Short Video by ProPublica: C-123 Agent Orange Veterans' Quest For VA Benefits vs. Dr. Al Young

 

ProPublica and The Virginia Pilot produced a short video on YouTube covering Dr. Al Young and the C-123 veterans' problems with him, the VA and Agent Orange. A follow-on to their excellent in-depth report on the same subject.

• note: related 2014 Vietnam Veterans of America radio interview
• here is a shorter recording, just the IOM opening statements by Maj. Wes Carter and Dr. Al Young
• note: Full recording of Dr. Al Young and others, June 2014 public hearing held by the Institute of Medicine C-123 Agent Orange committee, Washington DC
• statement by Professor Philip Kahn (Rutgers University) objecting at IOM hearing to VA foot-dragging
• note: brief summary of some of disappointments veterans had over the decades with Dr. Young
• note: C-123 Veterans Association concerns re: Dr. Al Young & VA, submitted to VA 2014

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.

It needs to be repeated: From the very beginning, VA science and policy were 100% WRONG on C-123 Agent Orange

In fact, VA was wrong and was determined to prevent our disability claims as a matter of policy regardless of the science involved. From the very beginning our search for help, VA ignored it's fundamental obligation to us as veterans.

No other veteran or veterans organization, supported in the scientific claims for harmful Agent Orange exposure by the CDC and other federal agencies as well as dozens of independent positions and university based scientists, has faced such an automatic VA opposition.  Today's perspective, 18 months after the release of the Institute of Medicine C-123 Report, clearly shows VA opposition was policy-based. VA simply had no scientific or legal basis to oppose the claims – yet they did.

Rather than permit us the benefit of the doubt required by law and M21-1MR they immediately took an adversarial position. That was most perfectly expressed by Mr. Thomas Murphy (Director, VBA Pension and Compensation) when on February 28 2013 he insisted no amount of proof from whatever source would be accepted by VA to support our claims.

Mr. Murphy explained that Veterans Health Administration Public Health decided upon our first inquiries back in early 2011 that, no matter what, C-123 vets were not exposed and VA would deny every claim. VA would do this while insisting that every claim would be considered on a case-by-case basis... and then automatically denied.

As regards the requirement to give us benefit of the doubt, VA reserved it for itself and denied it to the veterans. Even after support for our exposures was submitted to the VA by the CDC ATSDR as well as the National Institute of Environmental Health Sciences, DoD JSRRC and dozens of independent physicians and researchers VA stuck to its illogical and unscientific as well as blatantly anti-veteran position

Nothing illustrates the deception VA used against us better than the simple comparison of the May 2011 VA position statement (below, formulated by Dr. Terry Walters and her colleagues in VHA Public Health) and the final report on us published by the Institute of Medicine in January 2015.

Let's look at VA's five bullet points:
1) Correct, but irrelevant. The 1991 Agent Orange Act requires VA to treat all veterans exposed to Agent Orange if they have relevant illnesses. VA repeatedly assured Congress and the public via the Federal Register that it would do so.
2) Deceptive. There is only the issue of exposure, not the kind of exposure. For the purpose of opposing our claims, VA introduced the idea of remote/secondary exposure and claimed it made proven contamination of our aircraft no different than the theoretical contamination of the equipment used in Vietnam.
3) Ridiculous! VA stated it would ignore all proof of exposure from whatever source such as the CDC. We did not know it for years but VA had unscientifically redefined the word exposure to require bioavailability for exposure to be recognized. VA created its own unique redefinition of exposure to block our exposure claims, and were criticized for doing so by leaders in other federal health agencies. Even under this redefined exposure, VA should have acknowledged the bioavailability of the C-123 Agent Orange contamination when the CDC informed of them that veterans had a 200 times greater risk of cancer. VA uses Dorland's  Illustrated Medical Dictionary as the standard text of definitions... except for the word exposure.
4) Deceptive. The 1991 Agent Orange Act eliminated the requirement that a veteran establish medical nexus of illnesses associated with Agent Orange and instead provided a presumption. The scientific evidence suggested as missing was already established by the Institute of Medicine and it's numerous earlier reports. Further, as with the first point, VA have a legal obligation as well as the duty under its own regulations to treat all veterans with a proven Agent Orange exposure.
5) The last bullet point is perhaps the VA's most blatant policy driven deception. The opinions referenced as supporting our claims came from the CDC ATSDR, National Institute of Environmental Health Sciences, and dozens of university scientists and independent physicians. Rather than acknowledging this volume of proof, the VA Agent Orange desk in Veterans Benefits Administration simply asserted that it had "an overwhelming preponderance of proof" against our exposures. In fact there was no such proof against our exposure claims and VA insistence otherwise was merely a policy statement. The IOM C-123 Agent Orange Report relied on the same body of evidence to reach an opposite conclusion – veterans were indeed exposed!

VA Conclusions Rigged Uo To Deny Claims For Five Years:
1) "Even though residual Agent Orange may be detected in C-123 aircraft by laboratory techniques years after Agent Orange use, it must be remembered that there is no bio-availability of TCDD in these aircraft. "

2) "The potential for exposure to Agent Orange and TCDD and subsequent development of any adverse health effects from flying in potentially contaminated C-123 aircraft years after the Vietnam War is essentially zero."

Terry J, Walters, MD MPH: Director, Environmental Health, VHA

BUT, the Institute of Medicine concluded after studying the same data:
1)  Veterans suffered bioavailability of the dioxin aboard the aircraft by all three possible routes (dermal, inhalation, and ingestion.) IOM specifically disproved the VA theory of no bioavailability of dried dioxin advanced by VHA Post-Deployment Public Health. That flawed concept was earlier advanced by Dr. Alvin Young who actually argued against any hazards of Agent Orange in his article "Environmental fate of TCDD and Agent orange and Bioavailability To Troops in Vietnam."  A frequent VA and DoD consultant, Young was beneficiary of a no-bid sole source $600,000 consulting contract most of which focused on our aircraft.
2) "Reservists experienced increases in their risks of adverse health outcomes." In fact, the CDC told VA veterans had a 200 fold greater risk of cancer.

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.

A Gathering of Eagles (old ones, anyway) in honor of MSgt Gabby Gadbois

The Westover club overflowed with fellowship and affection Friday night, as crew members from the early '70s to today's folks met to honor retired Master Sergeant Gabby Gadbois, our former first sergeant. Gabby is a bit lame these days but fighting as he always has, only this time for himself and not us.

A First Shirt always puts the troops first, as Gabby has, but these days we are putting him first. First in our prayers, first in our hearts as well. Gabby has fought long and hard against soft tissue sarcoma, lung problems, chemo troubles and now brain cancer. We saw bravery in action Friday night as we gathered around him, and this time it is our chance to sustain and protect him! And, I confess, some of us there did a bit of moaning and whining about our own boo-boos, gifts of the Agent Orange debacle.

As you know, the VA has refused to recognize Gabby's Agent Orange illnesses as related to Agent Orange, despite his hundreds of hours flying the contaminated C-123s at Westover. The VA's policy is to insure that the number of Agent Orange victims receiving care is kept to a minimum, and this is done by constructing arguments against our exposure regardless of any proofs we offer.

And that's what they've done to this distinguished veteran of nearly 30 years service. Gabby's illnesses, according to the VA, cannot result from his years flying airplanes the Air Force certified as "heavily contaminated," "a threat to public health," "extremely hazardous, extremely dangerous, extremely contaminated."! Even decades after the airplanes' last Agent Orange spray missions in Vietnam, the C-123s tested over eight times the safe building reentry standards for dioxin contamination as recognized by every agency. The contamination had to have been much more intense back in 1972-1982.

Building the case against us was the November 17 VA press release. An amazing piece of work, best called "Bull!" by the Vietnam Veterans of America, and the only time anyone can recall that the VA took preventative strikes against veterans' claims. Still...it was completely amazing.

Amazing because it has holes in it big enough for a Mac truck. The VA says we weren't exposed because the heavy contamination in the aircraft couldn't transfer to humans. They cite the fact that the dioxin was measured by the AF toxicologists in 1994 using chemical wipes. Well, duh??

It turns out that there are two measurements taken to establish dioxin contamination: the first is an air sample, which the Air Force opted not to due as per many 2008 memos. In them, an Army expert opines that the air samples need not be taken, perhaps because of political issues. Mr. Charles Sarafini, an engineer with CBRN Decontamination Systems, stated that the aircraft were contaminated with dioxin in his memos to Major Carol McCrady, Operations Officer for the Proven Aircraft Squadron at Hill. Memos go back and forth, with an eventual decision to do chemical wipe samples because that was the gold standard for tests.

So what does our favorite Veterans Administration do? It turns and twists the facts in response to their orders from above, and reaches the amazing conclusion that because chemical wipes were taken on Patches and other aircraft, somehow the VA has managed to prove no dermal exposure could result. Instead of trying to find a way (you know...they benefit of the doubt which is supposed to be given every veteran submitting a disability claim!) that helps us qualify for the care we need, they proceeded with a mindset, and a determination, to prevent us from coming to them for medical care.

The press release is also amazing other toxicologists, chemists, public health officials and the press. Itshe pushes their opinion over the ledge of credibility by stating that even if exposure did occur, it wouldn't be enough to cause long term health. What about the industry standard regarding dioxin that "contamination equals exposure." VA ignores that one!

So, I guess our current cancers, heart disease, and other troubles are from our imagination! So much for the completely ignored VA requirement to give the veteran every benefit of the doubt. The hard, cold facts are that the VA can't handle any more disabled veterans on their current budget, and the best way to prevent further overload is to convince themselves that we're not eligible...that we're not disabled because of our decades of flying tainted airplanes...that our exposure to dioxin wasn't enough to have the VA give us the benefit of the doubt. The VA gives itself the benefit of the doubt and strikes out against us veterans with their November 17 statement.

So let's fight back!  Let's get all the documents like flight orders, Form 5s, signed personal statements, photographs of any C-123 crud we might have documented, maintenance info...anything you feel will help establish the condition of the aircraft once they were assigned to us. The USAF School of Aerospace Medicine has been tasked with looking into our problem and trying to make a statement about it...the statement may not be one establishing the exposure to a certainty, but at least the AF should reach a conclusion, in VA-speak, that the aircrews "more likely than not" have been exposed. It is called the benefit of the doubt, which the VA has forgotten was to be extended to us.

Let me know if you have documents we can use!