13 March 2013

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.

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