VA Directs 60-Day Processing for All Claims 2 years old and older

VA has directed its regional offices to complete processing of all claims two years old or more, and gave them 60 days to complete the project. Good in some ways, but I fear, it will lead to more of what's happening today.

Too often, a complicated case sits on a rating officer's desk, aging and eventually drawing attention to the officer's backlog. Too often, this is addressed with a simple denial of the claim, tossing the hands into the air and saying "Let the BVA sort it out."

The problem is that our lives continue. And with a claim denied and in the queue for the BVA (Board of Veterans Appeals) five years or more can be wasted, on top of the two or three it took to get the clam through the regional office! So perhaps then eight years of denied medical care, denied family benefits, denied compensation. Consider a veteran with kids headed for college - a 100% rating would entitle the kids to VA monthly support for 48 months...waiting eight years for a claim and a BVA decision, even if favorable, takes the kids through high school and college. Then, no longer eligible, what good the benefits the veteran earned.

"Fortunately" my two year old claim was denied even through supported by over 100 pieces of confirming evidence, and at age 66 with cancer, heart disease and more ailment than I can mention here a five year wait is useless to this veteran. When I mentioned that at the face-to-face meeting with VA's Compensation Services, a smile from them assured me it was the proper process, nothing else to be done.

I protest. What could have been done is a legitimate hearing of my claim and those of other C-123 veterans like Paul Bailey, both of us denied Agent Orange exposure recognition because the VA's Health Benefits Administration has introduced new flavors to the word in the law - eligibility - and using those new flavors finds a clever way to deny benefits.

Science and the law say we C-123 veterans were exposed to military herbicides and are due care from the VA. The VA, in defiance of law, science, medicine, justice, common sense and simple logic, says otherwise in the face of other federal agencies far better qualified to in their confirmation of our exposure. Who the heck made the VA science different and better than that practiced by the NIH, US Public Health Service, EPA, and CDC?
-------------------------------------------VA LETTER BELOW-------
VBA Letter 20-13-05
VA Regional Offices

DEPARTMENT OF VETERANS AFFAIRS Veterans Benefits Administration Washington, D.C. 204239

SUBJ: Guidance Regarding Special Initiative to Process Rating Claims Pending Over Two Years
Purpose
This initiative is the first in a series of efforts to address VA’s oldest claims. This letter focuses on those rating claims pending for over two years. Further guidance will be provided regarding claims pending less than two years. The intent of this initiative is to work all claims pending for more than two years within 60 days from the date of this letter. Regional Offices (RO) must immediately begin to process these claims based on the below guidance. For the claims at issue, this guidance supersedes all other guidance from other offices or personnel. It does not affect those claims that already require priority processing (Homeless, Terminally Ill, Medal of Honor recipients, Former POWs, and Fully Developed Claims).
Guidance for Processing Claims Pending More Than Two Years:
Identifying Claims
This guidance applies to claims received on or before July 1, 2011. The date of claim of the oldest pending claim in the file will be used to identify claims addressed under this special initiative. Use the Special Issue indicator “OCR – Old Claim Review” to identify these claims electronically in VETSNET Operations Reports (VOR). Follow the Brokering/Shipping Instructions provided in the enclosure.
Use of RO Personnel
ROs will devote all RVSRs and as many VSRs as are needed to ensure that all two-year old claims are processed within 60 days from the date of this letter.

Upon receipt of this guidance, immediately identify two-year old cases and develop an aggressive plan to complete these cases as soon as possible but no later than 60 days from the date of this letter.
Rating Actions
Raters will immediately begin to process two-year old rating claims and develop an aggressive plan based on the “available evidence” in the claims file. The rating decision produced will be considered a provisional rating unless ALL evidence in support of the claim has been received (and the claim is considered ready-to-rate) or the rating assigned provides the highest level evaluation authorized for the particular diagnostic code for each claimed issue. The End Product (EP) will be cleared for any rating completed as a result of this special initiative and no issues will be deferred on a rating decision.
Category 1 Cases: ROs will issue rating decisions, as normal, for ready-to-rate cases that meet the two-year old criteria and for cases where the rating assigned provides the highest evaluation authorized in VA’s Schedule for Rating Disabilities for each claimed issue. These will be FINAL decisions and appeal rights will be provided.
Category 2 Cases: ROs will issue “provisional” rating decisions for other two-year old cases even if VA is still waiting for certain evidence. RVSRs will complete these claims based on the available evidence of record as long as the appropriate Section (§) 5103 notice (formerly VCAA notice) was provided to the claimant UNLESS the following requests for evidence are outstanding:

• Service Treatment Records (STRs) for original claims;
  
• VA medical records;
  
• Any evidence needed to establish Veteran status and/or pertinent service dates, if
  available evidence is not otherwise sufficient;
  
• VA examinations, if such exams are pending at the time the case is reviewed or if one
  is required in order to issue a decision.
  The above minimal level of evidence must be available before a Category 2 rating is completed. Therefore, in order to meet the required completion date for these cases, ROs must expedite procedures to secure this evidence and decide the claim.
  In any Category 2 case where the RO is awaiting VA exam results, ROs will contact the appropriate VHA facility or contract examination provider to expedite completion of the required exam(s) so that a decision may be issued promptly. Only order a new exam when one is required to decide the claim.
  RVSRs will rate on the available Service Treatment Records (STR) of record, to include copies supplied by the claimant. If no STRs are of record or no STRs have been developed, immediately
  

develop for such records, and ensure they are available at the time of the rating (unless it is reasonably certain that such records do not exist or that further efforts to obtain those records would be futile).
RVSRs should make a provisional decision based on the evidence of record. If required Federal records outside of STRs have not been received, issue the provisional decision and then request the Federal records. If private records have been requested only once, issue the provisional decision and then request the private records again unless it is clear a second request would be futile. Establish an EP 400 using the special indicator "OCR – Old Claim Review" to make the request for Federal and/or private records.
RVSRs will accept Acceptable Clinical Evidence (ACE) evaluations where possible, and rate on the medical evidence of record in accordance with 38 C.F.R. § 3.326.
Because the decision notification for Category 2 cases will inform claimants that a provisional decision has been made, it is not necessary to include such language in the rating document.
In the “evidence” section of the Rating Decision, RVSRs will list all evidence considered, as normal. The RVSR will also list evidence identified but not available at the time of the provisional rating.
No issue(s) will be deferred on a rating document.
Other rating considerations for Category 2 claims:
For claims falling within the provisions of this guidance, the prohibitions against certain partial rating decisions found in M21-1MR III.iv.6.A.1.b do not apply.
RVSRs will grant entitlement to service connection for the claimed disability at the highest justifiable evaluation level of disability based upon the evidence of record, as warranted.
One year from the date of notification of the provisional decision, ROs will assess all Category 2 claims and provide notice of a final decision to include appeal rights. Compensation Service will provide additional guidance in the future regarding procedures for the review of Category 2 cases after the one-year period has ended.
Authorization Actions
All Category 1 cases will be processed as normal.
For Category 2 cases, the following procedures shall be followed:
• Before promulgation of the decision, local Veterans Service Organizations will be given a full 48-hours to review the rating decision. In addition, a POC (and alternate POC) shall be

designated within the Veterans Service Center so that Service Officers can contact these individuals directly if they have questions or concerns.

• Upon promulgation of this provisional decision, clear the controlling EP.
  
• No appeal rights will be provided to the claimant since the decision rendered is considered a provisional decision. After one year (or earlier if the claimant requests), the claimant will be
  notified that the claim has become final and provided appeal rights. This only applies to cases worked under this special initiative.
  Important: Be sure that any reference to "final" decision or appeal rights notification that is generated automatically in the notification letter is removed.
  
• Diary the case for one year from the date of the decision. Establish Diary Reason 39 - Review for Reevaluation.
  
• After the decision is issued, the completed claims should be added to the files sent immediately for scanning. Follow the shipping instructions set forth in the enclosure.
  
• If the claimant submits additional evidence or VA receives previously requested records within the one-year time period which allows a final decision to be made, VA will establish a new EP with a special issue “OCR – second review,” clear the diary, PCLR EP 400 if pending, and take the appropriate adjudicative actions.
  
• If all evidence is received at any time during the one-year period after the provisional decision is issued, take the appropriate adjudicative action and issue a final rating decision with appeal rights.
  
• In most instances, the effective date will go back to the date of claim of the earlier EP. Decision Notification Criteria
  The responsible party for preparing the decision notification for claims processed under this special initiative must include the following special language in the letter:
  “We have made a decision based on a special initiative to complete your pending claim. This is a provisional decision that is based on the evidence currently in VA’s possession. If you have additional relevant evidence pertaining to the issues decided here that you would like us to consider, please submit it to our office within one year of the date of this letter and we may reconsider our decision. If you want VA to obtain evidence that you previously told us about that was not available at the time of our decision, tell us and we may be able to obtain this evidence.
  If you want to receive a final decision with appeal rights before the one-year provisional period ends, send VA a signed statement as follows:
  “All necessary evidence was considered by VA. I request that this provisional decision be made final.”
  

STAR and QRT
Quality will continue to be assessed on decisions made under this special initiative. However quality will be measured based on the accuracy of the decision based solely on the evidence of record at the time the decision was made.

VA Defies FOIA - Hides Documents from Senate & C-123 Veterans with "Don't Exist" Claim

"FOIA - a vital part of our democracy" The Department of Justice (but not the VA)

"They are honorable" Marc Antony, Julius Caesar, Act 3, Scene II)

FOIA-requested materials concealed from C-123 veterans. Documents don't exist? Well, they certainly DID until our FOIA was filed a year ago! But given the issue so important to C-123 veterans and in light of their team's preparation and participation in meetings on the issue of C-123 Agent Orange exposure, and the dedication they show to making sure it is never conceded, we can understand their preference to keep their materials under cover. And as Marc Antony said, "They that have done this deed are honorable."

C-123 veterans, joined by scientific experts and Senator Burr's Senior Policy Advisor, Mr. Brooks Tucker, conducted two meetings, one in 2011 and one in 2012, with representatives of the Veterans Administration to discuss C-123 Agent Orange exposure concerns. One meeting was a teleconference and the second, a gathering hosted by Mr. Tucker at the Hart Senate Building.

Extensive preparation went into these meetings on the part of the veterans and

scientific advisors, and VA representatives participated with perfect familiarity with the subjects discussed and also arrived at the Hart meeting with proposals to submit some issues to the Institute of Medicine for a special project. This makes clear that the VA representatives were prepared, and we certainly saw notes with more notes being taken. Last year, veterans submitted a broadly-cast FOIA net for all materials used by the VA for preparation for the meetings, and notes taken during that meeting, and other materials.

At first, the request was denied by the VA. Then the request resulted in an estimated $4700 fee, appealed by the veterans. Finally, the VA responded that no such materials exist. No memos. No emails. No briefings. No reports to superiors. No nothing. Yes, I know that a double negative, because there certainly was material, just not which they were willing to submit in response to the law.

"The law" you ask? Right...you remember...that thing which veterans are obliged to obey and which the VA flaunts. The law, which we, and they, were all sworn to protect and defend. The law. The foundation of our society and upon which we depend to compel government by, and not OF the people. Doesn't matter - big laws or small, one veteran or a thousand. Law is law - it must reign supreme, otherwise we are to expect (or beg) for our veterans' benefits from the whims of  a capricious and hopefully benevolent administrator.

But among others, VA disregards the Freedom of Information Act. Hello...neat word...freedom. Previously, considered important in American-style democracy. Here, VA even has their general counsel helping us to understand that these materials "have gone missing" in response to our FOIA. And as Marc Antony said, "They that have done this deed are honorable."

Really now, are we to believe that employees did nothing regarding Agent Orange, failed to send emails, didn't use references or correspond,  were hired without qualifications being noted, haven't published professionally, and addressed issues of contaminated aircraft and vehicles without research or conclusions, other than voicing them at the meetings with veterans? Did they beam down and back up again without documents? 

The VA claims in its online publications and correspondence with Congress that it conducted "scientific research" by its scientists and physicians, but it cannot account for that in any way, other than the internet pages. But that undocumented "scientific research" seems to have been enough to deny Agent Orange exposure benefits to C-123 veterans, and in the face of other federal agencies such as the EPA, NIH, CDC/ATSDR and US Public Health Service claiming the C-123 veterans were exposed. VA, by claiming no such materials exist, must have simply sat down and started typing at a computer with the only work product being the online pages about the C-123 veterans magically being spared Agent Orange exposure. Right. Uh-huh. 

VA, by responding in the negative here, doesn't even have copies of the Air Force test results, the materials provided by other federal agencies and universities...nothing.

How could the VA conclude it would charge us $4700 to collect and duplicate materials which, on 11 March 2013 and a year after the FOIA submission, VA reports the items don't even exist? How could mid-level mangers from the VA's VBA and VHA organizations not prepare, not take notes, and not generate work product following a meeting such as this? Attending for the VA were physicians, scientists and managers such as Director Post Deployment Health and Deputy Director. 

Why is VA hiding these materials? Why are they even hiding the ones already published on their web sites? 

Can you please help? 

And remember, Marc Antony assuring us "They that have done this deed are honorable" men and women, as indeed they are. And, "If you have tears, prepare to shed them now." (Julius Caesar, Act 3, Scene II)

VA:"Bioavailability Equals Exposure" --- VA's Terribly Wrong Approach!

CLICK HERE FOR YOUTUBE VIDEO ON BIOAVAILABILITY

You'll have to follow me on this. We're going to expose together a twisted piece of bureaucratic double-think which the VA has developed against us. It all dawned on me as an epiphany an hour ago exactly what the nice folks back at VA's Health Benefits Administration are trying to pull (I was driving home from a week's "tune-up" at the Seattle Spinal Cord Injury Clinic run by the VA...fantastic people and fantastic facility and a perfectly focused health care delivery program. VA did it right!)

Veterans Health Benefits Administration has introduced a sly, wrong-headed new slant on our Agent Orange exposure, telling us that "bioavailability" is now a required element of proving exposure. No bioavailability...some proven impact on the body caused by whatever  it encounters...equals no exposure. Bioavailability is the fraction of a toxin (or other element) absorbed by the body.

Now, that makes some sense to a physician trying to figure out how to treat a patient exposed to a toxic element, but it makes no sense in the world of administering VA medical care and benefits due Agent Orange-exposed veterans. Long ago, Congress grew frustrated at the VA's stonewalling veterans worried about Agent Orange illnesses and took the VA's discretionary power away, telling them to work with the Institute of Medicine and identify illnesses which seemed to be associated with dioxin exposure. Illnesses such as soft tissue sarcoma and prostate cancer were identified and a list of "presumptive illnesses" was established. No longer did a veteran have to find  a wealth of evidence to put forward to a VA rating officer to convince the VA to recognize one of those illnesses as service connected. Further, Congress told the VA to recognize every veteran with "boots on the ground" in Vietnam as having "presumptive eligibility" to be able to put the string together: Vietnam service equals eligibility for service connection for any of the presumptive illnesses. 

Congress also left the door open for more diseases to be recognized by the VA and by the IOM and added to the list, and made clear that individual veterans could still make a case for diseases not on the presumptive list to be considered...individually...for service connection. Congress also recognized the VA's position as stated in the Federal Register of 8 May 2001 (page 21663), where the VA explained veterans exposed to herbicides other than on the ground during the Vietnam War would be treated the same as "boots on the ground" Vietnam War veterans. This means such veterans would not have to prove medical nexus for their illnesses if those illnesses were on the presumptive illness list.

And that's where The C-123 Veterans Association is impacted. In 2011 Paul Bailey and Wes Carter (that would be moi) joined by other Westover veterans, uncovered the toxic track record of C-123 Agent Orange contamination and on presenting it to the VA and USAF expected our exposure to be recognized and service connection awarded.WRONG! We immediately butted right up against the VA's kne-jerk position of "You were not exposed to (fill in the herbicide) when (fill in the situation and date) because (we'll figure out something later). Claim denied. Thank you for your service."

Lesson learned...VA automatically denies, denies and denies, doing to C-123 veterans as they did to Vietnam veterans decades ago. Faced with tests and opinions from other federal agencies such as the CDC making it impossible to say there was no contamination, VA shifted their position to one of no exposure. Ah...but then veterans showered the VA with outside experts' findings that they were exposed, In response, besides denying the expertise of the world-leading scientists and physicians who confirmed our exposure (grouped as unacceptable "lay evidence" by the Manchester NH VA) VA's clever folks then really focused on denying exposure via redefinition of that very word, publishing their conclusion that we'd suffered no bioavailability to dry dioxin transfer to the skin, dermal absorption being one of the three routes of toxin exposure. Well, even according to their own VA Post Deployment publications, dioxin transfer via dermal exposure is quite likely, plus we had inhalation via the dust particles to which dioxin readily binds itself. Sorry...I forgot that even VA publications are not admissible unless supportive of whatever the contemporary VA perspective might be...their choice, depends on what claims they need to deny at the moment.


Enter bioavailability. VA now insists that C-123 vets had no exposure because we have no proof of bioavailability. But what should be seen here is VA's twisted evasion of the requirements of the 1991 Agent Orange Act, Title 38, Sections 3.07, 3.08, 3.8.1, and the Federal Register of 8 May 2001. Congress told the VA to stop horsing around and recognize the list of Agent Orange presumptive illnesses if a veteran had been exposed and stop insisting on the vet developing a medical nexus.

We flew a contaminated airplane. We were exposed. And by the VA now insisting on no bioavailability and forcing us to prove there was, they have gone back to demanding that herbicide-exposed veterans establish medical nexus by their bureaucratic ruling that no such bioavailability existed for "our" dioxin on our C-123s.

That's all it is. Bioavailability equals medical nexus. VA introducing bioavailability into the equation is their attempt to seize back control over medical nexus requirements. Got it? If not, read these two paragraphs again, and Google both terms for extra convincing. VA has tried to back-pedal three decades and force veterans to prove medical nexus.

And that's not legal. And that has very recently captured the attention of several senators and congressional representatives, now aware of the sly maneuvering by Health Benefits Administration. Obviously our C-123 cases reaching the BVA have been successful for those veterans, but our appeal to all is that regional rating officers weigh fairly a C-123 veteran's claim for exposure and accept that proof of service aboard these toxic warplanes constitutes herbicide exposure and thus meets the legal requirement for awarding service connection.


Every C-123 veteran should be as blessed as I was this week, surrounded by talented clinicians and support staff, extra-wonderful folks dedicated to making sure this veteran, and all the wheel guys at Seattle SCI clinic, received world-class medical attention. And respect. And affection.

We should all be so lucky. And I believe, we are all so qualified. Get with it, VA!

C-123 Vets Meet with VA's Tom Murphy - unsatisfactory results!

"Not enough science," Mr. Tom Murphy seemed to say. "For every scientist you can give me saying C-123 people were exposed I'll find another who says they weren't." 

This type of response pretty much sums up the adversarial character of the recent disappointing meeting C-123 veterans had with the VA's Director of Compensation Services at his offices in Washington, DC. on 28 February 2013. Captain Marlene Wentworth NC  (thank you for being there!!!) and I spent an hour with Mr. Murphy, trying to learn why the VA has built a stone wall to C-123 Agent Orange exposure applications. We were grateful that Mr. Murphy and his staff accommodated our late arrival, having thought the meeting was to be at VA headquarters elsewhere.

Not enough science? Interesting. Mr. Murphy said Compensation Services will use that logic to continue denying each veteran's application for service connection, but "only after giving it careful individual consideration, before denying it." Also very interesting.

Asked about the value of the plethora (in the words of the Portland VA Regional Office) of independent medical and scientific opinions, he was completely dismissive. Asked about the weight of the numerous federal agencies who have provided opinions confirming our exposure, he was also dismissive. I asked how many more federal health or science agencies' voices he would need to be persuaded that we approach the VA's threshold of "as likely to as not" and was told no number would be adequate to persuade, as VBA deflects the authority for the VA having said "no" on C-123 claims to their Veterans Health Administration, seemingly the only authority he will recognize. 

Summation: it simply doesn't matter how much solid gold evidence a veteran submits to Compensation Services - claims will continue being denied regardless of merit. VA's legal requirement of "benefit of the doubt" is best summed up from their perspective as "no doubt shall be permitted" and thus no benefit of the doubt will flow.

"Go somewhere else."

And that somewhere is the VA's own Health Benefits Administration, which has already denied any exposure possibility re: C-123 veterans and issued regulations ordering regional offices not to honor claims from C-123 veterans regardless of the the claim's legal, scientific, medical, and every other justification. Still, VHA is where we must turn to have any effect, so my attentions will now be directed to VHA to see how we can work together! And I'll keep calling and emailing for an appointment as I have so many, many times thus far. The VBA physician is a public official and of course, certainly eager to help veterans...and is one herself.

Unfortunately, three time now, VHA has carefully "explained" why C-123 veterans will not receive service connection.

1. there wasn't enough dioxin or it was the wrong kind of dioxin ("dried dioxin")

2. there was no exposure by aircrews to dioxin, because it was dried dioxin

3. the human skin perfectly prevented any dermal exposure - not "enough" dioxin

4. any exposure was "secondary" and not permitted by law (not prohibited, either!)
5. the USAF C-123 Consultative Letter failed to conclude veterans were exposed 

Staff members of Compensation Services explained that denied claims can readily be appealed to the Board of Veterans Appeals, so I explained that such appeals, given our age and illnesses, are of interest only to our survivors...the appeals need five years and that totals seven with the initial claim - beyond most of our veterans' life expectancy. Somehow, I feel that they have absolutely no problem with us dying before claims are finished traveling through the VA system. Death before an appeal is heard doesn't ruffle any feathers at Compensation Services.

The killer claims barrier: staff insisted they simply had no authority to permit C-123 veterans' claims because Public Health has already completed a "scientific" review of literature to establish their position against veterans. This was their initial effort to deny claims and was done by "cherry picking" the references to avoid publications which would lead VA to accept our claims. VA made sure not to cite "gold standard" references such as TG 312 and the New York Reentry Standards, and they have dismissed all outside government agency conclusions in our favor as well as universities and other experts - even the VA's own physicians who have weighed in to support the veterans. 

Clearly, VA tells us any and all scientific and medical evidence supporting C-123 veterans' exposure claims is unacceptable. The VA position was authored by the very folks Compensation & Pension has told us to go see, and since they have already ruled against us and can be counted on to do so again, that's why we were referred to them. I'm not sure we have any chance of swaying them one degree off their predetermined course of preventing our claims. So far, VA is quite comfortable ignoring challenges from Congress, the press, other veterans organizations, universities, independent scientists and physicians, medical schools, VA physicians, and even other federal agencies. 

I asked about the Agent Orange Act of 1991, Title 38 and the C.F.R.s which in 2001 had the VA confirming (as reported in the Federal Register) that veterans exposed to Agent Orange outside Vietnam will be treated the same as those in Vietnam, and the clincher response about us is "there was no exposure." Regardless of the science or the facts, the VA will maintain that there was no exposure and therefore no claim approval. It doesn't matter how much we were exposed nor how long we were exposed nor how much damage the exposure caused - VA official policy is that we were not exposed. Got it? Good!

We were told one possible approach would be to have the Institute of Medicine conduct a review of our exposure situation. Perhaps C&P was not aware that was previously promised by the VA and canceled when the AF report was released. Remember the AF report on the C-123? It stated no conclusion could be reached about veterans' exposure and therefore veterans were unlikely to have been exposed. Amazing twist of logic there, right? Anyway, the IOM approach was eagerly accepted by us a year ago and the VA maneuvered away from allowing one. And that would waste another year or two we don't have. We need even-handed consideration of our claims at the Regional Offices!

I reviewed the very satisfactory meeting held the previous day at the Army's Joint Services Records Research Center, and the fact that the JSRRC archivists will now be able to provide responses to the VA with more accuracy regarding C-123 contamination. Mr. Murphy was unimpressed. My impression: unless JSRRC can be used by VA to deny our exposure, JSRRC input will not be evaluated.

C&P was asked if VA would continue denying benefits by claiming that TCDD is actually harmless. The director seemed unaware these official C-123 claims denials about TCDD (Agent Orange) were released over his signature, but I certainly wrote him in November (also without response) to draw his attention to this opinion which contradicts official VA policies. I gather this will continue as one of Compensation Services' tools to deny benefits, but I entertain faint hope VA will look into it for possible correction. 

Writing this on Wednesday morning of March 13, having waited in the area for fourteen days hoping that VHA would graciously provide the appointment that C&P suggested, I grow concerned that we will not have an opportunity to present our case at all. Other VA officials have already dismissed more effective speakers with more acceptable qualifications than I possess - they will not budge from their refusal to allow our veterans access to VA medical care. Whatever proofs or evidence we provide will be swatted aside with disregard for its veracity. 

I was most surprised by one of C&P's staff actually speaking. She explained that there can be no VA acceptance of medical or scientific opinion submitted by C-123 veterans which would otherwise establish our claims. On the various web pages veterans are directed to submit such proofs, but C&P explained that in fact, VA can only consider medical and scientific materials, and conclusions about such materials, from the VA's own Health Benefits Administration. I guess that's why EPA, NIH, CDC, DOD and even my own VA physician's medical opinion lacks value, according to Compensation Services. 

While polite, C&P's director didn't waste a smile on us that Thursday.  I was wasting his day. He didn't waste a dime offering Captain Wentworth and myself a cup of coffee or any such welcoming gesture. He didn't inquire of my health. He didn't waste an unnecessary "welcome" as we sat down together. He didn't waste any effort at helping us understand our situation. He certainly didn't offer anything to help us better seek care for our C-123 veterans, other than to take the problem elsewhere. I was wasting his day. Concerns about my own claim and claims of my friends should have elicited at least some expression of understanding and of guidance from Compensation Services about what we should do.

The director absolutely spared himself any "thank you for your service" thought, word or gesture on behalf of the Department of Veterans Affairs. So much for the duty to assist. Thank you for seeing us, C&P. And thank you, sir, for your own service.