Showing posts with label 439 TAW. Show all posts
Showing posts with label 439 TAW. Show all posts

11 November 2018

VA MAKES THE RULES – FOR VETS, NOT VA. BUT THEIR "RULES" ARE IGNORED

Multiple Federal Register comments about our C-123 Agent Orange regulation referenced a March 2013 correspondence from the Joint Services Records Research Center (JSRRC) to VA. JSRRC had cited the findings of a study by the Agency for Toxic Substances and Disease Registry (ATSDR) as relevant documentation establishing exposure to residual dioxin. The commenters requested that this memorandum be utilized as a basis for a retroactive effective date. Similarly, multiple comments referenced the 2015 findings of the Institute of Medicine (IOM) and requested that the date of these findings be utilized as a basis for the effective date of this regulation.
"VA finds no basis to utilize the JSRRC correspondence or the IOM findings to establish an earlier effective date for the regulation. For all regulations in which VA has established a presumption of exposure, there is a body of scientific evidence that must be considered and ultimately informs the decision to establish the presumption of exposure. This body of scientific evidence, by logical necessity, predates the effective date of the regulation. Exposure aboard contaminated C-123 aircraft is no different. As discussed above, to the extent VA has legal authority to establish a retroactive effective date, it is unquestionably the well-established practice of VA and Congress to establish liberalizing regulations and statutes benefitting other groups of veterans with prospective effective dates. Therefore, no change is warranted based on any of these multiple theories asserted in support of assigning a retroactive effective date for this regulation."

The ignored rules about the JSRRC VA's own regulation VA M21-1MR. VA's rule is tat claims adjudicators must inquire about non-presumptive disabilities and questionable presumptive claims. Yet in the paragraph above VA insists it was correct in ignoring the numerous JSRRC affirmations of C-123 post-Vietnam exposures.

Rules? For vets, not for VA!

05 December 2017

Retired USAF C-123 Vets with Agent Orange Illness Eligible for Combat Related Special Compensation

Combat-Related Special Compensation (CRSC) provides special compensation to military retirees who have retired pay reduced because of receiving U.S. Department of Veterans Affairs (VA) disability compensation. This means that qualified military retirees with 20 or more years of service that have "combat related" VA-rated disability will no longer have their military retirement pay reduced by the amount of their VA disability compensation. Instead they will receive both their full military retirement pay and their VA disability compensation. The following is a summary of Combat-Related Special Compensation:
Once a military retiree has been determined to be qualified he/she will receive their regular retirement pay plus an additional sum based on their VA disability rating.

COMBAT-RELATED SPECIAL COMPENSATION ELIGIBILITY

The following CRSC eligibility requirements apply:
In order for members to be eligible for CRSC, they must meet all of the following criteria:
  1. Receive military retirement pay for one of the following reasons:
    • Served on Active Duty, the Reserves, or National Guard with 20 years of creditable service;
    • Served on Active Duty, the Reserves, or National Guard and is also a permanent medical retiree (Chapter 61) regardless of years served;
    • Served on Active Duty, the Reserves, or National Guard and is classified as a Temporary Disability Retirement List retiree regardless of years served; or
    • Served on Active Duty, the Reserves, or National Guard and is classified as a Temporary Early Retirement Act retiree with 15-19 years served.
  2. Have 10% or greater VA rated injury that is combat-related.
  3. Military retirement pay is reduced by VA disability payments (VA Waiver).
  4. Must be able to provide documentation that injury was a result of one of the following:
    • Purple Heart
    • Armed Conflict
    • Simulating War
    • Hazardous Service
    • Instrumentality of War
    • Agent Orange
    • Radiation Exposure
    • Gulf War
    • Mustard Gas or Lewisite

27 August 2016

ANOTHER C-123 VETERAN'S AGENT ORANGE APPEAL TRASHED BY UNCARING BVA

WHAT A MESS! This elderly Massachusetts C-123 veteran served at Hanscom AFB before the 731st moved to Westover. His cancer claim was submitted years ago, and on appeal was heard in June...but was denied!

Read through it below. Look how the BVA and its aggressive attorney trashed this qualified veteran's appeal by simply ignoring everything the VA did last year in recognizing our Agent Orange veterans' benefits.

Their tact was to pretend the man wasn't a veteran...an issue resolved by Secretary McDonald's June 19 2015 Interim Final Rule which the BVA judge and the BVA attorney ignored, despite their duty under VCAA.




Citation Nr: 1622153 
Decision Date: 06/02/16    Archive Date: 06/13/16

DOCKET NO.  15-34 922 ) DATE
 )
 )

On appeal from the
Department of Veterans Affairs Regional Office in Boston, Massachusetts


THE ISSUE

Whether new and material evidence has been submitted to reopen a claim of entitlement to service connection for chronic lymphocytic leukemia (CLL).


REPRESENTATION

Appellant represented by: Massachusetts Department of Veterans Services


WITNESS AT HEARING ON APPEAL

Appellant


ATTORNEY FOR THE BOARD

J. Barone, Counsel


INTRODUCTION

This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2015).  38 U.S.C.A. § 7107(a)(2) (West 2014).

The Veteran served on active duty with the United States Navy from April 1946 to April 1948, and on active duty as a member of the United States Navy Reserves from October 1950 to August 1952.  It appears that he had an additional period of active duty from August 1959 to August 1962 and a verified period of active duty for training (ACDUTRA) with the United States Air Force Reserves from October 28, 1962, to November 28, 1962.  Effective June 18, 1976, he was removed from Reserves status and assigned to the Retired Reserve.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Boston, Massachusetts, which declined to reopen the Veteran's claim of entitlement to service connection for CLL.

The Veteran testified before the undersigned Veterans Law Judge (VLJ) by videoconference in April 2016.  A transcript of his hearing has been associated with the record.


FINDINGS OF FACT

1.  In November 2012, the Board denied service connection for CLL.

2.  Evidence added to the record since the November 2012 Board decision is cumulative or redundant of evidence previously of record, does not relate to an unestablished fact necessary to substantiate the claim of entitlement to service connection for CLL.


CONCLUSIONS OF LAW

1.  The November 2012 Board decision is final.  38 U.S.C.A. § 7104(b) (West 2014); 38 C.F.R. §§ 3.160(d), 20.1103 (2015).

2.  New and material evidence has not been received to reopen the claim of entitlement to service connection for CLL.  38 U.S.C.A. § 5108 (West 2014); 38 C.F.R. § 3.156 (2015).


REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

VA has a duty to notify and assist claimants in substantiating a claim for VA benefits.  38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5107, 5126 (West 2014); 38 C.F.R. §§ 3.102, 3.156(a), 3.159 and 3.326(a) (2015).  

The Veteran's petition to reopen the claim of entitlement to service connection for CLL was filed as a Fully Developed Claim (FDC), as a part of a VA program to expedite VA claims.  Under this framework, a claim is submitted in a "fully developed" status, limiting the need for further development of the claim by VA.   When filing a FDC, a Veteran is to submit all evidence relevant and pertinent to the claim other than service treatment records and treatment records from VA medical centers, which will be obtained by VA.  Under certain circumstances, additional development may still be required prior to the adjudication of the claim, such as obtaining additional records and providing a VA medical examination to the Veteran.  The notice that accompanies the FDC form informs a Veteran what evidence is required to substantiate a claim for service connection, a Veteran's and VA's respective duties for obtaining evidence, and information on how VA assigns disability ratings in the event that service connection is established.  See VA Form 21-526EZ.  Thus, the Board finds that VA's duty to notify has been met.

Moreover, there is no allegation from the Veteran that he has any evidence in his possession that is needed for full and fair adjudication of this claim, and the Board finds that the notification requirements of the VCAA have been satisfied as to timing and content.

With respect to VA's duty to assist, service, VA, and private treatment records have been associated with the claims file.  

Therefore, the Board is satisfied that VA has complied with the duty to assist requirements of the VCAA and the implementing regulations.  

For the foregoing reasons, it is not prejudicial to the appellant for the Board to proceed to a final decision in this appeal.

Analysis

Generally, a claim which has been denied in an unappealed RO decision or an unappealed Board decision may not thereafter be reopened and allowed.  38 U.S.C.A. §§ 7104(b), 7105(c) (West 2014).  The exception to this rule is 38 U.S.C.A. § 5108, which provides that if new and material evidence is presented or secured with respect to a claim which has been disallowed, the Secretary shall reopen the claim and review the former disposition of the claim.  

New evidence means existing evidence not previously submitted to agency decisionmakers.  Material evidence means existing evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim.  New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened, and must raise a reasonable possibility of substantiating the claim.  38 C.F.R. § 3.156(a).  

For the purpose of establishing whether new and material evidence has been submitted, the credibility of the evidence, although not its weight, is to be presumed.  Justus v. Principi, 3 Vet. App. 510, 513 (1992).  But see Duran v. Brown, 7 Vet. App. 216 (1994) ("Justus does not require the Secretary [of VA] to consider the patently incredible to be credible").

As noted, the Board denied the Veteran's claim of entitlement to service connection for CLL in a November 2012 decision.  

The record before the Board at the time of the November 2012 decision included evidence of a diagnosis of CLL in 2007.  It also included the Veteran's service records, showing that he performed as an Air Reserve Technician (ART) from 1970 to 1973, and that he participated in ACDUTRA as required by his enlistment in the Air Force Reserves.  

The record at the time of the November 2012 decision also included the Veteran's contention that while working as an ART at Hanscom Air Force Base from 1970 to 1973, he was exposed to Agent Orange from C-123 aircraft that had been used to spray the defoliant in Vietnam.  In this regard, the Board noted that certain civilian positions in the military departments were filled by individuals who were members of the active reserves, which, in the case of the Air Force, were known as ART positions.  Jeffries v. Dep't of the Air Force, 999 F.2d 529, 529-30 (Fed.Cir.1993).  Although they are full-time civilian employees, ARTs "are also members of the Air Force Reserve unit in which they are employed.  In addition to their civilian assignments, ARTs are assigned to equivalent positions in the reserve organization with a reserve military rank or grade."  Id. at 530.  ARTs "are required to serve as members of the Air Force Reserve one weekend a month and at least fourteen days a year of annual training."  See http://www.afrc.af.mil/shared/
media/document/AFD-070125-046.pdf.  "On these weekend Unit Training Assemblies (UTAs) and during their annual two-week tour of duty, ARTs train with fellow reservists."  Id.    At all other times, however, ARTs were civilian employees.  Id. (noting that "[d]uring the normal five-day workweek, ARTs perform as civilians-maintaining and operating the Reserve facility in direct support of their unit").

The Board also considered the possibility of service connection on the basis of incurrence of CLL during a period of ACDUTRA as required by the Veteran's Reserves status.  The Board observed that ACDUTRA was defined, in part, as "full-time duty in the Armed Forces performed by Reserves for training purposes." 38 U.S.C.A. § 101(22)  (West 2002); 38 C.F.R. § 3.6(c) (2014).  The Board also noted that inactive duty training is defined, in part, as "duty (other than full time duty) prescribed for Reserves . . . by an authority designated by the Secretary concerned and performed by them on a voluntary basis in connection with the prescribed training or maintenance activities of the units to which they are assigned." 38 U.S.C.A. § 101(23)(A) (West 2014); 38 C.F.R. § 3.6(d)(1).  "The term 'Reserve' means a member of a reserve component of one of the Armed Forces."  38 U.S.C.A. § 101(26). 

The Board indicated that when a claim was based on a period of ACDUTRA, in order to establish entitlement to benefits, there must be some evidence that the disability for which service connection is being sought was "'incurred or aggravated' during the relevant period of service."  Smith v. Shinseki, 24 Vet. App. 40, 47 (2010) (quoting 38 U.S.C.A. § 101(24)(B); Acciola v. Peake, 22 Vet. App. 320, 324 (2008); and McManaway v. West, 13 Vet. App. 60, 67 (1999) (citing Paulson v. Brown, 7 Vet. App. 466, 469-70 ("if a claim relates to period of [ACDUTRA], a disability must have manifested itself during that period; otherwise, the period does not qualify as active military service and claimant does not achieve veteran status for purposes of that claim"). 

The Board noted that Veterans who serve on regular active duty are entitled to several presumptions-such as the presumption of sound condition at entrance to service, the presumption of aggravation during service of preexisting diseases or injuries that undergo an increase in severity during service, and the presumption of service incurrence for certain diseases which manifest themselves to a degree of disability of 10 percent or more within a specified time after separation from service-to assist them in substantiating their service connection claims.  38 U.S.C.A. §§ 1111, 1112, 1153 (West 2014); 38 C.F.R. § 3.304(b), 3.306, 3.307, 3.309 (2015).  However, where a claim is based on a period of ACDUTRA, the claimant "can never be entitled to the presumption of service connection" because "[b]y definition, the presumption of service connection applies where there is no evidence that a condition began in or was aggravated during the relevant period of service."  Smith, 24 Vet. App. at 47. "By contrast, for a claimant whose claim is based on a period of [ACDUTRA] to establish entitlement to benefits, there must be some evidence that his or her condition was "incurred or aggravated" during the relevant period of service."  Id.  

The Board further observed that while CLL was a disease associated with exposure to herbicide agents and thus subject to the presumption of service connection despite a lack of evidence of the disease in service, see 38 C.F.R. § 3.309(e) (2014), the logic of Smith precluded application of the presumption of service connection provided for by 38 U.S.C.A. § 1116 (West 2014).  The Board pointed out that the Veteran, as an ART, was also a member of the Air Force Reserve, and that his service would have been limited to ACDUTRA.  See http://www.afrc.af.mil/shared/media/document/AFD-070125-046.pdf. (discussing requirements of ARTS Reserve service).  The Board concluded that evidence showing incurrence or aggravation of CLL during any relevant service period was lacking, noting that CLL was not diagnosed until 2007, and that there was no evidence to suggest that the disease first manifested during any required period of ACDUTRA while the Veteran was an ART.  The Board determined that, regardless of whether the Veteran was indeed exposed to herbicides at Hanscom Air Force Base sometime between 1970 and 1973, without a showing that his CLL first manifested itself during a period of ACDUTRA, any ACDUTRA performed while an ART did not qualify as active military service, and Veteran status for purposes of the current claim has not been achieved. 

The Veteran sought to reopen his claim in February 2015.  In support of his petition to reopen, he submitted annual statements of Reserves credits for 1972 and 1973, as well as a July 1973 discharge order.  He also submitted written statements describing his work as an ART, maintaining that he was exposed to Agent Orange during that time, which included active duty.  

Also added to the record is the Veteran's April 2016 hearing testimony.  He reiterated his contention that he was exposed to Agent Orange during his time working at Hanscom Air Force Base as an ART.  He also stated that he worked on contaminated aircraft while on ACDUTRA.

As discussed, service connection for CLL was denied because the Veteran's employment as an ART did not qualify as active service, and because there was no evidence that CLL first manifested during any period of ACDUTRA.  Since the November 2012 Board decision, evidence added to the record includes the appellant's contentions that he was exposed to Agent Orange during his employment as an ART at Hanscom Air Force Base, and that he was also exposed during periods of ACDUTRA.  These contentions and theories of entitlement were before the Board at the time of its November 2012 decision and are therefore cumulative.  In consideration of the foregoing, the Board finds that as no new and material evidence has been submitted, the claim of entitlement to service connection for CLL may not be reopened.  

ORDER

New and material evidence having not been received, the petition to reopen the claim of entitlement to service connection for CLL is denied.



____________________________________________
K. J. ALIBRANDO
Veterans Law Judge, Board of Veterans' Appeals



Department of Veterans Affairs

18 April 2016

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. 
-------------------
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.

06 April 2016

Post-Vietnam C-123 Vets' Kids NOT Eligible For Spina Bifida Care

(In its Monday April 2016 posting in the Federal Register, VA detailed how the laws covering Vietnam veterans' kids do not apply to post-Vietnam C-123 veterans' children. This was not unexpected as it had been explained to us earlier.)


Chapter 18 of title 38, United States Code, provides for benefits for certain birth children of Vietnam veterans and veterans of covered service in Korea who have been diagnosed with spina bifida, except spina bifida occulta, and certain other birth defects. These benefits include: (1) Monthly monetary allowances for various disability levels; (2) health care; and (3) vocational training and rehabilitation. VA's regulations concerning health care for children authorized under this chapter are published at 38 CFR 17.900 through 17.905.

On May 15, 2015, VA published a proposed rule to more clearly define the types of healthcare VA provides, including day healthcare and health-related services, which VA would define as homemaker or home health aide services that provide assistance with Activities of Daily Living or Instrumental Activities of Daily Living that have therapeutic value; and to make changes to the list of health care services that require preauthorization by VA. (80 FR 27878). The comment period closed on June 14, 2015. We received ten comments, which were all generally supportive. However, the commenters raised several issues regarding beneficiaries covered by this rulemaking, specific services provided, definitions included in the proposed rule, and provision of health care through non-VA care (care in the community). We respond to these comments below and adopt as final the proposed rule, without change.

Scope of the RulemakingBack to Top
One commenter stated that children of Vietnam veterans who have spina bifida may have children of their own, and VA should also provide care to grandchildren of Vietnam veterans who have spina bifida. The commenter stated that according to the US National Library of Medicine, spina bifida is likely caused by the interaction of multiple genetic and environmental factors, and that genetic changes in individuals with spina bifida may increase the risk of neural tube defects in the subsequent generation. The commenter stated that if a child with spina bifida can establish that the grandfather was exposed to herbicides during the Vietnam War, that child should also be covered.

Another commenter stated that children of Air Force active duty servicemembers and reservists who were exposed to Agent Orange while flying C-123 aircraft both during the Vietnam War and the post-war period should also be covered. The commenter noted that these servicemembers flew out of air bases in Thailand and Clark Air Base in the Philippine Islands, and some of the airplanes potentially contaminated by Agent Orange remained in service after the war.

In response to the first comment, VA does not have statutory authority to provide health care to grandchildren of Vietnam veterans who may have spina bifida. VA's authority to provide health care to children with spina bifida or other covered birth defects is limited by statute. A “child” covered under this statute is defined at 38 U.S.C. 1831(1) as an individual, regardless of age or marital status, who is the natural child of a Vietnam veteran, and was conceived after the date on which that veteran first entered the Republic of Vietnam during the Vietnam era; or, is the natural child of a veteran of covered service in Korea (as determined for purposes of 38 U.S.C. 1821), and was conceived after the date on which that veteran first entered service described in 38 U.S.C. 1821(c).

03 April 2015

Senator Blumenthal's Office: "Nothing soon from VA" to allow any C-123 Agent Orange exposure claims

VA C-123 Claims SITREP
Yesterday Senator Cory Gardner's (R-CO) staff informed us they'd just checked with Senator Richard Blumenthal's office and were told that no VA action is expected anytime soon. Blumenthal is Ranking Member on the Senate Veterans Affairs Committee, and was briefed last Friday by VA on their confidential deliberations.

News like this of continuing VA delays comports with statements by VA spokesperson Ms. Meagan Lutz who informed reporters that VA now has no set date for any C-123 Agent Orange announcement, in effect, an indefinite postponement of the announcement first promised for the first week in March.

Different VA sources have offered different reasons for the delays. After the Institute of Medicine published its January 9 2015 C-123 Agent Orange report which confirmed exposures, VA was supposed to formulate a response within 60 days. Whatever the reason(s) the effect is that VA's ban on medical benefits for these Agent Orange-exposed veterans will continue just as it has since 2011, with all claims denied per Compensation and Pension. Claim delays are money-savers for VA.

Compensation and Pension is the VA function which has ordered Agent Orange exposure claims denied on the basis that other federal agencies' confirmation of C-123 exposures are unacceptable to VA, and that dioxin (the toxin within Agent Orange) has somehow "not been shown to be harmful." Of course, dioxin is recognized elsewhere in VA and throughout science as the most toxic toxin made by humans and a known carcinogen. VA later wrote that it had used "an unfortunate choice of words" but the claims are allowed to remain denied as was the objective.

The inference was clear:  as has been the case from the first, all such claims were to be denied no matter what, citing anything as basis, whether accurate or not.

Perhaps voices within the Department preferring a pro-veteran program in compliance with the law are in conflict with other folks, mostly in Post Deployment Health and VA's Agent Orange desk and other leaders in VA's C-123 committee, who prefer to continue their own agenda of denying benefits to C-123 veterans regardless of merit.

There is concern among the veterans that VA still might create a response which excludes, rather than includes, exposed veterans. We are about each of our men and women, and their families.

30 December 2014

C-123 & Blue Water Navy: Similar IOM Experiences

C-123 veterans, families and friends are looking forward to the release of the Institute of Medicine C-123 report on January 9 at 11:00 AM in Washington, D.C. The report heavily influences whether or not the Department of Veterans Affairs will permit C-123 veterans to be admitted to VA hospitals for treatment of Agent Orange illnesses associated with their decade flying these former Agent Orange spray aircraft.

The only parallel to this situation is that of the "Blue Water Navy" where deep-water vessels' crews claimed Agent Orange exposure and IOM conducted a study after VA disqualified this group of veterans from "presumptive service connection" for which they'd previously qualified.

Looking over the Blue Water Navy and IOM, we see three events similar to how C-123 veterans have experienced. First, the VA issues a "charge" to the Institute of Medicine. This is a contract with objectives spelled out. The language of the charge is very carefully considered by the VA's Post Deployment Health Section as they seek to guide IOM to specific conclusions and not permit a more comprehensive or wide-ranging response. Second is the announcement by IOM of their findings, and third, the basic analysis of the VA, formed as closely as possible to VA's desired policy objectives.

Below are these three fundamental parts of the process, experienced by the Blue Water Navy veterans and likely to be the same process ahead for C-123 veterans. Veterans hope IOM's report will support our claims for service connection due to proven exposures.  Opposing them, as they have for years via other maneuvers, VA leaders hope the report will dismiss veterans' claims for Agent Orange exposures or at least provide some leeway, call into question, or offer some loophole permitting VA to continue refusing medical care to these veterans seeking care for Agent Orange-caused ailments.

The 9th of January will be an important day, and one we hope not as painful as was the IOM Blue Water Navy report for those worthy veterans! 

From another vet group's editorial addressing IOM's earlier review of Gulf War concerns:
"A final note -- while the IOM may claim it was just doing its job as mandated by the VA, that's not good enough, not for an institution that is part of the National Academies, which calls itself "Advisers to the Nation on Science, Engineering and Health." IOM could just as easily have read their Civil War-era Congressional mandate and told the VA that its request was not in accordance with IOM's mission nor with questions the nation needed answered. 
IOM could and should have informed VA science and the nation's needs would not be confined to the VA's policy-directed "charge," so cleverly phrased by VA to guide IOM to a pre-determined VA objective.
In fact, why didn't they stand up for good science? IOM says it advises "the  nation." 
The nation is not the VA -- the nation is veterans. The nation is not the CDC -- it's families and individuals coping with an autism epidemic. And the nation is certainly not the federal government -- the nation is the people who elected that government to protect and defend them; it's you and me. 
Sadly, IOM is not meeting objectives set forth in the law signed by Abraham Lincoln in 1863. Rather, IOM now meets objectives set by VA policy makers with only a sprinkling of scientific flavoring."

================================

ONE: The VA Charge to the IOM

Blue Water Navy Vietnam Veterans & Agent Orange Exposure


Type:
Topics:
Board:

Activity Description

The IOM will conduct a study and prepare a report on whether the Vietnam Veterans in the Blue Water Navy experienced a comparable range of exposures to herbicides and their contaminants (focus on dioxin) as the Brown Water Navy Vietnam Veterans and those on the ground in Vietnam (i.e., specifically with regard to Agent Orange exposure).  The IOM's report is expected to include:
1.    An historical background on:  the Vietnam War; Combat troops (ground troops); Brown Water Navy (includes inland waters); Blue Water Navy; VAO legislation
2.    A discussion of exposures (Blue Water Navy in comparison with ground troops in Vietnam): specifically compare exposures on ground with those on ships (discuss all possible routes of exposure); and examining the range of exposure mechanisms for herbicide exposures (i.e., concentrating toxics in drinking water; air exposure possibly from drift from spraying; food; soil; skin.
3.    A determination, if possible, of the comparative risks for long-term health outcomes comparing Vietnam veteran ground troops, Blue Water Navy veterans, and other "Era" veterans serving during the Vietnam War at other locations (given the possible dioxin exposure).
4.    A review of studies of Blue Water Navy veterans for health outcomes (assuming there are studies specific to that cohort of veterans).

==============================================================


From 1962 to 1971, the U.S. military sprayed herbicides, including Agent Orange, over Vietnam. Exposure to these chemicals is associated with several cancers and a variety of other health problems. The Agent Orange Act of 1991 established that veterans with any of the diseases linked to Agent Orange were presumed exposed during their service, and therefore could claim disability. The law saved veterans from the often impossible task of proving they were exposed to Agent Orange during their service. However, the Department of Veterans Affairs (VA) only compensates veterans who served on the ground or on inland waterways in Vietnam. The “Blue Water Navy”—those who served on deep water vessels—are not automatically eligible for disability benefits.

In response to a growing concern from Blue Water Navy Vietnam veterans that they may have been exposed to Agent Orange during the war, the VA asked the IOM to examine whether the exposure to Agent Orange of Blue Water Navy veterans was similar to the exposure of other Vietnam veterans. Although the IOM found several plausible ways by which Blue Water Navy veterans could have been exposed to herbicides, there was not enough information for the IOM to determine whether Blue Water Navy personnel were or were not exposed to Agent Orange.

=============================================================

THREE: VA announcement of report w/VA perspective:


VA asked the National Academy of Sciences' Institute of Medicine (IOM) to review the medical and scientific evidence regarding Blue Water Veterans’ possible exposure to Agent Orange and other herbicides.

IOM’s report Blue Water Navy Vietnam Veterans and Agent Orange Exposure was released in May 2011. The report concluded that "there was not enough information for the IOM to determine whether Blue Water Navy personnel were or were not exposed to Agent Orange."

- See more at: http://www.publichealth.va.gov/exposures/agentorange/locations/blue-water-veterans.asp#sthash.mSYMHdKx.dpuf