Showing posts with label office of general counsel. Show all posts
Showing posts with label office of general counsel. Show all posts

27 April 2015

Senate AGAIN Demands VA Action For C-123 Agent Orange Veterans

Following the April 9 conference at the Senate Russell Building to address C-123 Agent Orange veterans' medical and compensation benefits, senior members of the United States Senate repeated their earlier bipartisan demand that VA Secretary McDonald exercise his existing authority and order appropriate action now.

Initially, VA expected to propose legislation using language already agreed-upon by Senate staffers. Just before the conference VA pulled the legislation which had been objected to by the C-123 Veterans Association. The vets faulted VA for having inserted language barring retroactive claims, meaning those whose illnesses manifested over the years and who submitted claims not yet approved would be denied coverage and all claims honored only from March 17 2015 forward.

Actually, the entire idea of legislation was objected to, as everyone except VA realized the Secretary had all the authority needed to act immediately. Legislation would delay yet further any relief for veterans whose illnesses had been evident for years, and has the risk of not being enacted at all.

On April 23, Senators Burr, Merkley, Blumenthal, Brown, Bennet, Warren and Wyden forwarded a joint letter to Secretary McDonald. Outlining in detail the legal basis for Secretarial action versus legislation, the letter requested firm action by the VA within fourteen days. Their letter closely paralleled the scholarly, in-depth analysis authored by Yale University School of Law, the C-123 Veterans' legal advocate.

18 April 2015

Are C-123 Veterans Actually Veterans?

No. Not if VA Office of General Counsel can prevent it!

"You're not veterans. Even if you were veterans before or after Reserve duty or even veterans in both situations, you're not veterans for purposes of Agent Orange exposure unless you qualify as such during your Reserve tour."

That was the VA Office of General Counsel talking last Thursday at the Senate Russell Building, defending its views in front of veterans service organizations,  Yale School of Law, House and Senate staffers, the media and others. The legal definition of "veteran" was raised as a stumbling block in our path to VA health care and other benefits.

Of course, this element of the puzzle could have been raised long ago and resolved, but for some reason, VA has a record of throwing obstacles one after the other, rather than putting everything on the table for the puzzle to be seen in one piece. Having resolved the scientific question of exposure through the Institute of Medicine C-123 report released in January 2015 (a process first discussed and promised the veterans in 2012,) VA OGC identified the statutory definition of "veteran" as its next barrier to our claims.

It turns out that VA benefits are available for Reserve and Guard members only if injured during Reserve duty, or if the servicemember completes a period of recall to Active Duty during the period in question. It is the view that Reserve and Guard, even if legally qualified as veterans before or after the period in question, are not "veterans" under the law unless they meet this criteria.

Example: a Reservist sent to duty in West Africa returns home and reverts to civilian status, develops ebola two weeks later. but is not a "veteran." Reason: because the illness or injury didn't actually manifest itself while the person was in uniform, even though the exposure occurred during Reserve duty. As ridiculous as this sounds, this exact scenario was run past VA Office of General Counsel and they agreed: VA actually would refuse care to an ebola-exposed Reservist.

The example closely parallels our Agent Orange problem.  We were exposed to the toxin dioxin in Agent Orange during the C-123 years of 1972-1982. However, soft tissue sarcomas and other Agent Orange illnesses don't manifest  themselves overnight, but instead can take decades for the exposure to be manifested in disease.

VA says because we didn't actually develop prostate cancer during a drill UTA, we were not injured in our Reserve status and therefore are not seen by VA as "veterans" for purposes of protection. An exposure to a Reservist which doesn't cause an immediate injury doesn't qualify the Reservist as injured and therefore a veteran under the law.

As you can imagine, this extremely restrictive OGC view didn't go unchallenged last Thursday. Rather, everyone present was of one voice: exposed C-123 servicemembers are veterans and are due VA care and benefits. There are a couple foundations for this challenge: in 2002 VA Office of General Counsel provided a formal precedent-setting option that a Navy Reservist given an anthrax vaccine who later developed serious illness qualified as a  veteran. It held that the vaccine was a foreign substance which injured her at the time of inoculation, even though the complications became evident years later. Our point: dioxin is a foreign substance which injured us.

VA OGC didn't take this quietly, Instead, they did the amazing thing of declaring their 2002 decision to be in error and therefore not applicable to the C-123. Nobody there was willing to let VA cherry-pick or redefine their own references and it was clear any final solution doing that was headed straight for court.

Still, the conference ended without degenerating into total chaos. VA OGC agreed that proposed legislation would be withdrawn, and to rethink the opposing arguments, especially in light of the unified front against the VA position. VA also came to realize that somehow language had been inserted in the proposed legislation barring retroactive claim awards, even if those claims had been in their system for many years.

"Active Service Criteria for Veteran Status (from the Congressional Research Service

“An applicant for VA benefits must have “active military, naval, or air service” to be considered a veteran for most VA benefits. However, not all types of service are considered active military service for this purpose.

In general, active service means full-time service, other than active duty for training, as a member of the Army, Navy, Air Force, Marine Corps, Coast Guard, or as a commissioned officer of the Public Health Service, the Environmental Science Services Administration or the National Oceanic and Atmospheric Administration, or its predecessor, the Coast and Geodetic Survey.

Active service also includes a period of active duty for training during which the person was disabled or died from an injury or disease incurred or aggravated in the line of duty and any period of inactive duty for training during which the person was disabled or died from an injury incurred or aggravated in the line of duty or from certain health conditions incurred during the training.

Additional circumstances of service, and whether they are deemed to be active military service, are set out in law. For example, if on authorized travel to and from the performance of active duty training or inactive duty for training, a person is disabled or dies while proceeding directly to or returning from such duty, the duty will be considered to be active duty for training or inactive duty for training."

09 December 2014

VA Officials Asked to Designate C-123s as "Agent Orange Manufacture, Use, Storage, Transport" Sites

NOTE: 21 Feb 2015: Freedom of Information Act requests last week revealed DOD and VA agreed between themselves not to act on these requests.
(Letter sent to dozens of VA & DOD officials, seeking proper OPR action for such designations)

Dear Sir or Madam,

This Friday, the Department of the Air Force General Counsel informed us that it is the responsibility of the Department of Veterans Affairs to identify and list Agent Orange (military herbicide) sites associated with manufacture, transport, testing and use. Three times in two years we have sought just such a designation from LtGen Judith Fedder, DOD's OPR for installations, and each time have been told it is a VA responsibility. VA has repeatedly assured us, to the contrary, it is a DOD or AF function.

What is clear, from the DOD 2006 list, is that VA requested DOD to provide a list which was then prepared by a consultant (who has labeled Agent Orange veterans as "freeloaders, trash-haulers looking for a tax-free dollar from a sympathetic congressman. I have no respect.") through Battelle. He also sought and received an unbudgeted $600,000 contract through Veterans Benefits Administration on a no-bid, sole source two year deal for opposing post-Vietnam exposure situations on behalf of VBA and VHA.

In somewhat of a curious historical background, the consultant, in his capacity of Senior Agent Orange Consultant to the Office of Secretary of Defense, is credited by the USAF as being "the strongest proponent all along for immediate destruction without further testing" of the toxic C-123s in 2009, decades after they'd been designated by AF toxicologists as "heavily contaminated on all test surfaces" and "a danger to public health."

The VA consultant, towards the end of his two year contract, also assured the Institute of Medicine in June 2014 that the C-123s had been "decontaminated" after Vietnam although there is no documentation to that, and the suggestion runs contrary to Air Force tests over decades showing them still contaminated.

In reviewing the Air Force test results, the CDC informed the Institute of Medicine in June 2014 that aircrews should have been wearing full HAZMAT, or the airplanes grounded as unsafe in American airspace. The totality of this evidence of C-123 contamination exceeds that of nearly every site presently on VA and DOD lists.
• For instance, none of the vessels on VA's lists ever tested as positive for Agent Orange contamination, yet more than two dozen of our aircraft did.
• None of the Navy's ships were destroyed due to their contamination, yet all of our aircraft were.
• No Navy toxicologists testified in federal court that vessels were "a danger to public health," yet Air Force toxicologist Dr. Ron Porter did so regarding C-123s.
• No other federal agencies informed VA or DOD that Navy ships were contaminated and their crews exposed, yet CDC, NIH, USPHS, NIEHS and the National Toxicology Center have each so described our former Agent Orange spray aircraft.
• No naval ships were ever quarantined due to their herbicide contamination, yet all surplus C-123s were placed into HAZMAT quarantine at Davis-Monthan AFB.
• No US Navy ship were ever described by the Department of the Navy as "the Agent Orange ships" the Department of the Air Force referred to the C-123s as for decades.
• The EPA never proposed an illegal HAZMAT storage fine for naval vessels, yet EPA and AF JAG determined the Air Force was liable for a potential $3.4 billion fine for C-123s stored at Davis-Monthan, cited as partial authority for the unique destruction scheme in April-June 2010.

Accordingly, I request information as to the proper contact in your office of primary responsibility this function, as well as the criteria established for addition to the list, and your forwarding to them this request.

Please help us locate the authority by which Compensation and Pension rejects input from reputable toxicologists and epidemiologists, as well as physicians, who advised VA as to the contamination and exposure to military herbicides by C-123 veterans seeking who were seeking service connection for Agent Orange-presumptive illnesses. C&P stated these professionals lacked credentials to address medical nexus, but it is clear in VA 21-1MR as well as the numerous Federal Register postings that medical nexus is not a requirement for claims for VA-recognized Agent Orange illnesses. Was C&P unclear as to this requirement or did it seek to introduce conflict?

In a related matter, I'd appreciate any basis for which Compensation and Pension Service denies Agent Orange exposure claims with their statement, "In summary, there is no conclusive evidence that TCDD exposure causes any adverse health effects." This statement seems to run contrary to VA's long-established position, as well as contrary to contemporary medical and scientific understanding. It also seems contrary to the requirements of VA M21-1MR, Title 38, the Federal Register VA postings, and the 1991 Agent Orange Law: how can Agent Orange claims still be denied on the basis of VA suggestions that Agent Orange causes no adverse health effects?

We understand that addressing these questions might cause some difficulty, but please accept that our veterans being refused VA medical care also causes difficulty, as well as suffering and deaths. At least, the VA officials receiving this email and its associated documents will have the relevant materials in their files for which future examination might prove useful in understanding years of delays, circumventions and obstruction of benefits sought by eligible veterans – or our survivors.

Respectfully,

/s/  Wesley T. Carter, Major, USAF Retired
Medical Service Corps
(former Stan/Eval Flight Instructor & Flight Examiner, C-123K aircraft)

02 December 2014

Overview of Veterans' Agent Orange Legislation

Children Of Vietnam Veterans Health Alliance INC
Veterans Exposed to Agent Orange: Legislative History, Litigation, and Current Issues – R43790
By Sidath Viranga Panangala, first published December 1, 2014, Congressional Research Service
The U.S. Armed Forces used a variety of chemical defoliants to clear dense jungle land in Vietnam during the war. Agent Orange (named for the orange-colored identifying stripes on the barrels) was by far the most widely used herbicide during the Vietnam War. Many Vietnam-era veterans (and a great many scientists) believe that exposure to Agent Orange caused them to contract several diseases and caused certain disabilities, including birth defects in their children, and now their grandchildren.
The Aspen Institute provides an excellent overview of Agent Orange's tragic 50-year history. CLiCK HERE for an excellent summation of legislation being considered in the current Congress. Note that of over 10,000 bills now in process, fewer than 300 have resulted in new laws, and only three dealt with veterans' issues. Thus, any hope for a specific legislative approach to an issue such as Blue Water Navy has odds which appear insurmountable. Note further that the current Congress is properly termed a "do-nothing Congress" because it passed less than half the average number of new laws. And only a few weeks remain for the most serious issues facing the Nation to be addressed.
The Department of Veterans Affairs (VA) received the first claims asserting conditions related to Agent Orange in 1977. Although eventually thousands of veterans sought help, VA immediately took the position that Agent Orange was harmless, and any problem weren't anything worse 'than teenage acne," as the then-Administrator of the VA put it.
Since then, Vietnam-era veterans have sought relief from Congress and through the judicial system. Beginning in 1979, Congress enacted several laws to determine whether exposure to Agent Orange in Vietnam was associated with possible long-term health effects and certain disabilities. The Veterans’ Health Care, Training and Small Business Loan Act (P.L. 97-72) elevated Vietnam veterans’ priority status for health care at VA facilities by recognizing a veteran’s own report of exposure as sufficient proof to receive medical care, absent evidence to the contrary. This requirement is frequently most noted for being ignored by VA rating officials.
The Veterans’ Health Care Eligibility Reform Act of 1996 (P.L. 104-262) completely restructured the VA medical care eligibility requirements for all veterans. Under P.L. 104-262, a veteran does not have to demonstrate a link between a certain health condition and exposure to Agent Orange; instead, medical care is provided unless the VA determines that the condition did not result from exposure to Agent Orange. This authority was permanently authorized by the Caregivers and Veterans Omnibus Health Services Act of 2010 (P.L. 111-163).
Likewise, Congress passed several measures to address disability compensation issues affecting Vietnam veterans. The Veterans’ Dioxin and Radiation Exposure Compensation Standards Act of 1984 (P.L. 98-542) required the VA to develop regulations for disability compensation to Vietnam veterans exposed to Agent Orange. 
In 1991, in total frustration with VA's determination to block veterans' access to benefits associated with their service in Vietnam, Congress passed the landmark Agent Orange Act (P.L. 102-4) established a presumption of service connection for diseases associated with herbicide exposure. This proved to be the foundational legislation for treatment of Agent Orange-exposed veterans.
P.L. 102-4 authorized (and required) the VA to contract with the Institute of Medicine (IOM) to conduct scientific reviews of the evidence linking certain medical conditions to herbicide exposure. Under this law, the VA is required to review the reports of the IOM and issue regulations, establishing a presumption of service connection for any disease for which there is scientific evidence of a positive association with herbicide exposure. Based on these IOM reports, currently 15 health conditions are presumptively service-connected. The last of the IOM Agent Orange reviews began in October 2014 and will report its results in about two years.
Under current regulations, a service member must have actually set foot on Vietnamese soil or served on a vessel on its rivers (also known as “brown water” veterans) to be entitled to the presumption of exposure to Agent Orange. Those who served aboard deep-water naval vessels (commonly referred to as “Blue Water Navy” veterans) do not qualify for presumption of service connections for herbicide-related conditions unless they can prove that the veteran’s service included duty or visitation within the country of Vietnam itself, or on its inland waterways. 
The law also provides that veterans who can prove exposure to Agent Orange in situations outside Vietnam will receive the same presumption of service connection for recognized Agent Orange illnesses, but VA has resisted any such addition to the numbers of veterans needing treatment. In an Associated Press interview, Dr. Terry Walters, deputy chief consultant for Post-Deployment Health, stated "we have to draw the line somewhere." Veterans object, pointing out that there is nothing in the law, the Federal Register, nor VA's own governing regulation, VA M21-1M, permitting such a line to be drawn, and suggest that Dr. Walter's position reflects unpublished policy, rather than lawful agency procedures. Dr. Walters even argues that few, if any, of the Vietnam war veterans were exposed to Agent Orange.
Post-Vietnam C-123 veterans are the subject of an IOM study due out in January 2015, addressing whether those aircrews will receive care for exposures aboard their former Agent Orange spray aircraft. Along with other veterans' organizations, they are alarmed at recent steps by VA to redefine the basic word "exposure" to exclude exposed veterans by linguistic tricks. VA's Office of General Counsel in September 2014 wrote that VA has the authority to redefine any words not otherwise defined in legislation, even if the redefined medical or scientific terminology conflicts with other federal agencies.
Recently, Vietnam-era veterans and scientists familiar with the issue have increasingly expressed concerns about all types of medical issues occurring in their children, regardless of age, and in successive generations. Furthermore, they have asserted that more research should be done on paternally mediated birth effects, so that compensation policies might be developed similar to those that address maternally mediated birth effects of Vietnam-era progeny.
The complete PDF of this Agent Orange report by Sidath Viranga Panangala is available:Date of Report: November 18, 2014: 22Order Number: R43790e-mail:congress@pennyhill.com Phone: 301-253-0881

20 September 2014

"CASE BY CASE" Claims Processing: VA Empty Promises to C-123 Veterans

VBA C-123 Training Program
• "All claims are considered on a case-by-case basis." former Secretary Shinseki
• "All claims are considered on a case-by-case basis." – Under Secretary Allison Hickey
• "All claims are evaluated on a case-by-case basis." – VA Office of General Counsel
• "All claims are considered on a case-by-case basis." VA Deputy Chief Consultant Post Deployment Health
• "Claims accepted and reviewed on case-by-case basis." – Federal Register (VA per Dr. Terry Walters), May 11, 2011, December 26 2012, May 23, 2014
• "Makes a case-by-case determination..." – VA Office of General Counsel
• "Evaluations...conducted on a case-by-case basis." – VA response to Senate Veterans Affairs Committee
• "VA decides these claims on a case-by-case basis." – VA C-123 Agent Orange web page 
 • "These claims will be decided on a “case-by-case basis” – VA Agent Orange consultant
 • "All claims are evaluated on a case-by-case basis.” – VBA Director Compensation & Pension Service
• “Veterans' claims are evaluated on a case-by-case basis.” – VA Public Affairs spokesperson  
What VA means, in fact and in practice, is that C-123 claims are DENIED automatically. There is no true case by case evaluation, as VA’s own training materials have made clear.

No matter how often repeated, no matter who repeats the promise – these are shown to be empty VA promises, meant only to deceive. Proper case by case claim evaluation, particularly to weigh each veteran's disability claim individually, is a deception. The duty to consider cases on the merits of the situation is spelled out in the VA's own regulations, as well as numerous CAVC rulings. It is a duty which shouldn't be ignored by those responsible, even forgetting it amounts to Clear and Unmistakable Error.

These promises are deceptions, feints, misleading diversions...prevarications and dishonorable utterances. Dishonorable because most of the folks repeating the statements know VA has no intention of doing anything of the sort.

Proof of this was revealed yesterday, when VA's Office of General Counsel finally released a few of the documents C-123 Veterans had demanded under the FOIA. The fundamental VA deception regarding "case by case" claims evaluation was shown in the statements that no amount of scientific or medical proof would permit a C-123 claim to be approved...that VA had already predetermined none of the C-123 vets eligible for exposure benefits

Denied. Before claims are even submitted. Denied. While claims sit a year at the regional office before automatic rejection. Denied, forcing a three-five year appeal to the Board of Veterans Appeals where all C-123 claims have been awarded the veteran because there, at least, a sense of justice is working.

In this, and in other documents, VA makes clear its determination to block any C-123 exposure claims through legal or even extra-legal means. VA tosses off all obligations to be pro-veteran and non-adversarial, and pretends it never heard of Colvin, and tells the claims adjudicator his/her duty to evaluate all evidence has somehow been set aside. No.

Why? One suggestion is Slide 6 in VA's C-123 Slide presentation; please note the last point. Rather than focus on our needs and eligibility, VA worries instead about the impact on other Agent Orange controversies.

And throws us under the bus!

Above: Slide #Six, VBA Training Presentation on C-123 Claims






13 September 2014

VA Invents (But Ignores) Rules About Agent Orange Exposure

Faced with disability claims from C-123 veterans exposed to Agent Orange aboard our former Agent Orange spray aircraft, officials in Veterans Health Administration and Veterans Benefits Administration have been energetic in barring veterans from essential health care. And also very selective about which rules VA follows, when they ignore those rules, and how to create new ones as the occasion warrants.

Not only does VA's Office of General Counsel and VHA Post Deployment Health create unscientific redefinitions of exposure to block exposure claims, but they simply ignore the law and their own rules and regulations. Of course, at some point, justice prevails and claims are appealed and corrected...but the veterans are forced wait years while somehow finding health care elsewhere. 

Here's how VA ignores the law and breaks the President's and the Secretary's promises to veterans, forcing vets into the black hole of appeals...three to four years waiting, with a 25% chance of the claim being approved (so far, all C-123 claim reaching BVA have won,) but a 45% chance of the claims having errors forcing the claim to be remanded for more work and still more delays by the regional office.

• "A veteran who was exposed to herbicides in service and who develops one of these diseases within the applicable presumption period, if any, is presumed to have incurred the disease in service, without the necessity of submitting proof of causation."    Testimony of Dr. Leo McCay, Deputy Secretary  IGNORED

• "Presumption of service connection. VA will presume service connection where a veteran who was exposed to an herbicide agent during active military service is diagnosed with a disease listed in paragraph (e) of this section that becomes manifest to a degree of 10 percent or more within the time period"      Federal Register July 27, 2004  IGNORED


• ‘‘Evaluation of studies relating to health effects of dioxin and radiation exposure."  38 C.F.R. 1.17 IGNORED!

• Finally, we wish to make clear that the presumptions of service connection provided by this rule will apply to any veteran who was exposed during service to the herbicides used in Vietnam, even if exposure occurred outside of Vietnam. A veteran who is not presumed to have been exposed to herbicides, but who is shown by evidence to have been exposed, is eligible for the presumption of service connection for the diseases listed in § 3.309(e), including the three diseases added by this rule.   VA announcement in Federal Register 31 August 2010.    IGNORED, and the reason VHA scrambled to create its redefinition of exposure to block exposure claims.

Does the VA even have the authority to order, and then evaluate, a IOM C-123 Agent Orange study addressing bioavailability, relative to veterans' benefits under the 1991 Agent Orange Act? 

No. C-123 veterans with proof of duty aboard "Patches" or any of the other former Agent Orange spray aircraft are fully eligible right now for presumptive service connection, and for treatment of those illnesses. Indeed, it will take a new law or regulation to disqualify them.

Instead, 38CFR spells out the procedures the VA should employ evaluating outside scientific studies about the association of herbicide exposure with different illnesses, but not of the fact of exposure or the paths by which exposure may occur.  (Chapter 1, Section 1.17 (c), p. 14) Nothing indicates any procedure by which exposure itself may be denied, defined or by which VA can require bioavailability. So VA decided to invent a basis denial and a redefinition to block claims. 

VA has a very aggressive defense, and very anti-veteran. VA seeks out, or simply creates, barriers to claims rather than permitting eligible veterans to receive care for hazardous service and injuries.


• Indeed, based on current statute, the VA is not required to consider evidence on exposure magnitude or duration and all exposures are to be given equal weight when determining health effects. There is no qualification for amount of exposure, bioavailability, color, flavor or even whether it makes one robust and improves the humors – the only qualifications are (1) proof of exposure and (2) a recognized AO illness. That foundation...exposure...is exactly why VHA and the VA Office of General Counsel simply redefined exposure to block claims. Other government agencies more correctly use the CDC definition, by which there is no question as to the C-123 veterans' eligibility. CDC says exposure is contact with a substance by swallowing, breathing, or touching the skin or eyes.     IGNORED

In meeting its pro-veteran, non-adversarial obligation, VA has failed. The Law:      IGNORED

(for background, read the Congressional Research Service "Presumptive Service Connection" report)

10 September 2014

VA IG Report: "VA Managers Lied to Federal Investigators"

By Associated Press September 9 at 3:25 PM
"WASHINGTON — Managers at more than a dozen Veterans Affairs medical facilities lied to federal investigators about scheduling practices and other issues, the department’s inspector general said Tuesday. (Altogether, nearly 50% of VHA management lied to federal investigators, which is a crime.)

Richard Griffin, the VA’s acting inspector general, said his office is investigating allegations of wrongdoing at 93 VA sites across the country, including 12 reports that have been completed and submitted to the VA for review."

That was the bad news from September 9. It shows the breakdown of integrity at the VA's Veterans Health Administration. It leaves veterans convinced that Post Deployment Health and VA National Center for Ethics in Heathcare, both components of the Veterans Health Administration, cannot avoid sharing in this scandal. 

For Post Deployment Health, the failure is their dedication and creativity in obstructing veterans' exposure claims, even in the face of "as likely as not" medical and scientific evidence. The result of their actions has been the denial of VA medical care to an unknown number of post-Vietnam C-123 veterans.  

For VA's National Center for Ethics in Healthcare, their failure is avoiding action on ethical concerns brought to them regarding patient privacy and other issues. Instead of careful investigation in line with their mission statement, their response was to defer concerns to VA's IG which the Center knew had no jurisdiction, or other buck-passing non-solutions.

Other VA agencies have also failed veterans. VBA's Compensation and Pension Service failed Secretary Shinseki by drafting a crafty, disingenuous and error-ridden response to Senator Burr's C-123 inquiry. This is a perfect example of what General Shinseki meant by trusting in the honor and integrity of those helping him meet the needs of America's veterans.

For VA's Office of General Counsel, their failure is willingness to support Post Deployment Health in obstructing veterans' exposure claims by seizing non-existent authority to redefine fundamental scientific and toxicological terms. OGC, rather than guiding the Department in using the breadth of law and regulation to include veterans, instead created barriers to exclude otherwise eligible veterans. Responding to the Yale Law School brief on C-123 veterans, OGC attacked rather than welcomed legal research and scholarly confirmation of the veterans' eligibility for VA care.

For Veterans Benefits Administration Compensation and Pension Service, their failure is also obstructing eligible veterans' claims for exposure care. From preventing input to the JSRRC body of knowledge, from denying claims on the basis that TCDD (a known carcinogen) is harmless, to refusing to accept scientific and medical input supporting veterans' disability claims, Compensation and Pension has faithfully kept in step with VHA's insistence that "We cannot permit C-123 claims." Faced with scientific argument supporting C-123 veterans' exposure claims, VBA instead contracted for $600,000 to create obstruction and confusion, and also failed to follow its own regulations and honor commitments published in the Federal Register.

03 August 2014

VA Office of General Counsel Moves to Nullify VA Federal Register Commitments

Last week VA's Office of General Counsel reviewed, and rejected, the Yale Law C-123 report which held that C-123 veterans had been exposed to Agent Orange and are due presumptive service connection for recognized Agent Orange illnesses. Rather than find in the Yale report a channel to include veterans, the VA knee-jerk was to, as usual, "draw the line somewhere" and insure their denial of care.

But the OGC went far, far further! They want to reserve the definition of "exposure" for their own purposes. Here's why that's critical to our C-123 exposure claims. VA: "Exposure = contamination field + bioavailability." To the rest of the scientific world, exposure = skin (or eye) contact, ingestion or inhalation of a chemical of any type.

The 1991 Agent Orange Act was the result of Congress' frustration with the Department of Veterans Affairs stalling Vietnam veterans' Agent Orange exposure claims. Congress simply told the VA that it had to presume that all vets with "boots on the ground" were presumptively exposed, and therefore, presumptively service connected for diseases recognized by the Institute of Medicine as associated with Agent Orange. The 1991 Agent Orange took away the power of the VA demand medical nexus, making it presumed by law. VA could no longer hide behind that requirement.

VA set about to obey this law and over the years, various illnesses were recognized by the IOM, and therefore by the VA, as Agent Orange illnesses. Over those years, illnesses like diabetes and heart disease were added, and the VA published in the Federal Register its regulations, and interpretations of regulations. Three times, the VA specified that veterans exposed to Agent Orange outside Vietnam would be treated with the same presumptive service connection as Vietnam veterans.

Not once, but three specific statements in the Federal Register. The only qualifier..."exposure." But there was no definition of exposure given. Nor is one needed, as the other federal agencies such as the CDC/Agency for Toxic Substances and Disease Registry, and the National Toxicology Program, publish glossaries for terms such as exposure.

But OGC is working on a runaround of both the Agent Orange Act and the Federal Register publications. They want now to redefine exposure as they see fit, which will be to require bioavailability...another word for the forbidden medical nexus. By reinserting a non-Vietnam veteran's requirement to prove bioavailability through the redefinition of exposure to include it, all such claims can be denied because so much time as past, medical nexus/bioavailability become impossible to prove.

Not only that. Ignoring the Supreme Court's Christopher v. SmithKline decision, VA OGC, caving to the agenda of Post Deployment Health, wants to make retroactive their definition of exposure via either a regulation or an announcement in the Federal Register.

Fortunately, the Supreme Court severely limits a regulatory agency's ability to make such retroactive changes, and this situation is a perfect example of the desired prohibition...but ignored by OGC.

How can they do this? They can't, at least, not forever. At some point, a legislative change, or a court decision, overcomes such shady activity and the agency is ordered to correct its act. Perhaps, although rarely successful, this is done by a writ of mandamus or a presidential order. In any case...the VA wins.

They win by denying sick C-123 veterans all VA medical care, unless otherwise qualified, until such time as some authority insists VA complies with the law. At some long-distant future point in time justice prevails – but all that happens is VA gets ordered to do the right thing, begin taking care of the veterans it has ignored, and send a catch-up check for whatever disability payments owed the veteran. Regardless of its size, any check is peanuts compared to the cost of medical care the VA saves by keeping C-123 vets out of their hospitals, especially given our ages and illnesses.

Incalculable is the cost of medical care not sought by the veteran due to cost, such as dental care...incalculable except as a deduction from the C-123 veteran's remaining life expectancy.

Every day a claim is delayed is money saved by VA.  No medical care, no rehab. No pharmacy. No prosthetics. No counseling, no travel expenses, no funeral costs, no Dependent's Indemnity Compensation, no dental or vision care. No hearing aids. Nothing...VA saves big bucks by keeping C-123 veterans out, using Medicare or Medicaid instead of the quality VA medical care we earned.

As VA's Veterans Health Administration sees it, the fewer vets on the VA roles the better for their budget and appointment lists.

They can't lose. Every claim denied is big VA"win." The longer VBA prevents an Agent Orange claim, the more money saved for VHA. It doesn't matter how outrageous their excuse, such as parsing the word "exposure" and making their regulations retroactive, might be...every day that a C-123 vet stays out of their hospitals is money saved, and they face no penalty or punishment or such outrageous, anti-veteran procedures. All the court can do is order the illegal or improper procedure corrected at some date years later.

But we're not going to see that day. VA has stalled C-123 claims for years, despite reams of proofs. They stalled on the IOM investigation for two years, then started it up again to stall for more time, with the charge to the committee not even addressing the specific question needed answering...were the C-123 veterans exposed or not? Exposed is the only question under the law. So VA intends to answer that question its own way, so that no exposures occur. Neat trick.

No wonder OGC wants to reinvent the word, so that VA can grab back the requirement that veterans establish medical nexus for whatever the exposure situation might be...dirty water, immunizations, radiation, Agent Orange, burn pits...unless some law specifically demands that VA treat a specific exposure, VA will hide behind the OGC opinion so it can redefine exposure to prevent exposure claims.

What a mess.