Showing posts with label federal register 8 may 2001. Show all posts
Showing posts with label federal register 8 may 2001. Show all posts

05 November 2014

VA Makes Its Rules...Then Ignores Them

VA Ignores Its Rules & Blocks C-123 Veterans'
Agent Orange Exposure Claims

The VA follows through on delivery of laws passed by Congress through the United States Code, for most veterans meaning Title 38 C.F.R. VA creates rules and regulations whereby it defines how it will implement the laws, procedures by which claims are to be addressed. They also publish in the Federal Register those rules and regulations, as well as explanations of issues, procedures and unusual situations.

VA's manual addressing veterans' claims is VA 21-1MR. But VA has been picking and choosing which parts of it their agency will implement and which it will ignore, for the purpose of blocking C-123 veterans' claims.

In our case, VA opted not to follow its own published regulation nor adhere to the explanations of its rules and regulations repeatedly published in the Federal Register. Together with numerous other steps by VA, a convincing picture forms of the department's program to block C-123 veterans' exposure claims.

Let's look at how courts have said VA is supposed to respect its own rules, rules by which it determines veterans' eligibility for care and compensation:
The U.S. Supreme Court has stated that, "[w]here the rights of individuals are affected, it is incumbent upon agencies to follow their own procedures.  This is so even where the internal procedures are possibly more rigorous than otherwise would be required" by statute or regulation.  Morton v. Ruiz, 415 U.S. 199, 235 (1974).  This is important when VA takes a "short cut" to save time or effort and then denies a claim.  The law is that even if a regulation requires less effort than a procedure used by VA in similar circumstances, VA cannot pick and choose when to follow its own rules and when not to do so.  See Castellano v. Shinseki, 25 Vet. App. 146, 151 n.2 (2011) ("[T]he Secretary must adhere to his own policies when adjudicating veterans' claims." (citing Morton, 415 U.S. at 235 (1974)).  Yet, 38 C.F.R. § 19.5 states that "[t]he Board is not bound by Department manuals, circulars, or similar administrative issues."

Compliance with the M21-1MR can also be reasonably raised by the record such that the Board should address the issue.  See Schafrath v. Derwinski, 1 Vet. App. 589, 593 (1991) (Board must discuss provisions of law and regulation where they are made "potentially applicable through the assertions and issues raised in the record").  A regional office's failure to follow the M21-1MR and the Board's failure to identify such issues frustrates judicial review, warranting remand.  See Tucker v. West, 11 Vet. App. 369, 374 (1998) (where "the Board has incorrectly applied the law, failed to provide an adequate statement of its reasons or bases for its determinations, or where the record is otherwise inadequate, a remand is the appropriate remedy."); Allday v. Brown, 7 Vet. App. 517, 527 (1995) (holding that the Board's statement "must be adequate to enable claimant to understand the precise basis for the Board's decision, as well as to facilitate review in this Court").
That's the law. So why doesn't VA strictly obey it, as we must? Because they don't have to. Failure to perform as the law or its regulations demand have no consequence for the VA or any of its employees. If a claim goes to the BVA or Court of Appeals for Veterans Claims (CAVC) with clear violations of VA's rules, the worst that can happen is the claim gets remanded for reconsideration, with some comment from the judge if VA has been particularly outrageous. Nothing more.

No fines, No punishment, no nothing.  The only consequence is the veteran faces even more delay as the until the regional office gets around to reworking the claim and then its back in line again for reconsideration of the appeal. In some cases, this has happened three or four times with the CAVC becoming more and more irritated, and the regional office probably going "ho-hum." And the poor veteran waits years and years past when VA should, if following its own regulations, have awarded the claim.

So what's happening with C-123 veterans? For us, the regulation states that VA will follow a section of VA 21-1MR which addresses non-Vietnam War "Boots on the Ground" claims.

Violations of the its procedures set forth in the VA's claims manual (VA 21-1MR) are reversible errors on appeal to BVA or Court of Appeals for Veterans Claims. The CAVC has declared the M21-1MR manual has “the force of law” and if not followed by VARO raters and DROs violates both procedural and constitutional due process right of veterans. A case from Fort Ord had VA severely criticized for failing the "duty to assist" both stated and implied in VA 21-1MR when VA fails to follow its own rules. But the only penalty was paid by the veteran whose claim was remanded for further delay in the hopes of justice. (Eventually, the claim was successful.)

Legal experts advise us that the three Federal Register statements VA published regarding non-Vietnam exposures constitute VA rules published by the Secretary and VA is compelled to follow them. This is why OGC quickly opted to redefine exposure, different than other government agencies and even differently than VA's standard dictionary of medical terminology and its court-accepted definition of "exposure." Redefining standard terms differently than other federal agencies (CDC/ATSDR, ) to prevent claims, and predetermining our claims to be without merit, denies us due process.

When claims like ours have persuasive supporting evidence dismissed in advance, when VARO staff is trained that C-123 claims are baseless, and when VA fails to follow its own manual as well as the specific commitments made in the Federal Register, due process is denied and, as the CAVC and other courts have said, our Constitutional rights abused.

When VHA executives state "We cannot permit C-123 claims" or tell the Associated Press, "We have to draw the line somewhere" or "No C-123 veterans were ever exposed," our rights are abused. Not a little, but in direct trashing of our Right to Due Process under the Fifth Amendment to the United States Constitution. In case you're not familiar with it, that's one of the "Bill of Rights." VA trashes it, destroying personal liberties guaranteed us under the Constitution. That's a pretty big deal.

VA doesn't care. No problem for them, either as an agency or for the individual doing the trashing.

The VA has created a C-123 process like this:
1. Veteran files exposure claim (assuming he/she isn't dissuaded by the VA web pages stating somehow, no exposure occurred) or told by VSOs and VA staff there is no eligibility and therefore, no need for vets to apply as the process is hopeless
2. Claim gathers input from JSRRC if available, but claim is usually denied at the VARO on the strength of VHA/VBA instructions, training to dismiss/disregard veteran's proofs
3. Non-Vietnam AO claim is supposed to be routed to VBA Agent Orange desk, Mr. James Sampsel, the gentleman who drafted Secretary Shinseki's deceptive, error-laden letter to Senator Burr
4. Agent Orange desk issues Advisory Opinion directing the VARO to deny the claim
5. Claim is appealed and BVA correctly interprets scientific evidence; thus far all appealed C-123 claims are successful and our Fifth Amendment rights restored, albeit with great delay
6. Trend developing in non-C-123 Agent Orange situations where BVA is stating claims for exposure are not authorized for other than VN, DMZ, some ships, etc – this is a great error because every claim should be permitted to stand on the evidence of proven exposure, as VBA Under Secretary Hickey has stressed so many times, but without VA follow-through because instead, each claim is ordered denied
7. VA has spent $600,000 with an outside consultant for creation of monographs challenging C-123 veterans' claims, but not a penny was spent to support the claims. VA even invited Dow and Monsanto to submit a letter arguing against veterans' exposure claims. These "experts" continue to assert that dioxin has not been shown to be harmful, which is shown to be a false statement: the VA itself, EPA, NIH, CDC, FDA, WHO and virtually all other regulatory and scientific organizations recognize dioxin as a potent human carcinogen.

Why? We don't know. There aren't enough of us (about 2100 crew and maintenance veterans) to warrant such a continuing (1331 days) campaign to bar us from VA hospitals. Probably, admitting our exposures would trigger something else which we're unaware of but which VA is so determined to prevent.

We're waiting for the Institute of Medicine C-123 Agent Orange report, although it is months late from its anticipated September 30 release. Probably VA is fighting that report as well in the review process before publication, but perhaps we are just off base and the IOM is taking more time to make its report comply better with the VA's charge to the committee.

In any case, VA rating officials have ordered all C-123 claims postponed until results of the IOM are clear and implemented by the VA. This has meant eleven months thus far with more to come, in delaying VA from obeying the regulations it published for itself...and for us...to follow regarding Agent Orange claims.

Even in the most positive review of what's happened and what is to come in this process, VA wins, defeating our access to VA care for over 1331 days since we first sought their help. No catch-up check for delayed compensation makes up for denied medical care, denied family benefits, refused state benefits due vets with acknowledged VA disabilities, and the misery of having to fight this fight for years when our focus should instead be on family and resolving medical issues.

We fought our wars. We didn't expect to come home to do combat with the VA.

Time is of the essence once a veteran becomes ill and files a claim. Life-saving care won't be permitted until the vet's claim is processed and (hopefully) approved.

VA know this, which is exactly why VHA considers 1331 days of delay thus far a spectacular victory, a victory of preventing our access to its world-class medical institutions. Why?

The more vets receiving care, the longer the waiting lists which draw such attention from the media, and the more VA's budget is impacted in providing essential care. VHA sees prevention of our care their greatest cost-saving opportunity...the longer they hold off claims or keep them denied, the more money saved for VA.


01 February 2014

VA Insists VA Rule Does Not Apply To VA

"If a veteran did not serve in the Republic of Vietnam, but was exposed to an herbicide agent defined in 38 C.F.R. 3.307(a)(6) during active military service, has a disease on the list of diseases subject to presumptive service connection, VA will presume that the disease is due to the exposure to herbicides."
VA’s  Guide on Agent Orange Claims, Compensation and Pension Service,” carries this information, and VA repeats it on the Federal Register 8 May 2001 and Federal Register 31 August 2010.

VA, however, according to Post Deployment Health and as personally explained to me by the Director Compensation and Pension Services has decided to direct that Compensation and Pension never award service connection for Agent Orange exposures. This is because Post Deployment Health revised the standard definition of "exposure" to add "bioavailability" and, using their new definition, has continued their insistence that no C-123 veterans would receive service connection, actual fact-proven exposures or not.

This threatens all veterans concerned about every possible exposure...VA has redefined away exposures and their definition is now used to prevent exposure claims, even in the face of fact-proven exposure situations. With the new definition VA can pretend away every claim.

Thus, this VA rule does not apply to the VA, according to VA leadership.

20 October 2013

Veterans Ask Society of Toxicology for "Equal Time"

In our earlier posts we explained how VA used the Society of Toxicology poster display they presented
to redefine the scientific term "exposure." To prevent veterans from coverage for Agent Orange illnesses, VA redefined exposure to "Exposure = Contamination Field + Bioavailability."

This is incorrect. Exposure is defined everywhere as contact by the skin with a contaminant, or its inhalation or ingestion. There is no requirement for bioavailability, which is the VA's attempt to reintroduce medical nexus as a requirement for Agent Orange coverage – and this was prohibited by the 1991 Agent Orange Act and Title 38! The Federal Register specifically provides for our benefits.

The Association has approached the Society of Toxicology for some sort of platform for us to challenge the VA's unscientific, policy-driven poster presentation. The request to the SOT's president follows:
Dear Doctor Lehman-McKeeman,
We seek SOT assistance regarding the poster display submitted by the VA at an earlier conference, which addressed Agent Orange and our exposure aboard contaminated C-123 transport aircraft. 
We believe the science in the poster was flawed and policy-driven, to the point of redefining the term "exposure" to require bioavailability. This incorrect VA redefinition thus denies all our veterans' Agent Orange exposure claims. This definition defies that of the SOT, ATSDR, EPA and others. 
I earlier asked SOT's help with this but without response. The Washington Post, Huffington Post, Fox News, UPI and other sources have recently covered this sensitive issue, but the core of it is the VA's SOT poster standing unchallenged by SOT. 
I ask that SOT consider the attached article, edited for a more appropriate tone, as a layman's SOT essay. I ask that I be given permission to present at the 2014 conference on this topic, repeating what I said at the January Institute of Medicine meeting. 
At the very least, I ask that The C-123 Veterans' Association be permitted to submit a poster display addressing this issue. 
The VA used their SOT poster as their pulpit to deny over 2000 veterans coverage for Agent Orange benefits. The question of the medical or legal impact of the dioxin exposure is not at hand, only the word "exposure." 
VA has opted to redefine that without challenge by SOT. VA used SOT as a vehicle against our interests, used toxicological concepts which should have been challenged, and we are entitled to our response. 
Alternately, can you invite input from a recognized authority, perhaps an interested SOT member? 
I hope I can your help with this, as earlier suggested by Dr. Birnbaum. VA redefining science to oppose our claims should not remain unchallenged by toxicologists.
Sincerely,
Wesley T. Carter, Major, USAF Retired, Medical Service Corps
Chair, The C-123 Veterans Association
attached: "VA Redefines Science to Deny Agent Orange Claims"