VA & C-123 Veterans: "A Bellwether Moment" for Secretary McDonald (Navy Times Editorial)

Editorial: A bellwether VA moment

2:27 p.m. EST January 23, 2015

Bob McDonald must turn around VA.

New Veterans Affairs Secretary Bob McDonald has the Herculean task of trying to right his scandal-­plagued department, a mighty challenge forcefully defied by institutional resistance to change and a bureaucratic belief that its core mission is to serve the best interests of the government rather than those of the men and women who served the country in uniform.

VA's latest success in embarrassing itself involves the Air Force's fleet of C­-123 aircraft that sprayed the toxic defoliant Agent Orange on the jungles of Southeast Asia in the Vietnam War.

After the war, the planes were scrubbed down and kept in service, with 1,500 to 2,100 troops flying on them before they were retired for good in 1982. Many of those troops are now sick with cancer and other illnesses that they've long claimed were caused by toxic residue lingering in those C­-123 airframes.

That charge was backed up in 2012 in a government report. In customary fashion, VA's response was complete denial. Now, a new scientific review has come to the same conclusion as the earlier report — "with confidence." It's the latest in decades of VA health controversies: depleted uranium, burn pits, tainted anthrax vaccine, and more. 

In the pointed words of Rick Weidman of Vietnam Veterans of America, VA's standard approach to veterans' environmental health issues is "delay, deny, wait 'til they die."

McDonald somehow must turn around this massive, calcified outfit that still lacks vision, accountability, and, most importantly, trust among many of the

veterans it was created to serve.

VA officials promise to respond to the newest C-­123 report. That response will go a long way toward determining whether McDonald can effect the changes so badly overdue at VA.

House Veterans Committee Chair Blasts VA

He said it, right out loud. In the stately halls of Congress.

"FUBAR on steroids." Congressman Miller was referring to the Department of Veterans Affairs. If the phrase FUBAR is unknown to you, enjoy watching Saving Private Ryan again!

FUBAR for VA wan't good. It was Chairman Miller shooting from the hip with a couple full belts from his verbal .50 cal M2, expressing the nation's concerns over VA construction, claims, appeals backlogs and other scandals.

We don't know if VA opposition to C-123 claims these past four years fits into his FUBAR F-bomb, but we do know the delay has denied us medical care and also has cost us money. Denied state benefits because we still wait for VA disability ratings. Denied property tax relief while waiting for the VA to process our claims. Our kids, all now past college age anyway, denied tuition waivers due children of disabled veterans. There is a "catch-up" check of VA disability benefits when a long-delayed claim is finally approved, but there is no catch-up for everything denied the veteran during the years of waiting for "the big brown envelope" to arrive with a disability decision.

In our case, scientists have had everything the VA needed to properly adjudicated our exposure claims since at least 2008. VA, on the other hand, had everything it needed to delay our service connection ratings for these past years, and now seems ready to help only because the Institute of Medicine report showed the way.

That's their job, it seems. Our was to fly aeromedical evacuation. Both are important jobs with people's lives in the balance. We did our jobs to perfection. The airplane business is like that...imperfection equals death. The medical business of aeromedical evacuation is like that, too. Imperfection equals patient suffering or death. We did our jobs to perfection.

Can you imaging their take on us if we waited four years to do our jobs, getting around to picking up a load of patients? And doing our job only when forced to?

No...we were volunteers. We were professional and we were caring. The nation, and our fellow servicemembers, could and did count on us. No four year delay like we were handed by the VA.

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.”