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!

VA failure in its "duty to assist" veterans claims, particularly with C-123 Agent Orange

Guest article follows: 
My own experience with the VA duty to assist gathering evidence to support veterans' claim was quite painful. For verification of Agent Orange claims the VA turns to the Department of Defense Joint Services Records Research Center (JSRRC) for confirmation of exposures outside Vietnam. Despite the fact that JSRRC serves as the VA research authority, for years VA succeeded in blocking JSRRC input vital to confirm our exposures aboard C-123s. Fortunately, in 2013 VA was provided proof which was made more substantial in 2014 by the JSRRC.

FACT: VA would not accept the JSRRC input, even though it is required to per the VA Adjudication Manual M 21 – 1MR.
FACT: JSRRC was willing to submit the confirmation to VA and Mr. Sampsel but what is required to wait for his request which he never issued, even with my requests.

FACT: even though JSRRC confirmation eventually reached the VA, VA failed to act on it in violation of its own regulations, because individuals at VA were determined to, in the words of its consultant Dr. Alvin Young, "hold the line" against our disability claims. This was on their personal prejudice and their office unofficial personal policy of blocking our claims.

When I first learned that the JSRRC did not have all the material it needed about our aircraft, I had it sent to them by the Air Force Office of Historical Records Research, by the CDC, by the US Public Health Service, by the National Institute of Environmental Health Sciences, by medical schools and schools of public health all across the country. I visited the director of the JSRRC, Mr. Dominic Baldini (a Coast Guard veteran) and was impressed by his desire to serve the needs of America's veterans. That is, if VA would allow him to do so.

The JSRRC is in Fort Belvoir Virginia and I wanted to get there so badly I had to take my wheelchair four miles from the bus drop off point to his office where I was warmly received by Mr. Baldini and his staff. And four wheelchair miles back to my bus after that meeting. 

The VA contact for the JSRRC was Mr. James Sampsel who ran the VA Agent Orange desk, and it was his responsibility to liaise between the two agencies. The problem was Mr. Sampsel kept telling the JSRRC he would not accept input about our exposures for a variety of reasons cited in different ways over the years.

When Mr. Sampsel said he would not accept scientist or physician input except from military officers, we had it provided by commissioned officers of the US Public Health Service who are considered by law serving military officers, including Rear Admiral R. Ikeda MD USPHS. Repeatedly, Mr. Sampsel agreed to internal VA authorities that our veterans proof was persuasive (by law that should have settled things in our favor) yet he failed permit permit himself to be moved, contrary to the pro-veteran responsibility he had.

Then Mr. Sampsel wouldn't accept input because he hadn't specifically requested it from the JSRRC. And he wouldn't, for years. Another method Mr. Sampsel used to block JSRRC confirmation of our exposures was to insist only federal government documentation would suffice. This is despite VA Adjudication Manual 21 – 1MR stating JSRRC is responsible for gathering evidence from all the federal government agencies. Regardless, in his zeal to block C-123 veterans' claims, Mr. Sampsel apparently decided the CDC, USPHS, NIEHS and other federal sources would not suffice because they too directly confirmed the veterans exposures and abused his intent to deny VA medical care and compensation.

Further, although JSRRC and VA are to consider any credible source of scientific and medical information regarding a veteran's exposure, Mr. Baldini was forbidden by Mr. Sampsel to submit evidence from dozens of university medical schools and schools of public health as well as the independent experts VA itself had utilized for such studies. Amazingly, Mr. Sampsel's department even refused to accept input from toxicologists and other scientists from CDC and other federal agencies by stating only physician input would be accepted. This was a blatant abuse of rulings from the US Ninth Circuit Court but was also quite amusing because VA itself frequently used PhD experts whereever appropriate including veterans claims.

By 2013 the JSRRC and poor  Mr. Baldini had suffered enough grief for me about this that they simply force-fed confirmation of my exposure to Mr. Baldini by sending him an email. This didn't seem to help much because Mr. Sampsel simply refused to act on it. The issue finally was resolved only by Secretary McDonald and his interim final rule published in June 2015.

But Mr. Sampsel can still claim victory because he personally blocked 2100 C-123 veterans claims for four years and locked us out of VA hospitals and denied us compensation for our injuries and illnesses. His great respect for his friend Dr. Young have much to do with his motivation and his shouting throughout the VA for many years that he had "an overwhelming preponderance of evidence" against our claims – evidence consisting only of the VA webpage saying so, plus his preference for input from Dr. Young rather than the CDC, US Public Health Service and dozens of other federal, state, and scientific authorities supporting our claims. He wrote that EVERY proof of our exposure was his "real problem."

In the end the Institute of medicine study clearly established our exposure injuries but it was only a partial victory against the clear victory Mr. Sampsel enjoyed in keeping us from the VA hospital for four years. Contrary to law, his department was anti-claimant, adversarial, and obstructionist. He succeeded in "holding the line" against our claims as recommended by his favored consultant, Dr. Al Young.

CONCLUSION: VA hurt us through intrinsic and extrinsic ethical failures, none of which remain addressed today.

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Guest Article
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By Kevin Courtney November 22, 2016 Updated: November 22, 2016 10:06pm

The Navy’s Blue Angels performed jaw-dropping maneuvers and inspired our next generation’s service members during San Francisco’s Fleet Week last month. Unfortunately, those future sailors and Marines might end up like today’s veterans, suffering from a failing U.S. Department of Veterans Affairs. Thanksgiving is a great opportunity to reflect on how we can best serve our veterans and their families.

Veterans’ benefits claims may go undecided for more than a year, an unimaginably difficult year for those who haven’t experienced it. Our newly elected government leaders should address how the VA can better care for our veterans.

Today, the VA has a duty to assist veterans in preparing their claims by getting complete and relevant records from any federal agency. Congress created this “duty to assist” by passing the Veterans Claims Assistance Act in 2000. Under this standard, the VA must “make reasonable efforts to assist the claimant.” But what happens when a reasonable effort falls short of accurate or complete records? Deciding a claim based on inferior records likely requires an appeal, and the veteran will consequently suffer unnecessary financial and emotional stress.

The U.S. Supreme Court believes the VA should be a “pro claimant” and “non-adversarial” department when deciding claims because it is the sole agency responsible for providing federal benefits to veterans and their families. And there are two features built into the VA’s claim process to help veterans: first is the lack of a statute of limitations for bringing disability claims. A statute of limitations is usually the maximum amount of time after an event a veteran can bring his legal claim. The second feature is the VA’s more liberal burden of proof, which should allow it to decide in the veteran’s favor when the evidence supporting his claim is only 50/50. But are VA employees following these standards?

Congress has increased the VA’s budget every year over the past decade, so insufficient funding is not a reason why the VA fails to be “pro claimant.” While VA executives continue to receive performance bonuses, veterans are left waiting for help. It is important for President-elect Donald Trump’s secretary of veterans affairs to change the ethos found within the VA, improve its efficiency and ingrain compassion in employees. There are thousands of dedicated, caring VA employees, but some require a reminder that behind every claim is a veteran who honorably served this country. And they need the VA’s help before it’s too late.

Twenty veterans commit suicide every day in our country. If the VA streamlined its system, then some of these veterans might get the timely help they need.

The VA has an obligation to realize its mission: “To fulfill President Lincoln’s promise ‘To care for him who shall have borne the battle, and for his widow, and his orphan’ by serving and honoring the men and women who are America’s veterans.”

This Thanksgiving holiday, consider the benefits you enjoy thanks to a veteran. Then consider how you want the VA to treat our veterans.

Kevin M. Courtney is a student judge advocate for the U.S. Marine Corps and a second-year law student at UC Berkeley Hastings College of the Law. When the VA denied his claim for his father’s service-connected death, he spent the next four years trying to understand how the bureaucratic system functioned — or failed to function.

Guest article follows: my own experience with the VA duty to help gather evidence to support

veterans' claim was quite painful. For verification of Agent Orange claims the VA turns to the Department of Defense Joint Services Records Research Center (JSRRC) for confirmation of exposures outside Vietnam. Despite the fact that JSRRC serves as the VA research authority, for years VA succeeded in blocking JSRRC input vital to confirm our exposures aboard C-123s to the VA.

FACT: VA would not accept the JSRRC input, even though it is required to at the VA Adjudication Manual M 21 – 1MR. 

FACT: even though JSRRC confirmation eventually reached the VA, VA failed to act on it in violation of its own regulations, because individuals at VA were determined to, in the words of its consultant Dr. Alvin Young, "hold the line" against our disability claims. This was on their personal prejudice and their office unofficial personal policy of blocking our claims.

When I first learned that the JSRRC did not have all the material it needed about our aircraft, I had it sent to them by the Air Force Office of Historical Records Research, by the CDC, by the US Public Health Service, by the National Institute of Environmental Health Sciences, by medical schools and schools of public health all across the country. I visited the director of the JSRRC, Mr. Dominic Baldini (a Coast Guard veteran) and was impressed by his desire to serve the needs of America's veterans. That is, if VA would allow him to do so.

The JSRRC is in Fort Belvoir Virginia and I wanted to get there so badly I had to take my wheelchair four miles from the bus drop off point to his office where I was warmly received by Mr. Baldini and his staff. And four miles back to my bus after that meeting.

The VA contact for the JSRRC was Mr. James Samsel who ran the VA Agent Orange desk, and it was his responsibility to liaise between the two agencies. The problem was Mr. Sampsel kept telling the JSRRC it would not accept input about our exposures for a variety of reasons cited in different ways over the years.

When Mr. Sampsel said he would not accept scientist or physician input except for military officers, we had it provided by commissioned officers of the US Public Health Service who are considered by law serving military officers.

Then Mr. Sampsel wouldn't accept input because he hadn't specifically requested it from the JSRRC. Another method Mr. Sampsel used to block JSRRC confirmation of our exposures was to insist only federal government documentation would suffice. This is despite VA Adjudication Manual 21 – 1MR stating JSRRC is responsible for gathering evidence from all the federal government agencies. In his zeal to block C-123 veterans' claims, Mr. Sampsel apparently decided the CDC, US PHS, NIESH and other Federal sources would not suffice because they too directly confirmed the veterans exposures and abused his intent to deny VA medical care and compensation.

By 2013 the JSRRC and Mr. Baldini had had enough grief for me about this that they simply force-fed confirmation of my exposure to Mr. Baldini by sending him an email. This didn't seem to help much because Mr. Samsel simply refused to act on it and the issue finally was resolved only by Secretary McDonald and his interim final rule published in June 2015.

But Mr. Sampsel should still claim victory because he personally blocked 2100 C-123 veterans claims for four years and blocked us out of VA hospitals and denied us compensation for our injuries and illnesses. His great respect for his friend Dr. Young have much to do with his motivation and his shouting throughout the VA for many years that he had "an overwhelming preponderance of evidence" against our claims – evidence consisting only of the VA webpage saying so, plus his preference for input from Dr. Young rather than the CDC, US Public Health Service and all the other authorities supporting our claims.

In the end the Institute of medicine study clearly established our exposure injuries but it was only a partial victory against the clear victory Mr. Sampsel enjoyed in keeping us from the VA hospital for four years. Contrary to law, his department was anti-claimant, adversarial, and obstructionist. He succeeded in "holding the line" against our claims as recommended by his favored consultant, Dr. Al Young.

CONCLUSION: VA hurt us through intrinsic and extrinsic ethical failures, none of which remain addressed today.

----------------------------------------------------------

By Kevin Courtney November 22, 2016 Updated: November 22, 2016 10:06pm

The Navy’s Blue Angels performed jaw-dropping maneuvers and inspired our next generation’s service members during San Francisco’s Fleet Week last month. Unfortunately, those future sailors and Marines might end up like today’s veterans, suffering from a failing U.S. Department of Veterans Affairs. Thanksgiving is a great opportunity to reflect on how we can best serve our veterans and their families.

Veterans’ benefits claims may go undecided for more than a year, an unimaginably difficult year for those who haven’t experienced it. Our newly elected government leaders should address how the VA can better care for our veterans.

Today, the VA has a duty to assist veterans in preparing their claims by getting complete and relevant records from any federal agency. Congress created this “duty to assist” by passing the Veterans Claims Assistance Act in 2000. Under this standard, the VA must “make reasonable efforts to assist the claimant.” But what happens when a reasonable effort falls short of accurate or complete records? Deciding a claim based on inferior records likely requires an appeal, and the veteran will consequently suffer unnecessary financial and emotional stress.

The U.S. Supreme Court believes the VA should be a “pro claimant” and “non-adversarial” department when deciding claims because it is the sole agency responsible for providing federal benefits to veterans and their families. And there are two features built into the VA’s claim process to help veterans: first is the lack of a statute of limitations for bringing disability claims. A statute of limitations is usually the maximum amount of time after an event a veteran can bring his legal claim. The second feature is the VA’s more liberal burden of proof, which should allow it to decide in the veteran’s favor when the evidence supporting his claim is only 50/50. But are VA employees following these standards?

Congress has increased the VA’s budget every year over the past decade, so insufficient funding is not a reason why the VA fails to be “pro claimant.” While VA executives continue to receive performance bonuses, veterans are left waiting for help. It is important for President-elect Donald Trump’s secretary of veterans affairs to change the ethos found within the VA, improve its efficiency and ingrain compassion in employees. There are thousands of dedicated, caring VA employees, but some require a reminder that behind every claim is a veteran who honorably served this country. And they need the VA’s help before it’s too late.

Twenty veterans commit suicide every day in our country. If the VA streamlined its system, then some of these veterans might get the timely help they need.

The VA has an obligation to realize its mission: “To fulfill President Lincoln’s promise ‘To care for him who shall have borne the battle, and for his widow, and his orphan’ by serving and honoring the men and women who are America’s veterans.”

This Thanksgiving holiday, consider the benefits you enjoy thanks to a veteran. Then consider how you want the VA to treat our veterans.

Kevin M. Courtney is a student judge advocate for the U.S. Marine Corps and a second-year law student at UC Hastings College of the Law. When the VA denied his claim for his father’s service-connected death, he spent the next four years trying to understand how the bureaucratic system functioned — or failed to function.

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.

NEW ACTING VA BENEFITS UNDERSECRETARY SAYS AGENT ORANGE IS HARMLESS!

T. Murphy, VA Acting Undersecretary for Benefits

Problems continue to unfold at the Department of Veterans Affairs. The VA has had a series of recent personnel changes, one of them the departure of the man filling the office of Undersecretary for Veterans Benefits.

So, as a problem topped with another problem, in comes Mr. Thomas Murphy (himself a veteran, moving up from his Director, Compensation and Pension in less than a year to become Acting Undersecretary for Veterans Benefits. 

Mr. Murphy is a hard worker, and came to his earlier position at Compensation and Pension in 2010 where he oversaw VA's entire program for reviewing veterans' disability claims for approval or disapproval. His business background was at Home Depot.

Why is Mr. Murphy a problem? Because his six years at Compensation and Pension are fairly judged to be a relative failure in serving America's veterans. We'll focus here on two of these failures.

First, his determination and success in "holding the line" against Agent Orange claims. The two most visible groups he's fought on this are the Blue Water Navy Veterans and the C-123 Veterans Association.

In 2012 Mr. Murphy wrote his denial of a C-123 veteran's Agent Orange exposure claims after the Portland VARO said they wanted to approve...Mr. Murphy put a stop to that! "In conclusion, there is no conclusive evidence that TCDD exposure causes any adverse health effects." He wrote that to dismiss expert input from the CDC  confirming the veteran's exposure.

TCDD, the toxin in Agent Orange, is recognized by science to be the most toxic of the toxins, and definitely causes "adverse health effects." VA itself (but not Mr. Murphy) understands that it is a highly toxic substance. Likewise, NIH, EPA, WHO, NIEHS, US PHS and other health authorities understand TCDD ain't good for you.

His was no mere typo. Mr. Murphy's three-page denial blocked compensation and medical benefits to a veteran C-123 aviator. Four years later, VA itself conceded that veteran and other C-123 vets actually had been exposed to Agent Orange and could receive benefits.

At least, those who survived that long despite Mr. Murphy's policy of blanket denial by VA all C-123 claims would receive benefits.

Of course, Mr. Murphy assured veterans and legislators that VA had no such policy of blanket denials and instead promised to review all C-123 claims on a "case-by-case basis" – he just never bothered mentioning his assurance actually meant VA's case-by-case denial of every single claim submitted by every single veteran who flew the C-123.

Mr. Murphy must have been determined to deny this C-123 vet's claim. He rejected input confirming the vet's exposure not only from the CDC, but also from the National Institute of Environmental Health Services, the NIH, and numerous university-based scientists and physicians all supporting the vet's claim.

His denial opinion was read back to him, and he merely said he couldn't be familiar with everything leaving 1800 G Street over his signature. He hasn't made any correction to his 2012 statement, even with the last four years of confirmation of C-123 exposures.

In conference with C-123 veterans and his own staff, Mr. Murphy firmly explained that Veterans Benefits Administration had already determined none of the C-123 veterans were ever exposed, and no amount of proof from scientists or government agencies would raise the claim to VA's "as likely as not" threshold. All claims would be denied, he said.

But, of course, only after his "case by case" evaluation and automatic denial! It took four years and the Institute of Medicine study to get VA to begin permitting benefits for surviving C-123 vets. While that may have been a disappointing shift from the blanket denial policy VA still pretended not to exist, at least the department drew satisfaction in the money saved by blocking medical care and benefits for so many years.

A note: if Mr. Murphy's 2012 claim denial letter was written by a staffer for his approval, the staffer was most likely Mr. James Sampsel, manager of VBA's Agent Orange desk and liaison to the Joint Services Records Research Center (JSRRC) in DOD. Mr. Sampsel was also the staffer who drafted Secretary Shinseki's error-laden letter and deceptive C-123 Fact Sheet.

Mr. Sampsel, a Vietnam veteran himself, made his own perspective quite clear in a related email to Mr. Murphy. Mr. Sampsel determined that "the real problem" in denying C-123 veterans' claims is the amount of evidence confirming those exposures.

Get it? VA's "real problem" is that the veterans' proofs must be ignored by VA so as to deny the C-123 exposure claims. Mr. Sampsel, labeling CDC, NIH, US Public Health Service as "the real problem" in his email to Mr. Murphy, insisted VA had "an overwhelming preponderance of evidence" against the vets. He cited input from the VA consultant and VA's own web site, pretending that VA putting their policy statement online was "overwhelming evidence" sufficient to ignore the other federal agencies and dozens of independent scientists and physicians establishing the veterans' exposure injuries.

No legally required "benefit of the doubt" was even to be permitted. No contrary evidence was acceptable to VBA, Mr. Murphy or Mr. Sampsel...their policy overrode every regulation, law, Federal Register statements and assurances to Congress. Their anti-veteran preference overrode everything.

Even the DoD had tried to tell Mr. Sampsel it had credible evidence from many sources supporting the veterans. Mr. Sampsel, in response to DoD, put blinders on and was improperly very highly selective about what evidence it would acknowledge – if evidence supported C-123 claims it was immediately ruled unacceptable. As for VA and its campaign against C-123 claims, Mr. Sampsel would not request a JSRRC finding or permit one to be issued on C-123 veterans (note: this violates procedures described in VA's own regulation VAM21-1MR, as well as the Veterans Claims Assistance Act.) He then refused to acknowledge any JSRRC input he had not first requested...thus, no requests = no JSRRC confirmation = denied claim.

Mr. Murphy thanked Mr. Sampsel for his input.

Mr. Murphy's thanks were for Mr. Sampsel's success in denying all such claims for another three years. It wasn't until the Institute of Medicine's C-123 report was published that VA finally acknowledged the aircraft contamination and the aircrew's exposure.

Just as the CDC had said back in 2012, when more of the vets were still alive.

"An unfortunate choice of words" – how VA denied Agent Orange claim by insisting Agent Orange is harmless

Just received from the Department of Justice: DOJ has summarized VA's response to our inquiry regarding the famous statement used by VBA Compensation and Pension to deny a C-123 veteran's claim. VA actually ordered the claim denied by insisting there is no evidence of Agent Orange and its toxic component TCDD causing human health injuries.

Now, DOJ says that was "an unfortunate choice of words." Unfortunate but still adequate, however, for VA to have denied the claim for five years!

One of the first C-123 Agent Orange exposure claims faced the determined opposition of VBA's Compensation and Pension Service, a determined opposition which continues even years later, despite all scientific evidence.

Opposition (guided by VA's go-to consultant Dr. Al Young) which has included even denying Agent Orange claims by insisting that Agent Orange is somehow harmless and that Agent Orange benefits specified by Congress in the 1991 Agent Orange Law for Agent Orange exposure with resulting Agent Orange illnesses...claims which are to be denied on the personal whim of VA staffers annoyed at veterans seeking care. (sorry for the run-on sentence.)

C&P's view was that C-123 veterans' Agent Orange exposures are to be blocked, despite meeting the requirements of the 1991 Agent Orange Act, and VA's own regulation VAM-21-1MR.

Portland's VA Regional Office forwarded a C-123 vet's claim to VBA's Agent Orange desk as required, with the field's recommendation for approval given the vast amount of supporting evidence and compliance with the law. Compensation and Pension responded with what has continued to be their blanket denial of all such claims. Here is what was just an early example of their extra-legal injection of personal attitudes into claim denials:

VA Needs to Hear Our Argument on Retroactive Disability Compensation

Here’s the law for veterans and the VA on retroactive disability compensation (38 C.F.R. 3.114)

“(a) Effective date of award. Where pension, compensation, dependency and indemnity compensation, or a monetary allowance under 38 U.S.C. chapter 18 for an individual who is a child of a Vietnam veteran or child of a veteran with covered service in Korea is awarded or increased pursuant to a liberalizing law, or a liberalizing VA issue approved by the Secretary or by the Secretary's direction, the effective date of such award or increase shall be fixed in accordance with the facts found, but shall not be earlier than the effective date of the act or administrative issue. Where pension, compensation, dependency and indemnity compensation, or a monetary allowance under 38 U.S.C. chapter 18 for an individual who is a child of a Vietnam veteran or child of a veteran with covered service in Korea is awarded or increased pursuant to a liberalizing law or VA issue which became effective on or after the date of its enactment or issuance, in order for a claimant to be eligible for a retroactive payment under the provisions of this paragraph the evidence must show that the claimant met all eligibility criteria for the liberalized benefit on the effective date of the liberalizing law or VA issue and that such eligibility existed continuously from that date to the date of claim or administrative determination of entitlement. The provisions of this paragraph are applicable to original and reopened claims as well as claims for increase.”

C-123 veterans ask that VA more closely follow this section of 38 C.F.R. and further, interpret when possible in the most pro-veteran manner. Our exposures constitute injuries, which satisfy both our service’s and the VA’s requirements for statutory veteran status. Having all eligibility criteria met when the liberalizing benefit was promulgated, and having continuously maintained that eligibility, retroactive compensation is appropriate and not proscribed by 38 C.F.R. but instead provided for by it.

There is no justification in VA21-1M or 38 U.S.C. to prohibit Reservists and Guardsmen exposed to toxins which science and also VA acknowledges result in subsequent disabling injuries, illnesses and death. Indeed, prior to June 18 2015 and the C-123 Interim Final Rule, there was no prohibition to granting service connection for those exposures and grants were made repeatedly for Air Force Reservists’ C-123 exposure claims, including by different Boards of Veterans Appeals over many years.

Since early 2011 VA leaders, from the Secretary to more junior staffers, knowing that nearly all of the claims would be from Reservists, assured veterans and our legislators that each C-123 exposure claim would be considered on a case-by-case basis. This assurance was accompanied with directions to regional offices that no possibility existed to honor C-123 exposure claims and that VA regulations prohibited doing so. Secretary Shinseki published his June 7 2013 C-123 Fact Sheet through Senator Burr, in which he repeated that assurance and commitment. Any prohibition against retroactivity only arises from the June 18 2015 Interim Final Rule inclusion of an unnecessary liberalizing rule.

Between 1972 and June 2015, there have been no denials of C-123 Agent Orange exposure claims for Air Force Reservists, either at VARO-level or BVA, on the only recently raised question of veteran qualification. When BVA decisions addressed the issue of Reserve veteran status at all, it was to specify that the exposure injury, dating from the exposure, satisfied the statutory requirements.

This comports with binding VA OGC precedential opinions, which themselves have frequently been cited in VARO, DRO and BVA decisions on different illnesses and injuries.

The VA has stated it cannot permit awards retroactive from the date the Secretary’s dates for new rules. If that is the case, certainly VA cannot attempt to make retroactive the prohibition of retroactive compensation for claims properly submitted to Veterans Benefits Administration prior to the Interim Final Rule.  That, too, is blocked by the Secretary’s inability to effect changes for his rules prior to the rules taking effect.

It is proper for VA to determine it has the authority to deny retroactive benefits only for claims not filed before the June 2015 Interim Final Rule, and proper to also determine that it has authority to provide or deny retroactivity for claims received after the rule’s promulgation. Again, the Secretary’s authority to prevent retroactive compensation only derives from the Interim Final Rule but on a prospective basis, not prior to June 2015 for claims already submitted. Claims received by VA prior to June 2015 must be considered on a case-by-case basis with full retroactive effect of any awards. After June 18 2015 VA can apply both its barrier to retroactivity and presumptive service connection.

The Board of Veterans Appeals has repeatedly acknowledged the “veteran” status of Reservists exposed to toxins, BVA Docket 06-18 270 in 2007 held that a Reservist exposed to Agent Orange aboard my own C-123 aircraft (citing in particular #362 which I flew) at my own base(s) (Westover AFB and Hansom AFB, both in MA and both of which were bases I flew from) during the same time period, satisfy statutory requirements: The Board concluded:

“The Board will concede that the veteran was exposed to an herbicide during service. The service and museum (USAF Museum Dayton Ohio re: C-123 #362) records document the veteran’s reserve service in 1972 and 1973, the presence of that C-123 at Hansom in 1972 and 1973, the use of that C-123 in spreading defoliant in Vietnam, and service of that aircraft in Vietnam in 1972.
The board accepts that the veteran was exposed to an herbicide during service. The veteran was diagnosed with type 2 diabetes after service. The Board presumes that the veteran’s diabetes is service connected, and grants his claim.”

Another BVA case dealing with Air Force Reservists flying the same C-123s, concluded in its 2001 decision:

“Therefore, the Board resolves such reasonable doubt in favor of the veteran to find that the veteran was exposed to an herbicide agent used in support of the United States and its allied military operations in the Republic of Vietnam during, his active duty for training performed at Rickenbacker Air Force Base between 1970 and 1975. 38 U.S.C.A. 5107(b) (West Supp. 2001); 38 C.F.R. 3.102.

Other BVA decisions addressing Air Force Reservists in 2013 and 2014 (Matte [2014, Boston DRO] and Bailey [2013, Manchester DRO]) paralleled the several earlier decisions. In fact, there are no known BVA decisions addressing C-123 Air Force Reservists which did not acknowledge assume their satisfaction of statutory requirements for veteran status.

Thus, seven years of multiple well-reasoned BVA decisions about C-123 Air Force Reservists indicate that until the June 18 2015 Interim Final Rule was published, no such barrier existed to recognize satisfaction of an Air Force Reservist’s claim to veteran status via the herbicide exposure. There was no barrier because the VA OGC opinions satisfied the issue completely – until created in June 2015.

The C-123 AO exposure claim which generated the most attention from VA leadership was that of LtCol Paul Bailey. His denial in February 2013 dealt with the claim without concern for veteran status. When his claim was reconsidered by DRO, no concern was raised regarding statutory veteran status because it was conceded.

The Bailey decision received immediate and extensive scrutiny from VA leadership, including Secretary Shinseki. After the Washington Post’s August 3 story about the grant it generated email and other correspondence from VBA Compensation and Pension, VBA Agent Orange Desk, VHA Post Deployment Public Health, the Under Secretary for Health Administration, VA OGC, Congressional Liaison, and other officials…all without concern ever raised for any statutory veteran status and the only comments being that the claim was supported by credible scientific evidence and that is was proof of VA’s promise of “case by case” consideration.

On my own initial AO denial in 2012, no issue was made of statutory veteran status. Indeed, Mr. Tom Murphy in C&P directed the claim be denied, not on the veteran issue but instead by disregarding all the scientists’ and physicians’ input and asserting no exposure – my veteran status was unchallenged as in all the other veterans’ claims mentioned above. Mr. Murphy and the other VA executives with whom I’ve exchanged communications (VA OGC, Under Secretary Shinseki, VA Office of Congressional Liaison, regional offices) a question might have been raised by now regarding statutory veteran status, especially from Mr. Murphy or General Hickey. Denying my claim and appeal for years never touched on veteran qualification. If veterans failed to satisfy statutory veteran requirements for the specific time period associated with the exposure injury, that problem should have been raised by VA years ago. Instead, but problem of the Reservists’ status was created only with publication of the June 2015 Interim Final Rule.

Between 2007 and May 2014, each of the handful of approved Air Force Reservists’ Agent Orange exposure claims were granted on the fact-proven basis of herbicide exposure, but granted only through an appeals process involving DRO, or BVA actions where each of them was successfulasd433. In January 2015 the Institute of Medicine made that point even more clearly in its answer to Secretary McDonald’s charge to the committee. Before June 2015 each veteran granted service connection for C-123 Agent Orange exposures received full retroactive compensation. Our claims were submitted in the same time frame.

I flew with these veterans and was their flight instructor and flight examiner to train and certify them on the same aircraft on the same days, and we’ve had the same illnesses, yet my own claim was “postponed” for years and only recently awarded but with retroactive compensation blocked. Thus, my students received proper retroactive compensation but I do not, nor do other similarly situated Air Force Reservists, despite how perfectly parallel all the claims are, and only because VA did not process my claims or appeals within the 52 months it had them. The significant distinction here is only that some claims were granteed prior to June 2015 and most others, afterwards but without the same retroactive compensation. This is unfairly discriminatory.

Should this request for retroactive compensation for C-123 veterans be denied, we specifically ask for assurances that every effort was made by VA leadership to take the most pro-veteran perspective on each aspect of the issue.

A ray of hope might be found in the military Line of Duty determination process. In the Air Force, this is AF Instruction 36-2910, and the overall tone is strongly pro-veteran, and protective of servicemembers' VA rights. If the Air Force can generate LODs for our C-123 exposures and injuries, VA is supposed to accept them and thus we'll have satisfied the statutory requirement for "veteran" status and injury, and hopefully, then be qualified for retroactive disability compensation dated from date of VA claim. We'll see...here's the VA policy per 38 C.F.R. 3.1.:

In line of duty means an injury or disease incurred or aggravated during a period of active military, naval, or air service unless such injury or disease was the result of the veteran's own willful misconduct or, for claims filed after October 31, 1990, was a result of his or her abuse of alcohol or drugs. A service department finding that injury, disease or death occurred in line of duty will be binding on the Department of Veterans Affairs unless it is patently inconsistent with the requirements of laws administered by the Department of Veterans Affairs. Requirements as to line of duty are not met if at the time the injury was suffered or disease contracted the veteran was:(1) Avoiding duty by desertion, or was absent without leave which materially interfered with the performance of military duty.(2) Confined under a sentence of court-martial involving an unremitted dishonorable discharge.(3) Confined under sentence of a civil court for a felony as determined under the laws of the jurisdiction where the person was convicted by such court.(Authority: 38 U.S.C. 105)

Senator Gardner (Colorado) Raises C-123 Questions With VA

There is a lot of subtle deception in VA's answer today to Senator Gardner's inquiries. In particular, how C&P twisted the ATSDR "vets were exposed" conclusion to Mr. Murphy's summary, "TCDD causes no adverse health effects." In the military, this is a prevarication and unacceptable. Also interesting was VA's response about how they opted to just disregard JSRRC's confirmation of veterans' exposure, because VA wouldn't accept CDC and other government opinions and instead accepted Dow, Monsanto, and VA's Agent Orange consultant to constitute "an overwhelming preponderance of evidence" to block C-123 claims. Finally, VA continues to insist below that C-123 claims were denied for want of medical nexus...but VBA avoids reminding the Senator no veteran ever need prove medical nexus...only Agent Orange exposure. That's the law!

– Response to Senator Cory Gardner (CO) – 

Questions re Agent Orange - TCDD/C-123 Exposure

1. In 2012, VBA Compensation and Pension (over Mr. Tom Murphy's signature) directed VARO Portland to deny an Agent Orange exposure claim. Included in C&P's advisory was its summation of the CDC/ATSDR C-123 report by Dr. Tom Sinks, "In summary, there is no conclusive evidence that TCDD exposure causes any adverse health effects."

Question: does this remain C&P's official position regarding TCDD exposure and how have any adjustments in it (if any) been undertaken as regards this and other claims? Does the VBA perspective on TCDD differ from the scientific view of other VA departments?

Response:  The 2012 Compensation Service Director’s advisory opinion concerned that claim only. However, his advisory opinion was consistent with VA’s views on post-Vietnam exposure to Agent Orange on C-123 aircraft at that time.  VA’s current position regarding exposures on C-123 aircraft is reflected in the regulations published on June 19, 2015, which established a presumption of exposure to Agent Orange for a select group of Air Force and Air Force Reserve personnel who had regular and repeated contact with contaminated C-123 aircraft that the Air Force used in Vietnam in Operation Ranch Hand.  Under these regulations, a Veteran who meets the eligibility criteria for the presumption of exposure (air, ground maintenance, or medical crew members who served in units that had the aircraft after Operation Ranch Hand) may file an original compensation claim for a covered disability or may reopen a previously denied claim. (NOTE: question unanswered by VBA)

Question: this C&P statement was its summary of Dr. Tom Sinks' (CDC/ATSDR) conclusion that C-123 exposures resulted in 182-times exposure thresholds and 200-times greater cancer risks. Does the VA summary concluding its paragraph on the CDC/ATSDR report accurately reflect Dr. Sinks' conclusions?

Response:  Dr. Sinks’ views related to increased exposure were addressed in the January 2015 IOM report on C-123 exposures, and the IOM report provided the scientific and medical bases for VA’s current regulations.  As described above, these regulations provide a presumption of exposure to Agent Orange for certain C-123 crew members. (NOTE: question unanswered by VBA)

Question: has the above phrase been used on any other Agent Orange claims?

Response:  VA is not aware of the use of the above phrase in evaluating any other claim.

2. In March 2013, the DoD's Joint Services Records Research Center informed VA's Agent Orange desk in Compensation and Pension that evidence from federal health agencies (CDC/ATSDR, USPHS) existed supporting Agent Orange exposure claims of post-Vietnam C-123 veterans. VA21-1MR details the role of JSRRC confirmation of exposure, and VA personnel commented on whether the JSRRC information would affect veterans' claims. In May 2014, veteran-specific JSRRC confirmation of C-123 Agent Orange exposure was received by VBA.