NEW: Agent Orange linked to ‘aggressive’ bone marrow cancers in Vietnam veterans

(forwarded by Paul Bergeron)
Agent Orange exposure is a recognized risk factor for several types of bone marrow cancers, and is a presumptive condition for U.S. veterans seeking health and disability benefits. These include multiple myeloma and, based on recent research, myelodysplastic syndromes (MDS). 

Confirmed Bone Marrow Cancers:
VA officially recognizes the following bone marrow-related conditions as presumptively linked to Agent Orange exposure:

1. Multiple Myeloma: This is a cancer of the plasma cells, a type of white blood cell found in the bone marrow. The VA considers it a presumptive condition, which means affected veterans do not have to prove a direct connection between their service exposure and the disease to be eligible for benefits.
2. Chronic B-cell Leukemias: This group of blood cancers affects B-cells, which also originate in the bone marrow and are part of the immune system. 

Emerging Evidence: Myelodysplastic Syndromes (MDS):
Until recently, the link between Agent Orange and myelodysplastic syndromes (MDS) was less clear, creating barriers for veterans seeking care and disability benefits. However, significant new research, presented at the 2025 American Society of Hematology annual meeting and published in the journal Blood, has established a strong association.
The study identified genetic mutations tied to earlier diagnosis and faster progression of the disease, he said. “What we’re seeing is that Agent Orange added a mutation — and that mutation sets patients on the road to cancer 50 years later,” researchers stated.
These findings are expected to help formalize the recognition of MDS as a presumptive condition, aiding veterans in accessing the care they need. 

Key findings from this research indicate that exposed veterans:
• Have a higher risk of developing MDS.
• Tend to be diagnosed at a younger age.
• Exhibit more aggressive forms of the disease with a higher number of harmful genetic mutations.
• Are nearly twice as likely to see their condition progress to acute myeloid leukemia (AML). 

Actionable Steps for Veterans:
If you or a loved one are a veteran who was exposed to Agent Orange and have been diagnosed with a bone marrow cancer:
• Check Eligibility: Veterans who served in specific areas (e.g., Vietnam, the Korean DMZ) during defined time frames are presumed to have been exposed.
• Apply for Benefits: You may be eligible for VA health care and disability compensation. You can learn more about the process and eligible conditions on the official VA Public Health website. While many health problems such as MDS are not recognized by VA as presumptively associated with Agent Orange exposure, a claim can proceed for a case-by-case adjudication. This MDS study can help support such a claim. Seek help from an accredited veterans service officer, such as from DAV, VFW, state or local governments.
• Seek Specific Care: The findings from recent studies suggest that Agent Orange-related MDS has unique genetic patterns, which might influence specific treatment decisions. Consult with a hematology specialist. Make sure your health care providers are aware of your Agent Orange exposure history!
• Get an Exam: Eligible veterans can receive a free Agent Orange Registry health exam to document exposure-related health concerns. 

American Legion – Nine Years of Supporting C-123 Veterans

The American Legion got the ball rolling for C-123 veterans and our Agent Orange concerns. In 2012 Dr. Jeanie Stellman and I visited the Legion's DC offices for a meeting with their national leadership. We briefed them on Stellman's research and Air Force materials that established our Agent Orange exposures, and asked the Legion to get behind us with the power of their nearly one million members.

They said yes, and for us to return the next day with a draft resolution to be voted on at their next national convention. Stellman and I wrote it that night, the Legion executives accepted it, and our resolution was eventually approved as Resolution 128 at the 2012 national convention.

The Legion also led in January 2015 after the Institute of Medicine determined we'd been exposed to Agent Orange aboard our aircraft. Along with the rest of the "Big Six" veterans organizations they insisted that VA Secretary Bob McDonald act on the IOM findings, which he finally did on June 19 2015. 2100 C-123 aircrews and maintainers, and their survivors, got VA Agent Orange benefits that day, with much thanks due the American Legion.

Over the next few years, a number of articles about C-123 veterans appeared in Legion publications. I've gathered them along with Resolution 128 for your review.

In May I asked our local post to initiate a Colorado resolution supporting Gold Star Wives property tax exemption, and it was approved by the entire state organization on June 28. Lesson for me: resolutions are the Legion's slow but steady march towards better veterans benefits.

And again...thanks Legion!

VA Reverses Joe Collins' C-123 Agent Orange Claim Denial – grants full benefits at last

I wrote earlier (4 Oct 2016) about reading a June 2016 Board of Veterans Appeals denial of a vet's appeal that had a lot of C-123 info in it, including the years the unnamed vet served at Hanscom AFB and that he'd worked on the C-123s there. With the help of the Westover "old geezers' network we were able to identify the vet as Joe Collins.

The facts were clear...there was no way the denial would hold up, yet there it was, denied and any correction likely to take years. But the vet, according to the denial, had advancing cancer. It couldn't and shouldn't wait.

It only took a couple of phone calls to VA HQ as well as their St Paul C-123 claims center to start correcting this injustice. Three months passed. Yesterday VA posted the "new and improved" BVA decision about Joe Collins' claim, awarding him full disability and calling its error, "a denial of due process of law."

Whatever. What matters is that Joe and his wife are now protected with the benefits due his Agent Orange illnesses, and the event proves we have to keep looking out for each other, especially our elder brothers and sisters who too often get ignored or mistreated by VA.

Here's the text of the BVA re-decision. It states that new evidence was submitted after Joe's June denial, but that's incorrect. All I did was point out the VA's own magnificent error.

Citation Nr: 1637572

Decision Date: 09/23/16   Archive Date: 09/30/16

DOCKET NO. 15-34 922   )       DATE

On appeal from the

Department of Veterans Affairs Regional Office in Boston, Massachusetts

THE ISSUES

1.  Whether new and material evidence has been submitted to reopen a claim of entitlement to service connection for chronic lymphocytic leukemia.

2.  Entitlement to service connection for chronic lymphocytic leukemia (CLL).

REPRESENTATION

Veteran represented by: Massachusetts Department of Veterans Services

WITNESS AT HEARING ON APPEAL
The Veteran

ATTORNEY FOR THE BOARD

J. J. Tang, Associate Counsel
INTRODUCTION

The Veteran served on active duty with the United States Navy from April 1946 to April 1948, and on active duty as a member of the United States Navy Reserves from October 1950 to August 1952. It appears that he had an additional period of active duty from August 1959 to August 1962, verified periods of active duty for training from October 28, 1962, to November 28, 1962, and additional active duty for training in 1972 and 1973, with the United States Air Force Reserves.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Boston, Massachusetts, which declined to reopen the Veteran's claim of entitlement to service connection for CLL.

The Veteran testified before the undersigned Veterans Law Judge (VLJ) by videoconference in April 2016. A transcript of his hearing has been associated with the record.

This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2015). 38 U.S.C.A. § 7107(a)(2) (West 2015).

FINDINGS OF FACT

1.     On June 2, 2016, the Board issued a decision that declined to reopen the previously denied claim for service connection for CLL, and in this decision, the Veteran was denied due process of law.

2.     In a November 2012 Board decision, the Board denied a claim for service connection for CLL, based on the determination that such disability was not incurred in or aggravated by active service.

3.    The Veteran did not appeal the November 2012 Board decision to the United States Court of Appeals for Veterans Claims (Court) and did not file a request for reconsideration of the November 2012 Board decision.

4.    The additional evidence received since the November 2012 Board decision is new and raises a reasonable possibility of substantiating the claim for service connection for CLL.

5.    The Veteran has CLL, the Veteran was exposed to an herbicide agent from C-123 aircraft in the line of duty during a period of active duty for training in the Air Force Reserves during the Vietnam era in 1972 and 1973.

CONCLUSIONS OF LAW

1.   The June 2, 2016 decision of the Board is vacated. 38 U.S.C.A. § 7104(a) (West 2014); 38 C.F.R. § 20.904 (2015).

2.   The November 2012 Board decision, which denied entitlement to service connection for CLL, is final. 38 U.S.C.A. § 7104(b) (West 2010); 38 C.F.R. § 20.1100 (2012).

3.   The additional evidence received since the November 2012 rating decision is new and material to the claim for service connection for CLL, and the claim is reopened. 38 U.S.C.A. § 5108 (West 2014); 38 C.F.R. § 3.156(a) (2015).

4.   The criteria for service connection for CLL are met. 38 U.S.C.A. §§ 101, 1110, 5107 (West 2014); 38 C.F.R. §§ 3.6, 3.102, 3.303, 3.307, 3.309 (2015).

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS
Vacatur of Board Decision

The Board of Veterans' Appeals (Board) may vacate an appellate decision at any time upon request of the appellant or his or her representative, or on the Board's own motion, when an appellant has been denied due process of law or when benefits were allowed based on false or fraudulent evidence. 38 U.S.C.A. § 7104(a) (West 2014); 38 C.F.R. § 20.904 (2015). On June 2, 2016, the Board issued a decision that declined to reopen the previously denied claim for service connection for CLL, and in this decision, the Veteran was denied due process of law. Accordingly, the June 2, 2016 Board decision addressing the issue of whether new and material evidence has been submitted to reopen a claim of entitlement to service connection for CLL, is vacated.

Duties to Notify and Assist

Because the Board is reopening the previously denied claim for service connection for CLL and granting the claim on the merits, discussion concerning compliance with the duties to notify and assist is not necessary.

Application to Reopen the Claim for Service Connection

Even if a prior decision becomes final, a claim may be reopened if new and material evidence is presented. 38 U.S.C.A. § 5108. New evidence means existing evidence not previously submitted to agency decision makers. Material evidence means existing evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened, and it must raise a reasonable possibility of substantiating the claim. 38 C.F.R. § 3.156(a) (applying to claims to reopen that are filed after August 29, 2001). Evidence "raises a reasonable possibility of substantiating the claim," if it would trigger VA's duty to provide a medical examination in adjudicating a non-final claim. Shade v. Shinseki, 24 Vet. App. 110 (2010); see McLendon v. Nicholson, 20 Vet. App. 79 (2006).

In a November 2012 Board decision, the Board denied a claim for service connection for CLL, based on the determination that such disability was not incurred in or aggravated by active service. After the Veteran was notified of the adverse decision, the Veteran did not appeal the November 2012 Board decision to the Court, nor did he file a request for reconsideration of the November 2012 Board decision. Therefore, the Board decision became final based on the evidence of record at the time. 38 U.S.C.A. § 7104(b) (West 2010); 38 C.F.R. § 20.1100 (2012).

At the time of the November 2012 Board decision, the evidence of record included the Veteran's service records, post-service treatment records, and the Veteran's statements. Such evidence showed a diagnosis of CLL, that the Veteran served as an Air Reserve Technician (ART) from 1970 to 1973, and that the Veteran's service as an ART was during a period of active duty for training in the Air Force Reserves at Hanscom Air Force Base.

The additional evidence presented since the November 2012 rating decision includes the Veteran's written statements describing his work as an ART during active duty for training in the Air Force Reserves at Hanscom Air Force Base. The Veteran also submitted annual statements of Reserves credits for 1972 and 1973, in which the Veteran is shown to have had credits for days of active duty for training service during these years. The credibility of the Veteran's statements is presumed for the purposes of reopening the claim. Justus v. Principi, 3 Vet. App. 510, 513 (1992). Evidence that tends to indicate that the Veteran may have been exposed to an herbicide agent regularly and repeatedly in the line of duty during a period of active duty for training during the requisite time period in the Vietnam era was absent at the time of the November 2012 rating decision, and this evidence, in conjunction with the newly revised regulation pertaining to herbicide exposure for Air Force Reserves crewmen, raises a reasonable possibility of substantiating the claim. Thus, the Board finds that new and material evidence has been submitted. The claim for service connection for CLL is reopened. The merits of the claim for service connection are discussed below.

Service Connection

A Veteran is entitled to VA disability compensation for service connection if the facts establish that a disability resulted from disease or personal injury incurred in the line of duty or for aggravation of a preexisting injury in the active military, naval or air service. 38 U.S.C.A. § 1110 (West 2014); 38 C.F.R. § 3.303(a) (2015).

"Active military, naval or air service" includes periods of active duty for training (ACDUTRA) during which a disease or injury was incurred or aggravated in the line of duty. See 38 U.S.C.A. § 101(24); 38 C.F.R. § 3.6; see also Biggins v. Derwinski, 1 Vet. App. 474 (1991).

Generally, to establish entitlement to service connection, the claimant must show: (1) a present disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

The Veteran has been diagnosed with CLL, per the medical evidence of record. Thus, the present disability is shown.

The Veteran contends that his CLL is the result of exposure to an herbicide agent during active service. The Veteran contends that he was working as an ART at Hanscom Air Force Base from 1970 to 1973, and as discussed above, his Reserves credits records confirm periods of ACDUTRA in 1972 and 1973. The Veteran reports that he worked on C-123 aircraft that had been used to spray an herbicide agent in Vietnam. In a January 2009 statement, the Veteran reported that though he was not actually removing tanks and equipment from the aircraft, he was around the aircraft on a daily basis. In September 2009, the Veteran submitted a statement from a fellow ART that reported that over a period of several weeks, he and the Veteran physically checked on the status and decontamination of a C-123 aircraft that had arrived at the base for decontamination. The Veteran also testified at the April 2016 Board hearing regarding his specific duties as an ART on the C-123's, including taking floor boards out of the airplanes and doing maintenance inside and outside the airplanes. The Board finds that the Veteran's statements describing his duties as an ART during ACDUTRA and the Veteran's fellow ART's statements regarding their duties as ARTs are credible.

Newly revised 38 C.F.R. § 3.307(a)(6)(v) states, "An individual who performed service in the Air Force or Air Force Reserve under circumstances in which the individual concerned regularly and repeatedly operated, maintained, or served onboard C-123 aircraft known to have been used to spray an herbicide agent during the Vietnam era shall be presumed to have been exposed during such service to an herbicide agent. For purposes of this paragraph,'regularly and repeatedly operated, maintained, or served onboard C-123 aircraft' means that the individual was assigned to an Air Force or Air Force Reserve squadron when the squadron was permanently assigned one of the affected aircraft and the individual had an Air Force Specialty Code indicating duties as a flight, ground maintenance, or medical crew member on such aircraft. Such exposure constitutes an injury under 38 U.S.C. 101(24)(B) and (C). If an individual described in this paragraph develops a disease listed in 38 CFR 3.309(e) as specified in paragraph (a)(6)(ii) of this section, it will be presumed that the individual concerned became disabled during that service for purposes of establishing that the individual served in the active military, naval, or air service."

In light of the recent revised regulation, and given the credible statements as to the nature and duration of the Veteran's duties as an ART working with C-123 aircraft during these aforementioned periods of ACDUTRA, the Board finds that the Veteran regularly and repeatedly maintained C-123 aircraft during the Vietnam Era as a crewmember of an Air Force Reserve Squadron. Thus, under 38 C.F.R. § 3.307(a)(6)(v), exposure to an herbicide agent in the line of duty during ACDUTRA is shown.

CLL is included in the list under 38 C.F.R. § 3.309(e). There is a presumption of service connection for a Veteran who was exposed to an herbicide agent during active service and is diagnosed with CLL that manifested to a compensable degree at any time after service, unless there is affirmative evidence to show that the disease is not related to exposure to an herbicide agent. 38 C.F.R.

§ 3.307(a); see 38 C.F.R. § 3.307(d).

Here, the Board has found that exposure to an herbicide agent is shown, and such exposure constitutes an injury for purposes of determining whether the Veteran's CLL was incurred in active air service. Further, the Veteran's CLL is presumed to be service-connected on the basis of his exposure to an herbicide agent during his ACDUTRA service in the Vietnam era. For these reasons, the Board concludes that the Veteran's CLL was presumptively incurred in active air service, and service connection for CLL is granted.

ORDER

The June 2, 2016 decision of the Board is vacated.

Because new and material evidence has been received, the claim for service connection for CLL is reopened.

Entitlement to service connection for CLL is granted

American Legion Statement on New C-123 Veterans' Agent Orange Exposure Rules

C-123 veterans awarded benefit eligibility

The American Legion - June 24, 2015

Featured in Veterans Benefits Center

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After a tumultuous uphill battle, some Air Force Reserve veterans will finally be able to receive disability benefits to cover Agent Orange exposure while serving around Fairchild C-123 aircraft. VA announced the decision during a closed-door meeting with The American Legion and a handful of other veterans service organizations, effective June 19. The decision is projected to result in the awarding of over $47 million in disability benefits over the next 10 years; the decision may slightly add to VA’s backlog of disability claims.

Affected individuals, not otherwise eligible for VA healthcare benefits, will also be afforded access to medical care and survivor benefits once supporting documentation is provided indicating herbicide exposure. Previously used to spray herbicides during the Vietnam War, reservists utilized the aircraft from 1969 to 1986 to transport cargo and medical supplies.

VA’s denials of claims associated with C-123 aircraft were based upon the premise that reservists were not exposed to the toxic herbicide. Nearly one month ago, VA Secretary Robert McDonald agreed to recognize the findings of a January 2015 study by the Institute of Medicine revealing that reservists were exposed to the contaminant at levels that would impact their health. After an initial indication that VA would grant the presumptive exposure, VA delayed its implementation of the policy. The failure to implement the policy garnered national attention after three senators placed a hold on the nomination of David Shulkin, M.D., for Under Secretary for Health until a formal announcement of the change in policy regarding C-123 aircraft.

“Our sense of relief is tempered by the grief felt for lost comrades,” said retired Maj. Wesley Carter, president of the C-123 Veterans Association. “It is also tempered with memories of well-funded and adversarial actions employed against our claims by the VA. Every medical and scientific fact that convinced the Institute of Medicine of our Agent Orange exposures in 2014 had been presented to the VA years earlier, but was ignored.”

Carter attributed the success of the campaign to The American Legion and other supporters who rallied behind the association. Though VA’s announcement signifies a major victory, Carter added that VA leaders need to review their actions to ensure that veterans exposed to toxins no longer “face such an unhappy struggle.”

More information can be found by visiting the VA’s website.

Veterans are also encouraged to call (800) 749-8387 for more information, or email VSCC123.VAVBASPL@va.gov.

- See more at: http://www.legion.org/veteransbenefits/228319/c-123-veterans-awarded-benefit-eligibility#sthash.viacKJEn.dpuf

Pretty accurate news report covering C-123 exposures, from The Resident.

VA: C-123 Veterans' Service Connection – NOW!

The C-123 Veterans association is joined by other service organizations in calling on Secretary McDonald to recognize our aircrew and maintainers' Agent Orange presumptive service connection. 

It has been long enough.

American Legion Magazine Reports on C-123 Agent Orange Saga

The American Legion was the first service organization to stand with us in advocating Agent Orange benefits for our exposed C-123 veterans. Introduced to us by Columbia's Dr. Jeanne Stellman, Legion executives presented and the membership approved a resolution calling on the VA to recognize our toxin exposures.

Support from America's largest veterans organization is something that certainly got attention and respect from the Air Force and VA.

Continuing their focus on our C-123 issue, this month's Legion magazine carries an article by author Tom Philpott on page 19. Like the American Legion, Philpott is very familiar with C-123 issues, having begun his coverage of us in 2011 when we began our efforts. His coverage of the January 9 2015 report from the Institute of Medicine was very comprehensive, and carried through Gannett's chain.

Philpott has been covering military issues longer than most veterans served...over thirty years as a journalist, including his tour in the Coast Guard.

This month, he surprised us with his full page report in the Legion: we had no idea it was in the works. He certainly surprised me with his kind words, which are much appreciated as we anticipate wrapping up these four years of arduous work.

I believe the next report from Tom Philpott will announce (to use a naval metaphor) a terrific "sea change" in the way VA has evaluated our disability claims. That will be my favorite Philpott article ever! I can't wait!

Little-Known Benefits From a VA Disability Rating

Our focus, of course, is always on establishing our eligibility for VA medical care: No medical care means terrific suffering and financial hardship for veterans unfairly denied earned care.

For 100% disabled veterans, VA's embrace is wonderful. Ophthalmology, audiology, counseling, rehab, dental, prosthetics, pharmacy, specialty clinics, general medicine...a wide range of vital services to help a disabled veteran recover, or improve as much as possible seeking the greatest quality of life possible.

And, of course, there is compensation. It is called that because of the philosophy of replacing, with some financial adjustment, the veteran's lost earning capacity. It is not a pension, it is not charity, it is not taking something more properly due another deserving veteran...it is earned by each veteran with a recognized service-connected illness or injury. There is no means test, of course: that's something required for a pension, but not service-connected compensation.

But there is more that veterans should be aware of (but I'm no expert...check with the VA for details!)

• State benefits, typically property tax relief, veterans bonuses, automobile licenses and waived auto fees, state veterans' homes, cemetaries, college tuition waiver, children's college tuition waiver
• Veterans Cemetery Administration. Burial in a national cemetery, state veterans cemetery. Burial allowances for service-connected deaths
• Priority One for VA medical care, with no co--pays
• Educational benefits for children; continued medical care for children disabled before age 18
• Transportation costs for medical care beyond a certain distance from a veteran's home
• Contract medical care in the community
• Long-term health care (this gets tricky...VA needs to explain if you're interested) in VA facilities or contracted local facilities; VA assistance with state nursing homes which charge fees
• One year of fee-waived VGLI (must be applied for) 

• Clothing allowance for clothing damaged by medicines, prosthetics, wheelchairs, etc.

• Independent living assistance, sometimes including home modifications, quality of life issues
• Access to VA's War Injury and Illness Treatment Centers
• Combat Related Special Compensation. Adjusts taxes on military retirement, in some cases to zero, because Agent Orange is a "weapon of war"

• Some commercial firms, like Lowes and Home Depot, offer discounts 

• Survivor's benefits, including CHAMP-VA

VBA's Claims Accuracy Only 25% – Corrections Take Three-Four Years at BVA

According to the Vietnam Veterans of America and the American Legion, about 75% of all disability claims processed by the Department of Veterans Affairs Veterans Benefits Administration are flawed in some manner, minor or serious, affecting the veteran's benefits. A 75% failure rate in aviation be mission-unacceptable, a certain suicide before completing two missions. Similarly, VA literally condemns many of us to a suicide mission while awaiting claims processing following by appeals at BVA to fix the VARO errors. This is troubling enough without contemplating VHA's determination to prevent C-123 claims altogether.

Claims appeals: Why they take forever
The American Legion - June 19, 2013

On June 18 2013 the House Veterans’ Affairs Subcommittee on Disability Assistance and Memorial Affairs held a hearing to find answers as to why the Department of Veterans Affairs (VA) appeal process for veterans’ benefits takes so long to complete.
According to a fiscal year 2012 report from VA’s Board of Veterans’ Appeals (BVA), it takes about 900 days from the time an appeal is filed to when a final decision is reached. The claims appeals of more than 45,000 veterans are currently pending at BVA.
The American Legion, which has 2,500 accredited service officers nationwide and about a dozen full-time national appeals representatives in Washington, submitted a statement for the record. From Jan. 1, 2010 to June 1, 2013, the Legion’s appeals representatives have represented 29,542 veterans and their dependents who were trying to get benefits claims from BVA. The Legion effectively demonstrated that VA had erred, or failed to fully develop a claim, in 21,632 (nearly 75 percent) of those cases.
On June 3, VA reported an accuracy rate of 89.6 percent for claims adjudicated over the previous three months. Yet, the Legion’s statistics indicate that VA regional offices (VAROs) are providing quality decisions in less than one-fourth of the claims processed. Admittedly, claims handled by the BVA are only a portion of those submitted. However, they are a sampling of work that reflects the quality of claims decisions at 56 VAROs nationwide.
Unquestionably, the appeals process proves to be time-consuming and frustrating for our veterans. By the time BVA renders a decision, a claimant will often have spent several years in the appeals process.

President's Executive Orders Address Veterans' Issues

Speaking today at the American Legion's 2014 National Convention, President Obama announced nineteen steps he is taking through executive orders to address the ongoing scandal in the Department of Veterans Affairs. Unfortunately, nothing was mentioned about the claims or appeals process. (CLICK for complete speech)

Yesterday, the VA itself released an Inspector General report which indicates no deaths can be positively attributed to the delays in patient care in Phoenix, despite whistle-blower allegations.

Among the key points in the President's orders are:

• A new recruiting campaign to fill shortages of doctors and nurses at VA hospitals.

• Automatically enrolling military personnel receiving mental health care into mental health treatment programs by the VA.

• A partnership with five national banks to help veterans get lower rate mortgages easier.

• New efforts to better understand traumatic brain injuries, including a $34.4 million VA suicide prevention study involving 1800 veterans at 29 VA hospitals, and more suicide prevention training for military and VA personnel.

• Automatic enrollment of separating service personnel in transition programs.

In recent weeks the VA has also trumpeted grants for homeless veterans throughout the country, dedicating millions towards this serious need.

The VA scandal erupted in April when a retired doctor at the VA hospital in Phoenix disclosed that long wait times may have contributed to the deaths of as many as 40 veterans. A preliminary investigation found that delays and falsified records were widespread through the VA system.

The President assured the Legionnaires, "We are going to fix what is wrong. We are going to do right by you and your families, and that is a solid pledge and commitment I’m making to you here.”

The American Legion has long been a supporter of C-123 veterans' Agent Orange exposure claims, for which we continue to express our gratitude.

Court of Appeals for Veterans Claims Sees Trouble Ahead With Caseload

In its current condition, the U.S. Court of Appeals for Veterans Claims can handle its caseload. But a judge on that court with close ties to The American Legion told Legionnaires at the 96th Annual National Convention in Charlotte, N.C., that things are changing.
Past National Commander Alan Lance, Sr., a judge on the U.S. Court of Appeals for Veterans Claims, told the Legion’s Veterans Affairs & Rehabilitation Commission on Aug. 24 that staffing issues facing the court – along with an increase in appeals coming before it – could put the court in a precarious spot.
“Right now, we have nine judges, and we’re adequately staffed and prepared to deal (with the current caseload),” said Lance, the Legion’s national commander from 1999-2000 and a former Idaho attorney general. “Very soon, we’re going to start losing judges. Unless Congress reauthorizes the maximum strength of nine judges, that strength will be reduced to seven judges at about the time (the court’s caseload will increase).
“In addition to that, we have judges whose terms of service will expire, and it takes a while to get a judge nominated, confirmed and through the process. So … we’re going to be pretty busy, we think. I’m sure we’ll have some suggestions at the appropriate time, but right now we’re just watching it come down the mountain, trying to figure out when it’s going to hit and how much it’s going to be.”
In 2002, the Court of Appeals for Veterans Claims handled more than 17,000 cases. That caseload could approach more than 50,000 this year. “We’re prepared to deal with it right now, but as circumstances change, we may be coming back and explaining our problems to you,” Lance said.
An understaffed Department of Veterans Affairs’ Group 7 – attorneys tasked with more or less prepping cases to go before the Court of Veterans Appeals and then argue cases on behalf of VA – will impact the court, Lance explained. “They’re going to be requesting more time … and they’re going to slow up the appellate process if they’re not properly staffed,” Lance said. “Our court has no control over this. It’s the (VA) secretary’s bailiwick. But if (Group 7’s) processes slow down, then our processes will slow down. That’s my concern.”

C-123 Vet's Recent Clinic Experience, Fort Collins CO

I'd sought an appointment at Fort Collins VA Clinic upon being discharged from the VA Palo Alto War Injuries and Illness Center, which recommended I see my primary care provider within two weeks.

I gave all the details to the telephone operator who finally called back eight days after two messages were left on their machine...I repeated the situation, my medical issues of cancer and heart disease plus the newly-found cervical and lumbar damage, and Palo Alto's recommendation to see my doc in a couple weeks. I was given an appointment three months out and told I was to be seen twice a year...although if I had a medical emergency I could be seen earlier. This didn't feel top-notch, and I told the scheduler I had the resources to be seen elsewhere more promptly.

VA Clinic, Fort Collins, CO

At last month's American Legion Town Hall meeting in Fort Collins, the VA folks had no trouble rescheduling me the following week..."what day, what time is most convenient?" I don't know why one attempt by me resulted in an unacceptable three month delay, and another with a VA clerk using a laptop at the American Legion was immediately satisfactory.

The appointment itself was perfect: I was quickly processed through the front desk, waited about five to ten minutes before I was called by my doctor himself, received thorough counseling and review of the Palo Alto information, and escorted to the door by him when our visit was over.

A disappointment: I asked to see the administrator but after ten minutes, was told she was at an urgent event in Greeley. I left my card but have not been called back. I wanted to relate the initial appointment difficulty, express my satisfaction with the care that day and the rescheduled date, and discuss an upcoming Vietnam Veterans of America Town Hall meeting.

Fort Collins VA Clinic Experience

Fort Collins (CO) VA Outpatient Clinic

Today I related to the American Legion Crisis Action meeting here in Fort Collins my most recent
appointment experience. Previously, I'd been disappointed only with the long delay arranging an initial primary care appointment (I'm 100% service connected) after we moved to Colorado. I didn't think much about it and subsequent experiences, both with health care and appointments, were perfect; nice folks, superb care, attractive facility, short waiting time...everything great. Good reason to move to Fort Collins!

But a real problem hit in June. I'd been in the Palo Alto (CA) VA War Injury & Illness Study Center for several days of extensive tests, with more problems identified. I was discharged with instructions to seek an appointment with my primary care within two weeks. Doing so, I left a message with the Fort Collins VA Clinic recorder - no live person free to answer the phone, I guess. Gave the details of the request and waited.

Eight days later, not having heard anything, I called again, only to have to leave a message on their machine again. The next day I was called (June 26) and we discussed my request to see my primary care.

I related my recent VA hospitalization in California, mentioned I'd also just had shoulder surgery three days earlier, repeated my issues with heart disease, cancer, spinal cord injury, diabetes, 100% service connected and other stuff. The scheduler explained that I saw my primary care twice a year and so the next appointment should be in September.

Just in case he didn't understand or I'd not been clear, I repeated everything, especially the Palo

Alto VA orders to see my local VA primary care in two weeks (which would be late June into early July.) Just in case I didn't understand, the scheduler then repeated that my next appointment should be in September.

"Okay," I said. I certainly didn't want to "bump" anyone needing care more urgently, and the next available appointment offered me was again, September. I told the clerk that because I felt I needed care more promptly than that, I'd seek it through non-VA means. I repeated I didn't want to bump anybody from ahead of me at the VA. We finished our call.

Three months. A long time for a vet already rated "catastrophically disabled" and 100% service connected by the VA to wait for an appointment to see his primary care provider. An especially long time given the VA Palo Alto discharge instructions to see the primary care provider within a couple weeks. An especially long time given the twice-repeated summary of the reasons behind the appointment request, and also because the primary care had referred me to Palo Alto's War Injury and Illness Study Center and follow-up with him was necessary.

Admittedly, I was passive, unassertive, letting the appointment clerk make his decisions without my pushing, but carefully waiting to see what the outcome would be. How quickly would I be seen or how long would my appointment be put off? I was already alarmed because my first call to their appointments recorder had been eight days earlier. Eight days passed and I heard nothing until I called a second time, and then a day passed before we connected. Nine days, with the first request left on their answering machine apparently lost and never acted on.

Today, relating my situation to the team of VA specialists helping the American Legion conduct their Veterans Crisis meeting, the VA gentleman from Cheyenne typed my info into his laptop (on line with the VA) and offered me three choices for appointments next week. No big deal – when did I want to come in? What time of day was most convenient?

Wonderful! But I don't understand why I was tossed a 90-day delay with my earlier request, but today, before relating my situation in detail but simply saying I wanted to have an appointment,  was offered numerous possibilities anytime next week.

I do know the ninety day delay was bad enough that it could have left some vet dead. No non-vet would ever tolerate such a delay elsewhere in the medical community. Discussing it with VA managers today was unburdening but nobody took notes, nobody said it was something that wouldn't happen again, nobody said it was something to fix, everybody was polite.

I was told to mention it to my primary care when I see him next week. That's all.

I see no reason situations like this won't repeat, especially with confused, depressed, stoic or passive veterans who quietly accept whatever's offered in terms of appointments, scope of care, ancillary services, things which can be quite important to life and limb! The patient's role is to ask for help from the VA and explain the need.

In its ninety-day response, VA proved dangerously inadequate in my most recent experience. At least in this instance and in this place, VA's process depended on a patient to push past an appointment clerk for proper telephone triage appropriate for the urgency to be acted upon. VA cannot count on patients to push the system, and doesn't take well to them doing it, either.

National Veterans Groups Challenge VA on C-123 Agent Orange Claims Obstruction

On June 27, using the letter below, all six major veterans organizations firmly challenged the Veterans Administration (VA) for inappropriate use of a particular consulting firm. The firm represented the VA in a June 16 Institute of Medicine (IOM) committee meeting evaluating C-123 Agent Orange exposure issues. Veterans leaders dispute the consultant's findings, and insist the firm was cherry-picked for its known opposition to veterans' exposure claims, which in this case had been expressed by the firm for years. 

Veterans and Agent Orange experts reviewing the statements and documents submitted by the consultant to the IOM on behalf of the VA complain to the Secretary that the input was unscientific and failed to meet VA's published standards for quality, utility, integrity and objectivity of information released by the Department.

This group letter follows publication in the Sunday Boston Globe of a front page feature article about a C-123 veteran, Dick Matte had a heart transplant, lost his left leg in February and is increasingly ill but his Agent Orange exposure claims were denied, just as with all of other C-123 vets. 

Other news impacting the issue was the C-123 Veterans Association release of a "Casualty List" of ten deceased veterans who flew or maintained these former Agent Orange spray transports. All died after being refused VA care...turned away by VA, the veterans had to do their best seeking medical care elsewhere. 

That's not right! In the many ways VA is wrong in preventing exposed veterans' access to VA facilities , we leave it to the department's Inspector General or the Secretary himself to address.

======================================================= 

June 27, 2014

The Honorable Sloan Gibson

Acting Secretary

United States Department of Veterans Affairs

810 Vermont Avenue

Washington, D.C.

Dear Mr. Secretary,

We write to ask that you take immediate steps to reverse the action of the Veterans Health Administration (VHA), Office of Public Health section, in retaining a certain outside consultant firm regarding Agent Orange.

Having this particular consultant represent VA at the June 16 public meeting of the National Academies of Sciences Institute of Medicine (IOM) Committee on the Exposure of C-123 crews to Agent Orange is nothing short of reprehensible. As you move forward in your efforts to reestablish the trust of veterans in VA (including the strong united support of the nation’s veterans service organizations), we caution that employing that particular consulting firm will be seen as an inappropriate, anti-veteran choice.

This consulting firm’s decades-long association with the VA and its consistency of obsolete views over the past 40 years, despite all current scientific knowledge, is not what the public expects, as VA meets its own mandate for release of information:

“VA will ensure and maximize the quality, objectivity, utility, and integrity of information it disseminates to the public.” (http://www.rms.oit.va.gov/information_quality.asp#Release)

We ask that you review this firm’s unique contractual involvement with the VA and make appropriate decisions.

We are alarmed that VA had already assumed a position and that the contractor directly informed the IOM of the VA’s position. He made clear he was offering his input as a scientist to insure the integrity of the scientific record. In fact, as his own support documents submitted to the committee make clear, VA contracted with his firm to produce, and then release to the IOM, his reports, some of which targeted veterans’ claims directly.

Whether from Young or from other personnel in the Office of Public Health (OPH), the use of the term “bioavailability” is now being used to deny claims. This is a term in the development of pharmaceuticals that is used to refer to how much and how fast the active ingredients reach the specific part of the body that one is trying to affect. Of course, this has to be measured in a controlled setting. Air missions almost forty years ago do not lend themselves to such measurement. So this is nothing but junk science. If this were the standard used at the Love Canal, NY, or Times Beach, MO, toxic disasters, then one would judge that all those who died were not even sick, as “bioavailability” could not be measured or proven. This is patent nonsense.

This contractor’s reports, regardless of any possible partially factual accuracy they may convey, do not meet the appropriate standards of VA nor of any other federal, science-focused agency. The contractor’s reports yielded to the VHA/VBA agenda, serving VA rather than science and veterans. These reports could never survive peer review, yet VA selected this person to pressure the IOM into preventing the veterans’ exposure claims.

For four decades, this contractor has tried to obfuscate or hide the truth about the deleterious impact of Agent Orange. In fact, he has been paid to hide the truths regarding the negative health effects of Agent Orange and other phenoxy herbicides and organic phosphates used in Vietnam and elsewhere. 

In possible violation of ethics, VA’s contractor failed to disclose his 2009 recommendation to destroy the stored, toxic C-123’s, which was acted on in 2010. He had advised the Air Force, in numerous memoranda, that unless the planes were destroyed, veterans might apply for presumptive service connection because of their exposures. He then congratulated the Air Force for carrying out the destruction in a manner “below the radar.” His opposition to C-123 veterans is anything but “below the radar.” 

The contractor made numerous apparent misrepresentations during his June 16 presentation before the IOM, the most egregious of which was his use of photos of a reconditioned C-123, taken from a civilian owner’s website showing what the plane looks like today after the owner had rebuilt it. The consultant used these photos in an attempt to illustrate the 1972 results of Tail #664 and the other C-123s, claiming them to have been thoroughly refurbished after Vietnam. Actually, the photos he “borrowed” show modern cockpit modifications. The cargo deck photo shows equipment used today by the civilian owner for attending airshows. Certainly, these were not photos of modifications performed in 1972, as his report detailed. Of particular concern is the contractor’s use of the borrowed photos to challenge other scientists’ work, and we are troubled by such apparent deceptions aimed at these veterans.

While we would always rather focus on policies than personnel, in the case of this contractor, personnel is policy. On behalf of our nation’s veterans, we have an obligation to share with you the contractor’s record of positions, quite contrary to VA’s stated position, regarding the deleterious effects of one of the most toxic chemicals ever produced. The consultant’s record regarding Agent Orange is antithetical to good science on toxic exposures. Of grave concern are both his employment and the VA’s use of his “expertise” to construct obstacles to the delivery of care to veterans suffering from the very real toxic wounds afflicting our members and their families.

We welcome the opportunity to meet with you to discuss this contractor and other major problems of vital interest to our members.

Sincerely,

PETER S. GAYTAN

Executive Director

The American Legion

STEWART M. HICKEY

National Executive Director

AMVETS (American Veterans)

GARRY J. AUGUSTINE

Executive Director

Washington Headquarters

DAV (Disabled American Veterans)

Homer S. Townsend, Jr.        

Executive Director

Paralyzed Veterans of America                                 

ROBERT E. WALLACE

Executive Director VFW

Washington Office

RICHARD F. WEIDMAN

Executive Director,

Policy & Government Affairs

Vietnam Veterans of America (VVA)