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.

Compensation & Pension Exec Gets $11,000 Bonus for Defending Agent Orange!

VA's Veterans Benefits Administration includes the famed Compensation and Pension Service. Its director's bonus in 2013 was over $11,000 and over $20,000 with earlier years' checks. Well-earned? Perhaps so, but let's check.

In 2012, its director explained to C-123 veterans and the worlds of science and medicine that:

"In summary, there is no conclusive evidence that TCDD exposure causes any adverse health effects."

Really? This is reassuring, but wildly inaccurate even though it met VA policy objectives for denying exposure claims. Other VA executives and the entire Department of Veterans Affairs including the Secretary, consider TCDD to be a known human carcinogen. So do the CDC, NIH, EPA, OHSA, World Health Organization, National Institute of Environmental Health Sciences, National Toxicology Program and most middle school students. The Institute of Medicine confirmed C-123 veterans' Agent Orange exposures, and the harm to veterans who served aboard them, in their January 9, 2015 report.

TCDD, aka dioxin, is clearly not good for anybody. Not even veterans.

But Compensation and Pension's director wrote this statement in recommending his denial of an Agent Orange veteran's claim for Agent Orange medical care and benefits under the 1991 Agent Orange Act.

But perhaps the irony isn't immediately obvious: an Agent Orange claim was denied by C&P because, according to them (at least for the purposes of the veteran trying to get medical care) Agent Orange and its toxic component TCDD are harmless. No adverse health effects. Claim denied.

No adverse health effects. Except (well, by golly, according to the VA itself,) prostate cancer, diabetes, soft tissue sarcoma,multiple myeloma, B-Cell leukemias including hairy cell, Parkinson's disease, ischemic heart disease, Hodgkin's disease chronic lymphocytic leukemia, or non-Hodgkin's lymphoma. Plus peripheral neuropathy (acute or subacute), and a couple others which Compensation and Pension group into its "no adverse health effects" category.

Puzzled by this, veterans read it aloud, and showed the statement to the director of Compensation and Pension, in his office together with his staff, without any challenge or correction from him or them other than his statement that he wasn't familiar with everything leaving over his signature. This was on February 28, 2013.

His statement has been allowed to stand, and the veteran's claim remains denied and in appeal for three years. Three years have provided the director, and VA itself, ample time to amend or correct such an obvious error and anti-veteran missive. Some veterans' groups term this, "Delay, deny wiat
'till they die."

His bonus checks have probably been cashed already, the money long since spent. Certainly, denying veteran's claims is a VA money-saver which justified the bonus payments but it is not in line with what the Nation expects of the VA.

I've met the director of Compensation and Pension Service. One has to acknowledge the gentleman (he's a veteran himself) is, indeed, a hard-working and faithful public servant, but he seems more policy-oriented than veteran-oriented.

His policy as he explained it to Major Marlene Wilson and me: no C-123 claims were to be permitted, per VHA. And despite VA's assurances to Congress of C-123 "case-by-case" decisions, all have been denied per VHA. No claims been permitted – ever. Thus far, only DRO or BVA actions have permitted C-123 veterans to receive earned benefits and VA medical care. Every other claim remains denied or "suspended."

The TCDD veteran is still waiting for his claim to be reconsidered, the claim not even forwarded by the regional office to the Board of Appeals following the 2012 denial.

Appeals of bad decisions take three to four years in the VA system, with the greatest delay at the regional offices where claims sit for years before heading to the BVA. There, however, decisions are quickly resolved in just months. It seems delays are caused by volume, but also by design, allowing years to take a deadly toll of veterans already sick enough to have applied in the first place. Too often, veterans are sick enough not to survive the appeals process but continue in hopes of aiding their survivors.

Compensation and Pension Service, in ordering all C-123 claims denied (regardless of the language with which it was done, that was both the intent and the effect) disregarded VA's own assurances to Congress via the Federal Register that all non-Vietnam veterans exposed to Agent Orange were eligible for care.

Here is the entire paragraph in the opinion signed by the director, in which he summarizes (accurately? Read the Sinks letter and then C&P's summary) expert input to the VA from the CDC/Agency for Toxic Substances and Disease Registry. Nowhere in his summary of the CDC's finding does the director bother mentioning the CDC key points: C-123 veterans were exposed to 182-times the screening value for dioxin, and experienced a 200-fold increase in cancer risk.

Later, CDC reported to VA and DOD (repeatedly, by several subsequent directors of the ATSDR including Rear Admiral R. Ikeda, MD USPHS) that the C-123 veterans actually should have been flying in full HAZMAT protection, their airplanes were so contaminated with Agent Orange.

CDC-recommended C-123 aircrew and maintenance worker protection - FULL HAZMAT

Department of Veterans Affairs: "pro-veteran, non adversarial. All benefit of the doubt resolved in favor of the veteran." Thank goodness for the Institute of Medicine, and those worthy executives (specifically Under Secretary Hickey and Dr. Loren Erickson) in the VA who in2014 reordered the C-123 study, first promised by VA in 2012 but a promise forgotten once made but put right again by these folks. Again, thank you!

We agree that mistakes happen, even with veterans' claims as horrible as such cases may be. That's understandable. What is not understood and not forgivable is having the error pointed out (repeatedly, in writing as well as face-to-face) and yet the error allowed to stand for years! Wrongly denied veterans' claims mean financial loss, plus painful suffering and even death unless the vets can locate other care.

But "other care" can be hard to get for an Agent Orange veteran, even one blessed with solid health insurance. That's because most insurance carriers have a war clause and Agent Orange is a recognized weapon of war – thus no insurance, either. 

I am reminded of the famous quote from Upton Sinclair:

“It is difficult to get a man to understand something, when his salary depends on his not understanding it.”

C-123 Flight Suits – Before & After Agent Orange Contamination Identified on Our Aircraft

(L) BEFORE TELLING US OF CONTAMINATION                     (R) AFTER AF RELEASED THE NEWS

We were issued regular Nomex flight suits for duty aboard the C-123 between 1972-1982. In 1994 the Air Force learned the former Agent Orange spray airplanes remained contaminated with dioxin since the end of the Vietnam War and return of the airplanes to the US in 1972. Everyone in or near the stored C-123s at Davis-Monthan was ordered to wear full HAZMAT, at this point 23 years AFTER the last Agent Orange spray missions in Vietnam. Now, VA insists that aircrews were unexposed even aboard those contaminated airplanes without wearing PPE. CDC says otherwise: we were exposed, suffered a 200-fold greater cancer risk, and should have been in full HAZMAT protection from the very first flights in 1972.

Full HAZMAT as on the right was the only thing good enough for AF civilian employees. The Air Force Surgeon General was quite clear that the C-123s were dangerous and authorities wanted to protect base workers.

For Air Force personnel, neither the AF nor the VA had the same concern for safety of our pilots, navigators, flight engineers, loadmasters, flight nurses, maintenance personnel and flight medics...green NOMEX flight suits, useless for any protection, were all we had issued us. Money saved, too, by not decontaminating the C-123s even after the 1979 tests started revealing the presence of deadly Agent Orange.

Conclusion: authorities pretend that aircrews were safe for the decade C-123s were flown after Vietnam, but realized that civilian workers, backed by unions which complained via the USAF IG, needed full HAZMAT. Because of the cost of providing medical care to Agent Orange-exposed C-123 veterans, the VA and AF together pretend there was no exposure even in the face of other federal agencies insistence that we WERE exposed. This is wrong!

CDC Report Proves C-123 Agent Orange Exposures (Post-Vietnam)

In June 2014 at the Institute of Medicine C-123 Exposure Hearings, the CDC presented its findings about C-123 veterans' Agent Orange exposures, and they pulled no punches! We were exposed, and our duty aboard the C-123s subjected us to a greatly increased risk of cancer and were also 182 times greater than military limits for dioxin exposure.

These government experts determined that our post-Vietnam aircrew and maintenance workers suffered significant, and harmful, Agent Orange exposures which were probably even higher when we flew the planes, than when the Air Force tested them years after the C-123s were mothballed.

VA has had this information from the CDC since 2012, but just refused to evaluate it. Reviewing the details, VA's Compensation and Pension Service simply dismissed the facts presented as irrelevant to our claims.

For nearly four years now, VA has dismissed everything which possibly argued that we'd been exposed, and even ignores its own regulations to block our claims.

How much proof does it take to reach the "as likely to as not" threshold of the law? Apparently, much, much more than VA should be asking! They ignore the CDC, NIH, EPA, dozens of scientists and physicians (the "Concerned Scientists and Physicians",) National Institute of Environmental Health Sciences, National Toicology Program, US Public Health Service and even the DOD Joint Services Records Research Center.

The JSRRC report is considered "source DOD verification" of veterans' exposures – except with VA's treatment of C-123 claims. Our claims continue to be ordered denied by the VBA's Compensation and Pension Service, regardless of stacks of proof.

Below: Findings: CDC details proofs of C-123 veterans' Agent Orange exposures (from page 4, by Dr. T. Sinks)

CLICK HERE to read entire CDC C-123 Report

C-123 Agent Orange Exposures = "No scientific or public health basis for excluding from presumptive service connection.." (VA Official)

The question about non-Vietnam Agent Orange exposures did not come as a new one to the Fourth Program on Science for Judges, hosted by the Brooklyn Law School in November 2004. This came after contamination of the C-123 fleet was known to USAF officials and after concerns had been surfaced about the necessary elimination of the toxic airplanes. The program was presented, however, without specific concerns for C-123 exposure issues as these were topics yet to raise concerns among the affected veterans.

Dr. Mark Brown served at that time as VA's Director of Environmental Agents Service, and presented this paper at the Law for Judges forum. Dr. Brown's treatment of non-Vietnam exposures in his Part II "VA Approach to Disability Compensation for Vietnam Veterans" is extremely important – there, too, VA restates its duty to care for exposures other than the "boots on the ground" cohort, and to recognize their exposures are granted service connection. See page 64:

"There is no obvious scientific or public health basis for
excluding these non-Vietnam War veterans from the presumptive
service connection offered to Vietnam veterans. Nevertheless, the
Agent Orange Act does not reference these veterans. To partially
address this apparent inequity, the VA has established the general
policy that when a non-Vietnam veteran is diagnosed with one of
the presumptively service-connected Agent Orange illnesses and
the veteran can provide evidence of exposure to Agent Orange,
then he can be granted service connection through a sort of
modified direct service connection route."

Reading Dr. Brown's explanation delivered to the Brooklyn judges conference in 2004, it is clear that although no new laws have evolved, and although VA restated for a second time (April 16 2008) and a third time (August 1, 2010) in even stronger language that exposed non-Vietnam veterans would be treated with presumptive service connection, VA has more recently forced a sea change in such duties to veterans.

No efforts were described by VA regarding exposure other than measuring degrees of association with illnesses, in particular positive, negative or limited ("suggested") associations, frequency of exposures, exposures to different hazards, and similar peripheral references.

At no point in VA materials can we find a redefinition of "exposure" prior to the 2012 Society of Toxicology (SOT) poster from Post Deployment Staff titled "Agent Orange 50 Year History" in which exposure was redefined to be "exposure = contamination field + bioavailability." The poster was not subjected to peer review and no mention was made of the VA redefinition of exposure in the Abstract when the poster was accepted by the SOT.  The VA poster was subsequently challenged on scientific and ethical grounds by C-123 veterans.

An exhaustive review of publications from the Institute of Medicine Agent Orange committees fails to reveal any redefinition by VA or the IOM itself of the concept of exposure. One must agree, therefore, both agencies were proceeding during these studies utilizing the commonly understood and universally accepted definition, "tissue contact with a chemical (of an kind) or its ingestion or inhalation," At no point is bioavailability treated except as an element of risk assessment, not exposure.

Until SOT 2012. And at that point, unique with VA and by VHA Post Deployment Health (previously termed, "Environmental Agencies Service." Asking VA scientists today will still evoke a definition inline with ATSDR or other authorities, and an answer not to include "bioavailability" or "medical nexus" as a requirement for the event of exposure.

Our literature review of IOM materials, VA directives and other publications, and witness testimony by VA executives, of the Secretary's March 2001 directive to offer the Agent Orange Registry exam to any veteran expressing belief he/she had been exposed...a directive reversed in 2012 by Post Deployment Health staff which excluded C-123 veterans in particular.

The "Vietnam Veterans and Agent Orange Independent Study Course, (June 2008 Update,) to which Dr. Brown contributed, is very comprehensive. And without the words "bioavailability," or any other redefinition of exposure appearing.

Conclusion: As soon as C-123 exposure claims surfaced, the VHA's Post Deployment Health section immediately fielded their negative response, which which soon developed to include their departmental redefinition of "exposure" to incorporate bioavailability. This way, VBA determined, all C-123 claims for a decade of exposure were best denied. By blending the legal requirement that veterans prove exposure with the scientifically impossible requirement that they also prove bioavailability, VHA assured itself of a workable barrier to all C-123 Agent Orange exposure claims.

Job well done, Post Deployment Health! Although it certainly abused the veterans of any hopes that VA would find a way to treat veterans, rather than construct barriers against even entering VA hospitals. Job well done, it seems, except in meeting your responsibility for patient care.

VA broke the faith...and was not veteran-friendly, pro-veteran, or non-adversarial.

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.

More On VA's Claim That Agent Orange is Harmless

VA's Director of Compensation and Pension Service has directed that C-123 veterans' claims for Agent Orange ALL be denied on a variety of grounds, including his statement: 

"In summary [C&P is writing its review of the CDC conclusion by Dr. Tom Sinks that C-123 veterans actually were exposed, but the Director very pointedly skips that part so as to better deny claims]there is no conclusive evidence that TCDD [the toxin in Agent Orange] exposure causes any long term health effects." 

Gosh, maybe it is just me, but it really looks as though the VA deliberately reversed the actual finding of the CDC/ATSDR...just to deny C-123 veterans' claims.

C&P's staff, in denying vital medical care to Agent Orange-exposed veterans, perhaps didn't have the spare time to read up on Agent Orange.

One place the nice folks at Compensation and Pension might turn for TCDD information is...the VA! Yes, indeed! Right on the VA Public Health "Facts About Herbicides" web page the VA says "TCDD is the most toxic of toxins, and is classified as a human carcinogen by the Environmental Protection Agency." 

Do we have this right? Has C&P refused care to over a thousand C-123 vets seeking care for cancers, ALS,

diabetes, heart disease and other Agent Orange presumptive illnesses...because C&P has concluded TCDD hasn't been shown to have any health effects? Their statement was brought to his attention in a meeting in the C&P office on 28 Feb 2013, and VA has not corrected or modified it in any way since.

That same web page directs veterans to the CDC/Agency for Toxic Substances and Disease web page, where the dangers of TCDD are discussed in detail. This is also confusing, because C&P directed VA to disregard input from Dr. Tom Sinks, Deputy Director of the CDC/ATSDR, as well as other experts from agencies such as the National Institutes of Health, EPA and US Public Health Service...all of whom agree C-123 veterans were exposed to TCDD. C&P writes that these other government agencies are not qualified to discuss exposure to Agent Orange. Yet VA tells vets to rely on ATSDR for information about TCDD!!

It seems the only conclusion a reasonable person can make from all this is that C&P has decided that no C-123 veterans were harmed by their Agent Orange exposure, despite opinions from other federal agencies and in the face of its own conclusions about the dangers of TCDD. 

It seems the only reason for this action by Compensation and Pension is to insure, despite the law, that all C-123 vets are prevented from receiving care for their established Agent Orange illnesses. It seems C&P is determined to prevent "benefit of the doubt" or "veteran-friendly, non-adversarial" requirements to apply to C-123 vets.

Can't somebody from VA's Office of the General Counsel read the law to Compensation and Pension? Toss them a copy of the Federal Register 8 May 2001, page 23166 and also the Federal Register of 31 August 2010. Counsel should ask why rating officials in the regional offices are told by C&P to tell veterans "regulations do not permit" recognition of C-123 exposures. 


Somebody must explain to Compensation and Pension, and to Post Deployment Health, that the term "exposure" is not theirs to redefine in a totally unscientific manner, which is what they've done for their stated purpose of preventing C-123 veterans' claims!

Note: VA's regulation that implements 38 U.S.C. 1116(a)(3), 38 CFR 3.307(a)(6)(i), defines herbicide agents specifically: “2,4-D; 2,4,5-T and its contaminant TCDD; cacodylic acid; and picloram.” So C&P is charged with providing compensation and pensions to TCDD-exposed veterans, but VA elects to deny compensation and pensions to TCDD-exposed C-123 veterans because C&P has concluded it isn't harmful????

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

National Institutes of Health Physician CONFIRMS C-123 Agent Orange Exposure

Dr. Miller

In a letter received by the C-123 Veterans Association today (March 13, 2013), CAPT (Dr) Aubrey Miller stated, "It is my opinion that the scientific evidence is clear. Dermal exposure, including exposure to contaminated equipment or secondary exposure through contaminated clothing, tools, vehicles, etc. could result in absorption that would be problematic. Studies conducted in both humans and animals clearly demonstrate the ability of TCDD to be absorbed through the skin."

Dr. Miller is the Senior Medical Officer of the National Institutes of Health/National Institute for Environmental Health Sciences, and is also a public health expert. His comments were the result of inquiries from the C-123 veterans seeking confirmation of our exposure aboard our airplanes. Dr. Miller also referenced the 2012 finding by Dr. Tom Sinks, Deputy Director of the CDC/Agency for Toxic Substances and Disease Registry. Dr. Sinks concluded that aircrews were exposed, and Dr. Miller wrote that, at NIH, "we agree with Dr. Sinks January 25 2012 hazard summary for exposure to this residual TCDD contamination."

Dr. Miller is an acknowledged cancer researcher and toxicologist in the Commissioned Corps of the US Public Health Service. Unfortunately for C-123 veterans, the VA Veterans Benefits Administration on February 28 2013 informed us that other federal agencies, regardless of their authority in the field, will not have their input accepted in evaluating veterans' claims. Only opinions created by the Veterans Health Administration are acceptable. The VHA has since Day One ruled veterans were not exposed, regardless of science, medicine, law, logic or any standard imaginable.

"No" means "no" because they say so. 

National Institutes of Health Confirms C-123 Veterans Exposure

In her June 2011 letter to C-123 veterans, Dr. Linda Birnbaum stated "According to the narrative [the USAF C-123 test reports] exposure is assumed based on wipe-tests demonstrating high dioxin concentrations in the C-123K's."

Dr. Birnbaum has the credentials to address this issue, as the Director of the National Institute of Environmental Health and also Director of the National Toxicology Program. She's also a member of the Institutes of Medicine of the National Academies of Science, the body to which the VA turns for expert advice about military herbicides.

Thus, it is confusing why the VA pretends her official and obviously expert opinion has no merit. Instead, VA ignores her altogether. Keeping their blinders on, the VA also dismisses the expert opinions of Dr. Jeanne Stellman (Columbia University), Dr. Fred Bowman (Oregon Health Sciences University), Dr. Arnold Schecter (University of Texas), Dr. Wayne Dwernychuk (retired chief scientist Hatfield Constants) and every other expert whose agreement has been added to the case of C-123 veterans' exposure.

Similarly, the VA even dismisses without comment the official and expert opinions of Dr. Tom Sinks, Deputy Director of the CDC/Agency for Toxic Substances and Disease Registry, who concluded after his review of C-123 contamination, "I believe aircrews operating in this, and similar, environments, were exposed to TCDD." TCDD is the toxic element in Agent Orange. When asked for their input, EPA deferred to Dr. Sinks' official opinion, making it three in favor (CDC, NIH, EPA) of the C-123 veterans, vs. only the VA with their predetermined opposition to any new Agent Orange exposure claims....a matter of internal, unofficial policy, you see. Not law.

Every scientist whose opinion has been offered thus far agrees that C-123 veterans were exposed to "military herbicides" - as reads the law. They agree contaminated C-123 aircraft exposed us to military herbicides in both the scientific meaning of "exposure" as well as the 1991 Agent Orange law, about which the VA in the C.F.R.s stated veterans exposed outside Vietnam would be treated the same as those with boots on the ground. Every other federal agency which has looked into the issue agrees with C-123 veterans' exposure. Only the VA insists, contrary to law, science and logic, that contaminated aircraft did not expose the veterans who served aboard these tainted C-123s.

Clearly, VA's Public Health and Compensation Service departments oppose C-123 veterans' justified Agent Orange claims solely as a matter of personal judgment, not of law. Not of science. Not anything which justifies such intransigence.Washington...what the heck is going on?

C-123 Veterans Claims vs. VA Counter-Claims: Who is Ahead?

The Balance of Arguments

Veterans:

- "It is my opinion that (C-123) aircrews operating in this, and similar, environments were exposed to TCDD."

(Dr. Tom Sinks, Deputy Director, CDC/Agency for Toxic Substances & Disease Registry)

- "It is my professional opinion that (veteran name withheld) (and likely, other aircrew veterans who flew these aircraft in the same time period) was exposed to harmful levels of dioxin." 

(Dr. Fred Berman, Oregon Health Sciences University Toxicology Department) 

- "(The C-123 is) heavily contaminated. A danger to public health."

(Dr. Ron Porter, toxicologist, USAF Armstrong Laboratories)

- "In my opinion, it is highly likely that you and other crew members were exposed to the herbicides and to their highly toxic contaminant, 2,3,7,8- tetrachlorodibenzodioxin (dioxin, for short)" 

(Dr. Jeanne Stellman, Professor Emerita, Columbia University School of Public Health)

- In my professional judgment you are at increased risk for illness from the dioxin in Agent Orange because of your exposure to it from your (C-123) military service”

(Dr. Arnold Schecter, Professor, University of Texas School of Public Health)

VA:

- "No conclusive evidence that TCDD exposure causes any adverse health effects."

(VA Compensation Services in claim denial)

- "TCDD is the most toxic of the dioxins, and is classified as a human carcinogen by the Environmental Protection Agency."

(VA Public Health Bulletin )

- “(C-123 veterans’) Claims are decided on an individual basis."

VA Public Health Bulletin (however: 100% of claims denied -  0% approved, but on an "individual" basis, of course!)

- C-123 vets are "Trash-haulers. Freeloaders looking for a tax-free dollar. I have no respect for them but do for combat vets."

(The DoD & USAF consultant on Agent Orange, his 2011 email re: C-123 vets; in 2010 he recommended “quiet, low-visibility” destruction of C-123 fleet to prevent veterans learning of C-123 contamination & crew exposure. Most C-123 veterans are combat veterans of Vietnam, Desert Storm or both)