Challenge to VA - C-123 Veterans WERE Exposed by Skin Contact

VA "Dry Dioxin Transfer" Excuse Shot Down - Proven Unscientific! 

A key part of the VA's pretense that C-123 veterans were not exposed to dioxin aboard our aircraft is their invention of something called "dry dioxin transfer." Don't bother looking it up in Wikipedia - the idea is novel to the VA, created to dismiss the many Air Force tests which clearly proved our airplanes contaminated with dioxin, by pretending that aircrews, maintenance and aerial port personnel were not exposed to the contamination. I know...makes no sense to anyone but the VA. Admittedly, exposure and contamination are separate points, but the US Government has not made the distinction before this.

Working C-123 Hand

But despite the recent challenges of scientists and physicians from throughout North America, the VA continues to pretend their concept of "dry dioxin transfer" somehow makes enough scientific sense to prevent even the benefit of the doubt helping us veterans. WRONG - it makes NO sense! VA says that once Agent Orange dried on the C-123 it may have continued to contaminate, but contamination doesn't mean exposure. And the law reads that veterans must evidence exposure, not just contamination. So as the VA struggles to insure veterans' exposure claims are denied, they sling false inventions like"dry dioxin transfer" at us. The VA says the skin is a perfect barrier to dioxin exposure, when the truth is that dermal exposure is highly likely. Necessary for this VA pretense is that the skin be a perfectly clean, undamaged, oil-free surface. Guess the VA wonks never flew in a transport aircraft in their lives! Especially, not a C-123!

Thanks to a visit to a VA Regional Office, many of the documents used by the VA to deny veterans claims were made available for review. A key find was an article in the TOX Journal about dermal exposure to dioxin, carried in a 1995 article published in the TOX journal.  In this key document, clearly known to the VA but obviously ignored by them,  the likelihood of dermal exposure is carefully spelled out. In addition to the dioxin we ingested and inhaled aboard the Provider, the article's authors explain that our skin provided no special barrier to exposure. Indeed, they establish that dermal exposure is usually the most intense of the three routes of exposure.

VA Science?

So another missile is launched into the VA balloon and down it goes in flames, This TOX article joins the opinion of Dr. Jeanne Stellman, Professor Emerita at Columbia University who earlier destroyed the VA's dry dioxin transfer joke. Still, none of this push-back against the VA will mean much until some clear-headed VA policy maker sees what mistakes have been made about us by their staffers. I hope it will be of use during conversations at the Institute of Medicine conference at UC Irvine on 15 Jan 2013...it certainly will be a part of the materials I forward to the VA for support of my own Agent Orange exposure claim and I suggest you do the same!

Last article for 2012 - God bless and keep you all.

     Wes Carter and Family
      McMinnville, Oregon
      December 31, 2012

(thanks to MSgt Kathy Voiland for her help with the TOX article)

Why We Need Good, Smart, Brave Soldiers!

“The Nation that makes a great distinction between its scholars and its warriors will have its thinking done by cowards and its fighting done by fools.” - Thucydides

VA Director Compensation & Pension Service Slams C-123 Vets

Tom Murphy, VA Director of Compensation Services

"Claim Denied!" "Veteran submitted a few documents." Thus did Mr. Thomas Murphy, Director of Compensation Service for the VA fulfill his organizational duty of automatically denying a C-123 veteran's claim, no mater how justified the clam actually is. Thank you for your service, indeed!

The particular claim in question, one of our first C-123 claims, had over 80 supporting documents. Articles from medical journals detailing identical situations. Letters from physicians and scientists offering expert independent opinions. Sworn testimony of other veterans, including unit commanders, field grade officers, flight examiners and instructors, senior NCOs, fellow veterans. Treatment records from VA, military and civilian hospitals. Lots of stuff. And all of it, no matter how much of it, no matter what the science, all of it not enough.

Never enough to overcome the VA's knee-jerk automatic rejection of any dioxin exposure claim by every veteran outside those with Boots on the Ground in Vietnam, and some minor and very specific Thailand and Korea situations. For C-123 veterans, the full weight and majesty of the VA swings into action to immediately construct barriers to justice and medical treatment. To explain, even in the face of proof, why there is no proof. To explain even, even with dozens of non-VA experts and other federal agencies claiming veterans were exposed, why there was no exposure.

Why? "Because we say so!"

Duty to Assist? Benefit of the doubt to rest with the veteran? Again, no. Never. The VA, in two years of working with us, has done absolutely nothing to seek confirming evidence or opinions as the question of  C-123 veterans' exposure came to light. Not once have they ever introduced or admitted to a single fact which could be interpreted as supportive of C-123 veterans' claims. Every citation they have offered in their "scientific" bulletins has been to deny exposure claims. Every single reference, expert, whatever that supports the veterans' claims has been ignored. They probably had a struggle admitting that there ever were C-123 airplanes and people who flew them! "What? C-123? Never heard of it? Thank you for your service.

There is not a single scientific or academic journal which would accept such shoddy work from authors seeking publication of an obviously slanted article! Any reputable journal would demand a juried review, and that panel of independent experts would condemn using their loudest megaphone the lack of even-handed, scholarly work in such materials. "Unscientific" was the description offered by independent scientists. "Not dioxin experts" was the description offered by another federal agency's head after careful investigation...and that person is a dioxin expert!

Any benefit of the doubt? Never, not when the VA's nuclear-powered mission focusses denying veterans' claims, even when such claims are within the scope of their judgement. The benefit of the doubt to the VA means that if there is any possible way to reject claims, that way must be seized upon. The benefit of the doubt to the VA means that unless compelled by law, ordered by Congress, only those veterans specifically named in the law are covered, not those whom the law may allow to be interpreted as covered - and so the VA exercises every possible twist and turn, obfuscation, delay, evidence misinterpretation, denial of truth handed them on a golden platter - all to prevent C-123 veterans from getting medical attention for our Agent Orange illnesses.


 Veterans Say:
-"It is my opinion that aircrews operating in this, and similar, environments were exposed to TCDD."
(Dr. Tom Sinks, Deputy Director, CDC/Agency for Toxic Substances & Disease Registry)
- "It is my professional opinion that (veteran name withheld) (and likely, other aircrew veterans who flew these aircraft in the same time period) was exposed to harmful levels of dioxin." 

(Dr. Fred Berman, Oregon Health Sciences University Toxicology Department) 
- "Heavily contaminated. A danger to public health."
(Dr. Ron Porter, toxicologist, USAF Armstrong Laboratories)
- "In my opinion, it is highly likely that you and other crew members were exposed to the herbicides and to their highly toxic contaminant, 2,3,7,8- tetrachlorodibenzodioxin (dioxin, for short)," 

(Dr. Jeanne Stellman, Professor Emerita, Columbia University School of Public Health)

But VA Says:

- "No conclusive evidence that TCDD exposure causes any adverse health effects."
VA Compensation Services in claim denial)
- "TCDD is the most toxic of the dioxins, and is classified as a human carcinogen by the Environmental Protection Agency."
(VA Public Health Bulletin )
- "Claims will be decided on an individual basis."
VA Public Health Bulletin (however: 100% of claims denied -  0% approved, but on an "individual" basis, of course!)
- C-123 vets are "Trash-haulers. Freeloaders looking for a tax-free dollar. I have no respect."
(VA & USAF consultant on Agent Orange, email re: C-123 veterans; also recommended destruction of C-123 fleet to prevent veterans learning of C-123 contamination & crew exposure)

VA Resists C-123 Veterans' FOIA for Agent Orange Data

Early last year, LtCol Paul Bailey submitted our formal FOIA (Freedom of Information Act request) to the Veterans Administration, seeking information about how VA officials managed their participation in two meetings with C-123 veterans hosted by Senator Burr's staff in Washington DC. Our request to the Air Force for their materials had been granted earlier. It is our fear that the VA participants approached the question of C-123 dioxin contamination with a mindset of denial, rather than even-handed scientific concern. In went our FOIA as we hoped to learn about how we were treated at the meetings.

Result? $5000 in pushback from the VA as they denied the perfectly valid appeal! To prevent us getting information about ourselves. $5000 to make sure we'd never get it! $5000 to make sure veterans would never learn that VA officials approached our concerns about Agent Orange exposure with a determination not to uncover the truth, but instead to construct any argument necessary to prevent our access to VA medical care and benefits. Our concerns for this FOIA focused on uncovering all the information located by the VA, how they interpreted it, what instructions they gave their officials and whether those instructions were neutral or whether those instructions were to

Government agencies usually can't bury information like this without running up against the FOIA itself, but obviously there are times when the requested information might cause bureaucrats discomfort. This seem to be one of those instances. Solution? Delay. Delay. Delay. Delays then followed by charging prohibitive fees for the information requested! That's the VA solution to keep embarrassing information out of the hands of C-123 veterans.

But we have rights and options, and one was to appeal the VA's pricing and refusal to provide an expedited response. Paul submitted that appeal in May and the GSA took until late November to get around to refusing it..again! They claimed the FOIA law required VA to charge us because only journalistic, educational, and not-for-profit requests can be free. Another free category - information requested is in the public interest and informs the public of how the government operates. VA's Assistant General Counsel Deborah McCallum wrote Paul about her refusal to grant his appeal even though we were fully justified, but she was also required to tell us of a final route for an appeal before going to court: The Office of Government Information Services (OGIS) acts as a final arbiter of our rights to this information - and so we submitted our appeal on behalf of The C-123 Veterans Association on December 24, 2012.

In this last out-of-court appeal, we explained our journalistic presence in the form of blogs, web sites and newsletters, We explained that the public is intensely interested in both Agent Orange and veterans health care. We explained that we have no commercial interest in the requested materials, and that the Air Force honored an identical request, using the same FOIA law and regulations, and that the information is, after all, about US!

 In it, we explained the justification for our FOIA and the reasons its denial were improper. Now...we are waiting once again. The impact: we won't have the data in time for the 15 Jan 2013 briefing we are scheduled to give the Institute of Medicine's Agent Orange committee, but we will have both the VA and the Air Force extensive collections of materials ready to give Congress early in 2013 as we continue our struggle.

So...more waiting, more hoping. Keep the faith!

Christmas Morning Reflections From a C-123 Guy

"Aren't you bitter?" she asked me. She meant bitter about the VA officials so dedicated to preventing veterans' access to medical care. She meant about the AF officials over the years who dealt with the contaminated C-123 fleet but never bothered to worry about the health of the crews already exposed.

We'd both awakened early this Christmas morning. As we waited for grandbabies to wake up and come to cuddle, our conversation under the warm covers drifted to the theme of the Christmas Eve services we attended here in snowy Denver. That pastor's metaphor addressed having to be led, each of us, many times in our lives - and how we all depend on unseen others, and God, to carry burdens when we are heavy laden.

My wife's question wove the Christmas message into our C-123 battle with the Veterans Administration. I thought about her question while framing an answer (contemplation and preparation are usually not parts of my conversational skill group) - and it was "no, not bitter. Disappointed, tired, weary of the vast amount of information about dioxin and toxicology to deal with - but not bitter."

Even after watching dear friends like Gabby Gadbois die, I'm not bitter. Even after learning of disease heaped upon disease in all the hospital stays I've had this year, with a PICC line still dripping medicine into my heart - not bitter.

Not bitter because there is much to be grateful for, and mostly for others carrying such a mammoth part of the load I'd otherwise be crushed beneath. First and foremost, grateful for my wife picking up responsibilities she'd never imagined having to manage by herself...and not because of any lack of qualification (she's got several more graduate degrees than I do) but by the sheer effort she must expend. All the housework, all the yard work, coordinating refurbishing contractors, leadership as an ordained elder in several church programs, Shelly's House for offenders...and caring for me hand and foot. Literally, as I cannot even put on that my own shoes and socks. She is my rock and my foundation.

So the bitterness leaves me altogether. What I conclude, however, is that we're dealing with people not like us. Not like the officers and NCOs I've served with. Not like George Gadbois. Not like Mike Walker. Not like Bob Boyd or Tim Olmsted. So many VA and Air Force officials just are not like us.

I don't believe I have ever served with an officer who would make battle against us as have the VA officials who sat around the conference table twice this year. I know I have never served with officers and NCOs who would learn of such a health hazard as our exposure yet somehow not to notify the crews involved or accept an order to hide the information from them. "Hell, NO" would have been the response from anyone I've ever known. Not the kind of American officer or American NCO that this Nation trusts us to be and hopes we will be faced with hard decisions.

We are not the kind of officers who would have tolerated Abu Grahib. We are the officers who in honor would have stopped it, at pistol point if necessary. We are not the officers who would fail our wingman - ever. We are the soldiers who truly carry our honor and our country's values into the military. Trash haulers, perhaps. Freeloaders - never. We are American soldiers. We were the kind of solders who mastered basic,  flight school, survival schools, the misery of SERE school up at Fairchild, and seemingly unending trips away from the family...all we wanted was to serve.

VA decision makers? Not to paint them all with the same brush, but too many are not at all like us. "Benefit of the doubt?" They pretend, nothing more.

A Request of VA and USAF leadership: Don't laugh because of our airplane - it is what you ordered us to fly. We've all flown many other planes, but somehow, like Medal of Honor holder Joe Jackson, we remain "C-123 guys" just like the C-123 will forever remain "the Agent Orange airplane." We flew the plane we were tasked to fly because AF leaders we trusted said that old bird, and our skills aboard it, were vital to the nation's defense. We certainly proved it during REFORGER exercises! Guys like Gail French proved it bringing in Tail #707 in flames, earning the DFC the hard way. Guys like Charlie Brown who came back from Hanoi proved it by putting on a flight suit again and quietly served with us. We earned the Airborne's Iron Mike award! The Army truly loved us, and after all the Army was JOB ONE as our primary customer in wartime. Of course, it would have been very nice if the C-123 had been engineered with some sort of commode and at least a Mr. Coffee! Maybe even an autopilot? Alas.

Merry Christmas from Wes

Agent Orange? Nobody knew the bill we'd be handed over this mess, but it is what it is. The intolerable part, the painful part, is now being treated as pariah by the VA - treated thus by people who are not like us. Fellow vets, don't be bitter. We are trying hard to carry the issue and we have so many helping carry the load with us - American Legion. Vietnam Veterans, leaders like Senators Burr and Merkley with their staffs, scientists and physicians across America.

Who knows? We might even have a secretly sympathetic ear somewhere within the VA...an ear which may someday hear our voices, out here in the wilderness where we trying, trying so very hard not to be bitter.

Dear VA, USAF, fellow Veterans and your families - God Bless & keep you, and Merry Christmas.

Hagerstown Museum considers buying C-123!

N681DG,  USAF  54-0681,   SN 20130

HAGERSTOWN, Md. (AP) — The Hagerstown Aviation Museum is trying to bring a 55-year-old Fairchild airplane back to the western Maryland city where it was made.

President John Seburn says the twin-engine, C-123 cargo plane was built sometime between 1954 and 1958.

He says the U.S. Treasury Department has accepted the museum’s bid for the plane.

Now the group needs to raise $70,000 to buy it and fly it back from Fort Lauderdale, Fla.

Seburn says the acquisition would complete the museum’s collection of the three military cargo planes that Fairchild produced.

The C-123 was used heavily during the Vietnam War to transport troops and supplies.

It was also used for aerial spraying of herbicides, including Agent Orange.

The federal government says the risk of exposure to Agent Orange residue is extremely low.

(Copyright 2012 by The Associated Press. All Rights Reserved.)

C-123 Veteran's Comment: No, the comment "the federal government says the risk of exposure to Agent Orange is extremely low" is incorrect. That is the conclusion of the VA as it seeks to prevent C-123 veterans from receiving medical care for Agent Orange illnesses. In fact, the CDC and the NIH have both taken stands that the aircraft were (and are, for the few remaining planes) "heavily contaminated" and "a danger to public health", as testified by Air Force and GSA officials under oath. While even  official Air Force records are unreliable regarding spray operations, it does seem that Acft 681 is not an Agent Orange spray aircraft - an inspection of the wing roots and area between the engines and fuselage will confirm one way or another.

VA Practitioners Refuse to Release Medical Opinions

They really care - I haven't met a VA physician, PA, nurse practitioner, nurse or other medical professional who wasn't totally committed to my care - truly professionals. I recommend them highly and have taken the time to express my appreciation in many forums.

HOWEVER, there is a total breakdown when it comes to my VA doctor offering a medical judgement about my military illness or injury. Despite VA regulations clearly describing the limited manner in which a practitioner may assist a veteran, every single time I have asked for an opinion or comment regarding my many illnesses I have been refused! Even when I print out the VA regulation for them, I am told to my face they simply are forbidden to do so.

Net impact: the VA itself doubts the veterans' claims as to service-connection because the VA doctors won't speak up and provide an opinion - a medical nexus - as would a civilian doctor. Without the veteran's doctor giving an opinion, the veteran faces the highly skeptical VA rating officer who freely denies claims due to lack of medical support. The VA uses itself to stack the deck against veterans! A funny quirk - the VA permits its staff to provide second opinions...just not as to cause.

FIY, here is the regulation regarding veterans requesting medical opinions from their VA practitioners:

VHA DIRECTIVE 2008-071 October 29, 2008 3: 

d. Medical Statements to Support VA Benefits Claims. When honoring requests for medical statements by veterans for VA claims adjudication, care must be taken to avoid conflict of interest or ambiguity. 

(1) Determination of causality and disability ratings for VA benefits is exclusively a function of the Veterans Benefits Administration (VBA). VHA providers often do not have access to military medical records, and may not be familiar with all the health issues specific to military service, such as environmental exposure. As a result, they may not feel comfortable in stating causality of a current condition. However, this does not preclude VHA providers from recording any observations on the current medical status of the veteran found in the medical record, 

including their current functional status. All pertinent medical records must be available for review by VBA. NOTE: VHA continues to provide compensation and pension (C&P) examinations and reports as requested by VBA, as part of any new disability claims or review process. 

(2) Requests by a veteran for assistance in completing a VA disability claim are to be referred to VBA through official channels; however, the clinician, if requested by the veteran, must place a descriptive statement in the veteran’s medical record regarding the current status of the veteran’s existing medical condition, disease, or injury, including prognosis and degree of function. This may then be requested by VBA for the purposes of making a claim determination. 

Veterans to the VA - help us find a way

Dear VA - From Us to You:

Isn't there any way leaders within the VA's Compensation and Benefits or Public Health organizations can assist us in narrowly focusing on this problem, and helping our exposed veterans get care while excluding those not involved with C-123 hands-on duty?

Tell us. We're listening, and want to drop this matter from the public forum as soon as possible. Our agenda is honorable and our request just. You're not being fair to us.


Respectfully,

    Your Fellow Veterans

C-123 Veterans Presentation to Institute of Medicine 16 January 2013

Fellow C-123 Veterans:

Opportunity: Friday I was informed by the Institute of Medicine, Agent Orange Committee (part of the National Academy of Sciences) that C-123 veterans have been scheduled for a brief afternoon presentation to the Committee to discuss C-123 Agent Orange contamination.

Background: Congress set up a process in which the VA must consider findings of the Institute of Medicine regarding Agent Orange issues. While their meeting on 16 January does not directly deal with our airplanes, it is our chance to bring the lingering contamination and the VA's stonewalling of our claims to their very public forum.

Under Secretary Allison Hickey

Many of the scientists who have weighed on to support us are well-known to the Committee. These scientists' letter of 29 November to the VA's Under Secretary for Benefits General Hickey firmly reenforced the basis for our VA claims, in particular the input from Dr. Jeanne Stellman, Professor Emerita at Columbia University's Mailman School of Public Health.

Dr. Stellman has been a firm supporter of C-123 veterans for this past year, ever since her first independent expert review of the many Air Force tests on Patches and other aircraft. Although the young scientists assigned by the VA to refuse our claims have tried to dismiss Dr. Stellman's findings, the Institute of Medicine knows her very, very well. Her work is cited throughout many of their reports, she has appeared as an exert witness many times, and has also been contracted to do many research projects on Agent Orange as used during the Vietnam War. Conclusion: she knows her stuff and blows away the VA's wonks...they just don't know it! Interesting that none of the VA scientists are cited in these reports. On the other hand, Dr. Stellman and the other experts (from other federal agencies as well as numerous universities) are perfectly objective as scientists and physicians, they have studied the C-123 exposure issue, formed their opinions, which are in favor of the veterans, and they defend that position (and us!) mightily. The only possible response from the VA is to ignore the letter, of course. No surprise. One gets the impression the VA respects only those experts employed by them, whose job it is to construct barriers to veterans' claims. 

Request: We need a volunteer speaker!

We continue to seek venues such as this with the IOM to set right our unfortunate situation - we've been exposed and nothing will change that, yet our duty remains getting our veterans essential care for the typical Agent Orange ailments confronting us. Our Association is looking for one of our vets in the Irvine area to represent us at the University of California meeting on January 16, 2013. If we don't find a "volunteer", I'll do it, flying there from Denver where we're vacationing with our kids. If one of you airline-types can still fit onto a jump seat, want to take this on and save me the airfare? I'll do an outline if you wish, and even text the entire presentation - the IOM has offered to print and distribute to the Committee for us, and place it into their conference records.

Let me know...I have to get my flight and hotel reservation if nobody signs up to volunteer.

Christmas suddenly and horribly changed for so many Connecticut families in Newtown. God bless and keep them all. 

Peace.

VA Needs Data About C-123 Veterans - NOW!

The Veterans Administration and the Air Force...heck, EVERYBODY is confused about our C-123 veterans head count and personnel issues. The questions hitting us are:

1. How many C-123 veterans are there?
2. How many have submitted VA claims?
3. How many have VA claims which have been denied or approved? We don't know of any approvals.
4. Does any C-123 vet have an appeal of a VA claim denial in process with the BVA or other agency?
4. Can any or all of us claim having flown Patches or other known Agent Orange spray birds? IMPORTANT - did you fly Patches (Tail 362) or not?
5. We have been collecting a list of illnesses with LtCol Paul Bailey putting the list together in Excel - if you have not already submitted your name and whatever AO illnesses you claim, please give him your info by an email to: a208773@rocketmail.com
6. Please pass the word to other C-123 veterans - we estimate our people to number about 1560 aircrew, aeromedical evacuation, maintenance and aerial port personnel. The AF thus far has declined helping us search for retirees but we hope we can find each other by personal contacts. We also hope the VA can approach AF for help locating our people through retiree records. Again, have them write LtCol Bailey or Wes Carter, at wes@c123cancer.org
7. We need to know of deaths among our veterans. We know of just a few (Tim Olmsted, Bob Boyd, "Doc" Werner, George Gadbois, Lou Paskavitz, S. Glenn, Ron Ploof, Bill Schindler) but VA needs to get a better handle on those who have passed and their illnesses.

VA Sets Unfair Barriers to C-123 Veteran Agent Orange Claims

C-123 fleet in HAZMAT quarantine storage, Arizona

VA recognizes several groups regarding veterans' Agent Orange exposure. First and foremost, the "boots on the ground" Vietnam War vets. These men and women are presumed to be exposed to Agent Orange and eligible for treatment of a long list of VA-recognized Agent Orange illnesses - the "presumptive connection" illnesses.

VA also recognizes other groups, including Korean DMZ veterans, Brown Water Navy, and some vets who served in Thailand during the Vietnam War. All these veterans need prove to the VA is that they served "when and where".

Finally, VA has recently published a list of other veterans who, if able to prove their exposure to Agent Orange or other military herbicides, may be considered on an individual basis for Agent Orange-presumptive illnesses. These veterans need not prove the "medical nexus" of their exposure and illness, so long as the illness is one of the current list. Included here are veterans from stateside storage locations, some Blue Water Navy, and -of great interest to us- the C-123 veterans.

But even though we're on their bulletins, we're being treated in a most unique, most unfair manner. Only in the case of C-123 veterans has the VA established a special barrier built around the issues of contamination and exposure. You see, other veterans need only provide "as likely to as not" proof that their service in the military brought them into contact with contaminants of military herbicide. The VA seems to group the whole issue so that contamination equals exposure.

In fact, and we agree, contamination and exposure are separate issues. Contamination means the scientifically established toxicity of a veteran's workplace, vehicle, location, etc. Exposure means that in the presence of a contaminant, one is or is not EXPOSED via inhalation, ingestion or dermal routes of exposure. Separate parts of the larger story of toxic substances and how people are harmed.

But only in the case of C-123 veterans has the VA taken special illogical steps to prevent our group of veterans' lawful claims for treatment of typical Agent Orange illnesses. Once VA found out that there was no way to dispute the actual contamination of the C-123 fleet because so many Air Force tests had already been done, VA acted to bar us from service connection by dreaming up a phony argument that contamination for the first time somehow did not equal exposure! And regardless of the multitude of scientists and physicians who support C-123 veterans' claims, the VA remains dedicated to denying us vital medical care.

Hard to understand why, other than the determination (as always) by the VA to prevent any group of veterans from successful Agent Orange claims unless Congress demands the VA to recognize them. VA has never, on its own, reviewed a group of veterans and determined them to be AO-eligible, and they clearly are dedicated to preventing even one C-123 veteran from getting VA medical care. We recognize there is a budget impact, but the duty of Congress is to provide the dollars. The duty of the VA is to treat veterans. We wish they'd start doing so!

Scientists & Physicians Speak Out in Support of C-123 Veterans!

Dr. Stellman

Today, we were informed by Dr. Jeanne Stellman, Professor Emerita at Columbia University's Mailman School of Public Health, that ten scientists and five physicians joined forces and submitted their joint letter to the Under Secretary of Veterans Affairs, General Allison Hickey.

These eminent scientists and physicians spoke out in support of C-123 veterans' claims for Agent Orange exposure. The VA has spent this last year defying science, law, logic and justice in an effort to prevent C-123 veterans from making any claims for medical care for the Agent Orange exposure while flying and maintaining our airplanes which all government tests agree, were "highly contaminated" and "a danger to public health." The scientists and physicians who authored their joint letter aim to set right the VA on this issue! The letter should be a game-changer in our struggles with VA administrators.

Unlike the VA whose staff toxicologists were assigned the paid duty of creating arguments against veterans' claims, these independent scientists and physicians took time from their busy professional schedules, without compensation, and evaluated all the evidence and then put forth their views confirming the C-123 veterans' exposure and eligibility under law for Agent Orange service connection. We are fortunate that they have General Hickey to receive their letters, given her Air Force background as an aircraft commander before becoming Under Secretary for Veterans Benefits. Naturally, VA will immediately dismiss this letter using whatever spurious "reasons" that come to mind, whether or not such reasons are legal, just, or scientific.

What can we say to these independent experts except thank you. The scientists and physicians have asked that their names and institutions or federal agencies remain nameless except in the original letter sent General Hickey, but we know who many of them are likely to be. Our thanks. Our very profound thanks, especially to leaders in the effort like Dr. Stellman and others who've asked their involvement be confidential and thus objective, as is the standard in their profession. Thank you all for stepping forward to help us, just as our veterans stepped forward to serve in the military, flying these airplanes that left us exposed to deadly TCDD.

God Bless them from each of us!

     Wes

-cover letter to joint letter submitted to Under Secretary of Veterans Affairs, General Hickey:

(text of scientists' and physicians' letter, on a major university's letterhead)

November 29, 2012

Brigadier General Allison Hickey USAF (retired)Undersecretary for Benefits

Department of Veterans Affairs

810 Vermont Avenue, NW

Washington, DC 20420

Dear Secretary Hickey,

We have been asked by Major Wesley T. Carter USAF (retired) to comment on the October 12 letter in which you state that "VA is unable to extend the presumption of Agent Orange exposure to crew members of post-Vietnam C-123s or acknowledge Agent Orange-related disabilities as a result of this service." You based this statement on information provided to you by the VA Office of Public Health. We have carefully examined that Office's"Scientific Review of Agent Orange in C-123 Aircraft,"[1] and find it seriously flawed. We feel obliged to point out the scientific shortcomings in the VA appraisal and hope that you take our comments into consideration in any future decision-making with respect to post-Vietnam exposures in the C-123s.

In your letter you state that "the potential for exposure to dioxin from flying or working in contaminated C-123aircraft years after use in Vietnam, is unlikely to have occurred at levels that could affect health" and you base your statement on the VA Public Health Office conclusion that any dioxin present would be "biologically unavailable."Unfortunately, the Public Health Office, in turn, bases its conclusion on several erroneous assumptions about routesof entry of dioxin to the body, as well as other scientific misapprehensions.

The VA seems to dismiss skin absorption ("the skin would act as a barrier prohibiting further penetration of TCDD"). This is incorrect. Skin absorption is a primary occupational route of exposure for dioxin-contaminatedpesticides. Both the Air Force and Army technical assessments use a dermal absorption model,[2][3] as do numerous other agencies and authorities. When the Air Force applied its skin absorption model to a 2009 assessment of contamination of the C-123s prior to their disposal, it found average concentrations in two of the aircraft to be"statistically near the risk-based screening level for dioxins/furans, based on a one-year industrial exposure scenario" (page 20). (A one-year industrial exposure scenario is probably reasonable for C-123 crew and maintenance personnel in the 1970's.) Please note that these measurements were taken nearly 40 years after sprayingended, and certainly represent a lower level than would have been present in the 1970s.

The levels measured in another Air Force assessment of the C-123s, in 1994,[4] were significantly in excess of the screening levels proposed by the Army for office workers. The Army office worker exposure scenario provides forfar less opportunity for dermal contact than would have been likely for C-123 crew and maintenance personnel. Even with this very conservative exposure model, officials from ATSDR calculated "an average value of 6.36ng/l00cm2 for the three C-123 interior wipe samples collected on November 20, 1994", an average value that"exceeds the Army screening level by 182 times and is equivalent to a 200-fold greater cancer-risk than thescreening value."[5] The 2009 Air Force reference levels would similarly have been exceeded.

There are additional difficulties with the VA's scientific appraisal. For example, the VA proposes, "Once TCDD dries on hard surfaces, such as on an aircraft, it does not readily cross through human skin." By contrast, Army technical guidance is specifically formulated for dioxin that is characterized as "dried-on surface" (p. 63). The VAminimizes the possibility of skin absorption "especially given that the sampling for TCDD on the aircraft surfaces required use of a solvent (hexane) to displace and dissolve any residue." Hexane-based wipe sampling is standard procedure. The VA seems to deride the notion of occupational exposure because "sophisticated laboratory techniques many years after its use" were used to detect dioxin. Dioxin is a tricky substance to measure and only expensive and sophisticated techniques are available for its detection.

We also think it important to note, as you do in your letter, "the 1991 Agent Orange Act ... provides a presumption of herbicide exposure" (emphasis added). This means exposure to 2,4,5-T, 2,4-D, picloram and dimethyl arsenicacid (another carcinogen), not just the notorious Agent Orange contaminant, TCDD (dioxin), are covered by the Act. Airborne phenoxyherbicides were measured in air samples taken in the C-123 aircraft in 1979, albeit at levels below the occupational exposure limits.[6] It is difficult to extrapolate exposure levels back to 1972 because of an absence of data on applicable environmental temperatures and pressures, but it should be noted that there exists the likelihood of exposures to multiple environmental toxins in the C-123s, in addition to dioxin, and such multiple exposures generally require application of more conservative scenarios.

We hope that this letter may assist you in reconsidering your conclusion with regard to presumption of herbicide exposure for post-war C-123 crew and maintenance personnel. We would be particularly interested in learning the specific criteria used for determining that exposures to the dioxins were "unlikely to have occurred at levels that could affect health," since screening levels appear to have been exceeded and no safe level of dioxin exposure has asyet been agreed upon by regulatory authorities.

Please let us know if we may be of further assistance to you in your considerations. 

Sincerely,

[SIGNATORY LIST ATTACHED - confidential per their request]

[1] http://www.publichealth.va.gov/exposures/agentorange/scientific-review-residue-c123.asp

[2]"Dioxin and Herbicide Characterization of UC-123K Aircraft – Phase I." Prepared for Director of Operations,

505 Aircraft Sustainment Squadron and Hazardous Waste Program Manager, 75CEG/CEVC, Hill AFB, UT(prepared by Select Engineering Services, Layton, UT); 2009.(http://foundationforworkerhealth.wikischolars.columbia.edu/file/view/Reference+2_Hill+AFB_2009.pdf )

[3]Technical Guide 312 -Health Risk Assessment Methods and Screening Levels for Evaluating Office WorkerExposures to Contaminants on Indoor Surfaces Using Surface Wipe Data (June 2009). (http://foundationforworkerhealth.wikischolars.columbia.edu/file/view/Reference+3_TG+312+%28Health+Risk+Assessment+Methods+and+Screening+Levels+for+Evaluating+Office+Worker+Exposures.pdf )

[4]Consultative Letter from Capt Wade Weisman & Ronald Porter; Department of Air Force Armstrong LaboratoryMemorandum FOR 645 MedGrp/SGB Dated 19 Dec 94. (http://foundationforworkerhealth.wikischolars.columbia.edu/file/view/reference+4_Weisman_Porter_1994.pdf )

[5] Letter from Thomas Sinks, PhD, Deputy Director ATSDR to Maj. Wesley Carter (ret), Jan. 25, 2012. (http://foundationforworkerhealth.wikischolars.columbia.edu/file/view/reference+5_A TSDR+Letter+25+Jan+12.pdf)

[6]Conway, William, September 1979, Aircraft Sampling Westover AFB, MA, USAF OEHL Technical Report 79-59. ( http://foundationforworkerhealth.wikischolars.columbia.edu/file/view/reference+6_Conway_1979.pdf )