31 March 2014

All Veterans Alert: VA Develops Scheme to Prevent All Exposure Claims

Burn pits, radiation, toxin, biological hazards...everything. Everything a veteran might have been exposed to can now be denied by the VA.

That's right. VA did this by redefining the word exposure to their own liking. Since 2012, VA's redefinition of exposure is, "Exposure = contamination field + bioavailability."

This means VA won't acknowledge an exposure event unless and until the veteran can prove some biological harm specifically from the exposure. Unless VA or Congress establishes presumptive service connection, as was done with the "boots on the ground" Vietnam veterans, VA can now block any exposure claim unless the impact of the exposure is so immediate as to be indisputable.
Few veterans claiming burn pit exposure, disease, or Agent Orange exposure, or any other type of exposure, can ever prove its bioavailability. Example: you're exposed to biological hazards drinking local water in some remote wasteland and later develop an illness. While statistically you can suggest the association of your illness with the local water, VA won't recognize the exposure unless you prove it.

The VA definition is unique to science. In fact, challenged by the rest of science. The Director, National Toxicology Program reports, "In all my years as a toxicologist, I have never heard the term bioavailability as part of the exposure field."  In their determination to prevent claims, VA Post Deployment Health invented this just for us veterans!

VA won't concede your exposure if you walk into a tent of Ebola patients...unless you develop Ebola and can prove it was from that tent. But in fact, you've been exposed to Ebola, bioavailability or not, and VA won't treat you unless and until you develop Ebola as proof of your exposure.

But you can't prove it and the VA will deny your claim. That's their purpose of the redefinition of exposure...to prevent exposure claims from veterans who have been exposed.

Makes sense from their perspective: VA saves serious money by not treating disabled veterans ill from their exposures. Makes no sense from a veteran's perspective, finding VA hospital doors locked when we're ill.

In the case of C-123 veterans and our Agent Orange-contaminated aircraft exposing us to dioxin, VA employs their redefinition of exposure to prevent exposure claims, regardless of substantiation, electing to have their redefinition trump all evidence affirming the claim.

The list is long...occupational hazards such as asbestos and lead, inoculations, dirty water, radio frequencies, smoke, toxins, chem warfare, dust, bugs...everything for which a veteran might actually experience exposure can be denied with VA's handi-dandi redefinition of exposure, the magic of defining away your disability claim!

Look at the University of Washington exposure graph below, which shows outcome (bioavailability) as an event after exposure. Do you get it? VA now says exposure requires outcome to be exposure. If you can't prove the outcome you haven't been exposed...for example, if you can't prove your prostate cancer came from contact with Agent Orange, VA's definition says you were never exposed.

Using that definition VA can deny service connection for virtually every exposure. Indeed, using it, Post Deployment Health's Acting Chief Consultant informed The C-123 Veterans Association last year that no veterans were exposed to Agent Orange in Vietnam (other than perhaps some Ranch Hand crews.)

28 March 2014

Deceptive VA Poster – Created to Block C-123 Agent Orange Exposure Claims

The 1991 Agent Orange Act, Title 38 and Federal Register publications combine to, in the VA's own words, "make clear" the fact that veterans exposed to military herbicides will be treated the same as Vietnam veterans for presumptive service connection. The key word: exposed.

The VA mission: redefine exposure so veterans' exposures would not be exposures to the VA.

This they did at the 2012 Society of Toxicology. VA surrendered ethics to policy, and redefined exposure to prevent exposure being acknowledged for C-123 veterans' claims. Of course, careful reading of their redefinition makes clear VA can apply it to consideration of any exposure...radiation, other toxins, biological hazards, burn pits...anything.

The was deceptive. Its title promised an historical perspective on Agent Orange and an update. This was done, but the key objective was inserting their deceptive redefinition to block exposure claims by C-123 veterans. Thus, "exposure = contamination field + bioavailability." Wrong. Wrong in every way.

Bad science. The words used by scientists on reading it: ludicrous, unscientific, preposterous!

The words used by VA raters on reading it while considering C-123 claims: Claim denied! Any excuse will suffice to prevent exposure claims at Veterans Benefits Administration.

We make special observation at the title of a key section of VA's poster: "Risk Assessment of Post-Vietnam C-123 Aircraft."

Two points:
1. Actually, who cares from a claims perspective, as risk is irrelevant. The issue is exposure, and thus the section title should have been, "Exposure Assessment of Post-Vietnam C-123 Aircraft."
2. The risk assessment is unscientific, and recently challenged by the Environmental Science article. This means C-123 veterans are at risk for health issues which their civilian and VA physicians must be aware of, yet VA's unscientific poster pretends no health risks exist, a position taken only to save VA the cost of such care and only by pretending VA has the wherewithal to redefine fundamental terms in science for employment against their veteran clients' interests.

So far, job well done! Universal claims denial, with a neat circle of initial invitation to exposed veterans to submit claims, the inquiry to JSRRC with their response (VA edited, and VA-limited as to what can be fed back to VA,) followed by the referral for opinion from Compensation and Pension and their boilerplate denials, concluding in the claim's final denial letter to the veteran.

As both VBA and VHA intend, this wastes as much as two years, and that's a terrific built-in benefit for the VA as it keeps the doors locked against the C-123 vets. It saves VA money, more of us die, and then the BVA appeal is designed to lock those VA hospital doors for another two to three years. More of us die. Then, after what has been a four to seven year process, receive a BVA decision...always affirming...and can survivors walk (if they still can) into the VA hospital and get on the waiting list for treatment of our cancers, heart disease and other ailments we had been suffering when we first applied for care.

All this from their simple, unique redefinition of "exposure." We trust their annual reviews reflected the pride VA had on the skillful wordsmithing and other accomplishments the staff in Post Deployment Health exhibited in responding to the VA agenda of preventing C-123 claims...or perhaps even implementing that policy on their own.

Wouldn't want any papers left laying around for some FOIA miner, would they?

VA Public Affairs...Where They Fail the Veterans

I am a veteran.

The men and women in the The C-123 Veterans Association are veterans, as are all those we served with over the years. We are their "consumers," we are the final recipients of the professional services of the public affairs staff at the Department of Veterans Affairs.

We are, or we should be, the single most important audience for their professional services. Our needs at least should be of concern to them.

VA public affairs, in communications with us and about us to other audiences, serves our needs. VA public affairs, telling our legislators and the public about it as an institution, serves us. But it doesn't, and it is no way a delivery vehicle for truth.

We are the veterans, so serving us, and serving the VA to better serve us,  should be the role of VA public affairs.

To put it in an aeromedical evacuation context, we are their patients. That I can firmly understand because in aeromedical evacuation, nothing is more important. Nothing else is our focus, and the entire spectrum of what we do is to make that patient come out okay at the other end of our flight. Patients are more than self. The patient is my life and breath, which is why he is entrusted to me. Which is why he knows I'll get him home.

Comrade, ally, civilian, friend or foe...I'll get him home.

So where did VA public affairs become so very tainted and so much unlike us? Why is OPIA so much the servant of the institution that the institution became their only true focus? What happened that my needs as a veteran cannot be trusted to the public affairs staff of the Department of Veterans Affairs, as we learn that OPIA puts VA ahead of the veteran in their mission?

We know, don't we, that nothing, absolutely nothing critical or even mildly corrective would ever be communicated by VA OPIA? We know, don't we, that OPIA would never play a role in a course correction towards more a veteran-friendly Department of Veterans Affairs.

27 March 2014

Dr. Linda Birnbaum, Director Nat'l Institute of Environmental Health Sciences Recognized by C-123 Veterans

Members of the C-123 Veterans Association had the opportunity this weekend to recognize Dr. Linda Birnbaum and her staff for the dedication shown over the years by NIEHS and the National Toxicology Program, as they helped meet the needs of military families. Indeed...our profound thanks!

Unfortunately, having met this dynamic leader, I can't imagine there being a space left on her office walls for our plaque, but it certainly felt wonderful to express our appreciation and respect to this lady!

C-123 Veterans' FOIA Complaints Filed in US District Court Against VA & USAF

Acting on our behalf, the Washington DC law firm of Davis Wright Tremaine LLP today filed complaints for injunctive relief for violations of the Freedom of Information Act. Complaints were filed against both the Department of Veterans Affairs and the Department of the Air Force.

These actions are carefully considered and submitted only after months and years of efforts to gain the release of unclassified documentation, not protected by privacy concerns nor any other excuse. 

Focused on the exposure claims of C-123 veterans, we sought essential documentation to understand the Air Force 2012 C-123 report, and the stance taken by the VA prohibiting our veterans' exposure disability claims.

FOIA: Our rights abused by VA and USAF
It would be nice to immediately have the agencies provide the requested materials in sudden respect of our rights under the Freedom of Information Act. That's unlikely but perhaps some conversation might ensue.

In any case, we will soon have in hand official documentation vital to proving our case before the VA.

25 March 2014

VA Public Affairs' Honesty Challenged!

Veterans Affairs Stonewalling the Press

Veterans’ Affairs Committee website highlights VA refusal to comment

Veterans Affairs Secretary Eric Shinseki / AP
Veterans Affairs Secretary Eric Shinseki / 
BY: CJ Ciaramella  March 24, 2014 12:55 pm
The Department of Veterans Affairs (VA) failed to respond to nearly 70 media requests for comment over the past year, leading legislators in Congress to accuse it of stonewalling the public in a new website launched Monday.
The VA Honesty Project, created by the House Veterans’ Affairs Committee, shows scores of instances where the VA public affairs office was either refusing to comment or not addressing the questions that were asked, most of them occurring in 2013.
The site shows the VA refusing to give comment to newspapers and TV affiliate stations across the country, as well as publications such as the Military Times and CNBC.
“Despite the serious issues, the VA’s chief of staff walked away when we tried to ask about the report,” CBS Memphis reported in an October 2013 story about negligence at a VA hospital that resulted in three deaths.
“He refused to take any questions about the deaths at his facility and another report News Channel 3
uncovered showing VA center directors were getting bonuses in the millions at the same time their facilities were making deadly mistakes.”
In another instance, the VA stonewalled efforts by the Tampa Tribune to investigate the deaths of 19 veterans who died as a result of diagnostic delays.
VA officials declined to comment and told the reporter a Freedom of Information Act request would be required. The VA then denied the subsequent FOIA request.
Delaware Online reported in January of this year that it had been repeatedly stonewalled seeking information about a growing backlog of VA compensation cases in Wilmington.
As previously reported by the Washington Free Beacon, the VA also added a new layer of bureaucratic review before it releases Freedom of Information Act requests, further delaying the process.
KUOW journalist John Ryan first discovered the new policy while investigating the death of a Seattle Army veteran who died at a VA hospital after receiving a lethal dose of morphine. The VA did not comment on his story.
House Veterans’ Affairs Committee chairman Jeff Miller (R., Fla.) said in a statement that the site is dedicated to showing “how VA’s media avoidance strategy is doing the public an extreme disservice while damaging VA’s reputation in the process.”
“With 54 full-time public affairs employees, VA’s media avoidance strategy can’t be anything other than intentional,” Miller said. “What’s worse, the tactic leaves the impression that department leaders think the same taxpayers who fund the department don’t deserve an explanation of VA’s conduct.”
“At the Department of Veterans Affairs, we strive to provide accurate and timely information as we communicate every day with America’s veterans, their families, their survivors, and the American people,” a spokeswoman for the VA said in a statement to the Free Beacon. “We understand and respect the media’s important role, and we work to ensure veterans understand our commitment to provide them the services and benefits they have earned and deserve.”
“The public affairs office at VA headquarters responds to thousands of media queries each year, and we continually strive to provide reliable information quickly,” the spokeswoman continued. “VA also communicates with hundreds of thousands of veterans and those who care about veterans through many mediums, including social media.”

VA – Do Something Right Here!

No question now in law. (Yale Law)

No question now in science. (NIESH, ATSDR, US Public Health Service, scientists & physicians)

No question now in ethics. (Consult your own National Center for Ethics in Healthcare)

Eventually, some Pulitzer-destined reporter is going to ask, "and how many claim-by-claim awards have been permitted? as a follow-up to the pre-programmed VA public affairs blurb. Eventually that reporter will note that C-123 veterans like Dick Matte are being denied life-saving VA medical care on the personal whims of VA lawyers and at the direction of a few VA personnel in Post Deployment Health. Their agenda is personal, and targeted at us veterans.

The Lord Jehovah did not publish a rule change in the Federal Register directing Post Deployment Health to redefine exposure for the worlds of science and medicine, and empowering Post Deployment Health to campaign agains the medical needs of fully eligible veterans. At least, we didn't see the announcement, so probably the world continues to function under the rule of law.

VA's last assurances to Congress that veterans exposed to military herbicides outside Vietnam, as published in the Federal Register of 31 August 2010, still applies. Thank goodness the VA took special pains, as they wrote, "to make it clear!"

Science still defines exposure the regular way, not the VA way. And medicine is still denied C-123 veterans who flew the contaminated C-123 aircraft for a decade. Post Deployment Health has a vital role to play in meeting the needs of all America's veterans, and must do so for all of us from an unusable platform of science, law and ethics.

They should begin shoring up their platform on all three of these supports because each is limp. Personal views of those folks, and their determination that no C-123 veterans will be considered exposed, are wrong.

23 March 2014

Why C-123 Veterans Are Seeking VA Service Connection for Agent Orange Illnesses

I was asked today by one of our veterans why are we requesting VA Agent Orange benefits.

The question was put to him by a local reporter during an interview last week in Phoenix.

I'm no expert but here's what I think apply but do your own research to be sure. The VA and DOD both have comprehensive web sites.

  1. Proper honoring of your hazardous service to the Country
  2. Most of our C-123 veterans are not retired military nor otherwise VA disabled, so the VA service connection for their Agent Orange-presumptive illnesses means VA medical care and compensation they don't now receive
  3. All veterans with 50% or more VA disability can receive optical care, audio, prosthetics and other benefits not provided under Tricare. At 100% disability there is also dental care. At 80% disability plus unemployability, certain long term health considerations. I have been blessed with VA protection for two decades and am grateful for the skill and dedication of every health care practitioner I've encountered! VA care is not sought because it is free but because it is excellent!
  4. VA compensation is tax-free and may "shelter" all or most of the military retiree's service pension
  5. Most states have significant benefits for disabled veterans, such as property tax relief, motor vehicle registration, etc.
  6. Survivors of veterans who die of service-connected illnesses and injuries, or who are totally disabled for ten years or more, are eligible for Dependent's Indemnity Compensation of approximately $1250 per month, tax exempt
  7. If the military retiree was paying for survivor benefits and the survivor is also eligible for VA's DIC, the premiums withheld from the military pension are refunded to the survivor
  8.  VA medical care to veterans who have to travel certain distances is reimbursed
  9. Agent Orange illnesses make military retirees eligible for "combat related special compensation" and can mean keeping certain percentages of both the military pension and the VA pensions
  10. Most of us are past having children in college, but eligible dependents have generous federal and often, state educational benefits
  11. Disabled dependents of disabled veterans have certain benefits, including benefits which survive the veteran
There are certainly more reasons to seek a VA disability claim than are listed here...and an hour on the Internet or spent visiting a veteran's service officer from your state or DAV,VFW or Legion will be more informative.

Eliminate the Disability Claims Backlog – the VBA Plan

Eliminate the Disability Claims Backlog:

by Ms. Diana Rubins, deputy Under Secretary for field Operations

(c-123 veterans' perspective: vBA denies all our Exposure claims; consider Just denying them promptly so we can save a year and proceed to the BVA)
VA will provide timely, accurate decisions on Veterans’ disability claims and eliminate the claims backlog in FY 2015.  Improving quality and reducing the length of time it takes to process disability claims are integral to VA's mission of providing benefits to eligible Veterans in a timely, accurate, and compassionate manner.  In 2013, VBA began measuring the accuracy of individual issues for each claim (“issue-based accuracy”), as it provides a more detailed measure of workload proficiency.  However, VBA will continue to monitor and report out on claim-based accuracy as a key indicator for this APG.  To improve benefits delivery, VA is transitioning to an electronic claims process that will reduce processing time and increase accuracy.  As of the end of September 2013, over 60 percent of VBA’s inventory is in electronic format and is being processed electronically by VBA employees using the Veterans Benefits Management System (VBMS).  In addition, VA is delivering training that is more aligned with the needs of the workforce to operate in this electronic environment.  VBA is encouraging Veterans to submit Fully Developed Claims (FDC) that include all supporting evidence when the claim is filed.  The FDC is typically the fastest way for Veterans to receive a decision on their claims.  Increasing the number of FDCs filed electronically by Veterans, or by Veterans’ representatives on their behalf, reduces the major source of delay associated with gathering evidence to support a claim and helps reduce the overall time it takes to process a claim.  Through people, process, and technology integrated initiatives, the workforce will achieve the goal of eliminating the disability claims backlog.

ATSDR CONFIRMS Dermal Route for C-123 Dioxin Exposure

VA has "explained" to the veterans' community that C-123 flyers were not exposed, and primarily
because, as they put it, "TCDD does not readily cross human skin." This was their summation of Weber's quite dated 1991 article.

So, quoting a 23 year old publication and ignoring more current juried articles with contrary findings firmly supporting C-123 veterans' claims, VA's Post Deployment Health unit concluded C-123 veterans were not exposed. Because the dermal barrier is near-perfect, they told us. Anything to block disability claims.

They're wrong. VA VHA issued a blatant twist of facts. Along with similar conclusions in TG312, here what the CDC/Agency for Toxic Substances and Disease Registry said, confirming our OCCUPATIONAL EXPOSURE resulted in dermal absorption – BIOAVAILABILITY! 
"[T]he ability of the skin to absorb dioxins (bioavailability)is slow except during occupational exposures." (p.5)
Also, the Japanese Environmental Agency:
 "Oral Intake and AbsorptionDioxins are absorbed through the gastro-intestinal tract, skin, and lungs. The degree of absorption varies with the congener, the route of absorption,and the medium."
Thus, even with VA's twisted redefinition of exposure (exposure = contamination field + bioavailability) we have federal agency support for both our exposure and the bioavailability.

There's more. The NIH/National Institutes of Environmental Health Sciences also reported that dermal contact with TCDD results in absorption...dermal exposure:

 1991 Feb;107(2):302-10.

Absorption of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) after low dose dermal exposure.


Human dermal exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) occurs through contact with soil and paper products

22 March 2014

ATSDR Director Resigns Under Pressure – Senate Cites Poor Communications With Camp Lejune Marines

I find this turmoil in the ATSDR deeply disturbing, and regret the discomforts of its just-resigned director, Dr. Tanja Popovic. I am not familiar with her or her work but a 25 year career seems to have ended quite painfully for a long-time government servant.

Reported in the 20 March 2014 National Journal, reporter Mike Manger:

The head of a federal agency that investigates health problems linked to toxic-waste sites has stepped down after a clash with former Marines who believe their families were harmed by poisoned drinking water at Camp Lejeune.

Tanja Popovic's sudden resignation followed a tumultuous seven weeks as acting director of the Agency for Toxic Substances and Disease Registry, a division of the Centers for Disease Control and Prevention, during which she assured West Virginia residents that their water was safe to drink after a toxic chemical spill in January, questioned the need for a study of cancers that may be linked to Camp Lejeune's tainted water, and sent scolding emails to aides of lawmakers on Capitol Hill.

Popovic also had some tense email exchanges with the leader of a group advocating for victims of Camp Lejeune's contamination, former Marine Master Sgt. Jerry Ensminger, in which she accused Ensminger and his colleagues of sending messages that contained "disrespectful, condescending, and even offensive content."

"I take attacks on my professional and personal integrity very seriously," Popovic wrote to Ensminger on March 12, "and I am profoundly saddened to see that you will stop at nothing."

The friction culminated in a meeting on Capitol Hill last week between staff of lawmakers concerned about Popovic's handling of Camp Lejeune issues and congressional liaisons for Popovic's division, the CDC, and the Department of Health and Human Services, which oversees both agencies. That meeting included aides to the two senators from North Carolina, where Camp Lejeune is located, as well as Rep. John Dingell, author of the federal law that established the agency Popovic ran.

The next business day, Popovic's resignation was announced in an email to top managers at the CDC, headquartered in Atlanta.

A spokeswoman for the CDC, Bernadette Burden, said she could only confirm that Popovic's tenure as acting director of the agency began on Jan. 26 and ended Monday. "It's a personnel matter," Burden said, so no information about the resignation would be discussed.

Reached at her home in Stone Mountain, Ga., the scientist who worked for the federal government for 25 years declined to comment. "I would not like to make any comments, thank you," Popovic said before hanging up.

Widespread dumping of military waste at Camp Lejeune over at least four decades caused drinking-water supplies at the sprawling base on the Atlantic Coast to be contaminated with toxic chemicals from the 1950s until 1985, when 10 tainted wells were finally shut down. As many as a million Marines and family members, as well as civilian employees at the base, could have been exposed to the polluted water, and many of them believe illnesses and deaths were caused by it.

Congress passed a law in 2012 providing health care for Marines and family members who have specific illnesses that can be linked to the contamination, but the Agency for Toxic Substances and Disease Registry is still conducting studies of the pollution's health effects.

One of the studies sought by victims of the contamination would attempt to determine incidences of cancer among former residents of Camp Lejeune. But last month Popovic told lawmakers in a meeting called to get an update on the study that the agency had neither the authority nor expertise to conduct a cancer-incidence study.

The meeting prompted Dingell and the two senators from North Carolina, Democrat Kay Hagan and Republican Richard Burr, to write HHS Secretary Kathleen Sebelius on March 12 urging that the study be done and also asking that Popovic's agency work on better relations with victims of the Camp Lejeune contamination.

"For reasons we cannot yet discern, the desire for open communication seems to have waned within ATSDR in recent months," Dingell, Hagan, and Burr wrote to Sebelius.