Showing posts with label NIH. Show all posts
Showing posts with label NIH. Show all posts

26 May 2017

This C-123 Veteran's Agent Orange Essays: Five Years of Honest writing

Honesty and accuracy throughout. Right there is the distinction between VA and us. They mislead, manipulated, prevaricated. VA "Lacked candor."

That is how I characterize our long effort to earn VA benefits. It took 1515 days before VA approved my Agent Orange exposure claim for cancers and heart disease. I was already 100% service-connected disabled from the Gulf War and medically retired, so my Agent Orange illnesses became the “poster-child” C-123 Veterans Association test case. VA rules wouldn’t let me manage anyone else’s claim so I focused on mine and Paul Bailey’s...his claim was purely Agent Orange issues, and we wanted just this little variety in two amazingly identical claims.*

The objective: Work one case through the VA system, do the research, get scientific and government support, resolve problems and make all our eligible aircrews and maintenance folks (or survivors) able to submit VA disability claims for fair consideration. We did not seek “presumptive eligibility,” although that advantageous status was eventually granted by Secretary McDonald on June 18, 2015.

For 1515 days, I wrote. It sometimes felt like both day and night, I wrote. With no budget to do much else, I wrote. The blog alone eventually ran to seven volumes. I wrote and wrote and wrote. When I wasn't writing I did research for the next piece I'd write.

A website, a daily blog. Briefs, letters, proposals, VA 41-2138 statements, PowerPoint presentations, handouts, essays, press releases, YouTube videos, general correspondence. I kept writing. I wrote things like these essays and other papers.

Today is has been 2220 days since starting this campaign and I look back on complete honesty, consistently accurate writing. Nearly everything I wrote is still available to evaluate. I wrote expecting to be challenged; perhaps even in court so I tried very hard for accuracy. I certainly was an assertive advocate and that was wholly proper.

What wasn't at all proper was 1515 days of VA push-back. VA was antagonistic, unfair and not completely accurate in their resistance...sometimes plain deceptive. In the end, though, it didn’t seem to matter how much material I uncovered, nor how smart I was digging out and honestly writing about the truth, the only thing that mattered was VA denying us for four years, dismissing all the facts by insisting VA had an unspecified “overwhelming preponderance of evidence” against us, based on their imaginary “scientific study.”

06 November 2016

Agent Orange, the C-123, and VA: My summary of it all

(article I wrote for the VFW magazine)

For vets concerned with Agent Orange, and vets concerned with how VA will deal with similar hazards going forward.
Why care? Because we got our Westover, Pittsburgh and Rickenbaker veterans between $48M-$240 million in compensation. It is even possible the total may be over a QUARTER BILLION dollars, but even more important is the life-saving VA medical care now provided.
We accomplished something that will affect all veterans from now on, as regards line-of-duty chemical and biological hazards. I am Wes Carter, a third-generation life member of St Cloud MN VFW Post 428, and a St. Cloud native now retired to Fort Collins Colorado. Retirement has meant time with grandchildren, and also time for volunteer service with veterans, in keeping with VFW core values.
Veterans' advocacy projects are dear to me. The first turned out to be the hardest and longest. It was to seek disability benefits for members of the C-123 Veterans Association, an informal group I started that became recognized as the negotiating voice with the VA.
Our folks are mostly the men and women who flew or maintained these former Agent Orange spray aircraft in the years following Vietnam. The project was pure Westover, labor and money, only from the 74th, 905th and 731st. Vets from Westover, Pittsburgh, Rickenbacker, Elgin, Howard (Panama) and Clark (Philippines) Air Bases all benefited.
VA insisted, even though the aircraft repeatedly tested as heavily contaminated with Agent Orange, there was no way the contamination actually exposed us to the deadly toxin in the herbicide. I had to prove VA and its Agent Orange consultant wrong. This involved lots of travel to Washington DC between the years 2011-2015. Postage, websites, FOIA fees, printing and other huge expenses all added up.
It was (is) a good use of my own Air Force retirement and 100% percent VA disability. I was perceived as a more earnest advocate because there was nothing personally to gain since I was already VA disabled...the beneficiaries were my fellow crewmembers and our maintenance troops.
Challenging the VA involved contacting scientists in and out of government but particularly those in the CDC and the National Institutes of Health. Here I found great support from experts who disagreed with the VA and insisted our exposures were very harmful and, in fact, we should have been flying the toxic airplanes wearing full HAZMAT protection.
Dr. Jeannie Stillman of Columbia University acted as corresponding scientist for the Concerned Scientists and Physicians, a group of dozens of experts affirming our veterans exposures to deadly dioxin.
The VA responded by saying these experts’ opinions were unacceptable, and that VA had “an overwhelming preponderance of evidence” against our exposure injuries having been caused by Agent Orange on the aircraft.
Some of VA's so-called evidence was previously discredited information from Dow and Monsanto. Most of the VA position was only its policy against post-Vietnam Agent Orange exposure claims. Internal VA memos even insisted that the department "hold the line" against us. Eventually, it became clear that the VA "scientific studies" didn't exist and certainly weren't credible science.
We countered VA arguments with stacks of evidence and expert opinions from medical schools and other universities as well as independent scientists and several government agencies. Several scientists re-examined all C-123 toxicology tests, concluded that our veterans had been exposed via dermal, inhalation and ingestion routes of exposure. and published their peer-reviewed report in the journal Environmental Research. There was general agreement everywhere that we been exposed... everywhere EXCEPT the VA.
Enough controversy was created, with enough proof of our exposure gathered, that eventually VA submitted the issue to the Institute of Medicine of the National Academy of Science for its investigation and public hearings.
I testified at four of these hearings and offered input regarding aircraft and aircrew details, Agent Orange and dioxin toxicology, history of the aircraft, relevant United States code, VA's misinformation plus data on the post-Vietnam use of these former Agent Orange spray C-123s. I explained how VA and the Air Force considered the C-123s to be "Agent Orange spray aircraft" until the first veterans' claims surfaced. Our FOIA search uncovered many AF tests establishing severe contamination, disproving VA's insistence on only one test on one airplane. The VA consultant testified to IOM that the aircraft were not contaminated but we then showed that in 2009 he recommended Air Force destruction of all airplanes as toxic waste.
CDC testified our airplanes were so contaminated we should have been flying in full hazmat. CDC explained that our cancer risks are much, much higher.
The Institute of Medicine Committee of distinguished scientists and physicians considered the issue for nearly a year before publishing their conclusion: Yes, C-123 aircrews and maintenance staff were indeed exposed and harmed. Importantly, IOM reported that VA and the military routinely ignored or minimized evidence of Agent Orange illnesses. The VA consultant was found to have manipulated or misstated scientific and historical evidence affirming our exposures.
On January 18 2015 VA Secretary Bob McDonald finally authorized full VA benefits for our veterans if diagnosed with any of the recognized Agent Orange ailments.
This had never been done before by any veterans' organization. Along the way, I found powerful help from leadership in the American Legion, DAV, Jewish War Veterans, VFW, Vietnam Veterans, Air Force Association, Reserve Officers Association. Experts and leaders in NIH and CDC also leaned heavily on VA for us. Yale Law School published an outstanding legal brief, and major law firms provided over $120,000 of pro bono legal help as we fought the VA and USAF to get hidden documents released.
The Vietnam Veterans of America helped with a $3000 grant for travel expenses, and VFW leadership worked with other veterans organizations to press Congress and the VA for a resolution and full benefits for our 2100 men and women aircrew and maintenance veterans. I’m very grateful!
We found a sympathetic media from the very first. The Air Force Times, ProPublica, Virginian-Pilot, Boston Globe, Pittsburgh Gazette, Washington Post, veterans organizations magazines, the Springfield Republican, Gannett newspapers, Tom Philpot military.com, the Portland Oregon Oregonian, NPR, CBS and so many others spoke up for us.
Vietnam Veterans of America is active in presenting townhall meetings about Agent Orange and I've put on several of these. Somehow, there are always Vietnam veterans who don't know that their prostate cancer for diabetes or other ailments entitled them to VA benefits, so these are essential educational programs with great fellowship.
Other veterans’ issues are also a concern. In May the governor of Colorado signed legislation that I initiated to provide partial property tax relief to about 700 totally disabled military retirees. When we first moved to Colorado I read the state constitution which provided for property tax relief to 100% VA AND totally disabled military retirees, BUT noticed the enabling law only mentioned VA. Our law was thus in conflict with our constitution. It only took five months to fix that and it was hugely satisfying to get my free pen from the governor signing the new legislation.
While working on that issue I was shocked to learn that Colorado’s Gold Star Wives are not provided any property tax relief such as offered survivors of VA 100% disabled veterans. I’ve been appointed the Gold Star Wives official adviser, and helping these widows is my next project! They need help...VA provides only an inadequate $1252/month to these women who have sacrificed so much.
We are also still working to get retroactive benefits for our C-123 Agent Orange vets because VA back-dates awards only to June 2015. That is unfair because benefits are usually based on the date a claim is submitted. Some of our folks have claims as old as sixteen years.
We got one other change. VA's Veterans Health Administration has a section called Post-Deployment Public Health, led by retired Army physician Dr. Ralph Erickson. This unit will now be tracking all servicemembers' potential exposures to chemical and biological hazards throughout their careers. The NIH scientists who affirmed our exposures also explained to VA the hazards of multi-toxin experiences... the add-on of toxin upon toxin and biohazard upon biohazard...all brewing up over time into mysterious ailments.
In the spring of 2015, during our final rounds of negotiations with VHA, VA general counsel, veterans organizations and congressional staffers, I identified biohazards that Reserve Component servicemembers will face. Posing a hypothetical, I forced VA to acknowledge present rules might not meet both military readiness and VA's duty to care for exposed personnel. Solutions were found, some proposed by the surgeons general of the departments and others as potential legislative steps.
Summary: my health Is really messed up but this kind of work had the benefit of being immensely satisfying, especially when other vets tell me how much their approved claims have meant to them and their families. At our reunion last month one of the older vets from the 905th came out to the club with his wife, and called me outside to offer his thanks for helping get his claim approved.
Wow... that meant so much to me and my wife, Joan.
There's a great need for ALL of us to keep serving our fellow veterans and our nation. It doesn't take money (although that helps.) It takes imagination and dedication which, as veterans, we've all been demonstrating all our lives

02 February 2016

Boston University Study: Causes of Gulf War Illness Pinpointed (?)

Maybe the examiners performing my Gulf War Registry Exam at Fort Jackson back in '92 weren't too worried about the mysterious "Gulf War Syndrome." They instantly assured me I didn't have it – their appraisal seemed more from a script than an individual examination. This new study by Boston University is summarized by the National Institutes of Health on its MedlinePlus site.

I thought I had GWS. I still do. I had giant cell arteritis, hypertension, peripheral neuropathy, weakness, chronic fatigue, depression, cancers, heart disease, joint pains, skin rashes on my bum and other things I'd never had before.  I became subject to MRSA after major surgeries.

Without explanation, these were all dismissed as totally unassociated with Gulf War Syndrome. Years later, the Palo Alto War Injury and Illness Study Center performed tests on me which confirmed loss of brain white matter, a GWS issue and a very early warning sign of Alzheimer's

This new study suggests that Gulf War Registry exams weren't done with much concern about identifying veterans to qualify for benefits, but rather, to keep them from qualifying.
                                                              –//–

MONDAY, Feb. 1, 2016 (HealthDay News) -- Exposure to pesticides and other toxins appears to be the cause of Gulf War illness in U.S. veterans, a new analysis states.

The Boston University researchers reviewed studies on Gulf War illness, and said their findings "clearly and consistently" show a link between the disorder and exposure to pesticides and taking pyridostigmine bromide (PB) pills, which were meant to protect troops against the effects of nerve gas.

There's also evidence of a connection between Gulf War illness and exposure to the nerve gas agents sarin and cyclosarin, and to oil well fire emissions, according to the findings published in the January issue of the journal Cortex.

These toxins damaged troops' nervous and immune systems, and reduced the amount of white and gray matter in veterans' brains, said study leader Roberta White in a news release from the university. White is a professor of environmental health at Boston University's School of Public Health.

The main causes of Gulf War illness are like so-called "friendly fire," said study co-author James Binns. "We did it to ourselves," he said in the news release.

"Pesticides, PB, nerve gas released by destroying Iraqi facilities -- all are cases of friendly fire. That may explain why government and military leaders have been so reluctant to acknowledge what happened," Binns said.

About 700,000 U.S. troops fought in the first Gulf War 25 years ago, and as many as 250,000 veterans of that conflict have Gulf War illness, the researchers said. It is a debilitating disorder that features symptoms such as fatigue, joint and muscle pain, headaches, concentration and memory difficulties, gastrointestinal problems and skin rashes.

For years, Gulf War veterans have claimed that the U.S. Department of Veterans Affairs did not take Gulf War illness seriously. In 2008, a committee created by Congress and directed by the White House released a report that said Gulf War illness is a real disorder that's distinct from stress-related syndromes.

The report from the Research Advisory Committee on Gulf War Veterans' Illnesses called for research into the causes and treatments of the illness. Binns was chairman of that committee.

Efforts to find effective treatments for Gulf War illness have been unsuccessful, but recent research has started to offer promising leads, the researchers added.

SOURCE: Boston University Medical Center, news release, Jan. 26, 2016

04 December 2015

Department of Justice Confirms...AND DISMISSES...VA Errors on C-123 Vet's Claim

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Both VA and the Justice Department casually dismiss VA's refusal to permit years of vital medical care legally due C-123 veterans.

This week the Department of Justice officially informed via email the C-123 Veterans Association that VA's Compensation and Pension Service was in error denying a C-123 vet's Agent Orange exposure claim. Let's look at this in two separate reports, beginning here with why VA took extraordinary steps to dismiss a veteran's exposure claim, an exposure confirmed by the CDC.

C&P was summarizing (poorly, unscientifically, dishonestly) the opinion of Dr. Tom Sinks, Deputy Director of the CDC Agency for Toxic Substances and Disease Registry. Sinks' opinion was that C-123 vets had a 182-times greater exposure to TCDD than military standards permit, and consequently will experience a 200-fold increase in cancer screening values. To make certain VA got the point, Dr. Christopher Portier, Director of the CDC ATSDR also affirmed the report. So did the director after him, Rear Admiral (MD, US Public Health Service) R. Ikeda. All of this did no good, even coming from the CDC.

Pretty gruesome, but just to make certain the C-123 veteran's claim was denied, C&P made all this evidence disappear by stating, "In summary there is no conclusive evidence that TCDD exposure causes any adverse health effects."

Read that ridiculous statement again very carefully: VA was saying that TCDD (the toxin which makes Agent Orange toxic) is harmless. Somehow, VA insisted that this known human carcinogen, the most toxic of the toxins, causes "no adverse health effects." Here's how Justice weakly defended VA's missteps:
"VA states as follows: The statement regarding TCDD exposure and adverse health effects was written in error and was incomplete.  It was referring to a statement submitted to VA by ATSDR, which was vague on potential exposure and health effects.  The TCDD statement should have read that ATSDR did not provide conclusive evidence that (the veteran's) claimed exposure to dried and solidified TCDD caused his claimed adverse health effects".
But DOJ missed much of the impact of VA's errors and even repeated those errors in its statement!

1. Not only was the scientific opinion of another federal health agency dismissed improperly by VA, but C&P did so by insisting ATSDR didn't provide "conclusive" evidence. The problem is that conclusive evidence isn't required at all in VA disability claims! The law states a veteran need only produce proofs "as likely to as not" or 50/50, with the benefit of the doubt always resting with the veteran.

But C&P quietly raised the bar to insure this claim was denied. C&P rejected the CDC opinion because it wasn't deemed to be "conclusive." In fact, few exposure illnesses are "conclusive." And how many federal agencies did VA require to support the veteran's claim? Here, VA rejected not only the CDC but also the National Institutes of Health and the US Public Health Service...three federal health agencies insisting this C-123 veteran was exposed to Agent Orange but the VA dismissed them all! Not for any legal or scientific reason but instead because, as VA's Post Deployment Public Health Section told the Associated Press, "we have to draw the line somewhere" against C-123 claims.

2. VA's clear obligation is to provide presumptive service connection to any veteran who either is "boots on the ground" during Vietnam, or along the Korean DMZ during certain years, or who is otherwise able to establish factual Agent Orange exposure. There is no requirement that the veteran prove the "adverse health effects" in the DOJ statement. NEVER must a veteran prove that Agent Orange is harmful...that is assumed in the law and repeatedly promised by VA in its Federal Register postings. If a veteran is exposed, the veteran's Agent Orange injury, if present, is required to be presumed...automatically.

But not here. The VARO adjudicator initially wanted to approve this claim on the basis of what she described as "the plethora of evidence," but VA C&P torpedoed the vet's claim.  C&P injected phony extra-legal requirements in its advisory opinion of the C-123 veteran's claim to insure the vet's failure. And DOJ took no notice, so busy were those attorneys defending the VA rather than the veterans who'd been wronged.

DOJ's attorney's should read their own report and consider the VA's very serious errors.

14 December 2014

VA Defies NIH & CDC – Insists Dioxin is Harmless

The Department of Veterans Affairs defies scientific opinions from leading health experts at CDC, EPA, OHSA, the National Toxicology ProgramNational Institutes of Health, and elsewhere throughout the government. VA has refused veterans' dioxin exposure disability claims on the basis of dioxin being harmless. The veteran had claimed exposure to Agent Orange, which contained dioxin, the common name for the toxin TCDD.

"In summary, there is no conclusive evidence of TCDD causing any adverse health effects."

This statement summarizes VA's denial of a veteran's claim based on Agent Orange exposure aboard the Air Force Agent Orange spray C-123 transports, flown after the war until 1982. Agent Orange is simply harmless?

The summary is the official position of Veterans Benefits Administration executive Mr. Tom Murphy. Mr. Murphy is Director, Compensation and Pension Service, and heads VA's organization managing disability claims. His statement, over his signature, was read back to him at his office in February 2012, in the event of a possible misquote or typo. It was not retracted or modified and he allows it to stand as part of his decision to refuse VA medical care for an Air Force veteran's prostate cancer, a recognized Agent Orange exposure ailment.

Mr. Murphy did mention he could not be familiar with every document leaving his office over his signature, but again, permitted no change or modification of this unusual statement, even considering that it served as his basis for refusing medical care for a veteran's cancer, as well as several other ailments the VA associates with Agent Orange.

A year after being submitted, the veteran's claim was denied in 2012. The claim remains denied over two years later, still in appeal in the VA' s additional two to three year long process with the Board of Veterans Appeals. There, such an obvious scientific mistake is nearly certain to be corrected, but the process (called remand) merely sends the claim back to the original VA office with the errors pointed out and instructions to reconsider.

More years thus await a cancer victim seeking a VA's help surviving terrible illnesses. If he or she survives, it will only be because care was found somewhere other the the Department of Veterans Affairs.

Veterans who served in Vietnam are all presumed to have been exposed to Agent Orange and are provided care. VA had been asked by Congress and veterans service organizations about meeting the needs of veterans exposed outside Vietnam and three times via the Federal Register VA assured Congress that all exposed veterans are to be treated. Here, by pretending both that Agent Orange is harmless and exposed vets somehow weren't' exposed per the VA's unique definition of "exposure," VA's unofficial policy of blocking disability claims perfected. Why?

VA is determined, as its Deputy Chief Consultant of Post Deployment informed the Associated Press, with denying Agent Orange claims because, "You have to draw the line somewhere." Other federal agencies, such as the National Institutes of Health, CDC, OHSA and EPA, are concerned with health, not drawing lines over veterans' TCDD exposure claims. At VA, veterans' health and survival comes second to "draw line somewhere." In such denials, VA carefully considered the input received from Dow and Monsanto, who along with the VA's $300,000 per year Agent Orange consultant, strongly oppose veterans' exposure benefits.

This was strongly opposed by the Committee of Concerned Scientists and Physicians, with Dr. Jeanne Stellman of Columbia University as the corresponding scientist. The input of these dozens of experts was ignored because VA had predetermined (in VHA's Post Deployment Health Section) that all the claims were to be denied regardless of proofs and evidence.

Mr. Murphy was manifestly wrong in his statement regarding TCDD being harmless. Rather, TCDD is the most toxic and potent of the toxins.  To VA a denied claim, even if eventually overturned in the veteran's favor,  is a win-win situation because VA is able to deny medical care for many years in the process. Years when caring for cancer and heart disease patients becomes a very expensive proposition.

Here's what the National Institutes of Health tells us about about dioxin:
"TCDD dioxin is listed as a human carcinogen in the Thirteenth Report on Carcinogens published by the National Toxicology Program because it causes cancer, particularly lung cancer and non-Hodgkin’s lymphoma. 
Exposure to high levels of dioxins can cause reproductive and development problems, suppression of the immune system, increased heart disease and diabetes, changes in hormonal levels, liver damage, and abnormalities of the pancreas, circulatory, and respiratory systems. 
Exposure to low levels of TCDD can cause dermatitis, gastrointestinal problems, and excessive body hair. 
Exposure to low levels of all dioxins can cause a burning sensation in the eyes, nose, and throat; headache; dizziness; fatigue; blurred vision; urinary tract disorders; muscle and joint pain; impaired muscle coordination; nausea; and vomiting."
Here's what the Department of Veterans Affairs and Mr. Murphy tells us about dioxin:
 "Claim Denied." "In summary, there is no conclusive evidence of TCDD causing  any adverse health effects."  
The statement might be scientifically and medically wrong and absolutely contrary to experts throughout the government (as well as in the VA!) but Mr. Murphy's objective was met: VA drew its line and, as the VA and Office of Secretary of Defense Agent Orange consultant put it, veterans he considers "freeloaders, trash-haulers looking for a tax-free dollar from a sympathetic congressman" were told to seek care elsewhere...anywhere but the Department of Veterans Affairs.

Mr. Murphy's statement thus gets another claim out of the infamous VA backlog by the easy step of denying it, and helps resolve VA's budget and long lines in VA hospitals by keeping Agent Orange veterans' decisions denied as long as possible.

If only veterans could turn to Mr. Murphy to resolve their cancers with his pen as readily as he solves VA's problems.

29 November 2014

VA Redefines "Exposure" to Block Agent Orange Exposure Claims

OSHA, CDC, NIH and all the others...not quite good enough for VA. At least, not when VA is casting about for something to use to prevent veterans' exposure claims.

To other federal agencies, exposure is defined as contact between a chemical (of any type) and the outer boundary of an organism. CDC, in about the same manner, defines exposure as:
Exposure: Contact with a substance by swallowing, breathing, or touching the skin or eyes.
OHSA defines occupational exposure...the kind experienced by C-123 aircrews, as:
Occupational Exposure means reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employee's duties. 
But the VA needed to create its own definition. Not that there was anything incorrect or unscientific in standard medical or scientific definitions of exposure...its just that VA needed to create a definition to prevent exposure claims. All the other, scientifically correct definitions were, in fact, accurate but that was exactly why VA needed to create its own. Accuracy, and scientific correctness, were what VA saw as the problem in standard definitions of exposure.

VA needed to change the meaning of the word to prevent exposed veterans from qualifying for treatment of Agent Orange exposures.  Here's what the VA invented in their Post Deployment Health Section of Veterans Health Administration, in response to staff members insisting that no C-123 veterans would be permitted to have their Agent Orange exposure claims approved:
Exposure = contamination field + bioavailability.
As VA's Office of General Counsel explained, VA hasn't needed to define the word "exposure" before. There hadn't been any need, because  for one thing, VA never pretended to have the regulatory or scientific authority, or the need, to create its own unscientific and policy-oriented definition of the word. For nearly every situation, the standard reference of Dorlands Medical Illustrated Dictionary was ideal for every occasion.

But that need to come up with VA's own definition, however unscientific, arose just as soon as C-123 veterans pointed out the 1991 Agent Orange Act, and the multiple postings in the Federal Register all very clearly specify "exposure' as the single qualification for veterans to be able to seek VA medical care for Agent Orange-related illnesses.

So VA couldn't easily escape the obligation, oft-repeated, of honoring exposure claims and thus it simply changed the definition of the word...at least, within the VA. That's how the DOD, USPHS, CDC,NIEHS, EPA, NIH, OSHA, WHO, and all other government agencies consider C-123 veterans to have been exposed to Agent Orange, but the VA uses its private, and very unique, redefinition just so that the vets' claims can be denied.

12 May 2014

DOD Inspector General Complaint filed by C-123 Veterans Association


Today the C-123 Veterans Association filed an official complaint via the Department of Defense Inspector General Hotline, asserting failure of DOD officials to designate Agent Orange-contaminated C-123 aircraft as "Agent Orange Exposure Sites," on a list maintained by the Department of Defense.

Because the presence (or absence) of sites on the Agent Orange Exposure Site List guides VA in approving or denying veterans' exposure claims, failure by DOD to place these toxic Agent Orange spray aircraft has endangered the health of veterans. VA cites the absence of these Vietnam War Agent Orange-spray aircraft as proof against veterans' claims.

This is unscientific and illogical. The contamination of the aircraft was established
by the Air Force itself over decades of testing. More current analysis of those tests led the CDC/Agency for Toxic Substances and Disease Registry, the NIH/National Institute of Environmental Health Sciences and the US Public Health Service to inform the VA that the aircraft were contaminated with deadly dioxin, and the veterans exposed.

Most telling was the analysis by Dr. Tom Sinks, Deputy Director of the CDC/Agency for Toxic Substances and Disease Registry who concluded that the veterans were indeed exposed, and have a 200-fold greater cancer risk.

C-123 veterans have sought VA care for their Agent Orange illnesses for years, without success. VA even has denied C-123 veterans' exposure benefits, insisting that the toxin in Agent Orange is harmless. This is a wrong which veterans call on DOD to remedy.

03 January 2014

VA Leader Denies Agent Orange Claim – Insists Agent Orange causes “no health effects”


(Update Note: On December 4 2015, following action in the US District Court of Washington DC, the Justice Department released this statement from the VA:
"VA states as follows: The statement regarding TCDD exposure and adverse health effects was written in error and was incomplete." VA's error, but it sufficed to deny the veteran's claim for three more years.)
Figure 1: claim denied re: no adverse health effects from TCDD (12/3/2015-VA now says this was written in error)
The VA, along with virtually every other government agency, acknowledges Agent Orange as harmful to humans. TCDD, the toxin in Agent Orange, is recognized as the most toxic of toxins, and as a human carcinogen. The EPA data sheet is perhaps the most comprehensive.

Above: Advisory opinion from VA's Director of Compensation and Pension Service (C&P,) dated 25 Sept 2012. C&P ordered an Agent Orange-exposed veteran’s disability claim denied on C&P's director's own opinion that TCDD (dioxin, the toxin in Agent Orange) is harmless. In 2012, EPA officially classified TCDD as "carcinogenic to humans." In fact, the director was quoting from the opinion by Deputy Director Dr. Tom Sinks, Agency for Toxic Substances & Disease Registry who concluded veterans were exposed, and but Compensation and Pension clearly twisted ATSDR's summary by 180 degrees– Dr Sinks' ACTUAL summary: "I believe aircrew operating in this, and similar, environments were exposed to TCDD." I guess C&P didn't have space to type that part???

Below: Despite C&P’s preference to prevent claims, the law specifies herbicide exposure as the sole requirement for a veteran to be treated for Agent Orange illnesses. C&P’s actions were arbitrary and obviously, contrary to the 1991 Agent Orange Act, Title 38 as well as the Federal Register of 8 May 2001 page 23166, in which VA states all veterans exposed to military herbicides will be treated the same as Vietnam veterans, for Agent Orange-presumptive illnesses and diseases.

Figure 2: Federal Register 8 May 2001, p. 23166




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There are several other illegal or, at best, wildly illogical excuses by which VA evades the law to deny C-123 veterans' Agent Orange claims. All are invalid. Here are the proofs. 

Figure 3: C-123 Smelting, June 2010

3. The airplanes are safe in their present configurationThis VA statement implies the C-123 airplanes are not toxic – and this is true only because they were all smelted as toxic waste in June 2012. Their "present configuration" is aluminum ingots or tin cans.
4. Regulations prohibit acknowledging exposure on these airplanes. This is boilerplate language provided by Washington to their regional VA offices for use in denying C-123 veterans' claims. However, in two years of research the Library of Congress and the US Senate can find no such VA regulation! Actually, even if there were a regulation, it would have had to be published first in the Federal Register, which has never happened (the Administrative Procedures Act.) Finally, VA repeatedly responded to Freedom of Information Act requests seeking such a regulation with their response “no such document exists.”
6. VA has no way to determine which veterans flew any Agent Orange contaminated aircraft. The veterans can help the VA here, but rather than ask VA makes their negative statement. In fact Air Force aircrews are provided "Form 5s" which detail missions, tail number of aircraft, personnel on board, type of mission, and other details. Veterans also can provide individual or crew flight orders, flight logs, and VA 21-4138 forms certifying their duties aboard known contaminated aircraft.
7. PhD toxicologists are not qualified to comment on medical nexus (per Compensation & Pension Service) Actually, the PhDs who wrote the VA were certifying our exposure, not commenting on medical nexus, because exposure is the only concern under the law. Still, it is illogical for VA to refuse such opinions which were provided by the CDC, NIH, EPA and other federal agencies, as well as medical schools and schools of public health. The toxicologists who provided opinions include Dr. Jeanne Stellman and Dr. Linda Birnbaum, Dr. Fred Berman, Dr. Wayne Dwernychuk and others.
8. PhD toxicologists are not qualified to comment on medical nexus. This is not a duplicate of the item above (7). Here, the VA refused PhD opinions and also completely ignored the physicians' opinions which were provided. Ignored were opinions from Rear Admiral R. Ikeda MD US Public Health Service, Dr. Mark Garzotto VA Portland, Dr. Arnold Schecter University of Texas Medical School, CAPT A. Miller US Public Health Service, and other physicians.VA, requiring a physician's opinion but refusing the scientists', then dismissed the physicians...even VA physicians who are acknowledged Agent Orange-prostate cancer researchers, by simply ignoring their opinions. Veterans’ laws require VA to address each of the proofs put forward by a veteran in a disability claim, which is why VA ignored the physicians altogether. VA perhaps did not note, or believes itself above, the decisions by both the 8th and 9th US Circuit Courts that held arbitrary government dismissal of qualified toxicologist opinions regarding exposure issues is illegal.
In fact, the AF report simply states that by 2012 it proved impossible to decide the health risks caused by veterans who flew the C-123 fleet thirty years earlier – the AF study in no way dismissed exposure but simply said time's passage made precise measurements of health impact impossible. VA twisted that to their perspective that NO health impact was possible, clearly a prevarication. Further, scientists and physicians have challenged the AF report as "unscientific."
10. There is a low probability TCDD penetrated through the skin of these aircrews. Again, exposure itself is the sole question under the law, however even Department of Defense literature specifies dermal (skin) absorption as a significant route of dioxin exposure. Other VA, EPA and CDC literature recognizes occupational dermal exposure as perhaps the principal route of TCDD exposure. A 1995 study in Organohalogen Compounds by medical researchers reports that, based on its review of the scientific literature, “dermal uptake to TCDD is probably the primary route of exposure in the workplace."
11. Air Force testing concluded that the level of Agent Orange that crewmembers of C-I'23 aircraft were potentially exposed to, was "unlikely to have exceeded standards set by regulators or to have put people at risk for future health problemsAgain from the Air Force C-123 study, this VA twist is deceptive, because there are no "standards set by regulators" and the law specifies exposure, not any requirement for the veteran to prove or indeed even experience "future health problems." Obviously, however, the C-123 veterans seeking VA medical care have experienced health problems, typically suffering a number of the “Agent Orange presumptive illnesses.”
12. Currently, there is no equivalent legal basis for acknowledging"secondary" or "remote" Agent Orange exposure, such as that from contact with material or equipment previously used in Vietnam. This statement from Under Secretary A. Hickey misses the point – exposure is exposure, and the law does not specify secondary, remote, what flavor, what color or anything else. It clearly, precisely specifies exposure. And the contamination level on these aircraft was firmly established by the USAF as well as the CDC/Agency For Toxic Substances and Disease Registry whose director himself officially and directly informed the US Army Joint Services Records Research Center. Air Force tests identifying our airplane as "heavily contaminated" and "a danger to public health" are statements well beyond the VA's threshold of equipoise!
The VA is required to inquire of the JSRRC whenever a non-Vietnam War veteran claims exposure, and JSRRC, per Mr. Dominic Baldini, its chief, has ample US government opinion and archival information to respond positively to every VA C-123 inquiry. In fact, the VA could even (foolishly) assert that TCDD/Agent Orange is beneficial, and that would still have no impact at all on the legality of an exposed veteran's claim. (3 Oct 2014 update: JSRRC has begun providing adequate documentation of exposures)
13. The general claim of AO exposure among stateside C-123 crewmembers is based on a wipe test sample of residual 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) (the carcinogenic element in AO herbicide) found in only one C-123. This statement by Secretary Shinseki is amazing, in that indeed, the first two tests (Conday, 1979 & Porter/Weisman, 1994) confirming dioxin on our airplanes was on a single aircraft, however Secretary Shinseki ignored, for whatever policy reason, the subsequent test in 1996 which showed ALL seventeen C-123s stored by the AF remained contaminated with dioxin. This toxicity was identified even 25 years after the last C-123 Agent Orange spray missions. Here again, the Secretary was poorly informed before he signed his letter containing this blatant misstatement to Senators Burr and Merkley.
After 2003 the Air Force (355 AMDS/SGPB Captain Borma) grew concerned that no amount of testing would eliminate liability and concern about C-123 dioxin contamination, and the cost of wipe tests ($1,500 each C-123) led to the AMARC decision to cease sampling. Further, better and more definitive air sampling was ordered halted. The AF decision to avoid more definitive characterization of the toxin hazard cannot be used as some illogical proof the C-123s were not contaminated...all testing done proves otherwise. In 2009 AMARC, with Air Staff approval, determined all aircraft would be smelted as toxic waste, completed in June 2010. Approval correspondence from the Office of Secretary of Defense consultant to AF officials, and from them to their supervisors,  included official concerns already exposed veterans would learn of the contamination and seek veterans benefits. (Fig 4)
In 2011, the consultant referred to the C-123 veterans as "trash-haulers, freeloaders, looking for a tax-free dollar." Such prejudice renders anything from him unacceptable. Further, his views, which have been defensive of Agent Orange use, are directly countered by experts with the US Public Health Service, the EPA, the CDC and the National Institutes of Health.
Figure 4: Consultant's correspondence re: C-123 veterans

15. Wipe sampling is a universally accepted method used to detect at what level a chemical is present on a surface, but cannot be directly extrapolated to represent human health risk. Here again the Secretary errors. Wipe samples were the standard when the C-123s were first tested, and they are the standard today in civil and military situations. In fact, the military's "gold standard" on toxicology is Army TG312 which specifies wipe sample use. Further, under the law and Title 38, VA is prohibited from requiring any extrapolation of threat to health, or any other thing, for veterans exposed to Agent Orange claiming Agent Orange-presumptive illnesses.
Indeed, air samples might have further confirmed the contamination, but wipe samples were perfectly adequate, as confirmed by the Director, CDC/Agency for Toxic Substances and Disease Registry (Rear Admiral (MD USPH) R. Ikeda as well as the Director, NIH/National Toxicology Program (Dr. L. Birnbaum). Air sampling was done on C-123s initially but along with wipe samples stopped because of cost per airplane exceeding $1500, with no level of decontamination possible...the decision to save money and stop testing cannot then be used as proof against veterans' claims.
16. Given that the evidence from actual participants in Operation Ranch Hand does not show a health risk from direct exposure to TCDD, it is  difficult to ascertain a basis upon which to find a health risk among crew members of Post-Vietnam C-123 crews. Again the Secretary errs and ignores the laws he swore to enforce. Exposure itself is the question, not whether Vietnam-era veterans had more or less exposure than C-123 crews. Indeed, Dr. Jeanne Stellman, Professor Emerita at Columbia's Mailman School of Public Health, calculated that C-123 veterans had more Agent Orange exposure than the average Vietnam ground soldier, and somewhat less than the Ranch Hand crews.
The Secretary further errs in failing to consider that the C-123 crews flew their toxic airplanes for a full decade, not the eleven months that constituted a tour in Vietnam.
17. Chemical intake must also be taken into account. Actually, no.  In fact, it cannot be taken into account! The law specifies exposure, not chemical intake. Here the Secretary swaps around with "bioavailability' and "medical nexus," neither of which is legal to consider in a veteran's Agent Orange claim for presumptive illnesses, and such terms might be applicable only for illnesses not recognized by the VA as associated with Agent Orange.

[1] Kerger et. al., Validating Dermal Exposure Assessment Techniques for Dioxin Using Body Burden Data and Pharmacokinetic Modeling, 25 Organohalogen Compounds 172, 172 (1995)

22 October 2013

USAF Refuses to Designate C-123s as "Agent Orange Exposure Sites"

"Not our job," can be the summation of the USAF response to veterans' request to designate the toxic C-123 aircraft as "Agent Orange Exposure Sites." Go try the VA, was the decision by DCS/Logistics, Installations and Mission Support and Lieutenant General Judith Fedder.

Although all C-123s were destroyed back in June 2010 in special operations due to their confirmed dioxin contamination, veterans flew and were exposed aboard these warplanes for a decade after the Vietnam War. Concerned, and rebuffed by the VA which refused them medical care, the veterans asked the VA to consider in retrospect designating the known spray planes as exposure sites to permit claims to progress. Thus, veterans proving duty aboard these C-123s might progress in their claims for VA medical care for Agent Orange-associated illnesses.

Predictably, VA refused, referring the problem to the Air Force. So the veterans eventually identified the AF office with responsibility, and has recently also been refused their help. "Not our job," claim both AF and VA. Her letter is below, and our letter requesting reconsideration hasn't been answered.

Because of their known history of spraying Agent Orange, and because of the decades of AF-confirmed tests establishing their dioxin contamination, these aircraft are clearly covered by the language of both agencies' dealings with Agent Orange Exposure Sites. Because the CDC/Agency for Toxic Substances and Disease Registry and the National Institutes of Health/National Toxicology Program concur both with the contamination and the veterans' exposure, it begs the question what leads the AF to disagree?

We have absolutely no doubt that LtGen Fedder and her troops would storm the barricades to protect any active duty troop from potential harm. Like the School of Aerospace Medicine, that's their mission and their dedication can be assumed and relied upon. 

What we find disappointing is the failure of DCS/Logistics, Installations and Mission Support to consider any reasonable, merely administrative retroactive steps to make right earlier mistakes...mistakes such as AFMC and the AF Surgeon deciding not to notify already-exposed C-123 veterans that we'd had a decade of service aboard toxic airplanes!


17 August 2013

Wrong-thinking Sequester Ideas: This Has To Change!


George F. Will
George F. Will
Opinion Writer

The sequester’s a public health hazard


“The capacity to blunder slightly is the real marvel of DNA. Without this special attribute, we would still be anaerobic bacteria and there would be no music.”
The pedigree of human beings, Thomas wrote, probably traces to a single cell fertilized by a lightning bolt as the Earth was cooling. Fortunately, genetic “mistakes” — mutations — eventually made us. But they also have made illnesses. Almost all diseases arise from some combination of environmental exposures and genetic blunders in the working of DNA. Breast cancer is a family of genetic mutations.
The great secret of doctors, wrote Thomas — who was a physician, philosopher and head of Memorial Sloan-Kettering Cancer Center— “is that most things get better by themselves; most things, in fact, are better in the morning.” But many things require intelligent interventions — cures. So, to see the federal government at its best, and sequester-driven spending cuts at their worst, visit the 322 acres where 25,000 people work for the National Institutes of Health.
This 60th anniversary of the Clinical Center, the NIH’s beating heart, is inspiriting and depressing: Public health is being enhanced — rapidly, yet unnecessarily slowly — byNIH-supported research here, and in hundreds of institutions across the country, into new drugs, devices and treatments. Yet much research proposed by extraordinarily talented physicians and scientists cannot proceed because the required funding is prevented by the intentional irrationality by which the sequester is administered.
A2percent reduction of federal spending would be easily manageable. It has, however, been made deliberately dumb by mandatory administrative rigidities intended to maximize pain in order to weaken resistance to any spending restraint. Spending on basic medical research is being starved as the river of agriculture subsidies rolls on.
For Francis Collins, being the NIH’s director is a daily experience of exhilaration and dismay. In the past 40years, he says, heart attacks and strokes have declined 60percent and 70percent, respectively. Cancer deaths are down 15percent in 15years. An AIDS diagnosis is no longer a death sentence. Researchers are on the trail of a universal flu vaccine, based on new understandings of the influenza virus and the human immune system. Chemotherapy was invented here — and it is being replaced by treatments developed here. Yet the pace of public health advances, Collins says, is being slowed by the sequester.
He entered federal service to oversee decoding of the human genome, which he describes as “reading out the instruction book for human beings.” We are, he says, at the dawn of the era of “precision medicine,” of treatments personalized for patients’ genetic makeups.
This will be, Collins believes, “the century of biology.” Other countries have “read our playbook,” seeing how biomedical research can reduce health costs, produce jobs and enhance competitiveness. Meanwhile, America’s great research universities award advanced degrees to young scientists from abroad, and then irrational immigration policy compels them to leave and add value to other countries. And now the sequester discourages and disperses scientific talent.
In the private sector, where investors expect a quick turnaround, it is difficult to find dollars for a 10-year program. The public sector, however, with its different time horizon, can fund for the long term, thereby drawing young scientists into career trajectories and collaborations impossible elsewhere.
Collins is haunted by knowledge that the flow of scientific talent cannot be turned on and off like a faucet. Unfortunately, recent government behavior has damaged the cause of basic science. It has blurred the distinction between fundamental research and technical refinements (often of 19th-century technologies — faster trains, better batteries, longer-lasting light bulbs). It has sown confusion about the difference between supporting scientific research and practicing industrial policy with subsidies — often incompetently and sometimes corruptly dispensed — for private corporations oriented to existing markets rather than unimagined applications. And beginning with the indiscriminate and ineffective2009 stimulus, government has incited indiscriminate hostility to public spending.
NIH scientists seek intensely practical, meaning preventive and therapeutic, things that can save society more than any sequester can. The scientists also know, however, that the enchantment of science is in the phrase “You never know.” You never know where things might lead. Sixty years ago, James Watson and Francis Crick published a paper in the journal Nature describing the double-helix structure of DNA and noting almost laconically that it “suggests a possible copying mechanism for the genetic material.” They could not have known that this would lead to Collins’s career, which has led him here to days of dismay about exhilarations postponed.