April – Month of the Military Child

That was my grandfather, my dad, me and my siblings, and my own kids. All military brats. AKA "ankle biters." Dependents. The kids.

There was a price paid, and we all know it, but that's what Dad (or Mom) was called to do. 
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military bratNoun | \ ‘military brat’
1 a: CHILD; specifically: a child serving our country with strength, dignity an love as his or her parent(s) fight for our nation’s security domestically and abroad.

VA: SAME-DAY CARE PROMISED NATIONWIDE!

Seeking to end years of scandal over patient treatment delays, the Department of Veterans Affairs is working to offer its patients same-day care at each of its medical centers by year's end.

The goal is part of a nine-point list of initiatives announced Friday, which is being implemented at clinics and hospitals across the nation to better care for veterans in the embattled health system.

Already, 34 facilities offer that same-day primary and mental health care. Colorado Springs is not on that list, though the capability is expected to expand, said Dr. David Shulkin, the VA's undersecretary for health, during a conference for health care journalists in Cleveland.

"This is not only possible - we're doing it today," Shulkin said. "What we need to do is to consistently do it across our 168 member centers."

The VA also plans to roll out an app across the nation that allows patients to schedule their own appointments. And the health care system is implementing a new, easier-to-use scheduling system for its staff, Shulkin said.

The initiative, called a "declaration of access" comes as the agency continues to face withering criticism over the falsification of appointment records across the nation - including at Colorado Springs' clinic at Centennial Boulevard and Fillmore Street.

A recent report by the agency's inspector general found 11.5 percent of veteran appointments for care in Colorado Springs were delayed by 30 days or more. The figure is nearly four times the national rate, and it's up 7 percent from before the new 76,000-square-foot clinic first opened.

The report also found that local clinic workers delayed adding scores of veterans to a list for the "Veterans Choice" program, which would have allowed them to seek private care. It impacted 229 of 450 cases reviewed, the report said.

The new goals are meant to help the VA move past those issues, Shulkin said.

"That is not what we believe represents the current VA today," said Shulkin, of treatment delays that first gained notoriety two years ago. "We've now moved beyond that, reaffirmed our values and making sure we're putting systems in place that work for veterans."

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Contact Jakob Rodgers: 476-1654

Twitter: @jakobrodgers

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VA Claims & Appeals – as slow as ever?

Three years ago, this eBenefits report on my Agent Orange claim showed exactly what it does today. Unchanging. Or, if there is change, only at a glacial pace. 

Six years since the initial claim and counting...a long wait with cancers, IHD and more. A long wait for medical attention the VA won't provide until the claim is resolved.

I've talked to the VBA folks working on this. They work hard, and try their best. But hard work and staffers doing their best just doesn't seem to meet veterans' needs.

VA should contract this initial claim assessment work out to a qualified contractor (maybe a company made up of retired VBA staffers?) and use the VBA experts to review each claim for approval.

From today's eBenefits report on my appeal:

VA Denies Another C-123 Veteran Agent Orange Claim

Honoring its promise made us on February 28, 2013, the director of VA's Compensation Services (C&P) completed denial of my own C-123 Agent Orange service connection claim today. This completes C&P's 25 September 2012 advisory opinion provided the Portland VARO in which he directed opinions from toxicology scientists be disregarded because they weren't physicians.

The same advisory opinion also detailed the VA's one paragraph summary of the official finding of Dr. Tom Sinks, Deputy Director of the CDC/Agency for Toxic Substances and Disease Registry. Deliberately and evasively avoiding mention of Dr. Sinks' actual finding which stated "I believe that aircrew operating in this, and similar, environments were exposed to TCDD," C&P appends a sentence to that summary in a manner implying Sinks meant something altogether different: added was "In summary, there is no conclusive evidence that TCDD exposure causes any adverse health effects" - a conclusion completely opposite Dr. Sinks' finding! VA also conveniently ignored (ignored to better deny the claims!) the ATSDR finding that C-123 veterans now face a 200 times greater cancer risk, thanks to exposure aboard the contaminated airplanes. 

This unscientific and prejudicial editing of another federal agency's finding was discussed in person with C&P's director and his staff on February 28 at his offices, but without comment, modification, retraction, denial or anything...other than his statement that he can't be personally familiar with every piece of VA correspondence over his signature. I understand, but I did bring it to his attention (without response) in November 2012, before it was used to deny my VA claim. While selectively applied to C-123 veterans, thank God VA does not apply that mistake about TCDD to other Agent Orange-exposed veterans.

Agent Orange, and its toxic component TCDD, are generally thought to be somewhat harmful, and considered a human carcinogen and one of the most toxic toxins on the planet. The VA, paying billions in Agent Orange veterans benefits, might consider applying the above paragraph in reconsideration of all those expenses if, indeed, there is no evidence of TCDD being harmful. VA might wish, however, to first run the issue past the Congress, the veterans organizations, the courts, the Institute of Medicine and their own executives. Perhaps...the statement of TCDD being harmless is applicable only in the instance of denying C-123 veterans our claims.

Completely ignored in today's denial of my exposure claim are expert findings in my favor provided by the University of Texas Medical School (Dr. Arnold Schecter), the EPA, the NIH, Dr. Jeanne Stellman, Dr. Fred Bowman (Oregon Health Sciences University Toxicology Department) and other highly esteemed scientists. Ignored completely are the numerous juried scientific articles establishing the TCDD contamination of the C-123, the bioavailability of that TCDD, the routes of exposure as having been dermal, inhalation and ingestion, and dozens of other proofs. Best dealt with by the VA by ignoring them as opposed to acknowledging the fact of the matter...C-123 veterans were indeed exposed to Agent Orange.

VA Exposure Expert

The question of "exposure" is pivotal. The VA utilized its own special in-house extra-legal (even though the issue has already been adjudicated and resolved, and VHA is not free to redefine such things and VBA isn't supposed to approach veterans claims with a VBA predetermination for denial) definition of exposure, being in effect "no C-123 exposure is ever going to be acknowledged." Science, however, more correctly defines exposure as "the contact between a chemical or biological agent and the outer boundary of an organism." Quite simple, and according to the NIH adequate to establish that C-123 veterans were exposed to Agent Orange to the complete satisfaction of the law. 

Typical C-123 Veteran

The law? Forgettaboutit! The Agent Orange Act of 1991 and subsequent modifications, in particular the May 2001 VA promulgation of Title 38 (as detailed in the Federal Register) clearly spell out that VA will treat veterans exposed to Agent Orange outside the Vietnam "Boots on the Ground" group the same as the Vietnam veterans, and without having to establish medical nexus. Thus, given (1) our doctors' proof of Agent Orange-presumptive illnesses, and (2) the Air Force proof of the C-123 Agent Orange contamination, the only way for the VA to shoot down our claims is to (3) deny exposure. Deny, deny, deny.

Today, the VA Compensation Services locked on and fired, just as they promised they would for any C-123 veteran hoping to establish service connection for Agent Orange exposure.

Next step? Board of Veterans Appeals, at least, for any of our members surviving to present their claims after the typical five year waiting period which follows the two years wasted thus far.

C-123 Discussed at First 2013 Institute of Medicine Meeting

C-123 issues presented to the 15 IOM members, 16 January 2013

Yesterday's meeting of the Institute of Medicine's Agent Orange Committee included a briefing about post-Vietnam Agent Orange contamination of C-123 aircraft. While the Committee cannot act on its own regarding any single issue, we were able to present the fundamentals of our cause.

And that cause is that we flew contaminated aircraft and were exposed aboard them. Not only aircrews, but also aerial port, AME and maintenance personnel were identified to the Committee as the veterans deserving of their intervention. How that intervention might come about, publicly or privately, I don't know and I don't care...at least the IOM knows what the VA has been doing to us ever since the problems with post-Vietnam contamination first surfaced publicly in 2011.

The crux of that VA opposition has been their refusal to accept the contamination information as indicative of exposure also. Not only that, but they deny any exposure could have occurred because of a novel concept, unknown to science outside VA headquarters, of "dry dioxin transfer." Using it, and a pretense that there wasn't "enough" dioxin to cause long-term health issues, the VA has directed regional offices to continue refusing medical care and benefits to C-123 veterans. They even rely on the opinion of the Director, Compensation Services, to write in denying veterans' benefits "there is no conclusive evidence that TCDD exposure causes any adverse health effects." 

IOM Conference Center at UC-Irvine

This brought a smile, then a frown, from most Committee members when it was read to them! "Not sure which medical school or toxicology program that" (came from), was one Committee member's comment as he shook his head.

We shake our heads also, but in sadness, not just bewilderment. Recent VA actions and letters make it more clear than ever than no amount proof or expert independent opinions will sway them to permit service connection for C-123 veterans. It just won't happen. They have all the time in the world...and we don't. Besides, fellow veterans, we must come to understand that these VA people are not like us. They are different, with a different set of values, a different perspective regarding "those trash-haulers, freeloaders" (as the OSD consultant slandered us), and a different perspective regarding honor. 

Already, signaling this sea-change, I listened to the bulk of the Committee's free time being spent today on health issues of Vietnam veterans' children...and grandchildren. I was the oldest guy in the room.