Showing posts with label overwhelming preponderance. Show all posts
Showing posts with label overwhelming preponderance. Show all posts

24 June 2015

VA "Duty to Assist" – Why didn't they?

VA didn't help, but instead insisted for years no evidence existed to support C-123 veterans' Agent Orange exposure claims. VA insisted it had "an overwhelming preponderance of evidence" (a phrase created to encompass the VA policy, rather than weight of evidence) against the veterans' claims.

VBA's duty to assist arises from a variety of sources, including the Due Process Clause in the Fifth Amendment to the US Constitution, the Veterans Claims Assistance Act, and VA's own regulation VAM21-1MR. VBA errs when it fails to consider a M21-1MR provision's possible relevance with respect to VA's compliance with the duty to assist.  See 38 U.S.C. § 7104(a).  But here VBA simply excused itself from compliance with all of these mandates.

Here's the statutory language requiring VA to assist veterans in presenting disability claims:
§21.1032  VA has a duty to assist claimants in obtaining evidence.
(a) VA’s duty to assist begins when VA receives a complete or substantially complete application.
 (1) Except as provided in paragraph (d) of this section, upon receipt of a complete or substantially complete application for educational assistance under subpart C, D, G, H, K, L, or P of this part, VA will:
  (i) Make reasonable efforts to help a claimant obtain evidence necessary to substantiate the claim; and
  (ii) Give the assistance described in paragraphs (b) and (c) of this section to an individual attempting to reopen a finally decided claim.
 (2) VA will not pay any fees a custodian of records may charge to provide the records VA requests.  (Authority: 38 U.S.C. 5103A)
(b) Obtaining records not in the custody of a Federal department or agency. 
VA is specifically charged by VCAA with locating records from other Federal agencies as well as state and municipal governments. But the record shows VA elected not to search for these materials when needed for C-123 veterans' claims. Even when such vital documents for proving veterans' claims were in already in VA's possession, individuals in VA disputed them, failed to provide them to veterans and their attorneys, and failed to inform senior VA leaders of their existence.

But what's a little thing like the US Constitution to VA staffers determined to block C-123 veterans' claims? Well, it is quite a big thing, and such abuse quickly invites questions as is happening now.

What proofs did VA suppress or otherwise abuse?
1. March 2013 Joint Services Records Research Center confirmation of C-123 veterans' exposure per VAM21-1MR, with DOD specifically suggesting use of the confirmation by VA claims officials
2. CDC/Agency for Toxic Substances and Disease Registry confirmation of C-123 veterans' exposures. The deputy director (Dr. Tom Sinks,) the director (Dr. Christopher Portier,) and the interim director (Rear Admiral R. Ikeda MD USPHS) each informed VBA that CDC concluded C-123 veterans were exposed to 182-times military thresholds for dioxin exposure and suffered a 200-fold greater cancer risk. This information was disputed and not provided claimants who didn't already have it. VA also had but failed to act upon input from the National Toxicology Program, the US Public Health Service, the EPA (which concurred with the CDC finding but did not conduct its own investigation,) and multiple state agencies including medical schools, toxicology centers and even VA physician researchers.
3. May 2014 Joint Services Records Research Center began individual confirmation reports on C-123 veterans. Instead of accepting this proof and others as reaching the VA's low threshold of proof required of veterans, VA insisted it would continue with the ongoing IOM study thus delaying eventual claim approvals and blocking VA medical care for over one more year.
4.  Faced with a growing body of evidence submitted by veterans, VA's Director of Compensation and Pension minimized it as "a few items" when the total was over one hundred different proofs from multiple federal agencies, state governments, scientists and physicians. VA then characterized the small body of evidence it had as "an overwhelming preponderance of evidence," principally VA staff, VA web pages, a Dow-sponsored scientist's letter, a Monsanto-sponsored scientist's letter, and own VA's $600,000 no bid sole source Agent Orange consultant who had earlier denigrated the C-123 veterans as "trash-haulers, freeloaders looking for a tax-free dollar from a sympathetic congressman," telling his VA customers to "hold the line" against C-123 veterans' claims.
5. Faced with a large body of veterans' evidence, VA responded with a contract for its consultant to prepare monographs with a principal focus of blocking C-123 exposure claims. The contractor was paid $600,000 on his no-bid sole source contract to obstruct C-123 claims. Veterans sought but were permitted no VA assistance preparing their claims. and were left to their own means.
6. VBA characterized all non-physician scientists as unqualified to comment in support of C-123
veterans' claims, instead citing its own VA non-physician scientists as the only proper authorities. Federal courts have ruled that toxicologists are qualified to comment on medical nexus and excluding their input is an abuse of agency discretion and unfair to claimants.
7. Faced with one veteran's numerous proofs for exposure (the local VA office termed it a "plethora of evidence" but VA minimized the dozens of documents as "a few") VBA Director of Compensation and Pension directed a denial by stating, "In conclusion there is no conclusive evidence of TCDD (the toxin in Agent Orange) causing adverse health effects." VA later termed this "an unfortunate choice of words" but allowed it to serve for denying the claim. VA thus denied the Agent Orange claim under the Agent Orange Act with its response that Agent Orange is harmless.
8. In the years C-123 veterans have sought assistance proving their claims, not a single offer of help or suggestion or assistance in any form has been permitted by VA.
9. VA withheld its internal documents in denial of Freedom of Information Act requests. Ignoring requests for years finally had VA end up in the US District Court of Washington DC, where agreement was reached to finally release most of the materials. This release was minimal before the Institute of Medicine conducted its C-123 committee work, and only began in earnest after the IOM report was concluded and the VA information of less use to the veterans. As VA is specifically charged with helping veterans locate government documents helpful to claims, this specifically abused the veterans' rights to Due Process as well as under the Veterans Claims Assistance Act.
10. Because the issue of exposure was pivotal, VA redefined "exposure" in a unique and unscientific manner differing even from other VA agencies and Federal health and science agencies, as well as in conflict with VA's standard medical dictionary. The new VA definition of exposure would exclude virtually every exposure from VA coverage, such as Ebola.

Finally, veterans should have only had to submit their claims, and not argue against the VA for these past four years. VA should have been and was charged with being the veterans' advocate, handling claims in a paternalistic and pro-veteran manner. Instead, as VA told the Associated Press, "We have to draw the line somewhere," and that "somewhere" was over the bodies of C-123 exposure victims.

Why such push-back against just 2100 men and women C-123 veterans? Because VA had an attitude of no more Agent Orange claims, plus perhaps a prejudice against Reserve Component servicemembers. Certainly, veterans blocked from VA medical care for so many years saved millions in hospital costs and other benefits, and prevented even more veterans from swamping the already-limited VA patient care capacity. VA even managed to block retroactive disability compensation by setting the effective date of its new C-123 regulation as June 19, 2015 rather than the date of claim submission as with other disability claims.

Veterans now can hope that VA will process their C-123 exposure claims sometime soon, but every C-123 veteran not otherwise eligible is still forbidden all VA medical care and other benefits until then. Not a single C-123 veteran's claim has ever been honored, even though the Institute of Medicine C-123 Committee determined in January 2015 that their claims were correct from the very beginning.

This wasn't David against Goliath: This was David against hordes of the Philistine giants! "We have to draw the line somewhere," they were shouting!

22 February 2015

Early VA Actions "Stacked the Deck" Against C-123 Veterans For Years

"Overwhelming preponderance of evidence against veteran"...
CLAIM DENIED!

(VA Claims Motto??)
Wow. An "overwhelming preponderance of evidence "against a veteran's claim for Agent Orange certainly spells defeat for the vet. But it was a deception and there was no such "preponderance," much less an overwhelming one.

In fact, it was the reverse, with veterans' evidence being truly overwhelming but sneared at by VA.

Reading it aloud even now, it sounds like a VA must have had a tidal wave of facts and proofs to outweigh anything the veteran submits to substantiate a disability claim, rendering the claim completely without merit.

VA was aggressively opposed to C-123 claims, and annoyed that veterans continued to press their case and gather even more support...yet no matter how much proof veterans presented to VA, nothing budged its predetermination that anything conflicting with VA policy is useless, no more than a trifling and unpersuasive treatise.

That "overwhelming preponderance" catch phrase is one which stands out...shouts out... in reading hundreds of documents forced from VA's records via court action enforcing several Freedom of Information Act requests. VA initially denied all access to these records, then tried to deny access by charging thousands of dollars, and then simply refused to release anything.

"Overwhelming" prejudice would be a valid characterization of VA's approach to C-123 claims.

Finally, the C-123 Veterans Association suit in the US District Court of Washington DC prompted some cooperation. Over the past several months VA has given our attorneys at least some of the materials we sought.

"Overwhelming preponderance of evidence" is a thread running through many of these FOIA documents. Apparently the phrase was created by VBA's Agent Orange desk, and used by VA's Post Deployment Health Section in Veterans Health Administration as well as throughout VBA. It referred to, and summarized the conclusion of VA's facts against C-123 veterans' evidence about Agent Orange contamination and exposure.

But there was no such tidal wave of VA evidence. Rather, there was an "overwhelming preponderance of evidence" confirming C-123 veterans' arguments, all ignored by VA. Rather than permit evidence submitted by C-123 veterans to be fairly evaluated, Post Deployment Health trivialized it into insignificance against VA's evidence, using that characterization to assure senior VA leaders that C-123 veterans were completely in error and must be opposed.

To better avoid its non-adversarial, pro-veteran obligations, Post Deployment Health dismissed completely...even calling it "unfortunate, " all expert input from:
• CDC
• NIH
• US Public Health Service
• "Concerned Scientists & Physicians," Dr. Jeanne Stellman, Corresponding Scientist
• VA physicians
• Veterans private physicians
• Independent researchers with peer-reviewed articles establishing veterans' exposure

What was Post Deployment Health referring to with that phrase "overwhelming preponderance of evidence?"
• A letter from a Dow-sponsored scientist
• A letter from a Monsanto-sponsored scientist
• A VA contractor who had earlier denigrated C-123 veterans and who tailored reports to VA policy
• VA's own web pages, cited as their own authority, and which referenced only materials fitted to VA policy
• An inconclusive USAF report, later determined to have relied in part on poor math to reach its conclusions

Now that the Institute of Medicine C-123 report is on the Secretary's desk, VA should examine its initial knee-jerk reaction against the veterans' exposure claims, a position hard fought by VA from 2007 until January 2015. From the very first interaction with veterans in 2011, VA Post Deployment Health has clearly had a policy...perhaps a policy only among certain staff...that these claims were to be opposed.

The FOIA documents, and incidents through the years, show that VA predetermines veterans' claims to be denied yet still claim to offer a "case by case" evaluation. The record shows that such an evaluation actually means VA won't deny a claim until it is submitted,  and then it will deny it. Deny all such claims. But on a case by case basis, of course.

Statements were made by VA staff that C-123 claims would not be approved. The Associated Press was told, "We have to draw the line somewhere." Disability claims were denied – VA medical care refused to veterans seeking help – with language:
 "VA regulations do not allow us to concede exposure to herbicides for Veterans who claim they were exposed to herbicides after the Vietnam war while flying in aircraft used to spray these chemicals"
In fact no such regulations exist. When veterans' legislators challenged this, VA conceded that no regulations actually exist, but that claims denied using that language were still denied. VA ordered claims adjudicators to use different phrases...but continue denying the claims.

VA even cited "scientific studies" by VA Public Health which turn out to be a handful of staffers selecting literature to fit their policy of blocking all claims. Finally, even the Secretary of Veterans Affairs tried to reverse the only C-123 veteran's award ever permitted by VA, looking for CUE as a basis even though every single requirement in VAM21-1MR was met, and continues to be met, by all such claims.

"Overwhelming preponderance" was used and repeated throughout VA to the point the entire agency was convinced that C-123 claims were to be denied. The phrase became its own proof, cited to refuse veterans vital medical and other benefits.

Due Process was ignored, and didn't factor into VA's "overwhelming preponderance of evidence" because VA predetermined all veterans' materials worthless and claims were ordered denied. So much for VA's own regulation VA M21-1MR...ignored by VA in its blanket denial of C-123 veterans' claims. The creators of "overwhelming preponderance" were successful in their goal of 100% blanket denial...on a case by case basis, of course!

We're not making this up: read the hyperlinked references, call VA leadership, ask the reporters, scientists and veterans.

This was a skillful, deliberate, persistent (the word VA used to describe me...I'm credited with being "persistent") exercise in denial of the Fifth Amendment's Due Process Clause as regards VA's refusal to fairly evaluate veterans' qualified claims.

The question still on the table...what about other veterans' issues where VA does the same thing but without persistent self-advocacy by the vets? Dirty water, burn pits, immunizations, radiation, toxins, blast injuries, and all the other joys attendant to military service...what about them? Will VA reach out to veterans, or sit back and deride vet's claims with its all-too-prevalent "not on my watch" attitude?

There are new players in VA today, and we can hope for Due Process and the Constitution of the United States to mean something. We can look for a pro-veteran perspective to return to this essential institution. We can look...and hope to find it, for the sake of all veterans.

As for VA and Agent Orange: Never again can veterans be treated this way.
(C-123 Veterans' Motto)