Acting VA Secretary Seeks $18 Billion Extra to Solve Problems

Veterans Affairs Department officials want nearly $18 billion more in funding over the next three years to hire more clinicians, lease more space and cut down on wait times for medical appointments.

The money is also partly designed to serve as a down payment on rebuilding VA's reputation, proving to the public that with enough resources, the department can once again be a reliable asset for veterans seeking care.

In his first testimony on Capitol Hill, acting VA Secretary Sloan Gibson acknowledged to the Senate Veterans' Affairs Committee that VA today "has serious problems" that will take years to correct.

"We understand the problems we face. We own them. We are taking decisive action to begin to resolve them," Gibson said. "We can turn these challenges into the greatest opportunity for improvement in the history of the department."

Those challenges include nearly nonstop scandals over the past four months, including recent revelations about whistleblower retaliation and data manipulation in dozens of facilities.

But the overarching issue that forced the resignation of Gibson's predecessor — retired Army Gen. Eric Shinseki, who stepped down in May — was system wait time problems, covered up by administrators trying to protect performance bonuses.

As of July 3, more than 636,000 veterans — about 10 percent of VA's total appointment caseload — faced a wait of a month or more for medical appointments,

To fix that, Gibson wants to hire 10,000 clinicians in coming years and find more space for medical appointments through leases, VA facility improvements and new construction — moves that he said would provide not only a short-term fix but also a longer-term solution to the underlying resource issues.

"I know it sounds like huge numbers," he told lawmakers. "But [VA] historically has not managed to veterans' requirements, we've managed to budget numbers."

Congress is already considering an emergency VA reform bill that would boost funding by about $30 billion over the next three years, according to Congressional Budget Office estimates. But that measure would allot only $500 million to new hiring initiatives; the rest would be used to increase access to private care options for veterans having trouble accessing VA care.

The department already has seen dramatic jumps in funding over the last decade, adding about $100 billion to its base budget since fiscal 2004 and about $70 billion since fiscal 2008.

The additional funding request drew concerns from several senators, who questioned whether better management and use of existing resources would provide more results for veterans.

But Gibson insisted that addressing the fundamental problems behind the wait times will require more resources, and failing to back those plans "will mean that the wait times will get longer."

He also outlined a number of recent audits and policy updates to address the other scandals, and repeated his promise that VA whistleblowers will be protected — and those who retaliate against them will face punishment.

Vietnam Veterans of America Goes to Congress For C-123 Vets

Last week, VVA President John Rowan presented the association's 2014 Legislative Agenda and Policy Initiatives. Besides addressing
essential VA funding reforms and a forward-looking initiative on exposures, President Rowan reminded Congress of the VVA's famous, "No Veteran Left Behind" pledge.

This pledge took the form of President Rowan's testimony including C-123 military herbicide exposures in the post-Vietnam era. He reported:

Comments? From Staff of Post Deployment Health or Compensation and Pension?

You know what's wrong...set it right!

You VA staffers doing the grunt work...you see what's going on. You sat around the table when we had our meetings and heard the positions from us and from the VA. You've seen the in-house communications at the attitude VA has about these veterans. You've seen the orders to deny C-123 claims with boilerplate language provided by C&P.

You know how that contrasts with assurances by both General Hickey and the Secretary to the Senate, that no such blanket policy exists. But it does...you've seen it.

You've read our veterans' posts and seen our various supporting materials. And you've seen what the VA has done to obstruct the process. You know the behind-the-scenes maneuvers to prevent our veterans from recognition of their service-connected exposures.

Can we ask for your insights about this mess? Our men and women aircrews and maintenance personnel are still denied all VA benefits, the VA hospital doors closed to them unless other injuries or illnesses have made us eligible.

No dental. No vision. No prosthetics. No rehab. No pharmacy. No primary care. No clinics. No

 Bring back Honor to VA

counseling. No pension. No survivor benefits. Years of these needs being denied for, what seem to us, to be invalid barriers.

We were exposed. You've seen the proofs, especially those from other federal agencies. Imagine Compensation and Pension refusing input from the NIH and the CDC. Imagine Post Deployment Health already deciding that, regardless of any proofs which were presented in the past or would surface in the future, that no C-123 claims were to be permitted.

Consider that against Secretary Shinski's assurance to the veterans' legislators that there was no such blanket policy against C-123 claims. Consider the VA's denial of the veterans' FOIAs with assurances that no such materials exist.

Clearly, the Boss doesn't have the full details of what's done in Post Deployment Health or Compensation and Pension.

But you do. Inform the VA's own General Counsel. Contact the VA IG Hotline. Or call Congress today. Or contact the VA National Center for Ethics in Health Care.

Do what's right by the veterans. Do what's right by your own sense of Honor.

Serving veterans...that's Job One at the United States Department of Veterans Affairs. Somebody has to do it. Drop a dime.

Shutdown Continues to Sidetrack VA Exposure Claims

Another Quiet but Disastrous Collapse of the VA Claims Process

Got an Agent Orange exposure claim? Forget it! 

In many instances of "boots on the ground" Agent Orange claims for in-country exposure, VA turns to the Joint Services Records Research Center to confirm a veteran's service. Operated by the Army at Fort Belvoir, VA, JSRRC responds with whatever archival materials available to support, or deny, a veteran's claim. In nearly every case of a veteran claiming Agent Orange (or military herbicide) exposure outside Vietnam's "boots on the ground" population, VA requires an inquiry to JSRRC.

But JSRRC is closed. Its talented and dedicated staff of fifteen DOD civilian employees and managers are furloughed – absent from their usual duty posts so that means every Blue Water Navy, Brown Water Navy, Thailand, Korean DMZ and C-123 exposure claim will sit in their Fort Belvoir in-box until some day when Congress gets its act together.

Recommendation: If veterans can submit in their FDC ample official proof of their herbicide exposures, VA should skip the JSRRC procedure for now, granting presumptive service connection to be reexamined upon the government starting up again. Such proofs could be flight orders, deck logs, VA 21-4138s substantiated by authoritative sources, etc. Unfair to deny or delay veterans' claims just because JSRRC is furloughed!

VA Covered Up Gulf War Toxin Exposures (part 2)

Whistleblower: VA Withheld Health Studies On Soldiers’ Toxic Exposures (13 Mar 2013)

By: TAMARA LYTLE 

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The U.S. Department of Veterans Affairs suppressed information that shows links between health problems of veterans and the dangers they were exposed to in Iraq, Afghanistan and the Gulf War, according to a whistleblower who testified to a House panel Wednesday afternoon.

Steven Coughlin described an “epidemic of serious ethical problems” in the VA Office of Public Health, where he worked for 4 ½ years as a senior epidemiologist until December.

“If the studies produce results that do not support Office of Public Health’s unwritten policy, they do not release them,” said Coughlin, in testimony to the U.S. House Committee on Veterans Affairs, Oversight and Subcommittee.

“This applies to data regarding adverse health consequences of environmental exposures, such as burn pits in Iraq and Afghanistan, and toxic exposures in the Gulf War. On the rare occasions when embarrassing study results are released, data are manipulated to make them unintelligible,” he said.

Veterans’ activists have long complained that the VA has been loath to acknowledge connections between veterans’ health problems and the situations they faced in theaters of war. Agent Orange during Vietnam and Gulf War illness are two examples. The connection can make a huge difference for veterans in their benefits from the federal government.

In a prepared statement the VA said, “The Department of Veterans Affairs has a decades long history of conducting world-class research studies that meet accepted and rigorous scientific standards.  Research on the health of Gulf War veterans has been and continues to be a priority for the VA.  The department depends on this research to inform our decisions and guide our efforts in caring for Gulf War veterans.  All allegations of malfeasance are taken seriously and are investigated fully.’’

“The VA agrees with Gulf War veterans that there are health issues associated with service in the Gulf War…In 2010, the Administration recognized nine new diseases associated with Gulf War Illness, reflecting a determination of a positive association between service in the region and those diseases,’’ the VA statement said.

Coughlin was not the only witness venting frustration with the way VA treats health research and treatment.

VA doesn’t have effective treatments for Gulf War Illness, said Anthony Hardie, a Gulf War veteran who suffers from chronic health issues. “…A cabal of federal bureaucrats and contractors work at every step to delay, defer, and deny, and even so far a to obfuscate and refuse to implement laws, policies and expert recommendations,” said Hardie, who sits on the Congressionally-chartered Research Advisory Committee on Gulf War Veterans’ Illnesses, known as RAC.

Lea Steele, an epidemiologist at Baylor University who studies the health of Gulf War veterans, said the VA continues to ignore science and minimize the seriousness of the Gulf War illness impact.   A large study this year of Gulf War veterans, for instance, doesn’t even ask about symptoms from the illness.

“This is a wasteful and inexcusable missed opportunity at best and something akin to scientific malpractice at worst,” Steele said.

Victoria J. Davey, chief officer of public health for the VA Health Administration, said the department was committed to care for all veterans.

“VA intends to continue our ongoing efforts to improve our abilities to provide health care for Gulf War veterans; to better educate our health care providers; and to expand the evidence basis for the treatments we provide for Gulf War veterans, and all veterans,’’ Davey said.

In his testimony, Coughlin, now an adjunct professor of epidemiology at Emory University, claimed:

•   His supervisor told him not to look at data on hospitalizations and doctors’ visits for veterans of Iraq and Afghanistan when studying the relationship of their health problems to exposure to burn pits and other inhalation hazards.

•  VA officials at first refused to set up a system to offer intervention for veterans who told surveyors that they had suicidal feelings that they would be better off dead. Coughlin was threatened with disciplinary action by his bosses during the process.  He successfully appealed the decision to higher ups and eventually, mental health professionals were able to follow up with the troubled veterans.

• VA officials arranged for five speakers to brief the medical panel studying Gulf War illnesses with views that Gulf War syndrome is psychiatric “although science long ago discredited that position,” Coughlin said.

• When Coughlin tried to make changes recommended by experts to a study of Gulf War veterans, his supervisors killed the idea by falsely claiming it would cost $1 million to do so, he said.

• VA needs a better system for safeguarding data of studies and making it more widely available to researchers. One database of Gulf War veterans’ family members that was mandated by Congress was lost forever by a computer in Texas, he said.

Coughlin said some of the health research done by VA costs tens of millions but doesn’t serve the interests of veterans. He called on Congress to force change. “In view of the pervasive pattern where these officials fail to tell the truth, even to VA leadership, the VA cannot be expected to reform itself.”

Connecticut Veterans’ Affairs Commissioner Linda Schwartz said the U.S. Department of Veterans Affairs has long had a problem of conflict of interest in its health studies.

“There is much more effort put into disproving this stuff than dealing with these issues up front,” said Schwartz, who studied Agent Orange and has a doctorate in public health from Yale. “It does a disservice to the veterans and our country.” VA’s research should be done by academic institutions, she said.

The hearing was called to look at the care for Gulf War veterans. Gulf War illness is a chronic illness with multiple symptoms, including muscle pain, fatigue, cognitive problems and rashes, that affects veterans of the 1991 Gulf War. Although it was initially dismissed as psychosomatic, scientists have linked it to a drug given to troops to combat nerve gas and to toxic pesticides.

A $10 million study that Coughlin worked on called the National Health Study of a New Generation of U.S. Veterans looked at the exposures faced by veterans who served in Iraq and Afghanistan.

More than a fifth of those veterans also served in the Gulf War, but the VA has not released the treasure trove of data that could shed light on their health effects from the earlier war. “Anything that supports the position that Gulf War illness is a neurological condition is unlikely to ever be published,” Coughlin said.

U.S. Rep. Mike Coffman, R-Colorado, and the top Democrat on the committee, U.S. Rep. Ann Kirkpatrick, D-Arizona pressed Davey and other officials on why they are taking so long to develop better training for doctors and information for vets about the illness.

“I find the conduct of the VA embarrassing,” Coffman said, before asking the panel of VA officials if any of them were veterans. If there were, “I don’t think we’d be here today” he said, with an emphatic bang of his gavel.

VA & USAF Ignore Leading Agent Orange Expert on C-123 Exposure!

Hard to believe! Both the VA and the USAF opted to completely ignore the expert testimony of Dr. Jeanne Stellman, Professor Emerita at Columbia University's Mailman School of Public Health. Why...because it was her firm, expert opinion that our C-123 aircrews definitely were exposed to the deadly TCDD contaminants in Agent Orange when we flew those airplanes 1972-1982. She had to be ignored for the USAF and VA to reach contrary decisions...unless she was ignored her opinion would be emphatic

Professor Stellman

Why is it of concern? Because Dr. Stellman is the "go-to" expert who was relied on by the National Academies in their previous investigations...if her world-renowned expertise was so respected and authoritative in the IOM 2003 and other official reports, what is the excuse used by the VA and the USAF in ignoring her detailed explanation of our exposure aboard the C-123?

Answer: It is the only way to prevent our veterans gaining service-connection and recognition for our exposure. If the authorities were to fairly evaluate Professor Stellman's findings their barrier against allowing us to receive VA medical care disappears!

Background: Because of continuing uncertainty about the long-term health effects of the sprayed herbicides on Vietnam veterans, Congress passed the Agent Orange Act of 1991. The legislation directed the Secretary of Veterans Affairs to request the IOM to perform a comprehensive evaluation of scientific and medical information regarding the health effects of exposure to Agent Orange and other herbicides used in Vietnam. Congress had grown tired of the VA's posturing and delaying tactics, so legislation was passed to get them moving.

The IOM formed their Committee on Agent Orange. That committee of medical and scientific experts searched for the most outstanding scientific advice and quickly identified Professor Jeanne Stellman as their trusted  researcher to make appropriate findings and recommendations. In the Committee's 2003 report, Professor Stellman detailed the problems with dioxin, the means of exposure and the best ways to perform epidemiological studies to advance understanding of that toxin's impact on veterans.

Conclusion: So you cannot avoid seeing the conundrum. Stellman...expert enough for Congress. Stellman...expert enough for the Institute on Medicine. Stellman...expert enough for the Committee on Agent Orange. Stellman...one of the top two or three published scientists in this field. But magically...only in Stellman's finding that our aircrews were exposed does her expertise seem to fall short of the threshold necessary for the VA to accept our exposure to have been"as likely to as not". Further, it is impossible to ignore the VA's broken promise, made in our face-to-face meeting with their representatives (VA Public Health) hosted by Senator Burr (NC) in which the issue of our exposure was to be put to the IOM as a special project.

Ever-eager to prevent even a single veteran's access to essential medical care for Agent Orange illnesses, the VA leaped on the Air Force's faulty C-123 literature review, in which the AF said they were unable to reach a definite conclusion about exposure, so the VA took that piece of confused and twisted double-talk to use against us and canceled their promised IOM study. That move was to keep IOM from turning to their trusted expert, Dr. Stellman, who had already voiced her opinion about our exposure in her pivotal 2011 letter.

So let's look at a balance sheet of evidence regarding C-123 aircrew dioxin exposure: On the left, those who weigh in on our having been exposed, and on the right. those who weigh in on an opinion that we haven't been exposed. Judge for yourself! And consider why the opponents of our claim for AO exposure are so dedicated to saving money by preventing access to medical care, and not to fairly considering our situation!