25 August 2014

What VA Doesn't Want the Institute of Medicine C-123 Post-Vietnam Agent Orange Exposure Committee to Know:

VA gathered the Institute of Medicine this spring and summer to study the post-Vietnam C-123 transports and the aircrews' Agent Orange exposures. Their report on what the VA should do will be submitted to the Secretary of Veterans Affairs by the end of September 2014. C-123 veterans notified IOM staff and the VA we consider this an an unethical step by VA to prevent currently qualified exposure veterans from receiving care the law now provides, with VA seeking to use IOM to construct a specific barrier in our situation.

But the committee doesn't have all the facts before it. The C-123 veterans wish to make known the various reports, studies, and other relevant documents, because the end of June was the committee's cut-off date for formal submission and many new items have been uncovered in the last two months.

Here are new developments or materials not previously submitted to the committee:

1. USAF has withheld hundreds of pages of its post-Vietnam C-123 Agent Orange study from release to veterans and the public, but provided everything to the VA. 
The USAF, through suits filed in the US District Court of Washington DC, has released some of the materials sought under the Freedom of Information Act request we first filed in 2012. Last week, years late and too late for the IOM, USAF released only heavily redacted materials, with nearly every page of the 380 completely blank. The only useful item was a single paragraph in which the USAF research team on post-Vietnam C-123 exposures grouped our exposures with those of Operation Ranch Hand. They then concluded because Ranch Hand veterans are reasonably healthy, the C-123 veterans were somehow not exposed to harmful amounts of Agent Orange. Actually, the AF should have likened our degree of bioavailability to the Vietnam ground troops or even more, according to Dr. Jeanne Stellman of Columbia.

2. VA withheld most pages of its post-Vietnam C-123 Agent Orange activities from release to the veterans and the public.
VA promised through the US District Court requested documents by the end of May, but continues to request postponements and releases nothing except the request for the next postponement. VA references "scientific studies" on its web pages which even the VA Board of Veterans Appeals cites as authority for denying C-123 exposure claims, yet apparently no such studies exist...only the VHA collection of references and selection of those best aimed at preventing veterans' claims. Subsequently in July 2014, VBA officials even denied knowledge of the A.L. Young Consultants $600,000 contract let in 2012, and of all reports, correspondence and other information.

3. Other Federal agencies have concluded the C-123 veterans were exposed and suffered harmful results.
At one point, with the draft provided by a staffer at VBA who'd been a leader in blocking C-123 claims, the Secretary of Veterans Affairs told the Senate that "many independent scientists voluntarily came forward" to argue against C-123 veterans' exposure claims, but it turns out there were only three, and each was paid to offer their opinions, one by VA and the other two by Dow and Monsanto. The Secretary dismissed the dozens of "Concerned Scientists and Physicians" who'd written him through Dr. Stellman as their corresponding scientist, and all of whom were unpaid. The Secretary, writing Senator Burr, dismissed these experts with a minimizing adjective as "some."
Please note that three voices against the veterans are termed "many" but dozens confirming the veterans' exposures are termed, "some."

He ignored input from the National Institutes of Health/NEISH and the CDC/Agency for Toxic Substances and Disease Registry in explaining to the Senate why VA refuses C-123 claims. The Secretary's misleading letter to the Senate, perhaps an example of what the Secretary meant when he resigned because of poor staff work, was prepared by VBA which has opposed C-123 veterans' claims since we first began submitting them in 2011.

4.  Explaining the VA perspective to the IOM C-123 committee was VA's consultant, paid $600,000 for his services, but a detail not revealed to the committee. The Dow and Monsanto-sponsored reports properly noted their chemical industry sponsorship.  All six major veterans service organizations have demanded the VA cease contractual relationships with this firm.

5. As I told told the committee, the legal issue for the benefits claimed by C-123 veterans is exposure itself, and not bioavailability.
The law, regulations, US Code and Federal Register simply specify exposure to be eligible for what VA terms "presumptive service connection" for recognized Agent Orange illnesses. We've established our exposure to the satisfaction of legislators and Yale Law School as well as other federal agencies. Agencies with the actual statutory authority and expertise in exposure issues such as CDC, NIH and the US Public Health Service have informed VA that we've been both exposed and harmed by it. VA currently orders all C-123 exposure claims denied but the Board of Veterans Appeals almost always overturns and awards benefits to the veteran. To address this, VA's office of General Counsel has opined that VA can redefine exposure in any unique manner it wishes to prevent exposed veterans from being able to meet the law's requirement which only states "exposure."

6. VA, and the consultant explaining VA perspectives to the IOM committee, did not reveal that its spokesperson at the June 16 IOM was personally involved in ordering destruction of the toxic C-123s in 2010 (and as he stressed, to prevent potential veterans' claims), a unique element of his personal background which should have led VA to select another consultant regarding these veterans' health.
In a 2009 series of "Decision Memoranda" to Air Force leaders, the consultant, in his capacity as Senior Consultant to the Office of Secretary of Defense, recommended cessation of all further testing and the immediate destruction of the toxic C-123s, then in quarantine storage at Davis-Monthan AFB, AZ. Citing the consultant's unique authority from the Office of Secretary of Defense, Mr. Wm. Boor requested and received from the Air Staff approval for destruction.

This has provided the consultant a unique historical role over four decades:

7. VA Expenditures Regarding C-123 veterans' exposure claims:
    -Support Veterans' Claims: $0.00
    -Prevent Veterans' Claims: $600,000 plus contractor expenses, VA staff salaries, travel & benefits
    -Contract extension with Institute of Medicine: unknown but language of the charge is considered to direct a negative response regarding the legal question of exposure and to force an inconclusive response regarding degree of harm, as this has been the result of previous IOM, unless the committee opts to exceed its charge and act with independence. Dow & Monsanto also sponsored letters opposing C-123 veterans' exposure claims at the June 16 2014 Institute of Medicine hearing.

8. In 2013 the USAF Assistant Surgeon General informed the Senate Veterans Affairs Committee that the USAFSAM C-123 Consultative Letter should not be used by VA in denying C-123 veterans' claims.

Still, VA cites it as the foundational document in preventing all C-123 veterans claims. VA further cites its own "scientific study" which is actually only a single page point paper typed in 2011 in preparation for the initial teleconference between VHA, VBA,C-123 veterans, and several scientists. The VA "scientific study" pointedly ignored every finding and opinion supporting C-123 veterans' claims...only publications which could be interpreted to argue against exposure were cited. This "scientific study" was thus only a policy statement.

In its response to the Senate, the AF illogically also reported that its conclusion aircrews were not exposed was "consistent" with the ATSDR finding that aircrews were exposed, and AF simply disregarded the ATSDR finding that the aircrew cancer risks were greatly increased.

9. The Air Force Ranch Hand Study considered non-Ranch Hand C-123 aircrews as potentially exposed from flying converted spray airplanes.
From the early study:
"Another possible control group, the non-Ranch Hand C-123 population, is known to be too small (approximately 3000) to provide flexibility and replacement under the proposed best match variable concept (see below and Section VI,A). Many of the Ranch Hand aircraft were reconfigured for transport and insecticide missions and thus, non-Ranch Hand crews responsible for these other missions, may have been exposed to Herbicide Orange residues in these aircraft. This group may not be considered truly unexposed to herbicides..."

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