18 February 2013

VA Rejects Challenge From Physicians & Scientists re: C-123 Agent Orange Exposure

In ignoring their input, VA blatantly ignored members of the National Academy of Sciences, experts from other federal agencies, and faculty members from prestigious universities. These independent experts, according to the VA, are completely inadequate to sway the VA's Compensation Services to even grant veterans the "benefit of the doubt" required by law.
At least, the experts were assured that their independent opinions will be considered a source of evidence in C-123 veterans' claims. The veterans do not find this assuring, however, because while the VA says C-123 vets can qualify for benefits on one page of their web site, on others they explain why claims will be denied.

None of the concerned independent scientists and physicians were paid to research and present their expert opinions. 

The evidence associated with service on post-Vietnam C-I23 aircraft shows that
some of these aircraft contained dried residual traces of the Agent Orange herbicide
contaminant dioxin, which could only be obtained and measured by rubbing the interior
metal surface with the solvent hexane, You have stated that the dioxin obtained by this
process is sufficient to establish that the crewmembers were "exposed." However, the
scientists and medical doctors of the VA Office of Public Health have documented with
scientific literature that residual trace amounts of dioxin on metal surfaces is not
biologically available for skin absorption or inhalation because it is not water or sweat
soluble and does not give off airborne particles. As a result, they have concluded that the
likelihood of dioxin exposure was minimal, Your view of potential exposure must be
weighed against their view when VA evaluates a disability claim.
In addition to the issue of potential exposure, there is the issue of establishing a
medical nexus or link between the in-service event of flying on a post-Vietnam C-123
aircraft and development of a current Agent Orange exposure-related disease. VA laws
and policies related to Agent Orange exposure, whether presumptive or based on facts-
found evidence, address exposure contact that occurs during the actual spraying or
handling of the dioxin-containing liquid herbicide. There are no provisions for secondary
or remote exposure, as is the case with dried dioxin residuals on metal surfaces found
many years after the liquid state. The scientific evidence available to establish a medical
nexus in these cases is limited and the VA Office of Public Health has provided a medical
opinion that it is insufficient to establish the required nexus. While your letter focuses on
the issue of potential dioxin exposure, it does not offer an opinion on the medical nexus
issue nor does it address the potential for long-term health effects or disabilities resulting
from service on the post-Vietnam C-123 aircraft
Another issue you raised is the wording of the Agent Orange Act of 1991, which
establishes a presumption of exposure to "herbicide agents" used in Vietnam that
includes chemicals other than dioxin. You state that consideration should be given to
these other chemicals when considering disability compensation based on exposure
because they may have been present in the post-Vietnam C-I23 aircraft, However, since
there is no presumption of exposure to any herbicide agents without Vietnam service, this
legislation is not applicable. Additionally, the National Academy of Sciences' Institute
of Medicine, which is named in this legislation as a major source of scientific information
related to herbicide agent exposure and its adverse health effects, has determined that
dioxin is the primary "chemical of interest" associated with adverse health effects. If a
disability claim were based on exposure to other herbicide agents, the same evidence of
direct facts-found exposure and a medical nexus would be required for service

We appreciate your input and the evidence you have provided on the issue of
disability compensation for Veterans who served aboard post-Vietnam C-123 aircraft.
When VA receives claims from Veterans based on this service, they will be evaluated
based on the totality of the evidence, as described above, and determinations will be
made on a case-by-case basis.

Director of Compensation Services

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