Lack of Oversight Promotes VA Claims Mismanagement at Highest Level

"Lack of Oversight"

• For more than four years, James Sampsel got away with it. Mr. Sampsel was (and still is?) working from his home as manager of the VBA Agent Orange Desk. That's a key position in the Compensation and Pension Service with duties spelled out in VA Adjudication Manual M21-1MR. Every non-Vietnam veteran claiming Agent Orange exposure faces Mr. Sampsel's scrutiny. 

What did Mr. Sampsel get away with?
• Improperly blocked every single C-123 veteran's Agent Orange disability claim that crossed his desk. That denied vital medical care and disability benefits. Unless otherwise eligible, vets with cancers and other deadly ailments were locked out of VA hospitals. 
• He created a brief to the Senate Veterans Affairs Committee that falsely assured legislators C-123 claims were decided on a case-by-case basis, while he simultaneously directed VA rating officials to deny all those claims. This was to block legislative relief for C-123 veterans.

• His friendship with Dr. Alvin Young included supervision of a unique no-bid sole-source unsolicited contract for $600,000, with Dr. Young producing a series of monographs on Agent Orange issues of Mr. Sampsel's choosing. The largest single subject of the monographs was Dr.Young's enthusiastic support for Mr. Sampsel's opposition to C-123 exposure claims. The entire series was designed to buttress VA policies against Agent Orange claims.

• Mr. Sampsel was present at the June 14, 2014 hearing of the Institute of Medicine C-123 Committee at which Dr. Young denied he was representing VA in opposing C-123 exposure claims. In fact, Dr. Young was under his Sept 2012-Sept 2014 Agent Orange consulting contract, receiving $25,000 that month. Mr. Sampsel did nothing to correct Dr. Young's misleading statement to the IOM. Critical because Dr.Young tried to come off as a disinterested expert coming forward to advise the committee. In fact, Dr. Young was a paid VA agent under Mr. Sampsel.

• In one email, Mr. Sampsel even sarcastically shared patient information with an unauthorized colleague. He also recommended VA not respond to a different patient confidentially complaint about him as it would only "encourage" the vet. VA does not want to encourage veterans?
• He misled the Secretary into signing a deceptive and error-laden letter and C-123 Fact Sheet" for the Senate Veterans Affairs Committee.

How did he do that?

• Mr. Sampsel insisted VA had "an overwhelming preponderance of evidence" against C-123 claims but there was no such preponderance. Mr. Sampsel told raters there was no basis for honoring C-123 exposure claims, and even provided boilerplate claim denial language to regional offices. 
• Like others in VA, Mr. Sampsel wrongly promised every C-123 disability claim was addressed on "a case-by-case" basis. Amazingly, this is even while writing memos to Mr. Murphy questioning whether they should adopt a case-by-case basis. He directed VA's blanket denial policy while also denying hs policy existed. Some regional offices like Manchester NH took Mr. Sampsel's denials to be regulatory prohibitions of C-123  awards.

• Thus, every C-123 claim was denied from the earliest known in 2007 until June 2015. Tellingly, once free of Mr. Sampsel's twisted scrutiny, every denied C-123 claim appealed to the Board of Veterans Appeals was honored because the BVA more closely obeyed the law and followed VA regulations. Eventually, years after the Sampsel denials, C-123 vets go a fair deal at VBA...if they'd survived the interim delay.

• He also drafted Secretary Shinseki's error-laden June 2013 response to Senator Burr and the "C-123 Fact Sheet," thus forestalling legislative intervention by veterans' elected representatives

• Despite VAM21-1MR procedures, Mr. Sampsel refused to act on JSRRC confirmation of C-123 exposures. He received input as early as March 2013 yet for years continued to insist on his "overwhelming preponderance of evidence" against C-123 vets. It should be noted that the phrase "overwhelming preponderance" admits virtually no doubt – "there is no reason to believe otherwise"...even with contrary input from CDC, NIH, JSRRC, and dozens of other experts, Mr. Sampsel insisted to vets, legislators and VA itself there was no doubt. He was correct, but only in there was no doubt that all C-123 claims would be automatically denied by Mr. Sampsel's agency.

Who let him get away with it? 

• Mr. Thomas Murphy, at the time Director, Compensation, and Pension Service and now, Acting Under Secretary for Benefits. Mr. Sampsel had a key position under Murphy's organization.

How do we know Mr. Murphy failed to provide effective oversight?
• Because Mr. Murphy was personally briefed on these problems by Major Wes Carter. Further, Mr. Murphy was copied on veterans' correspondence to various VA leaders revealing specific failures of the Agent Orange Desk, and was copied by Mr. Sampsel on his internal correspondence. Veterans met with Mr. Murphy at his 1800 office on February 28, 2013 to discuss reasons for VBA blocking C-123 exposure claims. 

• One specific point covered was language in a claim denial that dismissed dioxin's harmful effects. Another was the Agent Orange Desk rejection of all opinions from the CDC/ATSDR, NIH and dozens of independent experts.

• Mr. Murphy signed the claim denial in question, and also signed VA responses to Dr. Jeanne Stellman, the Corresponding Scientist of the Concerned Physicians and Scientists. That group detailed scientific errors in the Agent Orange Desk rejection of C-123 claims

• Dr. Young's $600,000 Agent Orange consulting contract produced little if anything of value to VA, and was also pointedly anti-veteran as it obstructed C-123 claims.

What was the impact of Mr. Murphy's Lack of Oversight? 

• Vets were denied VA medical care. Vets were denied compensation for disabilities. Families were denied Champ-VA medical care and other benefits such as educational assistance for children. Veterans without VA certification were denied state benefits. Veterans were denied burial benefits. Overall, a discrediting of the VA benefits system and what one newspaper's editors called "the VA's latest success in embarrassing itself."

What has been done about Mr. Murphy's Lack of Oversight?

• Nothing. Nothing has been done to make right the harm done nor improve VA policies and procedures.

Why still be concerned about this injustice?

• Because vets were denied benefits until June 2015. While presently there is no recovery for medical care and other expenses vets faced without VA benefits, VA needs to honor old claims for retroactive disability compensation just as they do with every other claim situation because compensation is based on the date of application, not when Mr. Sampsel and company get around to doing the right thing.

• Because nothing has been done to address their failures, and the system is free to do this again to other veterans.

VA failure in its "duty to assist" veterans claims, particularly with C-123 Agent Orange

Guest article follows: 
My own experience with the VA duty to assist gathering evidence to support veterans' claim was quite painful. For verification of Agent Orange claims the VA turns to the Department of Defense Joint Services Records Research Center (JSRRC) for confirmation of exposures outside Vietnam. Despite the fact that JSRRC serves as the VA research authority, for years VA succeeded in blocking JSRRC input vital to confirm our exposures aboard C-123s. Fortunately, in 2013 VA was provided proof which was made more substantial in 2014 by the JSRRC.

FACT: VA would not accept the JSRRC input, even though it is required to per the VA Adjudication Manual M 21 – 1MR.
FACT: JSRRC was willing to submit the confirmation to VA and Mr. Sampsel but what is required to wait for his request which he never issued, even with my requests.

FACT: even though JSRRC confirmation eventually reached the VA, VA failed to act on it in violation of its own regulations, because individuals at VA were determined to, in the words of its consultant Dr. Alvin Young, "hold the line" against our disability claims. This was on their personal prejudice and their office unofficial personal policy of blocking our claims.

When I first learned that the JSRRC did not have all the material it needed about our aircraft, I had it sent to them by the Air Force Office of Historical Records Research, by the CDC, by the US Public Health Service, by the National Institute of Environmental Health Sciences, by medical schools and schools of public health all across the country. I visited the director of the JSRRC, Mr. Dominic Baldini (a Coast Guard veteran) and was impressed by his desire to serve the needs of America's veterans. That is, if VA would allow him to do so.

The JSRRC is in Fort Belvoir Virginia and I wanted to get there so badly I had to take my wheelchair four miles from the bus drop off point to his office where I was warmly received by Mr. Baldini and his staff. And four wheelchair miles back to my bus after that meeting. 

The VA contact for the JSRRC was Mr. James Sampsel who ran the VA Agent Orange desk, and it was his responsibility to liaise between the two agencies. The problem was Mr. Sampsel kept telling the JSRRC he would not accept input about our exposures for a variety of reasons cited in different ways over the years.

When Mr. Sampsel said he would not accept scientist or physician input except from military officers, we had it provided by commissioned officers of the US Public Health Service who are considered by law serving military officers, including Rear Admiral R. Ikeda MD USPHS. Repeatedly, Mr. Sampsel agreed to internal VA authorities that our veterans proof was persuasive (by law that should have settled things in our favor) yet he failed permit permit himself to be moved, contrary to the pro-veteran responsibility he had.

Then Mr. Sampsel wouldn't accept input because he hadn't specifically requested it from the JSRRC. And he wouldn't, for years. Another method Mr. Sampsel used to block JSRRC confirmation of our exposures was to insist only federal government documentation would suffice. This is despite VA Adjudication Manual 21 – 1MR stating JSRRC is responsible for gathering evidence from all the federal government agencies. Regardless, in his zeal to block C-123 veterans' claims, Mr. Sampsel apparently decided the CDC, USPHS, NIEHS and other federal sources would not suffice because they too directly confirmed the veterans exposures and abused his intent to deny VA medical care and compensation.

Further, although JSRRC and VA are to consider any credible source of scientific and medical information regarding a veteran's exposure, Mr. Baldini was forbidden by Mr. Sampsel to submit evidence from dozens of university medical schools and schools of public health as well as the independent experts VA itself had utilized for such studies. Amazingly, Mr. Sampsel's department even refused to accept input from toxicologists and other scientists from CDC and other federal agencies by stating only physician input would be accepted. This was a blatant abuse of rulings from the US Ninth Circuit Court but was also quite amusing because VA itself frequently used PhD experts whereever appropriate including veterans claims.

By 2013 the JSRRC and poor  Mr. Baldini had suffered enough grief for me about this that they simply force-fed confirmation of my exposure to Mr. Baldini by sending him an email. This didn't seem to help much because Mr. Sampsel simply refused to act on it. The issue finally was resolved only by Secretary McDonald and his interim final rule published in June 2015.

But Mr. Sampsel can still claim victory because he personally blocked 2100 C-123 veterans claims for four years and locked us out of VA hospitals and denied us compensation for our injuries and illnesses. His great respect for his friend Dr. Young have much to do with his motivation and his shouting throughout the VA for many years that he had "an overwhelming preponderance of evidence" against our claims – evidence consisting only of the VA webpage saying so, plus his preference for input from Dr. Young rather than the CDC, US Public Health Service and dozens of other federal, state, and scientific authorities supporting our claims. He wrote that EVERY proof of our exposure was his "real problem."

In the end the Institute of medicine study clearly established our exposure injuries but it was only a partial victory against the clear victory Mr. Sampsel enjoyed in keeping us from the VA hospital for four years. Contrary to law, his department was anti-claimant, adversarial, and obstructionist. He succeeded in "holding the line" against our claims as recommended by his favored consultant, Dr. Al Young.

CONCLUSION: VA hurt us through intrinsic and extrinsic ethical failures, none of which remain addressed today.

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Guest Article
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By Kevin Courtney November 22, 2016 Updated: November 22, 2016 10:06pm

The Navy’s Blue Angels performed jaw-dropping maneuvers and inspired our next generation’s service members during San Francisco’s Fleet Week last month. Unfortunately, those future sailors and Marines might end up like today’s veterans, suffering from a failing U.S. Department of Veterans Affairs. Thanksgiving is a great opportunity to reflect on how we can best serve our veterans and their families.

Veterans’ benefits claims may go undecided for more than a year, an unimaginably difficult year for those who haven’t experienced it. Our newly elected government leaders should address how the VA can better care for our veterans.

Today, the VA has a duty to assist veterans in preparing their claims by getting complete and relevant records from any federal agency. Congress created this “duty to assist” by passing the Veterans Claims Assistance Act in 2000. Under this standard, the VA must “make reasonable efforts to assist the claimant.” But what happens when a reasonable effort falls short of accurate or complete records? Deciding a claim based on inferior records likely requires an appeal, and the veteran will consequently suffer unnecessary financial and emotional stress.

The U.S. Supreme Court believes the VA should be a “pro claimant” and “non-adversarial” department when deciding claims because it is the sole agency responsible for providing federal benefits to veterans and their families. And there are two features built into the VA’s claim process to help veterans: first is the lack of a statute of limitations for bringing disability claims. A statute of limitations is usually the maximum amount of time after an event a veteran can bring his legal claim. The second feature is the VA’s more liberal burden of proof, which should allow it to decide in the veteran’s favor when the evidence supporting his claim is only 50/50. But are VA employees following these standards?

Congress has increased the VA’s budget every year over the past decade, so insufficient funding is not a reason why the VA fails to be “pro claimant.” While VA executives continue to receive performance bonuses, veterans are left waiting for help. It is important for President-elect Donald Trump’s secretary of veterans affairs to change the ethos found within the VA, improve its efficiency and ingrain compassion in employees. There are thousands of dedicated, caring VA employees, but some require a reminder that behind every claim is a veteran who honorably served this country. And they need the VA’s help before it’s too late.

Twenty veterans commit suicide every day in our country. If the VA streamlined its system, then some of these veterans might get the timely help they need.

The VA has an obligation to realize its mission: “To fulfill President Lincoln’s promise ‘To care for him who shall have borne the battle, and for his widow, and his orphan’ by serving and honoring the men and women who are America’s veterans.”

This Thanksgiving holiday, consider the benefits you enjoy thanks to a veteran. Then consider how you want the VA to treat our veterans.

Kevin M. Courtney is a student judge advocate for the U.S. Marine Corps and a second-year law student at UC Berkeley Hastings College of the Law. When the VA denied his claim for his father’s service-connected death, he spent the next four years trying to understand how the bureaucratic system functioned — or failed to function.

Guest article follows: my own experience with the VA duty to help gather evidence to support

veterans' claim was quite painful. For verification of Agent Orange claims the VA turns to the Department of Defense Joint Services Records Research Center (JSRRC) for confirmation of exposures outside Vietnam. Despite the fact that JSRRC serves as the VA research authority, for years VA succeeded in blocking JSRRC input vital to confirm our exposures aboard C-123s to the VA.

FACT: VA would not accept the JSRRC input, even though it is required to at the VA Adjudication Manual M 21 – 1MR. 

FACT: even though JSRRC confirmation eventually reached the VA, VA failed to act on it in violation of its own regulations, because individuals at VA were determined to, in the words of its consultant Dr. Alvin Young, "hold the line" against our disability claims. This was on their personal prejudice and their office unofficial personal policy of blocking our claims.

When I first learned that the JSRRC did not have all the material it needed about our aircraft, I had it sent to them by the Air Force Office of Historical Records Research, by the CDC, by the US Public Health Service, by the National Institute of Environmental Health Sciences, by medical schools and schools of public health all across the country. I visited the director of the JSRRC, Mr. Dominic Baldini (a Coast Guard veteran) and was impressed by his desire to serve the needs of America's veterans. That is, if VA would allow him to do so.

The JSRRC is in Fort Belvoir Virginia and I wanted to get there so badly I had to take my wheelchair four miles from the bus drop off point to his office where I was warmly received by Mr. Baldini and his staff. And four miles back to my bus after that meeting.

The VA contact for the JSRRC was Mr. James Samsel who ran the VA Agent Orange desk, and it was his responsibility to liaise between the two agencies. The problem was Mr. Sampsel kept telling the JSRRC it would not accept input about our exposures for a variety of reasons cited in different ways over the years.

When Mr. Sampsel said he would not accept scientist or physician input except for military officers, we had it provided by commissioned officers of the US Public Health Service who are considered by law serving military officers.

Then Mr. Sampsel wouldn't accept input because he hadn't specifically requested it from the JSRRC. Another method Mr. Sampsel used to block JSRRC confirmation of our exposures was to insist only federal government documentation would suffice. This is despite VA Adjudication Manual 21 – 1MR stating JSRRC is responsible for gathering evidence from all the federal government agencies. In his zeal to block C-123 veterans' claims, Mr. Sampsel apparently decided the CDC, US PHS, NIESH and other Federal sources would not suffice because they too directly confirmed the veterans exposures and abused his intent to deny VA medical care and compensation.

By 2013 the JSRRC and Mr. Baldini had had enough grief for me about this that they simply force-fed confirmation of my exposure to Mr. Baldini by sending him an email. This didn't seem to help much because Mr. Samsel simply refused to act on it and the issue finally was resolved only by Secretary McDonald and his interim final rule published in June 2015.

But Mr. Sampsel should still claim victory because he personally blocked 2100 C-123 veterans claims for four years and blocked us out of VA hospitals and denied us compensation for our injuries and illnesses. His great respect for his friend Dr. Young have much to do with his motivation and his shouting throughout the VA for many years that he had "an overwhelming preponderance of evidence" against our claims – evidence consisting only of the VA webpage saying so, plus his preference for input from Dr. Young rather than the CDC, US Public Health Service and all the other authorities supporting our claims.

In the end the Institute of medicine study clearly established our exposure injuries but it was only a partial victory against the clear victory Mr. Sampsel enjoyed in keeping us from the VA hospital for four years. Contrary to law, his department was anti-claimant, adversarial, and obstructionist. He succeeded in "holding the line" against our claims as recommended by his favored consultant, Dr. Al Young.

CONCLUSION: VA hurt us through intrinsic and extrinsic ethical failures, none of which remain addressed today.

----------------------------------------------------------

By Kevin Courtney November 22, 2016 Updated: November 22, 2016 10:06pm

The Navy’s Blue Angels performed jaw-dropping maneuvers and inspired our next generation’s service members during San Francisco’s Fleet Week last month. Unfortunately, those future sailors and Marines might end up like today’s veterans, suffering from a failing U.S. Department of Veterans Affairs. Thanksgiving is a great opportunity to reflect on how we can best serve our veterans and their families.

Veterans’ benefits claims may go undecided for more than a year, an unimaginably difficult year for those who haven’t experienced it. Our newly elected government leaders should address how the VA can better care for our veterans.

Today, the VA has a duty to assist veterans in preparing their claims by getting complete and relevant records from any federal agency. Congress created this “duty to assist” by passing the Veterans Claims Assistance Act in 2000. Under this standard, the VA must “make reasonable efforts to assist the claimant.” But what happens when a reasonable effort falls short of accurate or complete records? Deciding a claim based on inferior records likely requires an appeal, and the veteran will consequently suffer unnecessary financial and emotional stress.

The U.S. Supreme Court believes the VA should be a “pro claimant” and “non-adversarial” department when deciding claims because it is the sole agency responsible for providing federal benefits to veterans and their families. And there are two features built into the VA’s claim process to help veterans: first is the lack of a statute of limitations for bringing disability claims. A statute of limitations is usually the maximum amount of time after an event a veteran can bring his legal claim. The second feature is the VA’s more liberal burden of proof, which should allow it to decide in the veteran’s favor when the evidence supporting his claim is only 50/50. But are VA employees following these standards?

Congress has increased the VA’s budget every year over the past decade, so insufficient funding is not a reason why the VA fails to be “pro claimant.” While VA executives continue to receive performance bonuses, veterans are left waiting for help. It is important for President-elect Donald Trump’s secretary of veterans affairs to change the ethos found within the VA, improve its efficiency and ingrain compassion in employees. There are thousands of dedicated, caring VA employees, but some require a reminder that behind every claim is a veteran who honorably served this country. And they need the VA’s help before it’s too late.

Twenty veterans commit suicide every day in our country. If the VA streamlined its system, then some of these veterans might get the timely help they need.

The VA has an obligation to realize its mission: “To fulfill President Lincoln’s promise ‘To care for him who shall have borne the battle, and for his widow, and his orphan’ by serving and honoring the men and women who are America’s veterans.”

This Thanksgiving holiday, consider the benefits you enjoy thanks to a veteran. Then consider how you want the VA to treat our veterans.

Kevin M. Courtney is a student judge advocate for the U.S. Marine Corps and a second-year law student at UC Hastings College of the Law. When the VA denied his claim for his father’s service-connected death, he spent the next four years trying to understand how the bureaucratic system functioned — or failed to function.

ProPublica Publishes Major C-123 Agent Orange Report

Today, ProPublica, what I call the "NPR of the Internet," together with the Virginian Pilot, published the 19th in the major series on Agent Orange and the problems veterans had over the decades during and since Vietnam. The article is titled "Doctor Orange: The Secret Nemesis of Sick Vets."

It focuses heavily on the role of retired Air Force Col. Dr. Alvin Young. Dr. Young has consistently opposed veterans' claims for Agent Orange illnesses, insisting no serious harm is possible from the toxin. His views are refuted by virtually every government expert outside the VA including those at CDC and the National Institutes of Health and the National Academy of Science-Institute of Medicine.

In one of its most recent reports, the IOM concluded that the Department of Veterans Affairs, which for decades has relied heavily on Young's input, consistently ignored or minimized all evidence supporting veterans claims for Asian orange illnesses.

The veterans paid nothing for the opinions offered my government and industry experts. The VA, despite having evidence from government agencies available up to it paid Dr. Young and his consulting firm $600,000 via a sole source no bid contract. VA got what it paid for, written just the way VA wanted, as Dr. Young even submitted his reports in draft form to ensure they complied with VA policy!

Defying input from other government agencies and dozens of universities in medical schools, VA denied every C-123 vet's claim, insisting since 2011 that it had "an overwhelming preponderance of evidence" against their exposure claims.

VA was wrong.

Their so-called "evidence" consisted of Young's flawed opinions, the VA web page statement of position, and certain staffers' preferences to, as they told the Associated Press, "hold the line" against further such claims.

Congratulations are due Charles Ornstein and his team at both ProPublica and the Virginian Pilot for this report which joins the other eighteen in this exceptional series.

VBA explains to VHA why it decided to pretend DOD confirmation of C-123 veterans' exposures never existed

VA Claims Processing Violates VCAA

On 12 March 2013 Veterans Benefits Administration (Agent Orange Desk) received the first Department of Defense/Joint Services Records Research Center (JSRRC) confirmation of C-123 veterans' Agent Orange exposure.

And then VA cheated us. Determined for our exposure claims to fail, VBA Agent Orange desk breached both its duty to assist and duty to notify (of the JSRRC records) by personally waiving the VA duty to follow VAM21-1MR. 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. VA hasn't.

 Like every other piece of evidence confirming C-123 veterans' exposures, the JSRRC message was disregarded. VBA acknowledges only arguments against the veterans' claims, as one can still see on their web pages.

VBA cited input to substantiate its position from Dr. Al Young (the VA $600,000 no-bid sole source contractor,) plus two scientists sponsored by Dow and Monsanto for their input. Their input (all paid for) plus the VA web page stating the veterans weren't exposed, amounted to VBA "overwhelming preponderance of evidence" against input confirming the veterans' exposures submitted by CDC, DOD/ATSDR, NIH, USPHS, NIEHS, VA physicians, university researchers and dozens of scientists and physicians, all unpaid and voluntarily offered.

On 12 March 2013, VBA answered the Veterans Health Administration Post Deployment Health Section question about why the Agent Orange Desk decided to disregard the DOD input, considered vital for confirmation of veterans' exposure claims.

The VA has a statutory duty to gather government records for a veteran's use substantiating a claim ("duty to assist.") Here, VA opts to disregard that duty, as well as its other duties under the Veterans Claims Assistance Act, as well as disregard VA's own VAM21-1MR which has statutory requirements for compliance. "[T]he Secretary must adhere to his own policies when adjudicating veterans' claims." (Morton, 415 U.S. at 235 (1974)). 

Compliance with the M21-1MR by the VA is mandatory for all VA staffers in any VBA or VHA position. A regional office's failure to follow the M21-1MR and the BVA 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").

No explanation was offered by VBA – it simply exempted itself from these tiresome legal requirements, and directed veterans' claims and appeals to be denied for want of the very evidence kept hidden by VBA. As of today and since the first of our claims in 2007, not a single one has been permitted despite VBA assurances to all that it has no blanket policy against them.

Right.

Follow the VA's papers! See how VBA disregards Veterans Claims Assistance Act of 2000:

Standard VBA C-123 claim denial, citing "unable to verify your exposure." This is the need for JSRRC verification of the C-123 veteran's exposure. This is LtCol Paul Bailey's denied claim, Feb 2013, despite two pages of confirmation from several physicians, fellow officers, commanders, scientists, federal agencies, and researchers. This claim was reversed and awarded in August 2013 via Decision Review Officer. 

1. DOD-JSRRC confirmed C-123 veterans' Agent Orange exposure to VBA March 2013. Veterans never learned of this document's existence until May 2015 FOIA releases.

1a. AF confirmation of AF Museum C-123 (Patches, Tail # 362) "heavily contaminated" with Agent Orange

1b. Director CDC Agency for Toxic Substances & Disease Registry confirms C-123 veterans' TCDD exposures = 200/fold increased cancer risk, 182-times military TCDD exposure standards

1b. (continued, signed by Dr. C. Portier, Director, CDC/ATSDR. Later, another email followed with next ATSDR director (Rear Admiral R. Ikeda MD USPHS) concurrence with Sinks' C-123 ATSDR finding.

2. VHS apparently aware of #1, properly inquires about use in claims file for JSRRC message per VAM21-1MR.  VBA says no, and states his refusal to let JSRRC "dictate policy issues to VHA on health care issues." Apparently, referring to JSRRC confirming veterans' exposure to prove their disability claims was seen as DOD "dictating" VA policy."

3. In 2013 VBA Agent Orange desk establishes internal policy to disregard JSRRC input until 2015, in violation of VAM21-1MR procedures on JSRRC input and in violation of VCAA. Of course, had this input from JSRRC  agreed with VBA policy rather than disagree, it would have been  perfectly acceptable as evidence against veterans' claims. VBA is highly selective about what C-123 evidence it recognizes, and acknowledges only evidence that fits VA policies and disputes everything else. 

4. Without bothering to reveal JSRRC confirmation of C-123 exposures received five months earlier, VBA assures Compensation & Pension that VA somewhow has an overwhelming preponderance of evidence against C-123 veterans. Describes other proofs of the C-123 veteran's exposure as "the real problem." Proof is a problem for VA? LtCol Paul Bailey's claim award made via DRO August 2013; SECVA disagreed with decision and tried to reverse the award but didn't; decided "it would be politically unwise."

5a. VHA quoted by the Associated Pressn insisting VA "must draw the line somewhere" to stop Agent Orange exposure claims, May 2014, more than a year after JSRRC exposure confirmation, three years after the Sinks CDC/ATSDR exposure confirmation

5b. Dr. Walters quoted in AP page 2

5c. Dr. Walters' "draw the line" quoted in AP, page 3

From: Kruse, John (VACO)

[mailto:John.xxxxa.gov] 
  

Sent: Friday, June 06, 2014 2:21 PM
 

To: Tucker, Brooks (Burr)
Cc: Lindsay, Jason; OCLA Benefits Team 

Subject: jk2427: Sen Burr ATDSR Question 

Good afternoon.  VBA has provided the following response.  Please let me know if you  have additional questions.Regards 

John E. Kruse, Director, Benefits Legislative Service Office of Congressional and Legislative Affairs June 6, 2014 (202) 461-xxxx  

Burr Request: I understand the procedural requirement for JSRRC to provide VA with only "DoD documents", however, if VA has addressed this matter in good faith for veterans, it would seem incumbent upon VA to insist that DoD turn over all relevant information in its file regarding C-123 exposure concerns that could potentially assist VA's knowledge of the issue or at least request documents DoD has received from within the Federal government from subject matter experts familiar with the C-123 issue.
The attached letter from ATSDR sent to JSRRC Director last year is clearly such information. Relative to the prior RFI and this ongoing issue, please let us know, before 9 June 2014,if the attached letter been received at VBA from JSRRC and if it has not been, has VBA requested the letter from JSRRC?
  

VA Response:  VBA is committed to a fair and impartial evaluation of all disability claims, including those from Veterans associated with post-Vietnam C-123 aircraft.  The letters referred to by Mr. Tucker and Mr. Carter were provided to VBA by the Agency for Toxic Substances and Disease Registry (ATSDR) and by Mr. Carter and were evaluated by Veterans Health Administration (VHA) medical scientists and public health experts.   

6a.  June 2014, Email answer from VA Congressional Liaison to Senator Burr’s questions. VA still denies JSRRC confirmation and disputes ATSDR finings by simply not mentioning C-123 200-fold greater cancer risk. One year later claims remain denied even with IOM report. VBA simply avoids answering Burr's inquiry about why JSRRC materials were not provided veterans for their claims or acted upon by C&P. 

(continued)This evaluation contributed to VA’s decision to create the current VHA C-123 website
http://www.publichealth.va.gov/exposures/agentorange/locations/residue-c123-aircraft/index.asp), which explains that dried and solidified TCDD cannot be absorbed by the human body in any significant amount, and that there is no scientific evidence supporting long-term health effects from association with an environment containing such dried and solidified TCDD. 

The letters under consideration were solicited by Mr. Carter from government agencies and refer to an amount of TCDD that was obtained from one C-123 aircraft by vigorous rubbing with a strong solvent.  This amount was then compared to an industry standard for exposure to environmentally “active” TCDD and, as described in the
Letter Mr. Tucker forwarded, ATSDR concluded that this solvent-extracted amount exceeded the active TCDD industrial safety standard and therefore “TCDD exposure” occurred.  Due to the conflicting scientific opinions on this issue, VA contracted with the Institute of Medicine to review all available studies and literature and report its findings later this year. 

However, Compensation Service has been notified that JSRRC has begun providing these letters, or summaries of their content, to VBA regional offices for consideration in claims based on association with post-Vietnam C-123 aircraft.  In particular, information from these letters was provided to the Portland VA Regional Office for consideration of an appeal filed by Mr. Carter. 
 

6b. (Continued.)