VA Official Rejects Institute of Medicine Agent Orange Report!

The VA's Compensation and Pension Service, part of that agency's Veterans Benefits Administration, rejects input from the Society of Medicine's Institute of Medicine Agent Orange Committee!

In his action of September 25 2012 by which he ordered a C-123 veteran's claim for Agent Orange exposure to be refused, The Director of Compensation and Pension Service, determined that no input from scientists was to be accepted by his department. A reasonable conclusion: VA rejects the IOM report because nearly all its members were scientists! VA does, of course, accept input from its own staff scientists, such as its Director, Post-Deployment Health, Dr. Victoria Davey...a scientist, not a physician.

That C-123 veteran's claim had included numerous findings from toxicologists, epidemiologists and other scientists attesting to the contamination of the C-123 and the veteran's own exposure.

Among the official findings confirming the veteran's exposure were those from Dr. Linda Birnbaum, Director of the National Institute of Health National Toxicology Center and also Director, National Institute of Environmental Health Sciences. Included was an official finding from Dr. Christopher Portier and Dr. Tom Sinks, Director and Associate Director, respectively, of the CDC Agency for Toxic Substances and Disease Registry. Included were similar detailed conclusions from leading Agent Orange experts such as Dr. Jeanne Stellman, Professor Emereta at Columbia University Mailman School of Public Health.

Seemed impressive, but all were ordered ignored by C&P. Throughout its order forbidding the veteran's claim, C&P rejected scientist after scientist, stating each was "not a medical doctor competent to provide that medical nexus."

Actually, none of the scientists even sought to provide medical nexus, but rather only their qualified professional finding that the veteran had actually been exposed, because exposure itself is the only criteria under the law.

Get it? The scientists were addressing exposure, not medical nexus, so C&P junked all their input because in his view, scientists shouldn't address medical nexus...which they weren't addressing anyway.

Amusing, isn't it? And how very transparent the dedication of Compensation and Pension Service in obstructing valid exposure claims. Amusing also that VA even rejects input from other federal agencies with both the expertise and the statutory authority to decide issues like exposure. It is clear...the only evidence accepted in veterans' claims is that evidence which conforms to the VA's policy objectives of denying Agent Orange exposure.

Ignored throughout the Director, Compensation and Pension's personal rejection of the veteran's claim were the numerous physicians' opinions, perhaps not dealt with because they couldn't be challenged...thus all  were ignored to insure the success of the director's action. In particular, the VA ignored the opinion of its own Portland OR director of urology oncology, Dr. Mark Garzotto, a recognized Agent Orange researcher, who agreed with the veteran's exposure claims.

So how is the conclusion reached that the IOM has been rejected? Because nearly all of the committee members were scientists, and not physicians. In fact, only two of the fifteen Agent Orange experts on the committee were physicians...the others, all scientists whose opinions C&P and the VA have emphatically rejected...at least for purposes of veterans' claims.The IOM fails C&P's physician test!

So..it seems when scientists agree with C&P and the VA, their opinions are somehow acceptable. But when scientists disagree with the Director's personal views, and policy objectives (which are outside the law) of the VA leadership, the scientists' opinions are unacceptable altogether! We note the C-123 Agent Orange research contract the VA has with an agricultural specialist...again, that specialist is not a physician but because he constructs views acceptable to the VA, his opinions are worth purchasing to help obstruct veterans' claims.

So much for the manditory "veteran-friendly" appproach of the Department of Veterans Affairs! Doesn't anyone else see through the VA's "cherry-picking" of input to prevent veterans' claims? The VA is policy-driven to prevent, in particular, C-123 veterans' claims and nothing in two years of our struggle says otherwise!

By the way, VA's Post-Deployment Health Section, which sets VA policy against C-123 claims, is headed by a Dr Victoria Davey, a scientist, not a physician! Her Chief Consultant Post Deployment Health is another scientist, Dr. Michael Peterson. Another example of VA carefully selecting which opinions are acceptable for the purpose of preventing veterans' claims. That gentleman, Dr. Peterson, is the one who responded "We all die" when asked by a veteran if a veteran's claim could be processed before the man died.

Note that we are not saying these VA personnel are not dedicated public servants and well-qualified for their positions–just that VA pretends others, extremely well-qualified and dedicated are not. VA maintains this pretense because the others...Stellman, Berman, Birnbaum, Dwernychuk, Ikeda, Sinks, Portier, Garzatta, Schecter, Miller, etc...are physicians and scientists who disagree with VA policy-driven decisions, and all have concluded the C-123 veterans were indeed exposed!

Perhaps VA should read the CVs of those with whom it disagrees!

Office of Secretary of Defense Linked to C-123 Agent Orange Evidence Destruction

Air Force documents uncovered recently via the Freedom of Information Act link the Office of Secretary of Defense to the actions by Air Force Material Command to destroy toxic C-123 transport aircraft, specifically to prevent veterans from learning of their exposure to Agent Orange. Revealed

were procedures untaken to bar Agent Orange benefits from already exposed aircrews and maintenance veterans, procedures involving press manipulation and destruction of the evidence which would support claims for Agent Orange benefits by over 1560 men and women.

C-123 transports, used earlier in Vietnam for spraying Agent Orange, remained contaminated with deadly dioxin for the decade the planes remained in service after the war, until they became obsolete and were retired in 1982. Although toxicologists first established the hazardous condition in 1979 the Air Force opted not to spend the necessary money (estimated at over $40,000 per aircraft) to properly decontaminate the fleet of C-123s and instead ordered base maintenance workers to wipe interior surfaces (those that could be accessed) with Dawn detergent and to cover the intense stench which sickened aircrews with area deodorants. Using paint scrapers and even dental picks, maintenance personnel scraped Agent Orange residue where it had caked up during Vietnam, but huge amounts remained inaccessible in the wings, under the cargo deck, and in portions of the landing gear wells. Agent Orange had even soaked into the paint, wood, leather, fabrics, ceramics, adhesives and other surfaces inside the C-123, little of which could be removed.

In 1994, twelve years after the fleet was retired to desert surplus storage in Arizona, more tests firmly detailed the toxicity of these medium assault transports in 1994 as the Air Force examined an aircraft ("Patches") being moved into the USAF Museum. Results: "Heavily contaminated on all test surfaces" and "A danger to public health," confirmed toxicologists from the highly-respected
USAF Armstrong Laboratories. At this time, either through oversight or a specific decision, the Air Force opted not to inform the veterans who'd flown these airplanes, veterans who'd previously been assured there was no risk of Agent Orange exposure, that in fact they'd been exposed for a full decade.

A more deliberate act by the Air Force to hide information from veterans about their exposure to Agent Orange was undertaken in 1996 by the USAF Office of Environmental Law. JAG attorney Major Ursula Moul directed that all information about C-123 contamination be "kept in official channels only," a deception costing the exposed veterans nearly two decades of awareness of their exposures. Two decades during which at least minor health precautions could have been observed, such as monitoring PSA numbers or limiting dietary fat intake.

After decades in storage the surplus fleet of C-123 transports needed to be eliminated as they couldn't be sold, parted out, or even buried as toxic waste. Seeking input, in 2009 the Office of Secretary of Defense (OSD) offered the Air Force the name of Dr. Al Young. Young is also a retired Air Force colonel, and his career has focused on use of Agent Orange from the earliest days of its use in Vietnam.

Young then guided the AF to the decision to destroy the old airplanes and in at least three memos to three different officials, introduced the point that if veterans learned of the airplane contamination, the old aircrews and maintenance folks would approach the VA for what Dr. Young called "presumptive compensation," meaning compensation for exposure illnesses and VA medical care as well. This apparently was something he felt should be prevented, even though the veterans had already been exposed and were presumably eligible for such care. His recommendation to destroy the airplanes to prevent veterans' awareness was repeated up the Air Force chain of command and finally approved by the Air Staff. All remaining C-123s were destroyed as toxic waste in June 2010. Young even helped Air Force Public Affairs craft a press release minimizing references to "Agent  Orange" and such attention-grabbing words - a press release never released but held in the event of media attention. There was none.

He was also mentioned in the letter from VA's Secretary Shinseki to Senator Richard Burr, Ranking Member of the Senate Veterans Affairs Committee. The Secretary commented on Dr. Young's having volunteered details (even though he was under a $600,000 VA post-Vietnam Agent Orange consulting contract) analyzing the details of the dioxin the test results. C-123 veterans note that VA's Compensation Services has uniformly rejected expert independent evidence from toxicologists and other scientists, with the claim that such professionals, even though from an allied health profession, are unqualified to comment on medical nexus or exposures. Included in the rejected list are the Director of the CDC/Agency for Toxic Substances and Disease Registry, Rear Admiral Robin Ikeda MD, as well as the Director National Institutes of Health/National Toxicology Center, and physicians from the US Public Health Service. All unqualified because their degrees are not in medicine (Compensation Service ignored those experts who were physicians, illogically grouping them instead in the unacceptable non-physician pile).

Is the VA cherry-picking their experts, accepting only those supporting the VA against C-123 veterans? Is the VA cherry-picking experts because, as Veterans Health Administration puts it, she "cannot permit" C-123 veterans' claims?

Veterans invite our fellow citizens to consider the CVs of experts who've weighed in on this issue. Google them...see who has the expertise and reputation to speak out on this subject.

For Veterans' Exposure: Dr. Linda Birnbaum, Dr. Christopher Portier, Dr. Jeanne Stellman, Dr. Aubrey Miller, Dr. Arnold Schecter, Dr. Fred Berman, Dr. Wayne Dwernychuk, Rear Admiral Robin Ikeda MD (US Public Health Service), Dr. Tom Sinks, Dr. Mark Garzotto, others from universities and federal agencies identified to the VA as members of the Concerned Scientists and Physicians. Please note all opinions were offered without compensation.

Report: Scientists Confirm Veterans C-123 Agent Orange Exposure

There are two foundations for C-123 veterans’ Agent Orange claims (legal and scientific) and we’re going to look into the scientific basis. But first the legal: under the 1991 Agent Orange Act, and the Federal Register of 8 May 2001, all veterans exposed to military herbicides will be treated the same as are Vietnam veterans.

The Basis for C-123 Agent Orange Veterans Claims 

The C-123 aircraft were contaminated with Agent Orange following their Ranch Hand spraying operations during Vietnam, and aircrews, maintenance and aerial port personnel after the war were exposed while flying and maintaining the toxic airplanes between 1972-1982. Agent Orange, especially in the earlier years of the Vietnam War, was contaminated with dioxin, also known as TCDD. TCDD is a known carcinogen, and considered the most toxic of the toxins. Not a good thing in our airplanes!

Exposure to a toxin such as TCDD is via inhalation, ingestion or dermal routes. C-123 veterans experienced all three routes, but base claims on dermal exposure and inhalation. Generally, dioxin exposure is most readily via ingestion, then inhalation, then dermal routes.

In 1979 Air Force testing first confirmed the presence of “military herbicides” on the C-123, although no testing was completed for dioxin. The first comprehensive scientific testing of that same C-123 was fifteen years later in 1994 at the Air Force Museum, where the warplane was found to be “heavily contaminated” and “a danger to public health” by the Air Force toxicologists Drs Ron Porter and Wade Weisman. Using standard hexane wipes, they detected high levels of dioxin on all test surfaces, and consequently mandated HAZMAT protection for museum personnel working around that airplane until decontamination, which required three attempts, was decontaminated.

The 1994 Porter/Weisman data was joined by test results on airplanes stored at the Air Force boneyard in Arizona, where tests were completed between 1999 and 2009. These tests continued to show the toxicity of the warplanes, although degrading over time since the last Agent Orange spray missions completed in 1971.  Air samples were generally acceptable and wipes continued to report dioxin contamination.

Unable to justify decontamination of the aged airplanes and forced to address their disposal in some manner, the Air Force ordered all C-123s destroyed as toxic waste in 2010. At that point no further testing was possible, although two former spray aircraft used as museum displays may someday be examined (Pima Air Museum, AZ and the AF Museum at Warner-Robins AFB, GA). 

Thus, only the testing data already existent is available to analysis. When the veterans learned of the C-123 contamination via the Freedom of Information Act results in 2011, their inquiries to the Department of Veterans Affairs were immediately, and apparently without any even-handed analysis, rebuffed with VA insistence that the airplanes could not have exposed the veterans.

The veterans, convinced by the 1994 Air Force test results, turned to recognized experts in universities and government agencies to find confirmation of their exposure.

The first of these was Dr.Fred Berman of Oregon Health Sciences University Toxicology Program. Berman, himself a licensed pilot, examined the results of Porter/Weisman and concluded veterans were exposed. Addressing the Secretary of Veterans Affairs Dr. Berman wrote:

“It is my professional opinion that…aircrew veterans who flew these aircraft in the same time period)were exposed to harmful levels of dioxin in the course of aircrew duties. I opine that exposure was intense, and long-term, and that cited illnesses are as likely as not to be associated with the aircraft's dioxin contamination.”

Berman had earlier participated in a teleconference between scientists, VA staff and veterans on the issue of C-123 exposure, and in his independent expert opinion dismissed the VA’s contention that the “dried dioxin” on the aircraft could not have exposed the aircrew. In particular, he noted that there was no support in scientific literature for precluding exposure to dry, or surface dioxin, and that two of the authors cited by the VA had themselves stated their articles did not address aircrew exposure and were not relevant to that issue. 

Dr. Jeanne Stellman was also consulted by the C-123 veterans, and she, too, provided an in-depth analysis of their exposure. Dr. Stellman is world-famous in dioxin issues, a decades-long focus of her professional career in public health. Her conclusion paralleled that of Dr. Berman. She confirmed their exposure in her message to the veterans:

“There is every likelihood that you would have been exposed to both airborne herbicides and their contaminants, as well as come into contact with surfaces contaminated by these toxic substances.” “In my opinion, it is highly likely that you and other crewmembers were exposed to the herbicides and to their highly toxic contaminant,2,3,7,8-tetrachlorodibenzodioxin (dioxin, for short), although it is not possible to estimate the precise levels of exposure because of the failure of the Air Force to carry out proper assessments of contamination levels prior to assigning the contaminated aircraft to post-Vietnam military operations.”

Dr. Stellman also concluded C-123 veterans were exposed more than ground soldiers were in Vietnam, and somewhat less than aircrews in the wartime Agent Orange spray operations. She strongly and directly criticized the VA’s “dry dioxin transfer” position (which VA used to argue against the veterans’ exposure) by writing, “These statements, to be blunt, are technically flawed and show insufficient understanding of surface contamination. Concerned about the poor science procedures followed by the VA, and acting on behalf of fifteen of her physician and scientific colleagues, Dr. Stellman wrote the Under Secretary of Veterans Affairs to challenge the government’s position on C-123 veterans.

Further support for the veterans’ exposure claims was offered by the CDC/Agency for Toxic Substances and Disease Registry. Deputy Director Dr. Tom Sinks, whose opinion was later joined by that of the ATSDR Dr. Christopher Portier, confirmed the C-123 exposures. While lamenting the paucity of available testing data, Dr. Sinks, and later Dr. Portier, wrote:

“I believe that aircrew operating in this, and similar, environments were exposed to TCDD.”Considering the dioxin concentration, they wrote “This average value exceeds the Army (Technical Guide 312) screening level by182 times and is equivalent to a 200-fold greater cancer risk than the screening value.”

Further agreement with the veterans’ claims to have been exposed were provided by Dr. Wayne Dwernychuk, retired chief scientist of the Hatfield Group, the leading engineering and environmental group specializing in Agent Orange. Dr. Dwernychuk concurred with the findings of Berman and Stellman, and the ATSDR, and using the VA’s preferred language reported the group of C-123 veterans “is more likely than not to have been exposed.” Dwernychuk in addition, particularly challenged the statement used by the VA's director of Compensation and Pension in denying a veterans’ exposure claim, where the government stated “there is no conclusive evidence that TCDD exposure causes adverse health effects”. “This statement I find blatantly disingenuous” wrote Dr. Dwernychuk.

Among the physicians examining the C-123 exposure issue are Dr. Arnold Schecter, professor of medicine at the University of Texas Medical School. Dr. Schecter is perhaps America’s leading physician specializing in Agent Orange, and offered his opinion:

“There is no doubt in my mind, as a physician who has studied Agent Orange and dioxin in Vietnam and in the USA since 1981 that you have had, as a result of your work in the military, to above background exposure to TCDD from work in fixed wing aircraft previously used for Agent Orange spraying missions.” “In my professional opinion you are at increased risk for illness from the dioxin in Agent Orange because of your exposure to it from your military service.”

The US Public Health Service also reviewed the C-123 Agent Orange issue, and Dr. Aubrey Miller’s expert finding on behalf of that agency was:

“Regarding the association between dermal exposure and effects that seems to have been a matter of some dispute, it is my opinion that the scientific evidence is clear. Dermal exposures, including exposures to contaminated equipment or secondary exposures through contaminated clothing, tools, vehicles, etc. could result in absorption that would be problematic.”

Another expert offering her careful review of the exposure issue is Dr. Linda Birnbaum, Director of the National Institutes of Health/National Toxicology Program. Her opinion:

“According to the narrative, exposure is assumed based on wipe-tests demonstrating high dioxin concentrations in the C-123K's. While contact with the aircraft results in exposure to dioxins, the magnitude of these exposures is uncertain.”

Each of these authorities has volunteered their independent expert opinions and findings, while the VA position against veterans’ exposure was written by staffers assigned to do so as part of their jobs. 

Observers might compare the CVs of the VA staff to those of the independent experts...those writing for the VA are hard to even find, if at all, in Google Scholar while the independent experts, like Shecter, Birnbaum and Stellman, total hundreds of pages of CV references and thousands of pages of scholarly contributions to this field. Isn't it clear...people opposed by the senior scholars of their profession! Imagine a court setting with opposing "experts" and the obvious differences between them...no court would fail to side with the veterans, and indeed, no BVA will fail to award service connection for a C-123 veteran but we simply don't have the years waiting for BVA justice!

Supporting the C-123 veterans’ claim to have been exposed aboard the toxic C-123 fleet are federal agencies such as the EPA, NIH and CDC, and prestigious universities and independent experts. The scientists named here have stressed to the veterans that they’re not advocates for one view or another, but instead neutral observers whose opinions are based on the science involved, not the politics. And the veterans note that gives their conclusion about exposure even more weight.

The C-123 veterans ask the VA to yield on its predetermined disqualification of these airman from Agent Orange medical care. Congressmen and senators are asked to stress to the VA our complete qualification under the law for the care we desperately need for our Agent Orange illnesses.

(note: source documents for each issue dealt with are downloadable from www.c123kcancer.blogspot.com)

-- http://youtu.be/JtFQ1svAp

CDC Stands Up For C-123 Veterans on Agent Orange Exposure

In January 2012 we received an opinion confirming our Agent Orange exposure on the C-123s from the ATSDR, part of the Center for Disease Control.. This was a big step for us, giving scientific as well as federal agency merit to our claims with the VA. The Army operates the Joint Services Records Research Center to advise the VA on veterans claims and whether official documentation exists to support them, It has been responding to VA inquiries with negative answers. 

This letter of 6 March 2013 was requested by the JSRRC from the CDC/Agency for Toxic Substances and Disease Registry to clarify further their initial finding letter about that aircraft were contaminated and our veterans exposed---and without any reservation ATSDR again said YES in this letter to JSRRC authorities. This time, to make sure their point was clear, the ATSDR director himself rammed their point home...which was, the C-123 veterans were exposed...heavily!

Unfortunately, VA advised Wes Carter and Marlene Wentworth during our meeting them at Compensation Services on 28 February 2013 that no such information from US Government agencies is acceptable in the VA's evaluation of veterans' Agent Orange exposure claims. This flows from the VA's earlier determination by its Health Benefits Administration forbidding C-123 claim approvals - the VA has implemented a policy that there actually was no exposure to Agent Orange by any veteran, including Ranch Hand and others with "boots on the ground" excepting only those with diagnosed chloracne. A recent addition of "bioavailability" to VA requirements means, because no veteran other than those with chloracne can prove individual bioavailability, therefore no veteran has ever been "exposed" in the VA's perspective.

Still, this and other documents certainly spell success in other forums such as the Board of Veterans Appeals and federal court. So take heart...not everyone in government is determined to deny us quality VA medical care (which I'm blessed with for the next two weeks here in Seattle), and thank God for men like Dr. Portier who lends his professionalism to our cause!

Domenic Baldini

Chief, Joint Services Records

Research Center US Army

Records Management and

Declassification Agency

Dear Mr. Baldini:

On January 25, 2012, the Agency for Toxic Substances and Disease Registry (ATSDR) sent the

attached letter to Wesley T. Carter, USAF Retired. Major Carter had contacted ATSDR seeking

an opinion about his potential exposure to 2,3,7,8 tetrachlorodibenzo-p-dioxin (TCDD) while

flying C-123 aircraft from 1972-1982. The letter represented the opinion of ATSDR and our

subject matter experts.

The ATSDR letter to Major Carter included several important findings. Information contained

within parentheses have been added for explanation:

• ATSDR calculated an average value of 6.36 ng TCDD/100 cm squared

for the three C-123 interior the wipe samples three collected on November 20, 1994. 

This calculation was based on information from a consultative letter from Capt Wade Weisman

 & Ronald Porter (see footnote 3 in correspondence to Major Carter).

• This value is 182 times higher than the screening value established by the United States

Army Center for health Promotion and Preventive Medicine — Technical Guide 312.

(see footnote 2 in correspondence to Major Carter.) [Levels below a screening value are

often considered acceptable. Levels above the screening value are often considered

unacceptable because of an associated health risk.]

• ATSDR pointed out that the average value of the three wipe samples represented a 200-

fold excess cancer risk above the screening value established by the Department of the

Army.

• ATSDR stated that the office worker scenario used in Technical Guide 312 likely

underestimates the daily exposures of Air Force flight personnel inside confined

contaminated aircraft but that this depends upon exposed skin surface area, duration of

exposure, hand washing, and food intake as well as airborne dust].

• ATSDR stated that TCDD levels on-board contaminated planes were likely higher in

1972-1982 than in 1994 when samples were taken.

• ATSDR stated that it could not exclude inhalation for ingestion] exposures to TCDD

while working on contaminated aircraft.

• Based upon the available information. ATSDR concluded that aircrew operating in this,

and similar, environments were exposed to TCDD.

I hope this information is useful. Please contact XXX  if you have any questions.

/signed/

ChristopherJ. Portier, P.h.D.

Director, National Center, and Environmental Health and Agency for Toxic Substances and Disease Registry