Institute of Medicine Criticizes VA & Air Force

In its C-123 Agent Orange Report, published under consulting contract to the Department of Veterans Affairs, the National Academy of Sciences Institute of Medicine made a startling accusation. Startling, because of the obvious intrinsic and extrinsic failures of which the IOM was accusing both the Department of Veterans Affairs and the United States Air Force. 

Citing numerous examples, the IOM broadly condemned these authorities for failure to accurately and objectively report, and then utilize, information about military toxic exposures and veterans' illnesses. From page 5:

Reports "from those in the military or associated with the VA tend to minimize the possibility of an increased risk of exposure and adverse health outcomes."

The IOM made clear the fact that veterans' exposures were treated by the VA in a manner calculated to either dismiss altogether or at least minimize the harm done military personnel whose duties presented toxic hazards.

This certainly made clear the VA failure to be pro-veteran and non-adversarial. Get the picture? Our VA doctors and scientists (including its consultant with his $600,000 no-bid sole source VA contract) were saying we were not exposed when they had facts in hand that we were exposed.

An analogy would be your doctor saying your arm isn't broken while both of you look at the x-ray of your broken arm. Plus, other medical experts and federal health agencies had already told your doctor the arm was broken. But the doctor and your insurance company had decided that they don't cover broken arms. Especially from you.

And for four years, our VA doctors in Post Deployment Public Health were determined to send us on our way untreated for our cancers and other illnesses because they had already reached a policy decision not to acknowledge any exposures. Especially from us.

In fact, as we were repeatedly told to our faces by VA officials, no amount of proof from whatever source would ever permit our claims even to come up to the minimum standard of "as likely to us not." And this was after the CDC/ATSDR had already informed the VA that we had a 200 times greater risk of cancer then screening standards. This was after dozens of university scientists and medical experts to Agent Orange aboard our old airplanes. But still, the VA Agent Orange Desk insisted to one and all, both inside and outside the VA, that VA had "an overwhelming preponderance of evidence" against us... But it didn't!

Remember, a veteran's claim is to be assumed truthful and factual on its face, but in case of a question the claim need only arise to equipoise – a level of "as likely to has not," or a 50-50 balance of the question. In fact, every benefit of the doubt is to be given the veteran in the claim. We know now, however, that no amount of proof would be accepted to support these claims – VA policy, rather than VA regulations and science had already been implemented at both VHA and VBA against the veterans.

Our association made accusations of ethical failures, all supported with documentation, against the Department of Veterans Affairs in our presentation to the Society of Toxicology at its 2014 Phoenix convention. Sponsored by a former president of the society ,we addressed the scheme by the VHA Post-Deployment Public Health Section which used a similar presentation to the SOT in 2012 which attempted to redefine the medical-scientific term "exposure." The VA presenters reinvented their use of the word exposure as "exposure = contamination field +bioavailability."

In fact, their redefinition of exposure by the addition of the word bioavailability as a required part to the concept of exposure made impossible most exposure claims from veterans, especially those like us, exposed years earlier and with illnesses such as prostate cancer or soft tissue sarcoma taking years to evolve after our toxic exposure event.

No expert we could find, insider or out of government, agreed with the VA redefinition. All took exception to it, even the director of the National Toxicology Program who said she had never heard of such a thing. She explained bioavailability is a separate but related term. Inventing its own definition rather than use the standard ATSTR glossary of terms Dorlands Illustrated Medical Dictionary (the VA standard reference,) Post-Deployment Public Health was driven by its unofficial, improper but rigidly applied policy to block C-123 Agent Orange exposure claims.

So one has to ask: Did the medical and scientific errors revealed by the IOM in the VHA Post-Dedeployment Public Health Section ever result in comment or criticism, or did they get their full bonuses? One wonders if questions arose about VHA intrinsic and extrinsic ethical failures as regards veterans health? At least one of the 2012 VA poster team still works in that section of VHA... were there any career implications for her participation in this campaign against C-123 veterans?

Finally one must also ask were these experts more disappointed in their failure to implement VA VHA policy against C-123 vets than in the IOM accusations?