Patches & the IOM C-123 Agent Orange Report

Visiting the USAF Museum, Wright-Patterson AFB and home of "Patches," our Agent Orange-contaminated C-123.

To all post-Vietnam C-123 Veterans: if you haven't already, contact VA and arrange your Agent Orange Registry physical. This is a free comprehensive exam looking for any possible Agent Orange exposure medical issues and it is vital whether you have any such illnesses or not. The first friend I talk into having the physical was found to have a life-threatening heart problem, and the physical perhaps saved his life. Call VA now!

I'm holding the report from the Institute of Medicine/National Academy of Sciences that convinced the VA our aircraft had been contaminated, we were exposed to Agent Orange, and we were harmed greatly by that exposure. Behind me is Patches, now decontaminated, of course. CDC actually notified VA that Patches and our other aircraft were too contaminated to be flown in American airspace, and the crews all should have been wearing full hazmat!

The report summary can be downloaded free at https://www.google.com/url…

The archives at the museum revealed the evidence of testing back in 1979 and 1994 and 1996, and the evidence that USAF bioenvironmental scientists concluded the airplane was "heavily contaminated with dioxin on all test surfaces, STILL after its last spray missions in 1968 during the Vietnam War.

We started flying Patches in 1972 and were exposed to the Agent Orange residue for the next decade. Although the CDC informed VA and USAF that the aircrews and maintainers had been exposed, officials at VA continued to insist otherwise and stated VA had "an overwhelming preponderance of evidence" against any harm being done.

In 2014 it became clear, based on the IOM study and the report I'm holding, that VA's position was based solely on its policy decision to block additional Agent Orange claims like ours. Policy, not science. Policy, not law.

The US Senate agreed. Under leadership from Senator Burr of North Carolina and Senator Merkley of Oregon the Senate blocked all VA confirmations until the C-123 issue was resolved. The national commander of the VFW testified to Congress that that full benefits for C-123 vets must be authorized,  All six major veterans organizations insisted VA act, with the Vietnam Veterans of America leading their joint efforts.

The media was behind us all the way. The first press coverage was in early 2011 in the Air Force Times where reporter Patricia Kime detailed our USAF Inspector General complaint wherein the service was asked, but refused, to notify our veterans of their potential exposures. Subsequent articles appeared in the Washington Post, Springfield Republican, American Legion Magazine, the Oregonian, Associated Press, CBS News, Pittsburgh Gazette, NPR All Things Considered, Boston Globe, Air Force Magazine, plus Military.Com and other Internet outlets. Air Force Times and the Springfield Republican both ran editorials insisting VA act in our behalf.

In 2009 Dr. Alvin Young, VA's principal consultant on Agent Orange, had strongly recommended to the USAF the immediate destruction of all C-123s stored in a hazardous material quarantine section of Davis-Mothan Air Force Base because, among other reasons, our already exposed air crews and maintenance veterans might approach the VA seeking care for Agent Orange illnesses. Destruction of the aircraft would help prevent such claims, especially, as it was pointed out, if the aircraft disappeared without public attention. Preventing claims seems to of been awfully important to the VA and so many others. It seemed so important to Dr. Young because in 2011 he denigrated us as "trash haulers, freeloaders looking for a tax-free dollar from a sympathetic congressman." The VA certainly found the right voice to help it oppose our claims – VA had found a man who holds us in contempt to help VA avoid treating our illnesses.

In 2013 Dr. Young was in the middle of his unique VA two year $600,000 no-bid sole source Agent Orange consulting contract. He urged Mr. James Sampsel at the VA Agent Orange desk to "hold the line" (his words) against our claims. For his part, Mr. Sampsel informed his VA colleagues and supervisors that all proof confirming our exposure submitted to VA by independent scientific authorities and other federal agencies (CDC, DOD, USPHS, NIH)  was merely the real "problem" for VA – proof Mr. Sampsel and others in VBA would ignore despite VA regulation VAM21-1MR and despite the Veterans Claims Assistance Act.

Dr. Terry Walters at the VHA Post-Deployment Health Section, told the Associated Press that a line had to be drawn against our claims. Hold the line, indeed!

For too many years the VA "held their line" and denied every single claim submitted by our veterans of the post-Vietnam C-123 spray aircraft. While being paid by VA Dr. Young testified before the Institute of Medicine C-123 committee against our exposure claims. He even attacked the IOM report after its publication in January 2015 using arguments similar to ones used earlier when Dow and Monsanto sponsored him. But the committee saw through that. The committee also criticized VA and USAF for routinely dismissing, ignoring or minimizing  proof of veterans' exposures

In June 2015, the Institute of Medicine report I'm holding in the photo was acted upon by Secretary McDonald. He brought truth, science, law, and compassion into the process at last. The 2100 of us who volunteered to serve our country by flying and maintaining our aircraft willingly accepted the hazards of aviation service and now are acknowledged to have also endured hazardous toxin exposures for which the VA will now care.

As VA Secretary McDonald said to me at the White House, "We won." He meant "We" the veterans and "We" the VA, No longer adversaries.

Let's not let this happen again to other veterans facing toxic exposures.

VA ESTIMATE OF C-123 VETERANS' AGENT ORANGE DISABILITY COMPENSATION? $46,000,000

 $46,000,000

The biggest part of the battle was behind us. Finally, the Institute of Medicine had completed their two year study by a distinguished group of scientists and physicians, and agreed with us that we have been exposed to Agent Orange and harmed by that toxin. Their report was submitted to the Secretary of Veterans Affairs on January 9, 2015.

The IOM had a public hearing to announce their conclusions, and I attended to represent both active-duty and Reserve post-Vietnam C-123 veterans. Several attorneys from the law firm that represented us accompanied me. Observers were there from the US Air Force, the Senate, CDC, the press and the VA. 

Finally, I was to meet Assistant Secretary Linda Schwartz, a medically retired Air Force flight nurse who’d flown with us on occasion "back in the day" and is herself a C-123 veteran. Four years earlier I’d met her on the Internet in her capacity as Connecticut’s Commissioner of Veterans Affairs. She immediately offered the first of many critical suggestions on the conduct of our contest with the US Department of Veterans Affairs.

We’d won. No longer could the VA insist on its imaginary “overwhelming preponderance of evidence” against our disability claims. That evidence had been shown to be a total pretense, a policy sham advanced by the VBA Agent Orange desk and the VHA Post-Deployment Public Health Section. Both of these VA functions had been policy-driven to oppose our claims and this marks their defeat. In addition, the US Air Force School of Aerospace Medicine C-123 report released in 2012 was shown to be both scientifically and medically flawed (Lurker, 2014.) The IOM accused both the VA and the military of deliberately ignoring, disputing or minimizing all proofs of our exposure to prevent our claims.

It was quite a ground-breaking moment. Never before had a single group of veterans successfully argued its case and established the facts surrounding their Agent Orange exposure.  Before, as well as after us, VA always successfully argued against other veterans' claims. We’d won, but as Senator Richard Burr (R-NC),  ranking member of the Senate Veterans Affairs Committee, said in his own press release, “it shouldn’t have taken this long or been this hard.”

It remained for VA to finally decide whether and how to implement the conclusions of the IOM. This was a process we were unfamiliar with and one that took VA Secretary McDonald six months to complete and publish in the Federal Register.

Because of requirements built into the 1991 Agent Orange Act regarding how VA treats IOM conclusions, it was likely that VA would acknowledge our exposures. A working group was formed within the department and it submitted its recommendations to the Secretary.

Now the internal machinations began within VA. One of the biggest was to determine how much this was to cost the government.  The White House Office of Management and Budget weighed in with its estimate of $46 million to cover disability compensation. OMB made no estimate of the cost of medical care or survivor benefits each item expected to exceed the cost of disability compensation itself. In 2014, working with the Harvard School of Government, we calculated the total cost to be nearly $250,000,000!

On June 18 2015, I was invited to VA headquarters to hear Secretary McDonald’s decision:

1.   • VA would acknowledge the statutory veteran status per U.S.C. Title 38 of our aircrews, aeromedical evacuation crews and aircraft maintenance technicians, if they had any of the presumptive illnesses associated with Agent Orange. This was legally necessary to permit VA to provide benefits because the law is all specified ”veterans.” Unless activated, Reservists are not considered veterans in the law. The VA decision did not award veteran status to anyone not confirmed to have an Agent Orange illness.

2.    • VA would begin compensation effective June 19, 2015 and would not require claim submitted prior to that date to be resubmitted. Disappointingly, VA also decided against any retroactive compensation. This was disappointing to us because some have had claims in to VA for seven or more years.

3.    • VA would give all claims submitted for the next year and effective date of June 19, 2015 in effect making those claims partially retroactive.

I had always suggested a total number of our C-123 veterans to be about 2100. VA estimates that 25% of the personnel who served in Vietnam now have disability benefits for their exposures. If that same 25% applies to us, it means an average compensation of over $88,000 per veteran. The Harvard estimate of $250 million may yet be correct calculating in survivor benefits and the cost of medical care given our veterans.

That, and the VA medical care plus other benefits were what we had fought for these last four years. One of the most important of these benefits is VA Dependents Indemnity Compensation of $1240/month  for survivors, a benefit particularly important to our veterans who do not have military retirements. Another benefit is “Champ-VA” for families of totally disabled veterans without TriCare. 

We’d won,  and now our objectives became getting the word out to thousands of our folks now scattered throughout the country in the decades after our duty aboard the C-123 transports. We'd won, but were left without the retroactive compensation clearly due us, compensation which was supposed to be based on the date of claim application. That is our remaining objective.

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."

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ONE: The VA Charge to the IOM

Blue Water Navy Vietnam Veterans & Agent Orange Exposure

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Type:	Consensus Study
Topics:	Veterans Health, Environmental Health, Select Populations and Health Disparities
Board:	Board on the Health of Select Populations

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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).

For more information

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TWO: IOM report and press release

Blue Water Navy: 

Veterans’ Risk of Agent Orange‑Related Health Problems Unclear

Released: 5/20/2011

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.

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THREE: VA announcement of report w/VA perspective:

Institute of Medicine Report on Agent Orange Exposure

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