA executives have not been responsive to our requests. Suggestions that our claims await denial, to then be appealed, are of interest only to our survivors...we will not be around for justice at that point. Delayed medical care is denied medical care.

We are in an intolerable situation of increasing age and disabilities, contesting with the Department of Veterans Affairs for over three years, seeking earned medical care and other benefits associated with our Agent Orange exposures. We simply do not have the years left to squander while VA ponders and stalls, saving money at our expense and maintaining appointment schedules by keeping us out of their hospitals.

The laws now in effect, clarified by multiple postings by VA in the Federal Register, mean we are to be treated for our Agent Orange illnesses now. We are ill now. We have members dead or dying now. The law now qualifies us for care but VA denies us.

The urgency of our need for a solution increases every day, as our illnesses progress and as we continue to be denied access to VA hospitals (unless otherwise eligible for care.)

18 July 2014

Updated C-123 Agent Orange Document Chronology (in reverse order)

Chronology Of C-123 Agent Orange Exposure Documents

(generally newer to older): 
Note: About one-quarter of all C-123K/UC-123K aircraft were used for spraying Agent Orange in Vietnam until 1971. Most Vietnam-based
aircraft returned USAF Reserve inventory in 1971-1972, then flown for regular airlift and aeromedical evacuation missions until 1982 when most were retired to Davis-Monthan AFB AZ for storage with some diverted to museum use.  Three bases were used for these warplanes: Westover AFB, Chicopee, MA, Pittsburgh Airport, PA and Rickenbacker AFB, Ohio. Each base had maintenance squadrons, and Westover AFB and Pittsburgh AFB also had aeromedical evacuation squadrons. Unit commanders and senior enlisted leaders have estimated their veterans total 2100 men and women, mostly aged between 45-80 years of age.

 42% of all post-Vietnam C-123 aircraft had been Agent Orange spray airplanes during the war. VA awards service connection to veterans evidencing a source of Agent Orange contamination, exposure to that contamination, and an Agent Orange-presumptive illness (Title 38 3.09.) VA opposes C-123 veterans by refusing to recognize exposure, redefined by VA to include “bioavailability.”

The C-123 Veterans Association is an informal association of former aircrews (including flight surgeons and aeromedical evacuation crews,) maintenance and aerial port personnel, advocating for recognition by the Department of Veterans Affairs of the Agent Orange illnesses experienced by our members

19 Jul 14: C-123 Veterans’ Request for Investigation by Office of Special Counsel by Office of Special Counsel, Items I & II
17 Jul: Veterans Concerns re: VA Ethics and A. L. Young Consultants; IG complaint by C-123 veterans
1 Jul 14: C-123 Casualty List: Joint press release with Vietnam Veterans of America regarding deaths and illnesses of C-123 veterans with denied Agent Orange exposure claims
30 Jun 14: Errors detailed in VA Input, cited by C-123 veterans to VA A.L. Young Consultant's presentation to IOM 16 Jun 2014
27 Jun 14: Joint Letter to Acting Secretary of Veterans Affairs: complaint by VFW, DAV, American Legion, AMVETS, Paralyzed Veterans of America and Vietnam Veterans of America regarding employment of A. L. Young Consultants, Cheyenne, WY in Agent Orange exposure issues
7 Jun 14: VA Office of Congressional Liaison informs Senate Veterans Affairs Committee that Joint Services Records Research Center will begin accepting non-military federal documentation regarding veterans' exposure and PTSD claims re: verification requests from Department of Veterans Affairs
15 May-16 Jun 14: Veterans Health Administration & C-123 Veterans Association: Release of documents to Institute of Medicine C-123 Agent Orange committee; folder includes veterans' responses, ancillary materials submitted by veterans. Also includes complete audio of final public meeting held 16 June 2014
11 Mar 14:  Air Force Times, Vets Battle VA on Post-Vietnam Agent Orange claims. Reporter Patricia Kime details C-123 history, contamination, testing and VA reactions to C-123 veterans’ exposure claims
10 Mar 14:  VA Modifies Web Pages re: Institute of Medicine C-123 Study addressing Agent Orange modified to mention referral of C-123 issue to the Institute of Medicine for a late 2014 report
19 Feb 14: Environmental Research, C-123 Exposures Confirmed; exposures occurred aboard post-Vietnam C-123s used during the Vietnam War for spraying Agent Orange, and which remained contaminated with TCDD
14 Feb 14:  Emails between VA Public Affairs and Wes Carter/C-123 Veterans Association addressing VA definition of “exposure.” Public Affairs referred Carter back to VA Public Health which had previously defined exposure as “contamination field + bioavailability”
14 Feb 14: Privacy Complaint filed by C-123 veterans with VA’s National Center for Ethics in Health Care, regarding outside contractor access to patient records 
6 Feb 14: Ethics concerns reported to VA National Center for Ethics in Health Care, submitted by C-123 veterans to VA National Center for Ethics in Health Care, suggesting intrinsic and extrinsic ethical failures, especially regarding VA deception regarding ATSDR and NIESH findings supporting C-123 veterans’ claims
5 Feb 14: LtGen Judith Fedder, correspondence between DOD and C-123 Veterans Association. Again refuses request for DOD designation of C-123 fleet as “Agent Orange Exposure Sites.”
18 Jan 14: Yale Law Veterans Legal Clinic C-123 Report; detailed legal brief, prepared under supervision of Law School Dean Michael Wishnie, confirms eligibility for herbicide exposure benefits for C-123 veterans establishing fact-proven exposure and presumptive service connection
15 Jan 14: Correspondence: C-123 Veterans requested Mr. Hipolit suggest claims be managed more in line with law, pointing out various illegal procedures used to deny claims. Mr. Hipolet declined to intervene, suggested concerns be resolved through appeals to Board of Veterans Appeals rather than corrected at source
10 Jan 14:  General Overview of Connection Between Exposure, Metabolism and Bioaccumulation. Prof. R.S. Pollenz, University of South Florida. Explains why bioavailability is not part of the toxicological event of exposure
28 Dec 13:  C-123 Update: Senator Bennett, Colorado. Senator’s briefing: C-123 Veterans Association. General background of C-123 issue for US Senator Bennett. The Association updates a similar document when seeking assistance from senators and congressmen
24 Dec 13: VA21-4138 Request, JSRRC Memo Request.pdf: C-123 Veterans to Mr. Dominic Baldini, Chief, Joint Services Records Research Center, Fort Belvoir, VA. Requests his agency prepare a memorandum for record, similar to the one addressing Blue Water Navy, for insertion in VA 21-1MR for VARO guidance on C-123 claims. JSRRC declined. Earlier requests to VA for a JSRRC memo were declined. Requests to the US Army Congressional Liaison Office by Senators Burr and Merkley staff were rebuffed…VA does not want such a memorandum to exist
1 Dec 13: C-123: Decades of Deception; free iTunes eBook by Major Wes Carter, C-123 Veterans Association. Covers Agent Orange contamination of C-123 post-Vietnam and effort by veterans to earn VA service connection for Agent Orange illnesses. Also available as PDF
Nov-Dec 13:  The Officer, "First Step Towards a Grassroots Victory" Reviews efforts by C-123 Veterans Association and first successful claim, LtCol Paul Bailey
16 Aug 13: C-123 Veterans Response to VA Contractor Report “Investigations Into Allegations by C-123 Veterans”, by Al Young Consultants, dated 12 Nov 2012
13 Nov 13: McMinnville (Oregon) News-Register, News story about C-123 veterans’ claims
7 Aug 13: Steve Vogel The Washington Post article, “VA Reverses C-123 Agent Orange Claim” (re: Paul Bailey, Bath, NH)
 5 Aug 13: Steve Vogel The Washington Post article, “Agent Orange’s Reach Beyond the Vietnam War”
31 Jul 13: Rating Decision, Manchester VARO (approval). Paul A. Bailey, reversed after evaluation by Decision Review Officer, awarded 100% disability backdated to date first applied; first known C-123 claim approved without resort to BVA appeal
22 Jul 13: Bailey Proof Set by C-123 Veterans Association. Establishes Agent Orange contamination of 731 TAS aircraft, contamination of C-123s, assignment of former Ranch Hand aircraft to 731 TAS and various agency proof statements (HQ AFRC, USAF Historical Records Research Center, etc.)
22 Jul 13: Statements US PHS commissioned officers confirming C-123veterans' exposure; USPHS commissioned officers are members of the Armed Services and their evidence satisfies JSRRC requirements for acceptable evidence. Both statements are from senior Public Health Service physicians (RADM R. Ikeda, CAPT A. Miller)
17 Jul 13: C-123 Veterans' Detailed Response to Secretary Shinseki's Letter to Senator Burr re: VA C-123 Perspective (dated 7 Jun 13) (note: 48mb)

13 Jul 13: C-123 Veterans' Radio Interview, Portland KBOO Radio

11 Jul 13: Reporter Lynne Peeples Huffington Post, “Veterans Sick from Agent Orange-Poisoned Planes Still Seek Justice.” Reviewed C-123 contamination and VA position against veterans' claims of exposure to dioxin

4 Jul 13: Article The Oregonian: "Many Veterans Suffering from Diseases Linked to Agent Orange Still Can't Get Disability Benefits," reporter Mike Francis

30 Jun 13: USAF Historical Records Research Agency confirmation C-123s were used for Operation Ranch Hand; flight orders, other historical documents satisfying SECVA concern about veterans' proof of duty aboard known contaminated aircraft
25 June 13: FOIA response to C-123 Veterans Association. This FOIA responder wrote VA has no rule keeping C-123 crews from admission to the Agent Orange Registry. Post Deployment Health had earlier instructed VAMC to not permit C-123 veterans any Agent Orange Registry exam, in which she overturned an earlier order from the Secretary of Veterans Affair
24 June 13: Official Email, RADM (Dr) R. Ikeda, Director, CDC/Agency for Toxic Substances
13 June 13: Boilerplate language provided by Veterans Benefits Administration to regional offices with instructions to deny all C-123 veterans' claims, regardless of merit or evidence

7 June  13: Official Letter, Secretary Eric Shinseki to Senate Veterans Affairs Committee, detailing basis of VA policy against C-123 veterans' Agent Orange exposure service connection