30 October 2013

LtCol Paul Bailey - obituary and funeral details

Paul A. Bailey

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Retired Lt. Col. (USAF) Paul A. Bailey

BATH, NH -- Retired Lt. Col. (USAF) Paul A. Bailey, 67, of Joy Road, passed away on Monday, October 28, 2013, at Cottage Hospital in Woodsville, NH after a courageous battle with cancer.

Paul enjoyed a distinguished 37 year military career in both the US Army and US Air Force. His flying experience was while based out of Westover AFB and Hanscom AFB. Just out of high school at Clover Park Washington in 1963, he completed parachute training and earned his Combat Infantry Badge as a member of the Army's 82nd Airborne Division. He married Nancy Rainey on October 18, 1969. In 1970, he received a Bachelor of Science degree in Elementary Education from Lowell State College in Lowell, MA. In 1974, he received a Master of Science degree in Educational Administration from University of Massachusetts, Lowell, at which time he joined the Air Force Reserve's 74th Aeromedical Evacuation Squadron, where he served as a flight instructor. In his civilian career, Paul also worked for Fidelity Investments, managing the logistics, mail, and currier operations for over 14 years in Boston, MA.

He was predeceased by his father, Master Sergeant Paul C. Bailey, US Army (Retired) 

Survivors include his wife of 44 years, Nancy (Rainey) Bailey of Bath, NH; a daughter, Laura LaValle and husband Sal of Pelham, NH; two grandchildren, Joseph and Rachael LaValle both of Pelham, NH; his mother, Dorothy Bailey of Sanford, ME; a sister, Maryann Sousa of Sanford, ME; three brothers, William Bailey of Grand Junction, CO, Thomas Bailey of Lowell, MA, and David Bailey of Mechanicsburg, PA; a foster daughter, Brooke McNiff of Groton, MA; and several nieces, nephews, and cousins.

A Mass of Christian Burial was on Monday, November 4, at 10:30 AM, at St. Joseph's Catholic Church, 15 Pine Street, Woodsville, NH with Father Jeffrey Statz as celebrant.

Burial was at New Hampshire State Veterans Cemetery, 110 Daniel Webster Highway, Route 3, Boscawen, NH on Monday, November 4, at 2:30 PM with full military honors.

29 October 2013

Lieutenant Colonel Paul Bailey Died Monday, October 28 2013

Our dear friend Paul Bailey passed away yesterday in Bath, New Hampshire.

Paul leaves wife Nancy, daughter Laura, two beloved grandchildren, brothers, and countless friends. His life was an example of patriotism, valor, love of family, and dedication to friends.

His illness, prostate cancer caused by Agent Orange exposure, was the basis of great debate with the Department of Veterans Affairs and their stubborn denial of his claim was the subject of national news. So was the eventual approval by the VA of Paul's claim.

27 October 2013

Prayers for Lieutenant Colonel Paul Bailey

The next few days, far too few, will be very hard for Paul Bailey and his family, as he concludes his service to God and country. According to wife Nancy, the doctors have recommended no further invasive procedures so as to leave him as comfortable as possible.

Sunday, he was comfortable enough to telephone me and to watch the football games with friends and family, although between his much-needed naps. Al and Gail Harrington, members also of our C-123 group, were there for much of the day and expect to return Monday.

Paul's 37 years of service to the US Army and US Air Force stand as testimony of his valor, patriotism and dedication to friends and family.  An Army "brat," he enlisted and earned his Combat Infantry Badge and Paratrooper wings before his teens were out. Leaving active duty to earn his BA and MA degrees, he later joined the Air Force Reserve and altogether served nearly four decades.

Even in retirement, he served as a supporter of New Hampshire's veterans causes and, in particular, of The C-123 Veterans Association of which he was an officer. There was pride, too, in his service both as an NCO and an officer.

Paul was exposed to Agent Orange aboard our C-123 transports which he flew between 1974-1980. Suffering from prostate cancer, he learned in 2011 the aircraft had remained contaminated but the Air Force toxicology reports were suppressed from 1994 on. Paul's struggle to obtain VA medical care and benefits began, but without VA action. His plight was highlighted in an August 3, 2013 full-page story in the Washington Post, authored by reporter Steve Vogel. On August 7,  Vogel ran the news of Paul's claim for exposure benefits suddenly being approved by the VA.

Please keep Paul, Nancy, daughter Laura and the grandchildren in your prayers.

God bless Paul Bailey, my best friend.

24 October 2013

More: Congressional Support...or lack of it...for C-123 Veterans. Where is Rep. Neal?

Susanne Bonamici, D-OR
Although Westover Air Reserve Base (Chicopee, Massachusetts) is located in his district, and although most of the Agent Orange-exposed veterans are his own constituents, Congressman Richard Neal has declined to sign his colleague Suzanne Bonamici's letter to VA Secretary Eric Shinseki.

Bonamici led a bipartisan effort in the House urging the VA to acknowledge C-123 veterans' exposure claims, submitting their letter to the Secretary on October 23, 2013.

A parallel Senate effort has been led by Senator Richard Burr (R-NC) and Senator Jeff Merkley (D-OR).

A large squadron of the C-123 troop transports was stationed at Westover Air Reserve Base in Chicopee between 1972-1982. The C-123 was the aircraft used for spraying Agent Orange in Vietnam, and Air Force tests revealed in 1994 that 34 of the warplanes remained contaminated through the decade of use following that conflict. The aircrews, aeromedical evacuation crews and maintenance personnel were exposed to dioxin, the toxin in Agent Orange, by skin contact and inhalation of dioxin-laden dust.

As the Congressional letter noted, the veterans' exposure has been confirmed by numerous other federal agencies, including the CDC and National Institutes of Health, yet the VA declines to provide essential medical care and other benefits. 

VA utilizes their unusual in-house definition of "exposed" (one unique among federal agencies and scientific societies and disputed by EPA, CDC and NIH) to skirt requirements under the Agent Orange Act of 1991. That law requires VA to care for Agent Orange veterans. In the agency's dealing with C-123 veterans, VA has added a requirement for proof of individual exposure to Agent Orange tied to resultant specific illnesses, termed "medical nexus." 

VA's special definition effectively denies all C-123 veterans' claims of exposure because such proofs are not possible for individuals, and only possible for larger groups when evaluated by epidemiological specialists. Congress removed this virtually impossible individual burden of proof for Vietnam veterans by passing the Agent Orange Act. Title 38 and the Federal Register of 8 May 2001, page 23166, detail that VA will care for any veteran exposed to "military herbicide,' thus VA's special definition of "exposed" was created to bar C-123 veterans from care.

Rep. Richie Neal, D-MA
Representatives of The C-123 Veterans Association, visiting with Congressman Neal in his office in March 2013 were personally assured of his support, although no action seems to have been taken by his office in furtherance of that commitment . Neither have local Massachusetts C-123 veterans been successful seeking his assistance, and Neal's absence from the list of Congressional signers to this letter is disconcerting. 

Veterans suffering Agent Orange illnesses, such as prostate cancer, heart disease, peripheral neuropathy, ALS and otherrecognized ailments continue to hope that Congressman Neal, like so many of his colleagues in the House and Senate, eventually notice their situation and lend his support. Given the veterans' severe illnesses and age averaging in the late 60s, Mr. Neal's help would be useful sooner, rather than later.

Why is it left for the able Congresswoman from Oregon to lead this effort which should have had Congressman Neal's early and enthusiastic intervention with the Department of Veterans Affairs? Where is the voice of Westover's Congressman? How serious do our illnesses need to be to warrant his concern?
Then-Mayor Richard Neal with then-Captain Wes Carter, Springfield, 1991

Note: I first met Mr. Neal the night of the Springfield chlorine incident, when I was the first medical officer responding to the city's request for military assistance. Later, Mayor Neal honored all of the 439th Military Airlift Wing personnel who helped that stressful night, and later still, I met him at various city events. Lastly, we spoke in his Washington office where I sought his guidance and assistance for his district's veterans. 

As with the other C-123 veterans who've sought his help, including his constituents, many subsequent letters and requests have been unanswered, although his staff had asked me to detail the situation for them. Apparently, requests for Congressman Neal's comments from Springfield's The Republican newspaper have also been ignored. 

The Congressman is an able legislator so there must be a significant political reason for his avoidance of this issue. But for us as dioxin-exposed veterans, there is no avoidance possible.

23 October 2013

C-123 Agent Orange Book Now Available for ALL Macintosh Computers!

Yesterday's release of Apple's newest operating system for the Macintosh, Mavericks OS 10.9,  included the much-desired ability for iMac and MacBook computers to read iBooks publications. Until yesterday's newest software, those terrifically interactive, multi-media iBooks could only be read on Apples iPads. Now, these publications are available throughout the Apple user base.

Got a Mac or an iPad? Got you covered! Download our free C-123 Agent Orange book now!

Exciting–packed with high drama! Stunning in scope and revelations!
Read now! Don't wait for the movie!

Congress Urges VA to Recognize C-123 Agent Orange Exposure!

In their letter submitted Monday, October 22, representatives from both parties joined Congresswoman Suzanne Bonamici (D-OR) and Congressman Paul Cook in demanding the VA recognize C-123 veterans' exposure to Agent Orange. The deadly toxin contaminated the fleet of C-123 warplanes, used earlier in Vietnam for spraying Agent Orange.

October 22, 2013
Dear Secretary Shinseki:

Thank you for your work on behalf of our nation’s veterans.  We were pleased to hear that the Department of Veterans Affairs recently reversed its denial of disability benefits for LTCOL Paul Bailey, who served on C-123 aircraft in the years after the Vietnam War.  In light of this, we urge you to reevaluate previously-denied claims for other veterans who also served on C-123 aircraft.  In addition, we ask that you expedite review on current pending cases for the veterans who served aboard these planes, many of whom are suffering from multiple illnesses.

From 1972 to 1982, between 1500 and 2500 aircrew, aerial port, and maintenance staff served on C-123 aircraft that had been used during the Vietnam War to spray military herbicides, including Agent Orange.  These men and women served their country without knowledge of the danger posed to them by the dried herbicide residue on the aircraft.  Many of the country’s top experts on Agent Orange, including the Director of the National Institute of Environmental Health Sciences and the Director of the Agency for Toxic Substances and Disease Registry, have written detailed statements supporting the claims of the  crewmembers that they were exposed to Agent Orange.  Despite overwhelming evidence and support from the scientific community, the VA continues to deny that any level of exposure occurred.

As described in a recent Washington Post article, a 2009 recommendation by Hill Air Force Base in Utah stated that “smelting is necessary for these 18 [C-123] aircraft so the Air Force will no longer be liable for ‘presumptive compensation’ claims to any who works around this ‘Agent Orange’ metal.”  This appears to indicate a desire to obscure evidence of Agent Orange exposure in order to deny benefits to those who served; if that is accurate, it is shameful and an affront to many who put their lives on the line for our country.

The C-123 veterans deserve better than this.  Given the vast evidence from the toxicology community, as well as documentation from the military, the VA must seriously reconsider its position on this issue.  Those whose claims were denied deserve to have their files reopened and reevaluated.  And the claims that are still being processed must be given expedited, careful, and thoughtful review.  This attention should be given to all C-123 veterans who, from 1972 to 1982, flew the same aircraft from the same bases and with the same mission.

We will continue to follow this issue closely.  We look forward to a prompt response from you outlining the steps you plan to take to help the C-123 veterans.

   /Congressional Committee//

22 October 2013

USAF Refuses to Designate C-123s as "Agent Orange Exposure Sites"

"Not our job," can be the summation of the USAF response to veterans' request to designate the toxic C-123 aircraft as "Agent Orange Exposure Sites." Go try the VA, was the decision by DCS/Logistics, Installations and Mission Support and Lieutenant General Judith Fedder.

Although all C-123s were destroyed back in June 2010 in special operations due to their confirmed dioxin contamination, veterans flew and were exposed aboard these warplanes for a decade after the Vietnam War. Concerned, and rebuffed by the VA which refused them medical care, the veterans asked the VA to consider in retrospect designating the known spray planes as exposure sites to permit claims to progress. Thus, veterans proving duty aboard these C-123s might progress in their claims for VA medical care for Agent Orange-associated illnesses.

Predictably, VA refused, referring the problem to the Air Force. So the veterans eventually identified the AF office with responsibility, and has recently also been refused their help. "Not our job," claim both AF and VA. Her letter is below, and our letter requesting reconsideration hasn't been answered.

Because of their known history of spraying Agent Orange, and because of the decades of AF-confirmed tests establishing their dioxin contamination, these aircraft are clearly covered by the language of both agencies' dealings with Agent Orange Exposure Sites. Because the CDC/Agency for Toxic Substances and Disease Registry and the National Institutes of Health/National Toxicology Program concur both with the contamination and the veterans' exposure, it begs the question what leads the AF to disagree?

We have absolutely no doubt that LtGen Fedder and her troops would storm the barricades to protect any active duty troop from potential harm. Like the School of Aerospace Medicine, that's their mission and their dedication can be assumed and relied upon. 

What we find disappointing is the failure of DCS/Logistics, Installations and Mission Support to consider any reasonable, merely administrative retroactive steps to make right earlier mistakes...mistakes such as AFMC and the AF Surgeon deciding not to notify already-exposed C-123 veterans that we'd had a decade of service aboard toxic airplanes!

21 October 2013

Apple Publishes "C-123 Veterans: VA Illegally Denies Agent Orange Benefits," Verson 3.2 for iPad

Free book! Worth every penny!

Got an iPad? If not, start dropping Christmas gift suggestions, because the iPad version of our C-123 book has been published by Apple. This is the 3.1 edition of the book, which has been constantly updated with new materials such as VA regional office decisions, correspondence, and other helpful resources...over 350 pages of background on the C-123 Agent Orange saga.

A great feature of the iPad books is the ability of authors to insert photos, videos, recordings...things to make the book come alive with motion and content as it is read. We have inserted such great items, but at the cost of the book file being quite large...over 150 MB.

Please download this free iBook from Apples' iTunes site. 
Free. Read it NOW!

VA Legal Office Challenged to Ethics Review

C-123 veterans have spent years seeking a sympathetic ear at the VA. By "ear," we mean someone focused on the law and veterans. For too long, individuals and sections at the Department of Veterans Affairs have predetermined C-123 veterans to be ineligible for exposure benefits. The law says otherwise!

Today, as we also did in June of this year, without response, this has been brought to the attention of VA's Assistant General Counsel. It is our hope that the most recent request won't be ignored as was the earlier. It is our hope that Attorney Hipolit has a few moments to offer our dioxin-exposed veterans the benefits prescribed by law, rather than allowing VBA and VHA to continue proscribing us from those protections.
Richard Hipolit, Assistant General Counsel
Department of Veterans Affairs
810 Vermont
Washington, DC 2042
Dear Mr. Hipolit, 
This June I brought to your attention concerns The C-123 Veterans Association has regarding blanket policy-driven denials of our veterans claims for service connection, but without response from your office.  
I request that you again consider our request, as it is inappropriate for the Department of Veterans Affairs to continue refusing medical care for veterans whose Agent Orange exposure is confirmed by several federal agencies as well as numerous university medical schools and schools of public health. 
We seek a better solution than the VA denying decisions until our veterans have entered hospice care to make such deserved awards, as was the case this July of Lieutenant Colonel Paul Bailey (Huffington Post July 10 2013, Washington Post 3 August 2013, page A1 and page A14, and Washington Post page A2 and UPI, 7 August 2013,  Fox News, 11 August 2013, Stars and Stripes, 15 August 2013, many others.) 
 We believe the blanket predetermination of our ineligibility, as per the verbal assurance given me on 28 February 2013 by officials of Compensation Services that no amount of proof from any university, federal agency or military service will permit approval of our claims to be improper. And not “veteran-friendly.”  
We believe VBA’s blanket refusal to accept expert toxicologists’ input in support of veterans’ claims to be incorrect, considering decisions by both the 8th and 9th Circuit Courts. 
We believe the failure to correct numerous prejudices and improper, VA-unique VHA Post Deployment Health redefinition of the word “exposure” to reintroduce medical nexus is an issue that demands attention from your office.  
If you feel I am incorrect in these assertions, I, as chair of a national veterans organization whose argument has been vetted by both the American Legion and Vietnam Veterans of America, then ask that the issue be referred to the ethics office which overseas both VHA and VBA. believe it proper for VA to adhere to the law, even without specific court orders to do so. Somebody at VA might agree. 
Wesley T. Carter, Major, USAF Retired, Chair 

20 October 2013

Veterans Ask Society of Toxicology for "Equal Time"

In our earlier posts we explained how VA used the Society of Toxicology poster display they presented
to redefine the scientific term "exposure." To prevent veterans from coverage for Agent Orange illnesses, VA redefined exposure to "Exposure = Contamination Field + Bioavailability."

This is incorrect. Exposure is defined everywhere as contact by the skin with a contaminant, or its inhalation or ingestion. There is no requirement for bioavailability, which is the VA's attempt to reintroduce medical nexus as a requirement for Agent Orange coverage – and this was prohibited by the 1991 Agent Orange Act and Title 38! The Federal Register specifically provides for our benefits.

The Association has approached the Society of Toxicology for some sort of platform for us to challenge the VA's unscientific, policy-driven poster presentation. The request to the SOT's president follows:
Dear Doctor Lehman-McKeeman,
We seek SOT assistance regarding the poster display submitted by the VA at an earlier conference, which addressed Agent Orange and our exposure aboard contaminated C-123 transport aircraft. 
We believe the science in the poster was flawed and policy-driven, to the point of redefining the term "exposure" to require bioavailability. This incorrect VA redefinition thus denies all our veterans' Agent Orange exposure claims. This definition defies that of the SOT, ATSDR, EPA and others. 
I earlier asked SOT's help with this but without response. The Washington Post, Huffington Post, Fox News, UPI and other sources have recently covered this sensitive issue, but the core of it is the VA's SOT poster standing unchallenged by SOT. 
I ask that SOT consider the attached article, edited for a more appropriate tone, as a layman's SOT essay. I ask that I be given permission to present at the 2014 conference on this topic, repeating what I said at the January Institute of Medicine meeting. 
At the very least, I ask that The C-123 Veterans' Association be permitted to submit a poster display addressing this issue. 
The VA used their SOT poster as their pulpit to deny over 2000 veterans coverage for Agent Orange benefits. The question of the medical or legal impact of the dioxin exposure is not at hand, only the word "exposure." 
VA has opted to redefine that without challenge by SOT. VA used SOT as a vehicle against our interests, used toxicological concepts which should have been challenged, and we are entitled to our response. 
Alternately, can you invite input from a recognized authority, perhaps an interested SOT member? 
I hope I can your help with this, as earlier suggested by Dr. Birnbaum. VA redefining science to oppose our claims should not remain unchallenged by toxicologists.
Wesley T. Carter, Major, USAF Retired, Medical Service Corps
Chair, The C-123 Veterans Association
attached: "VA Redefines Science to Deny Agent Orange Claims" 

19 October 2013

Agent Orange & C-123: The VA Ignores its Own Documentary Evidence

"JOB ONE: Prevent Claims" should read the bronze plaque at 810 Vermont, the VA's headquarters, rather than Lincoln's famous, more compassionate words from his poetic Second Inaugural.

Chart VHA used to sneak in redefinition of "exposure"
VA's dedication to preventing C-123 Agent Orange claims is one of their particular objectives. Actually, as veterans know too well, the VA its its own worst speed bump in the road to service connection! To better insure denial of these dioxin-exposed veterans who are clearly entitled to care, personnel from VA's Veterans Health Administration's Post-Deployment Health section delivered a poster display at t
he San Francisco gathering of the Society of Toxicology (SOT). Entitled "Agent Orange: The 50 Year History & The Newest Chapter of Concerns," the poster was not subjected to the usual scientific scrutany expected of professional articles. VA simply had their poster designed and put it on a stand.

And then they used it to make sure C-123 veterans are denied Agent Orange exposure claims! 

Our two most recent posts addressed the VA's creation of a special, in-house definition of the scientific concept of "exposure," one created by VA to skirt the law's requirements. VA simply added qualifiers to that word to prevent C-123 veterans from being considered as exposed, even though other federal agencies such as the CDC and NIH have argued otherwise...C-123 veterans were indeed exposed...except in the VA's definition.

But there's more. VA realized that the C-123s were used for spraying Agent Orange during the Vietnam War between 1961-1971 and began service with stateside Air Force units in 1972. The aircraft returned to the US and most had the spray tanks and pipes removed by a contractor at Dothan, Alabama to return to their original C-123K configuration. Many, however, remained in their UC-123K configuration and were assigned to insect control operations at Rickenbacker Field.

VA also realized that dioxin remains toxic and biologically available for quite some time once sprayed in the military herbicide, and VA knew the liquid settled throughout the fuselage and especially, below the cargo deck. Air Force tests even decades later confirmed the toxicity and in 2010 the AF took an extraordinary step of shredding and smelting all remaining C-123 warplanes as toxic waste.

VA acknowledged this lingering contamination, at least recognizing a year's worth of it, in their SOT poster. The fourth paragraph clearly states"
"Inhalation the least likely contributing route one year after spraying missions due to rapid drying of Agent Orange droplets, movement via wind, and removal of contaminated dust via decontamination efforts after returning from Vietnam."
Spray operations stopped in 1971. Stateside, C-123 veterans began flying the airplanes in 1972. Seems within that "one year after spraying missions" and includes our service, doesn't it?

Toxicology experts familiar with the Air Force research on C-123 operations have examined the issue of C-123 dioxin contamination and exposure via the inhalation route, and argue that it was absolutely a significant risk for aircrews! Vibration and the dirt and dust characteristic of cargo flight operations resulted in crew exposure because dioxin readily binds to dust. 

Flight after flight, breath after breath, aircrews continued to be exposed. Not just the year even VA recognizes, but over the full decade of operations until the C-123 fleet was finally all retired in 1982. IT only remained for the crews to grow ill, and for the VA to formulate policy-driven excuses to deny them care for the full range of Agent Orange-presumptive illnesses.

And that's why a new plaque should be ordered for 810 Vermont Street NW, Washington, D.C.

18 October 2013

VA Bars C-123 Veterans Agent Orange Claims - By Redefining Science

PART TWO: The Grand Deception
You see the VA's trick, don't you? They took the standard interpretation of "exposure" and redefined it. They added the requirement that exposure to the toxin dioxin in Agent Orange be linked to specific reactions in the bodies of the C-123 veterans. "Exposure = contamination field + biological availability." But it turns out  this is a completely false, illogical, and unscientific definition challenged by other agencies such as the CDC...agencies with the statutory authority and scientific expertise to make such determinations. 

That is a blatant rebuilding of the medical nexus barrier used by VA against Vietnam veterans to prevent their decades of exposure claims. Congress, reacting to the amazing bad faith exhibited by VA towards veterans (actually, in not responding!) passed the 1991 Agent Orange Act. This obliged the Secretary of Veterans Affairs to utilize the National Academy of Sciences and its prestigious Institute of Medicine to evaluate Agent Orange exposures and resultant illnesses.

Medical nexus was completely eliminated as a requirement for a veteran's claim. The law obliged the VA to treat all veterans with "boots on the ground" during Vietnam as a "presumptive eligibility" cohort. If you were in-country, you were covered. Covered, eventually for nearly 20 illnesses and diseases which the IOM and VA agreed to associate with Agent Orange exposure. Diabetes, prostate cancer and other illnesses could be treated for any veteran with proof of boots on the ground.

But the laws went further. Congress made it clear that exposure to Agent Orange and other "military herbicides" was hazardous in and of itself, and Title 38 explicitly requires VA to treat all veterans with proof of military herbicide exposure if those veterans are diagnosed with one of the Agent Orange presumptive illnesses. Of course, should a veteran claim a disease not on the IOM list, proof of medical nexus could be required in such situations...and only in those situations.

Just to be quite clear about it, VA was formally asked by Congress and the public just how such veterans would be treated. On 8 May 2001 the Federal Register, on page 23166, repeated the VA's answer that all veterans with Agent Orange exposure would be treated the same as boots on the ground Vietnam War veterans, as far as Agent Orange illnesses were concerned.

Fast forward to the C-123 veterans discovering their aircraft contamination after the FOIA-forced released Air Force documents showing the warplanes "heavily contaminated on all test surfaces" and "a danger to public health," as read the Air Force toxicologists' reports. The veterans sought VA care–and this is what the Department of Veterans Affairs Post Deployment Health section was ordered to prevent!

C-123 veterans had little difficulty establishing their exposure to Agent Orange, given the decades of military testing documents and correspondence about "the Agent Orange airplanes" and the fact that the remaining warplanes were destroyed as toxic waste. C-123 veterans had little difficulty establishing their Agent Orange illnesses with physicians' diagnosis in-hand as they turned to the VA. Relying on law and the Federal Register verbiage, veterans knew that proof of exposure plus proof of Agent Orange illnesses should result in a VA recognition of service-connection and thus access to VA medical care.

C-123 veterans, however, were unaware at the time of the resolution inside VA offices that Agent Orange claims be prevented from any veterans other than the Vietnam War vets already covered. Prevented by any means possible, And the bright idea of redefining "exposure" in a way to prevent claims was born. We can just imagine the meeting where VA staff congratulated themselves on the strategy – to pretend that exposure doesn't mean exposure.

But what does it mean? According to the CDC/Agency for Toxic Substances and Disease Registry, the EPA, the National Institutes of Health and other federal agencies as well as civilian authorities, "exposure" means the contact between the skin and a contaminant. Or, ingesting or inhaling the contaminant. Thus, one is exposed by simple skin contact in the case of C-123 veterans having a decade of such service aboard toxic Agent Orange spray aircraft. But VA set out to redefine the word to mean only what VA wanted it to mean so that the law's requirements could be ignored.

Clever VA staffers utilized the Society of Toxicology conference to introduce their sly scheme to prevent C-123 veterans' claims. Because poster displays are invited and not subjected to the same rigorous scientific challenges as medical and scientific articles in professional journals,  it was decided to simply submit a poster display at the SOT gathering and then flood the Internet with references to it as through it was some sort of scientifically established proof. And without challenge from the SOT or other scientists and physicians, it pretty much was allowed to condemn C-123 veterans' claims.

No veteran exposed to an herbicide can specifically prove the illness suffered is tied to the herbicide. There can only be the "likelihood" or "demonstrated possibility" of such an association. The VA hid behind this for decades in their mission of denying benefits, but medical nexus was lifted from the veterans' burden of proof through the Agent Orange Law and Title 38.

Enter the bright folks from Post-Deployment Health. Dedicated, professional, mission-oriented scientists and physicians, charged with preventing veterans' Agent Orange claims and both eater and tireless in meeting meeting their responsibilities. Their approach? Redefine, at least within the VA, the word exposure. Pretend that VA has the scientific authority to change the meaning of a word in order to then use it to prevent successful claims.

With the vehicle being their SOT poster display, which wasn't juried or subjected to critical review by other physicians and scientists, the folks from Post-Deployment Health inserted medical nexus into the VA requirement for recognition of exposure. They said no exposure existed except in cases where the veteran proved subsequent bioavailability, or the impact somehow of the toxin on the veteran's health.

Clever! And it took a great while for the veterans so catch on. Our visit with Veterans Benefits Administration's Compensation and Pension Services had one result being the recommendation to speak with the Deputy Director of the Post-Deployment Health section of the Veterans Health Administration. VHA kindly explained the requirement now in place at the VA that exposure isn't recognized unless also supported with proven bioavailability...thus the reintroduction of medical nexus as a claims barrier despite the law. VHA further explained that by that definition no veterans of the Vietnam War were exposed, except perhaps some of the Operation Ranch Hand flyers. And certainly not, any of the C-123 veterans!

The C-123 Veterans Association sought out opinions from experts in other federal agencies and in civilian institutions. All disagreed with the VA's redefinition of exposure, and all reaffirmed that exposure is the simple contact between skin and toxin. Authorities from CDC/ATSDR, NIH and others all agreed that the VA had improperly redefined the word to its own policy objectives.

Requests for review of the VA's poster display by the Society of Toxicology were ignored, even when routed through previous SOT leadership.

16 October 2013

Veterans Benefits Administration REDEFINES Science to Prevent Agent Orange Claims

PART ONE: The Grand Deception
A simple line deep in the middle of a poster presentation offered at the Society of Toxicology convention is where VA did it to the C-123 veterans, and other vets exposed to Agent Orange in situations other than "boots on the ground" during Vietnam. Here is where VA showed its eagerness to prevent service-disabled veterans from, as VA and DOD consultants have put it, becoming "freeloaders looking for a tax-free dollar from a sympathetic congressman."

The Society of Toxicology invites poster displays as well as scientific and medical presentations from members, and VA's Veterans Benefits Administration and Veterans Health Administration prepared their large poster for that San Francisco meeting.

Their objective: enjoy a freebee trip to the Golden Gate city justified on the basis of doing something useful like the poster, but also engineer a special way to skirt the law and insure Agent Orange veterans, in particular, C-123 veterans, all be denied exposure benefits clearly provided for by law. What law? The Agent Orange Act of 1991, and also Title 38, as well as the 8 May 2001 Federal Register, page 23166 which has the force of regulation.

These laws, regulations and announcements provide that veterans exposed to military herbicides will receive exposure benefits without requirement that they provide proof of medical nexus...which is virtually impossible for any individual to do. Think here of a non-smoker getting lung cancer. Where and when cannot be proved with today's science, but it surely came from somewhere. Same here with military herbicide exposure and the "Agent Orange" presumptives, a list of illnesses acknowledged the the VA and the National Academy of Science/Institute of Medicine to be associated with dioxin exposure.

Seems simple enough. Exposure proof would result in claim approval. Nope! Faced with the possibility of C-123 veterans continuing their legitimate pursuit of essential, life-saving medical treatment for Agent Orange illnesses, VA executives realized that the Agency needed to focus on exposure. The Air Force had already determined that C-123s used for spraying Agent Orange during the Vietnam War remained contaminated ("heavily contaminated on all test surfaces" and "a danger to public health" read the AF toxicology reports.) That left the VA weak on any challenge to the fact of contamination of the aircraft, and any veteran's confirmed diagnosis of an Agent Orange illness prevented any challenge on that issue, so the only approach would be to deny the exposure itself.

VHA Poster Display
Here is where VA gets amazingly creative. Simply disregarding the law, and challenging the entire world of science and medicine, Veterans Health Administration utilized the Society of Toxicology conference to present a non-juried poster display entitled "AGENT ORANGE: 50-Year History and Newest Chapter of Concerns." Folks, C-123 veterans were cited as the VA's "chapter of concerns." Folks, the "concern" was the VA's in dread of eligible veterans actually receiving the benefits to which our Agent Orange exposure entitles us!

So somebody at 810 Vermont Avenue, Washington D.C.  got the clever idea, "Let's redefine the word "exposure" to prevent any exposed veteran from ever being approved. Let's pretend, just here at the VA, that "exposure" will mean something extra...that "exposure," the simple and precise word used in the various laws, will mean only what we say it means. And that definition is going to be that "exposure equals contaminant plus bioavailability." This way, with our special private redefinition, we can pretend that the laws of the United States do not apply, that science, logic and justice do not apply, and we can once again require proof of medical nexus!"

VA associates us much too closely with the tens of thousands of Blue Water Navy veterans, and VA is frightened that approving C-123 vets will lead to approving Blue Water Navy also.

Midway down the SOT poster made up by the VA, left column, at the fourth paragraph, the reader comes to the alarming deception employed by VA's Post Deployment Health staffers who wrote this poster. C-123 Veterans Association leaders encountered them all at the March 2013 conference hosted by Senator Burr's staff as we tried to find common ground. Sadly, this non-juried piece of policy-driven verbiage is the result!

Read carefully, won't you? Chew carefully on the highlighted items. We'll discuss this vicious VA deceptions in our next post. Meantime, Google words like "medical nexus, "exposure," and take a moment to read Page 23166 of the 8 May 2001 Federal Register, the last section of the middle column. Very revealing!

GAO rips VA over vague criteria for doctor bonuses

The Government Accountability Office has criticized the Veterans Affairs Department for giving bonuses to physicians when its medical centers and clinics haven’t clearly defined what the extra pay is meant for.
In at least five cases in 2011, the vague policies allowed physicians to receive bonuses between $7,500 and $10,500 even though they had been disciplined for errors ranging from leaving residents unsupervised during surgery to working without a valid license.
At one hospital, a doctor refused to see patients in the emergency room because he believed they were improperly triaged, resulting in wait times up to six hours and prompting nine patients to leave without being seen.
The physician received a performance bonus of $7,500 — half the maximum allowed — despite the incident and meeting only one of 13 defined performance goals that year.
GAO said VA must clarify performance pay policies to make sure they are clearly linked to “outcomes and quality.”
“VA officials responsible for writing the policy told us that the purpose of performance pay is to improve health care outcomes quality, but this is not specified,” GAO analyst Debra Draper wrote.
According to the report, about 80 percent of the department’s nearly 22,500 providers received performance pay in fiscal 2011 and about 4,000 were given performance awards — lump-sum payments that are based on annual performance review ratings.
In fiscal 2011, the Veterans Health Administration paid nearly $150 million to doctors in performance pay, an average of more than $8,000 per provider. It gave about $10 million in performance awards, an average of $2,587 per person.
The House Veterans’ Affairs Committee has sharply criticized VA for awarding large performance bonuses to hospital administrators whose facilities have a history of mismanagement or negligence resulting in patient illness and, in some cases, death.
The GAO report, released Aug. 23, provided members with more ammunition for the argument that VA’s bonus and performance pay system operates independently of achievement.
“I am very disappointed in these findings,” said Rep. Michael Michaud of Maine, the committee’s highest ranking Democrat. “When I requested GAO conduct this evaluation, it was due to concerns ... that health care providers were being given performance pay and awards when they did not deserve it. This report appears to confirm that perception.”
“Secretary [Eric] Shinseki owes it to America’s veterans and American taxpayers to conduct a top-to-bottom review of VA’s performance appraisal system,” said committee chairman Rep. Jeff Miller, R-Fla.
In its response to the report, VA agreed with the GAO’s recommendations, with one sticking point: VA officials noted that, of the cited cases, only one was a “performance” — an instance in which a radiologist failed to read mammograms accurately — while the rest were “conduct” problems under VA rules.
As if that makes a difference, according to Michaud.
“It is clear to me that, too often, those who do not perform above and beyond are reaping rewards they do not deserve,” he said.
VA spokeswoman Victoria Dillon said Aug. 29 that VA agrees with GAO assessments but added that such pays help recruit and retain skilled employees.
“VA remains committed to effective oversight to ensure that performance pay and award systems are based on the achievement of clear goals and objectives that contribute to VA’s mission to serve veterans,” Dillon said.
She added that VA has taken steps to improve the system and better monitor it.
In 2012, VA eliminated retention bonuses for nearly 6,700 employees after a VA inspector general audit found that most of the distributed bonuses lacked justification.

14 October 2013

Lawyer Decries Air Force Response to C-123 Veterans


Jim Fausone, Veteran Disabilty Lawyer
Those veterans who flew on C-123 airplanes dropped more than 10 million gallons of Agent Orange to destroy enemy cover and crops during the Vietnam War.  
After the war between 1972 and 1982, about 1,500 men and women served aboard 34 C-123s that were previously deployed in Operation Ranch Hand, a large-scale defoliation mission in Vietnam and other countries in Southeast Asia. VA does not recognize AO exposure onboard the C-123s during or after the Vietnam war. If the veteran can prove boots on the ground during the war he can establish AO exposure.  However, those who were exposed outside the country or after the war by residuals from the C-123s are not as fortunate.  
Spreading the word among scientists, veterans and politicians and posting evidence publicly at c123kcancer.blogspot.com is one way to keep this in the public eye even as veterans pass away.
Just as the Navy and VA have shame for how they treat Blue Water Navy vets, the USAF has shame for its treatment of C-123 crews.
(note: Mr. Fausone is with the Michigan-based firm Legal Help for Veterans PLLC)

Veterans Urge EPA to Release Dioxin Cancer Study


Veterans, Environmentalists Seek Final EPA Dioxin Cancer Assessment

Environmental and veteran groups are preparing to petition EPA to finalize the agency's long-delayed assessment of the cancer risks of dioxin and are cultivating congressional support for the effort that could lead federal and state regulators to further strengthen cleanup goals for the contaminant at sites around the country.

Sources with the Vietnam Veterans of America (VVA) and the Center for Health, Environment and Justice (CHEJ) say the groups are drafting a petition they will circulate at a series of meetings with veterans and also through the groups' websites calling for EPA to finalize the cancer portion of the reassessment of dioxin's health risks, which the agency drafted in 2003, and pledged last year to finalize "expeditiously."

Dioxin is a category of persistent and accumulative chemicals inadvertently created through industrial processes that involve incineration and also through the burning of trash and forest fires. It was a primary ingredient in the herbicide Agent Orange used during the Vietnam War.

Last year, EPA released the non-cancer portion of the reassessment of dioxin health risks, prompting EPA scientists to calculate a stringent health goal of 50 parts per trillion for use in determining cleanup levels for the common contaminant in soil. Although EPA, at the time, promised the expeditious release of the cancer portion, advocates say they have received no specific indication of when the cancer document will be finalized (Risk Policy Report, April 17, 2012).

In addition to the veterans and environmentalists, Sen. Ed Markey (D-MA) is also planning to push EPA to finalize the cancer assessment. Markey, who served in the House of Representatives before being elected to the Senate, has previously written to EPA asking the agency to release the dioxin health risk assessment.

A spokeswoman with Markey's office told Inside EPA that Markey's staff has spoken with environmental groups about renewing pressure on the EPA, focusing on the release of the cancer portion of the reassessment, and also for updated cleanup goals for dioxin contaminated soil at waste sites.

Markey "will continue to urge EPA to take action on this and as well [he] will continue to monitor the work in communities around cleanups," the spokeswoman said.

A source with the Community Advisory Group (CAG), which is assisting EPA with the Dow Chemical Co.'s cleanup of the Saginaw-Tittabawassee River in Michigan, says action on the long-delayed cleanup increased considerably after EPA released its reassessment of dioxin's non-cancer risks last year. 

The cleanup there is focusing on containing dioxin-contaminated sediment in some parts of the river and cleaning others. But the source also says cleanup goals for the river remain unclear and that additional information on dioxin's toxicity could help ensure the river is cleaned to the appropriate level. The source says, however, the cleanup is not waiting for updated information on cancer risk, and that it is unclear when that part of the reassessment may be issued.

The extent to which dioxin causes cancer has been a concern since at least 1985 when EPA, in a prior assessment, called dioxin a probable human carcinogen. In the 2003 draft reassessment, EPA strengthened the language, calling dioxin "carcinogenic to humans," though since that time, the agency has issued new guidelines for classifying chemicals' carcinogenicity.

Also, in 2006, the National Academies of Sciences' (NAS) National Research Council found the 2003 draft reassessment underestimates uncertainty concerning the health risks of dioxin and might overstate the chemicals' human cancer risk, according to a 2006 NAS statement. The NAS urged EPA to re-estimate dioxin risks using several different assumptions, before finalizing the reassessment.

EPA says on its website that it will complete the cancer portion of the reanalysis "as expeditiously as possible" and that the document will include a reevaluation of available cancer mode-of-action data and also will have improved cancer dose-response modeling that includes justification for the approaches the agency takes.

EPA's website says almost every living organism has been exposed to dioxin but that by working with states and industry the agency has reduced known and measurable dioxin emissions in recent years. Those efforts have reduced air emissions of dioxin by 90 percent so now most Americans have only low levels of exposure, according to the agency's website.

The VVA source says dioxin exposures through Agent Orange continue to cause adverse health effects in the children and grandchildren of Vietnam War veterans. The CHEJ source says dioxin exposure poses risks for people near contaminated sites and that the chemicals are also present in fatty foods such as hamburger meat and dairy products because airborne dioxin blows to farmland and is consumed by cattle.

The push that VVA and CHEJ are planning comes a year and a half after EPA's pledge to finalize the cancer reassessment expeditiously, and grows out of dozens of meetings the VVA has held and will continue to hold to educate the group's 70,000 members around the country on the health effects of dioxin exposure.

During the meetings, the VVA is also collecting reports from veterans and their children and grandchildren on continued effects of dioxin they say are occurring as a result of exposure to Agent Orange decades ago. The group plans to use those accounts to push for legislation requiring additional research on dioxin's health effects, and as part of the call for EPA to finalize the cancer reassessment.

"We've been talking to various people on the Hill and these meetings are ongoing," the VVA source says, adding that meetings with VVA members have recently been held in Michigan, California, Louisiana and Pennsylvania. The group plans to begin circulating the petition, now in draft form, in the coming weeks, at upcoming meetings and on its website.

The CHEJ source says finalizing the reassessment of dioxin's cancer risk could prompt federal and state regulators to strengthen cleanup goals for contaminated sites, though it is not certain that cleanup goals will change since the results of assessments are not legally enforceable, allowing cleanup decisions to be made on a case-by-case basis.

That cleanups are not required to follow the newest and best science is a key frustration for environmentalists, the source says.