28 April 2014

President Obama Orders Investigation of VA "Secret Lists" & Veterans' Deaths

MANILA, Philippines (AP) — President Barack Obama says the U.S. will get to the bottom of whether veterans were denied help they needed at a VA hospital in Arizona.
Obama says he immediately ordered Veterans Affairs Secretary Eric Shinseki to investigate following allegations that up to 40 Arizona veterans died while awaiting medical appointments at the Phoenix VA Health Care Center.
Obama says he takes the allegations, quote, "very seriously." He says an inspector general is also investigating.
Obama says he wants to ensure not a single U.S. veteran lacks the help they need. He says he's increased the VA's budget more than any other agency in his government.
Obama spoke at a news conference in Manila while traveling in the Philippines.

26 April 2014

Insuring an Adequate VA Compensation & Pension Exam

By Lauren Kologe, Vietnam Veterans of America
When a veteran files a claim for disability compensation or pension benefits, the Veterans Administration (VA) is often required to provide a medical exam to confirm the veteran’s eligibility for benefits and to determine the appropriate disability rating.  This is known as a C&P exam (Compensation & Pension).  The first question the veteran should ask the doctor is, “have you had a chance to review my claim file?”  If the answer is no, the veteran should ask the doctor to first review the claim file. The veteran should only proceed with the exam after the doctor has reviewed all the information the veteran has submitted and VA has received regarding the claim (the claim file or c-file).
The same is true when the veteran asks his or her own doctor to provide an opinion on the claim.  The doctor must review the veteran’s entire claims file, state that he or she has read it, and comment on the veteran’s military and medical history contained in the file so that it is apparent the doctor has actually reviewed the records.
If you, the veteran, had an examination that was short, cursory, or one in which the doctor asked questions that he or she should have known from reviewing your records, you will want to obtain a copy of the C&P exam from VA.  You are entitled to one free copy under the Privacy Act.  If the doctor did not state that he or she read your claim file, and misstated or left out relevant facts contained in the claim file, you will want to point that out to VA, and you will want to ask for a new examination.  VA is required by the “duty to assist the veteran” to provide examinations that fully consider the veteran’s medical and military history.
This is supported in many cases by the Court of Appeals for Veterans Claims, Federal Circuit, VA law (Title 38 of the United States Code), and VA regulations (Title 38 of the Code of Federal Regulations).
Fulfillment of the duty to assist “includes the conduct of a thorough and contemporaneous medical examination, one which takes into account the records of prior medical treatment, so that the evaluation of the claimed disability will be a fully informed one.” Green v. Derwinski, 1 Vet App. 121, 123-24 (1991); See also, 38 U.S.C. § 5103A(d). 
In the case Bielby v. Brown, 7 Vet.App. 260, 268 (1994), an examiner failed to read the claim file, and the Court held that an independent medical examiner’s opinion is without evidentiary value where he failed to review the veteran’s record, and thus had no basis of fact or data upon which to render an expert opinion.
Even if the C&P examiner states that he or she has read the claims file, if there are obvious errors or inconsistencies in the reporting of those facts, the medical opinion is not adequate.  The Board must be able to conclude that a medical expert has applied valid medical analysis to the significant facts of the particular case in order to reach the conclusion submitted in the medical opinion. See Nieves-Rodriguez v. Peake, 22 Vet.App. 295, 304 (2008).
The VA’s regulations require that a report of a disability examination must be adequate for rating purposes in order for it to be justifiably relied upon by a rating authority in order to evaluate a veteran’s disability.  38 C.F.R. § 4.2. 
Moreover, an examiner’s assessment of the disability in the exam report must be based on an assessment of the disability, both currently and historically, that is factually accurate.  Id.

Some of the items in a veterans’ claim file may be other medical opinions and treatment records.  The Court of Appeals for Veterans’ Claims has remanded several claims where the Board failed to discuss and weigh the credibility of favorable evidence.  See, Cathell v. Brown, 8 Vet.App. 539 (1996) (BVA ignored reports of treating physician and another psychologist without adequate explanation).  See also, Cropper v. Brown, 6 Vet.App. 450 (1994) (BVA failed to address all evidence of record including probative value of veteran’s psychiatric examination).
In Gabrielson v. Brown, the Court determined that a medical opinion that the VA intends to use to deny a claim must discuss the positive evidence, or major positive factors, in favor of the claim.  See 7 Vet. App. 36, 40 (1994).  Conversely, the Court stated that the Board may not adopt a doctor’s opinion as the basis for its denial of benefits when the doctor’s opinion failed to discuss all the positive evidence in support of the veteran’s claim.  See id.
If you have been denied a claim for disability benefits based on an exam (whether VA or private) that did not consider your military and medical history, please contact a Veterans Service Officer near you to explore options for appealing or re-filing a claim.  You can find a VVA representative near you by using our search tool at: https://benefitsforum.org/Rep.aspx.  You can also find a listing of all persons accredited to represent Veterans in VA claims by using VA’s search page at:http://www.va.gov/ogc/apps/accreditation/index.asp.  VSO representatives prepare claims at no cost to the veteran.  Attorneys or agents may charge for representation on appeals. 
Lauren Kologe is the Deputy Director of the Veterans Benefits Program at VVA.

25 April 2014

Oregon's Civilian Agent Orange Victims

Agent Orange Zone Wednesday, April 11, 2012

The poisoning of Oregon’s Paradise Guest Viewpoint

By Amy Pincus Merwin

(Appeared in print: Tuesday, April 10, 2012, page A9)

I am a survivor of Oregon’s Agent Orange war. I was never in Vietnam, but in 1980 I moved to Deadwood valley and was exposed to Agent Orange (2,4-D and 2,4,5-T) and its mutagenic byproduct, TCDD dioxin. I live with all the health issues of a Vietnam vet.

Agent Orange was used in Oregon’s national forests because Oregon State University professor emeritus Dr. Mike Newton, the godfather of forestry pesticides, changed the forestry model from clear-cut and slash-burn to clear-cut and spray, spray, spray. Oregon’s forests are no longer slash-burned, yet clear-cuts and intensive, repeated use of poison pesticides is standard practice.

In Lane County from Jan. 1 to March 31 more than 338 spray notices covering thousands of acres were sent to citizen subscribers. This pattern is repeated on corporate forests in every Oregon timber-producing county.

I attended the March 21 meeting of Oregon’s Pesticide Analytical and Response Center because the members, representing different Oregon agencies, were discussing the suspension of the Oregon Health Authority’s Highway 36/Triangle Lake investigation. I learned that after 33 years, PARC has no protocol for investigating Oregonians’ long-term, low-dose exposure to pesticides; has a backlog of many years of complaints about pesticide exposure that never seem to be addressed or resolved, and has never filled a required citizen-at-large position.
READ MORE: http://special.registerguard.com/web/opinion/27872830-47/oregon-pesticides-health-oregonians-spray.html.csp

OPB Reported Eastern Oregon Agent Orange Toxins in 2012

Agent Orange Dump Site Is Oregon Desert’s Toxic Legacy

May 3, 2012 | OPB
A deal cut by the state with the foreign company that owns the site has now been dropped. And the Department of Environmental Quality has no plans – or money – to clean it up.
About 60 miles north of Lakeview a barbed wire fence surrounds a patch of desert. Warning signs tell people to stay away.
Boyd Levet remembers watching in 1976 as the dump was created.
“It was probably just acres but it seemed like miles and miles of barrels just lined up in rows. It was a sight you would not expect to see in a place as beautiful as Oregon,” says Levet, who was a reporter back then for KOIN-TV.
25,513 barrels containing more than 1 million gallons of pesticide had been stacked next to Alkali Lake. They promptly started leaking.
Levet’s old news film shows the state of Oregon sent in bulldozers. They didn’t just bury the drums. They crushed them, allowing more toxics to pour out.
The chemicals include 2,4,5-T and 2,4-D – the prime ingredients of Agent Orange – notorious for its use during the Vietnam War.
Oregon’s Department of Environmental Quality pushed the 25-thousand crushed barrels in trenches, then shoved dirt on top.
The trenches were not lined.
The dioxin-laced pesticides quickly reached the water table below, just 3- to 6-feet down.
Contaminated groundwater samples
“The groundwater near the landfill is very contaminated,” says Bob Schwarz, DEQ’s current project manager over the Alkali Lake Disposal Site. He adds:
“The chemicals caused the water to be a bright red color. Pretty striking to see.”
The state has put up a fence around it. Tests have measured contaminated ground water spreading nearly half a mile underground. The nearest families live 3 miles away. And the town of Christmas Valley is about 30 miles to the west.
“I would say if it was near any population center, even a town as small as Christmas Valley it could very well have been declared a Superfund site,” Schwarz says.
Former Lake County Commissioner J.R. Stewart is angry that the state does not intend to clean up the chemical dumpsite.
“If it’s not affecting you it’s not a problem. Well, it’s affecting Lake County,” he says. “It’s affecting the state of Oregon and it has the potential, in time, to be a great effect and a danger. Why not remedy a very bad situation as soon as possible, rather than turn a blind eye until you absolutely get beat over the head and have to do it?”
Stewart has been to the site several times. He says he can still smell the chemicals there. DEQ says those chemicals dissipate in the wind so they are no hazard as long as people stay away.
study for the EPA last year found contaminated water reaching the surface in an area known as habitat for the threatened western snowy plover. No studies have been done on whether they have been affected.
The company that originally made the Agent Orange has been sold several times since. The current owner is Bayer CropScience. In a written statement, a company spokesman says that Bayer CropScience thought it had reached “a fair and appropriate resolution” with DEQ in 2009.
The settlement did not address cleanup or future testing. Bayer would have paid 700-thousand dollars towards the 2-million dollars taxpayers have already spent fencing, burying and keeping tabs on the site. And if anyone else sued, Bayer would have paid 20% while taxpayers would cover 80 percent of litigation costs.
Lake County residents and officials filed objections, saying the proposed settlement let the company off the hook.
“The chemical companies you’re talking about are multi-billion dollar corporations. Come on,” Stewart says. “Let’s fight for what we know is right and get it done.”
Late last year, without any public announcement, DEQ quietly dropped the settlement. It has made no decision about pursuing the company. It has no plans to clean up the site, which could cost hundreds of millions of dollars.   
(note to disclose potential financial interest: the C-123 Veterans Association blog manager is vested in an Agfa-Bayer retirement benefit earned in 1989, through employment in Massachusetts and was not aware of this contamination until noting this OPB article on April 25,2014. At the time of his employment his firm was not associated with Bayer, and the contamination occurred many years before his employment with a firm acquired by Bayer in 1980.)

Eastern Oregon Site of Early Agent Orange Tests!

Department of Defense documents recently released details of testings conducted by the Air Force in Eastern Oregon, under the management of Oregon State University. On pages 65-66 of the "The History of the US Department of Defense Programs for the Testing, Evaluation, and Storage of Tactical Herbicides" was a review of the 1973-1974 testing which covered over 300 acres with five drums of concentrate Agent Orange, diluted with kerosene for effective spraying.

The disturbing document was a summary of world-wide US military use and storage of the wartime defoliant, infamous for its lingering toxic impact.

It was generated by contract with Batelle Columbus, which subcontracted for actual research and writing to a retired Air Force colonel. He directed much of the post-Vietnam denial posture adopted by both the Department of Veterans Affairs and the Department of Defense.

At various times he seems to also have served as Senior Consultant to the Office of Secretary of Defense, and he continues writing projects about Agent Orange ordered by VA under a long-term contract. In 2010 he happens to had a role in directing that obsolete, desert-stored C-123 transports all be destroyed as toxic waste. He also insists the former Agent Orange spray aircraft were somehow safe.

The OSU effort was led by Professor M. Newton, now Professor Emeritus. Although he later suggested that his research shouldn't be used relative to exposure claims by C-123 veterans, In 2011 Professor Newton wrote to a military-oriented publication and offered his startling opinion that inhalation of dioxin by veterans is not a concern, surface contact with contaminated surfaces is not a concern, and assured readers that only individuals who've actually handled Agent Orange and dioxin might have been in enough contact for the toxin to be harmful. No mention was made in his opinion that he'd been involved himself in spraying military Agent Orange. Neither was mention made that his work on Agent Orange was decades old.

Clearly, the OSU personnel involved in the testing should consider the effects of their dioxin exposure, and the industrial concerns which offered their property for this testing might also investigate.
(note: Professor Newton posted a discussion HERE of his Agent Orange views)

22 April 2014

Military Times: VA "Games" IOM Investigations

      Note: this was reported by Patricia Kime, Military Times Reporter. The significant point is that VA not only carefully words its "charge" or detailed specifics of a proposed investigation into veterans' health, but also attempts to influence the results of the Institute of Medicine committee work while underway. Veterans have long complained that the IOM process leaves the VA in too great a control over issues: (1) VA choses whether or not to order a study, (2) choses the specifics about the study and very carefully choses the words of the IOM "charge," (3) decides how much to pay for it, and (4) then decides whether to even accept the study's conclusions and recommendations. 
     Four acknowledged significant controls over what is generally misunderstood as being an independent process. Kime reports on another, a fifth control over the IOM process.       
     Here, the questionable influence was exerted by officials of the Veterans Benefits Administration, but the "charge to the committee" was issued to the IOM by a different organization, the Veterans Health Administration. Reporter Kime illustrates how one top official in the VA exerted influence over the IOM's activities in a manner apparently meant to direct the "independent" OM results into a form more acceptable to VA perspectives.     
     Kime did not note the sixth control VA exerts: VA refuses to honor Freedom of Information Act requests, denying the IOM and interested parties all essential unclassified information regarding its studies, resources, communications, and other relevant documents. For years VA has simply denied C-123 and other veterans' FOIAs by claiming information exists, not even their own web pages. Lawsuits forcing release of the information are resolved years after the IOM studies conclude, thus tainting the scientific record with incomplete data. 
     Veterans can only trust in the integrity of the IOM committee staff and members. Veterans and the public trust that, regardless of appropriate – or inappropriate – influence by VA, the IOM will seek the truth and the cleanest science in its activities
After the Institute of Medicine in March recommended using the term “Gulf War illness” to describe symptoms affecting more than 200,000 Persian Gulf War veterans, a top Veterans Affairs Department official expressed concern that such a change would imply a direct causal link between service in the 1990-’91 conflict and long-term illness.
That potentially explosive news was contained in an email sent by an IOM staffer to panel members who made the recommendation, including chairman Dr. Kenneth Shine. A copy was obtained by Military Times through a third party and later verified as genuine.
In the email, the IOM staffer said Allison Hickey, VA’s undersecretary for benefits, questioned the use of “Gulf War illness” rather than the VA-favored “chronic multisymptom illness” in a briefing on the report, “Chronic Multisymptom Illness in Gulf War Veterans.“
Hickey “was concerned that changing the name from CMI to GWI might imply a causal link between service in the Gulf and poor health which could necessitate legislation for disability compensation for veterans who served in the Gulf,” according to the email.
The statement appears to confirm what many ill Gulf War veterans have long suspected: VA has dodged references to Gulf War illness and research into the condition because officials fear a flood of new disability benefits claims and costly payouts — greatly complicating VA’s highly publicized goal to eliminate its backlog of benefits claims by the end of 2015.
Further fueling some veterans’ suspicions: Why was Hickey, VA’s top benefits official, weighing in on what is, at its core, a health issue?

21 April 2014

Clarification: IOM C-123 Study INCLUDED with other projects. Doesn't cost $1.8 million as we first reported

Thanks to the watchful eyes at the Institute of Medicine, we have both the opportunity and responsibility to correct a mistaken impression: The IOM C-123 study will be included with other issues in the cost we reported earlier: The C-123 study only costs a portion of what we first claimed.

Repeat: the actual IOM contract is for $1.7 million, and the C-123 study was tagged onto an existing contract and doesn't cost the public the higher figure we stated in earlier posts.

As for the utility of the study. The issue moves towards resolution and that's obviously a good thing from our perspective, as we insist we have science, medicine and law behind our claims.

Because the question of our exposure claims is, after all, resolved per the law, in this case our concerns were expressed because the months consumed by the study means ill veterans will continue to be barred from VA medical care when there is no legal excuse for that VA restriction.

Further, the question boils down to one of the law, which clearly states exposure needs to be proven by non-Vietnam veterans, not medical nexus, for inclusion in the presumptive category.

Thanks to M.P. for the opportunity to correct our statement. We try to find facts, draw conclusions, report data as given us...and not make errors such as this which affect readers' impression of our reliability.

We are passionate, but we are also truthful.

20 April 2014

Jewish War Veterans Support C-123 Veterans!

Apologies! And thanks to our JWC brothers and sisters in arms.

Overlooked last year was the very kind and meaningful support offered by the Jewish War Veterans in their Congressional testimony. It is gratefully acknowledged, with apologies for not being aware of it until today, Easter Sunday, 2014.
In June 2013, JWV National Commander Sheldon Ohren issued the following statement calling on Congress to address C-123 exposure claims:
    Agent Orange remains a concern, as thousands of veterans exposed to the toxin are left behind when it comes to vital treatment and benefits. JWV remains committed to ensuring all veterans who served in areas of exposure receive recognition and treatment for conditions linked to Agent Orange. Time is running out for those veterans not designated as having “boots on the ground” during the Vietnam War. JWV urges VA to work with DoD to finally complete the list of exposure locations outside Vietnam, including the C-123 K transport aircraft, Thailand and other supporting areas of the Vietnam theater, as well as Korea.  
Jewish War Veterans

    JWV urges continued close scrutiny by the Institute of Medicine into Agent Orange, Gulf War illness and other concerns. When problems are identified, VA must act swiftly to ensure current compensation and treatment is based on the most recent scientific findings.

19 April 2014

C-123 Exposure Study by Institute of Medicine – More Details Emerge

The National Academy of Sciences Institute of Medicine has been handed a contract by the
Department of Veterans Affairs to evaluate the C-123 Agent Orange contamination and exposure concerns raised by veterans. The study has its first committee meeting May 15, and the final on June 16, with a report due back to the Secretary of Veterans Affairs by the end of September. Veterans hope that, with such a narrow study focus, the report might be finished earlier.
A full description of the VA assignment, the IOM plans for its meetings, and committee members is available at the IOM website or here.

18 April 2014

Vets Love VA Medical Care - if they can get through the doors!

WASHINGTON — The American Customer Satisfaction Index (ACSI), an independent customer service survey, ranks the Department of Veterans Affairs (VA) customer satisfaction among Veteran patients among the best in the nation and equal to or better than ratings for private sector hospitals.   The 2013 ACSI report assessed satisfaction among Veterans who have recently been patients of VA’s Veterans Health Administration (VHA) inpatient and outpatient services.   ACSI is the nation’s only cross-industry measure of customer satisfaction, providing benchmarking between the public and private sectors.

In 2013, the overall ACSI satisfaction index for VA was 84 for inpatient care and 82 for outpatient care, which compares favorably with the U.S. hospital industry (scores of 80 and 83, respectively).   Since 2004, the ACSI survey has consistently shown that Veterans give VA hospitals and clinics a higher customer satisfaction score, on average, than patients give private sector hospitals. These overall scores are based on specific feedback on customer expectations, perceived value and quality, responsiveness to customer complaints, and customer loyalty.  One signature finding for 2013 is the continuing high degree of loyalty to VA among Veterans, with a score of 93 percent favorable.  This score has remained high (above 90 percent) for the past ten years.
“Every day, our dedicated VA employees, many of whom are Veterans themselves, strive to provide millions of Veterans with the excellent care they have earned and deserve,” said Secretary of Veterans Affairs Eric K. Shinseki.  “Our Nation’s Veterans deserve the best care, and the ACSI survey results help us better understand how Veterans feel about their overall health care experience at VA. There is always more work to do, and we are focused on continuous improvement to the care we provide.”
Additionally, Veterans strongly endorsed VA health care, with 91 percent offering positive assessments of
inpatient care and 92 percent for outpatient care.  When asked if they would use a VA medical center the next time they need inpatient care or outpatient care, Veterans overwhelmingly indicated they would (96 and 95 percent, respectively).
Veterans also responded positively to questions related to customer service for both VA inpatient care (92 percent favorable) and outpatient care (91 percent).   Medical providers and appointment personnel were considered highly courteous with scores of 92 and 91, respectively.   Additionally, VA medical providers ranked high in professionalism (90 percent positive).
“VA’s strategy of providing a personalized, proactive, patient-driven approach to health care is positively impacting Veterans’ experiences at our 1700 sites of care nationwide,” said Dr. Robert A. Petzel, VA’s Under Secretary for Health.  “We are transitioning to a health service focused on Veterans’ personal health care goals, and this is reflected in the ACSI score.”
With over eight million Veterans enrolled, VA operates the largest integrated health care delivery system in the United States.  Our mission is to honor America’s Veterans by providing exceptional health care that improves their health and well-being.   VA provides a broad range of primary care, specialized care, and related medical and social support services.  VA provided 89.7 million outpatient visits last fiscal year. VA has 236,000 health care appointments per day.

16 April 2014

A Vet's Daughter Writes The C-123 Veterans Association

"I guess God put you here, pouring your heart and soul into this for others in needThank you for all your hard work."

Her father had both Army and Air Force service. He was a combat veteran before he could vote, and flew hundreds of hours in "Patches."  He died in 2013, and was my best friend, Lieutenant Colonel Paul Bailey.

Review of VA Claims Statistics...Improving!

VA & USAF Defy FOIA – VA & AF Hide Data & Threaten IOM Study

An Institute of Medicine investigation of C-123 Agent Orange issues will begin June 16 – but with essential, unclassified VA and USAF data withheld. Although directly relevant to the assignment given IOM by the Department of Veterans Affairs, the committee will not have vital information for their studies. Without all available C-123 information made available to the IOM, their committee report will be fatally flawed, and the affected veterans harmed.

Both VA and AF have relevant, unclassified information about this 60-year old airplane and its Agent Orange history. This information has been improperly refused release to the public in defiance of Freedom of Information Act. Complete and valid requests go back over a year in each case, but they have been ignored.

In stark defiance of the Freedom of Information Act, it is clear that both Departments prefer at least some documents demanded by the veterans not to be released and available to the IOM. Although relief has been sought through the US District Court of Washington D.C. to force release of the materials, there is no possibility of court action before the June 16 workshop. 

This leaves the IOM C-123 committee tackling their VA assignment but with VA withholding information, years of its own investigations, all specifically relevant to the issue at hand. 

The June 18 IOM C-123 project is only the third such study on a unique population since the Vietnam War. Veterans who flew these airplanes which the AF tested as "heavily contaminated" claim their exposure to Agent Orange residues. Since becoming aware of the C-123 toxicity, and also responding to the C-123 veterans' inquiries, both AF and VA have completed studies, exchanged correspondence and conducted meetings and conferences. 

This extensive background of materials has been demanded under their rights expressed in the Freedom of Information Act. The materials are particularly relevant to the IOM investigation because VA has used it for years as justification for denying all C-123 veterans' exposure claims.

Both VA and AF have refused compliance with their own regulations requiring prompt release of non-sensitive materials such as the veterans' seek. The President of the United States has described FOIA as a fundamental American right, as have the courts. But neither VA nor the USAF seem to have been impressed.

According to the USAF FOIA web page:
"The principles of government openness and accountability underlying the FOIA are inherent in the democratic ideal: "The basic purpose of the FOIA is to ensure an informed citizenry, vital to the functioning of a democratic society, needed to check against corruption and to hold the governors accountable to the governed."

The Air Force, and the Department of Veterans Affairs, have determined that the democratic ideal can be best realized by their disregard of the FOIA and the rights of veteran citizens.

Can't IOM or other interested parties contact AF and VA for prompt release of the FOIA materials without any unnecessary court action? 

IOM, Irvine, CA   (16 Jan 2013)
If such vital information is withheld from the veterans and the IOM with the resultant incomplete report so vital to the veterans' health, it must be known to senior leadership of both Departments as well as the public.  

It should be made known that from a legal basis, budgeting for the IOM C-123 Agent Orange review is potentially wasted money. Not only is there no component of the IOM charge involving the complete legal qualification of the C-123 veterans seeking Agent Orange exposure benefits (detailed in the Yale Law report,) but VA and AF are withholding large amounts of data relevant to the committee's investigation. 

IOM's final report will be flawed by being incomplete, by design...by the calculated defiance of the FOIA, as VA prevents essential documentation from being evaluated by the Institute of Medicine.