VA Uses IOM For New Delays in C-123 Claims

Thanks to the VFW, some clarification has come from VA's Compensation and Pension regarding their position blocking all C-123 exposure claims. VFW reports that C&P stated:

"We consider claims as received and will consider any and all medical and/or scientific evidence provided.  If evidence provided and/or obtained results in a determination that there is reasonable doubt as to the cause of an exposure, the claim will be granted. 

We have asked the Institute of Medicine to look at the potential for harmful exposure to Agent Orange in C-123s that were used to spray the chemical in Vietnam.  We expect their report to be released in the first quarter of FY 15.  VA will review it and brief the Secretary on any findings and recommendations." 

In the meantime, we will consider claims on a case by case basis.”

I wonder why this was a month ago, with no involvement of the affected veterans?

Problem: VA Compensation and Pension, and VA Post Deployment Health (which issues the project to the IOM), have already ruled that no "reasonable doubt" will be permitted to exist. They already told us they'd decided no C-123 veterans were exposed, and therefore no claims will be honored. Putting a fine point on it, Dr. Peterson actually said "probably not" when asked if any C-123 claims could ever be approved.

And Compensation and Pension already told us that no amount of evidence from whatever source would be permitted to move a claim to reasonable doubt or "as likely to as not" because absolutely no doubt exists (per policy) in their minds.

There is no doubt in our minds, either. We were exposed. So says the CDC/ATSDR, the NIH/National Toxicology Program, the US Public Health Service and many others. The law clearly states exposed veterans will be treated for Agent Orange-type illnesses, as reaffirmed by the VA itself in the Federal Register of 31 August 2010. Exposure is the key, and exposure is what VA has fought. And lost.

Now, thanks to an excellent juried article published in the Journal of Environmental Research, exposure to military herbicides is in no doubt. VA's highly selective choice of references in their "thorough" review of scientific literature won't hold up to a juried article by distinguished experts, especially with the weight of the other findings and opinions.

So...VA, seeing the ground disappear from beneath their platform of exposure denial, now proposes to change tactics. They'll call for a two to three year time out by NOW turning to the Institute of Medicine.

Readers will recall our enthusiasm back in early 2012 when we met with VA's Post Deployment Health in a conference hosted by Senator Burr's staff. The VA explained that they would not yield on considering our claims for Agent Orange exposure. But at the end of our discussion VA promised us as a compromise a special review through the Institute of Medicine. That promise was broken, then finally ordered in March 2014.

In May 2012, the Air Force released its now-tainted UC-123 Consultative Report which didn't agree with veterans' claims, nor with other government agencies which had opined that the C-123 crews were exposed. The VA, without discussion with the veterans to whom they'd made their promise, promptly broke their promise and cancelled the IOM study.

Ever since, VA raters have continued denying claims by citing non-existent regulations prohibiting recognizing our exposure, or saying a thorough search through military records fails to show evidence of exposure, or TCDD is harmless...a variety of Compensation & Pension-provided boiler plate denials.

VA slams us with one of two, or perhaps both, harmful results. One is that the IOM project will float back to VA in 2015, and perhaps a reaction from the Secretary a year or so later.  Great, says VA, because at least they avoid covering expensive medical care for Agent Orange-exposed veterans for another two or three years...on top of the years we've already waited. On top of the two years since their last broken promise...now they suggest we wait a few more years. Back in 2012, Dr. Dick said it would only take six months...but now VA certainly hopes to stretch that out as far as possible...the longer the wait, the greater the savings for VA.

The second possible result is that IOM disagrees with the medical impact of the C-123 exposures. VA would then deny all claims and insist that BVA also deny appeals. VA hopes for both results.

But (we pray) an IOM decision is unlikely to go against the C-123 veterans. Exposure and medical impact are already evidenced. No medical tests could prove bioavailability today, given the half-life of dioxin in the human body is seven years and it has been 32 years since the veterans' last exposure, and 42 since the veterans' earliest exposures.

But lets say the IOM fails to support the veterans' assertions. VA is still faced with the obligation to treat all veterans exposed to military herbicides. Does Compensation & Pension expect VA to turn to Congress and ask for new legislation to prohibit Agent Orange claims from C-123 claimants?

This won't wash! Two years ago, we fell for it and accepted with good graces VA's promise to seek an opinion from IOM. They broke that promise. Now that we have even more proof, even clearer legal foundations, even stronger support, VA is telling us they've discovered a new way to delay.

Delay, delay, delay until we die. The more of us who die off, the greater the VA savings.

We have to ask our legislative representatives and veterans' organizations not to let this happen. Our claims are fully justified today, and it is immoral and illegal to block our access to VA medical care for more years.

If the USAF had made known our exposures when they were first identified in 1994, those of us with Agent Orange-presumptive illnesses could have sought care then and since. Instead, all contamination information was "kept in official channels only" per order of the USAF Office of Environmental Law.

We began uncovering the C-123 contamination story in early 2011 and faced the immediate, automatic, mindless VA denial. Post Deployment Health had the responsibility to look into this in a pro-veteran manner, but instead stooped to redefinition of exposure to prevent acknowledgement of our proven exposures.

They denied perfectly valid claims stating TCDD is harmless. They ignored official confirmations of our exposure submitted by the ATSDR, ignored and tried to hide findings that crews were exposed and that our cancer risks were 200-fold greater, and completely mischaracterized the ATSDR conclusion by 180 degrees. They ignored the finding submitted in our support by the CDC/NIESH. They manipulated responses from the JSRRC. And I believe the Secretary isn't fully informed about any of this.

Compensation and Pension knows exactly what they are doing. They are skillful and dedicated. Dedicated to preventing our claims because of their personal preferences to block us.

Compensation and Pension knows exactly what they are doing. At our average age of 65, with even a regular life expectancy of seven years remaining, VA now suggests their scheme to consume 40 to 60% of our remaining life expectancy waiting to see what the Secretary will do.

Compensation and Pension knows exactly what they are doing. At our ages, with (from the webmaster's situation) heart disease, diabetes, peripheral neuropathy, avascular necrosis, spinal cord injury and prostate cancer...they propose that a guy like me wait more years to see if the VA will try to save my life?

Immoral, Unethical. Illegal. Unscientific. How dare they scheme to lock VA hospital doors for another two or three years?

Colorado's Leaders Step Forward: Demand VA Recognize C-123 Agent Orange Exposure Claims

Thanks to Colorado's Senators Bennet and Udall and Congressman Polis, even more strength has been added to the pressure on the Department of Veterans Affairs to obey the law. The law says (most recently restated in the Federal Register of 31 August 2010) that all veterans exposed to "military herbicides" will be treated as presumptively exposed and eligible for treatment of Agent Orange-associated illnesses.

Senator Bennet and Senator Udall, joined by Congressman Polis, submitted their joint letter to the Secretary of Veterans Affairs on February 14, a perfect Valentines' Day message to the Nation's veterans and, in particular, post-Vietnam veterans who flew and maintained the USAF C-123 transports. These were the Agent Orange spray airplanes during the Vietnam War, and their lingering contamination exposed veterans for many years after.

Perceptions of C-123 Veterans Seeking Agent Orange Exposure Care From VA

There are different perceptions of our post-Vietnam C-123 veterans, formed in the minds of the public, our legislators, the Air Force, other veterans, ourselves and our families. (note: last photo is graphic and very disturbing.)

C-123 veterans as seen by families welcoming us back from the Gulf

C-123 veterans (med techs and flight nurses) as seen by their patients

C-123 veterans as seen by ourselves

C-123 veteran, the late LtCol Tim Olmsted, as seen by the ground crew

C-123 veterans, as seen by Hondurans

C-123 veterans, as seen by the flight surgeon

C-123 veteran, the late LtCol Paul Bailey, as seen by New Hampshire American Legion
(combat veteran of 101st Airborne before the Air Force, served 36 years)

C-123 veteran, as seen by surgeon and family. Soft tissue sarcoma.
 Photo provided by the late Master Sergeant George Gadbois. VA claim denied
(photo shown because George wanted it shown)

RIP, Old Hoss

Why didn't we do this back in 1972?

New Science Supports C-123 Exposure Claims - but automatically dismissed by VA

What happened? What'd they do?

That’s right...dismissed. Automatically, with reasons to be developed later if necessary, but like all other evidence supporting C-123 veterans' claims, refused without evaluation.

The decision was against us was reached a year ago...that all evidence supportive of C-123 claims is to be dismissed...disregarded...ignored.(clarification...VA C&P told us that no evidence would ever be accepted to bring a claim to "as likely to as not" and that "probably" all claims would be denied...as all have been since we were told this by VA's Dr. Michael Peterson)

VA Post Deployment Health as well as Compensation and Pension Service (C&P) will not accept Friday’s Environmental Research article about C-123 veterans' exposures for support of the veterans' claims.

This has already been decided and the C-123 veterans informed of the decision. At our February 2013 meeting with the Compensation and Pension Service Director, he and his staff explained that no amount of support or evidence, such as the recent Environment Research article or even official findings confirming our exposures from CDC or other federal agencies, will be allowed to elevate a C-123 veteran's claim to "as likely to as not."

While this seemed extraordinary when we were told by the Director, Compensation and Pension, subsequent conversations with the Acting Chief Consultant Post Deployment Health did make things clearer. We learned, through Post Deployment Health, that none of the C-123 veterans were ever exposed.

As simple as that. Change the definition and the problem goes away. That is, their problem...our diseases still sit on our doorstep, if not theirs. The benefit to the VA is that the infamous backlog gets reduced, it goes into the appeals backlog which nobody cares about, and the decisions due the veterans are postponed for years, with tremendous savings in VA medical care denied in the interim which can be as much as five to seven years.

No dental, no vision, no audiology, no prosthetics, no pharmacy, no rehab, no surgery, no anything. Years with the veteran either doing without these services or paying privately, unless otherwise eligible for VA care for other wounds or injuries.

Any civilian or Civil Service employees out there willing to wait seven years to be treated for an on-the-job injury? Hello? Hello??

Which is why Post Deployment Health directed the regional medical centers to refuse requests from C-123 veterans to receive the Agent Orange Registry exam – VA has already decided these vets were not exposed, by having redefined exposure, so no need for the physical. This was double-checked with Post Deployment Health leadership who explained the policy.

Perhaps...it depends how you define the word exposure? To paraphrase a former president.

Post Deployment Health ruling was made based on her group’s internal redefinition of exposure (Exposure = contamination field + bioavailability.)

Thus, even though C-123 veterans have clearly qualified under the law for Agent Orange exposure benefits, no claims will be approved and, in fact, all claims will be ordered denied by C&P, which even provides the rating officials proper boilerplate language to use.

We're reminded of the Secretary's assurances to the Senate that claims will be carefully, individually evaluated without any blanket policy against C-123 veterans. Instead, claims are carefully, individually evaluated and all denied by policy, whatever name it goes by.

And even though C-123 veterans have clearly met scientific criteria for claiming Agent Orange exposure and proved their exposure as well as increased cancer risk and other health impacts, no claims will be approved. Just ask Post Deployment Health.

At first the C-123 veterans concluded that this was a blanket policy against our claims. Both the
Secretary and the Under Secretary for Benefits assured us and our legislators that VA has no blanket policy against C-123 claims. Apparently, VA uses a different word for blanket policy and can thereby nullify the law providing for our benefits.

No C-123 claims will be permitted to be approved, per VHA. They're right...none ever have been approved, although one denied claim was "reconsidered" once enough attention was generated by newspapers and legislators...LtCol Paul Bailey of Bath, NH. His claim was denied in Feb 2013 and reconsidered in August 2013, just after he entered hospice.

The VA blanket policy (I don't know the word VA uses to describe their universal denial of C-123 claims so I'll use that word for now) leaves only legislative relief, which is unlikely given our ages and illnesses, or federal court action. Court action is also unlikely due to the cost and well-known determination of VA to fight claims as far as possible, thus outspending any resources we might muster for the effort.

Nothing will ever help our claims get approved unless the Secretary takes notice of what has been done to us, or if DOD designates the C-123 spray planes retrospectively as Agent Orange Exposure Sites.

Even then, we can expect Compensation and Pension to fight every claim with passion. That’s their job, their mission. They do it well and with pride.

AMERICAN LEGION CALLS ON VA TO RECOGNIZE C-123 VETERANS' AGENT ORANGE EXPOSURE

WASHINGTON--(BUSINESS WIRE)--The American Legion has announced its support for extending Department of Veterans Affairs (VA) benefits eligibility to veterans who were exposed to aircraft that had previously sprayed Agent Orange over Vietnam.

“should provide the evidence needed for post-Vietnam veterans to receive the same health treatment as in-country veterans. They need and deserve it.”

The Legion’s support is based on a study published Feb. 21 in the scientific journal Environmental Research: “Post-Vietnam Military Herbicide Exposures in UC-123 Agent Orange Spray Aircraft.” The study reports that environmental testing of such aircraft revealed traces of dioxin levels above Department of Defense (DoD) standards for maximum permissible exposure to poisonous chemicals.

U.S. Air Force and VA policies do not currently recognize “dried residues” of herbicide and dioxin as harmful.

Based on recent surface wipes and airborne concentration tests, occupational health researchers have concluded that inhalation, ingestion, and skin absorption of dioxin and Agent Orange occurred in crews who came in contact with the spray aircraft after the Vietnam War.

“The Legion is committed to ensuring that veterans receive the benefits they deserve,” American Legion National Commander Daniel M. Dellinger said. “We will work with Congress and the VA to promptly designate C-123K aircraft as Agent Orange exposure sites, thereby qualifying veterans who worked with these planes to be eligible for Agent Orange-related benefits.”

According to Dr. Jeanne Mager Stellman, Professor at Columbia University’s Mailman School of Public Health, the study “should provide the evidence needed for post-Vietnam veterans to receive the same health treatment as in-country veterans. They need and deserve it.” Stellman is senior author of the study.

The American Legion and Stellman worked together in the early 1980s to prove that adverse health conditions among Vietnam War veterans was linked to Agent Orange exposure, establishing a link that authorizes VA compensation and health care for those veterans.

In 1983, the Legion sponsored an independent study by Columbia University that established the effects of exposure to Agent Orange on Vietnam War veterans. Congress received the results of the “American Legion-Columbia University Study of Vietnam-era Veterans” in 1989.

The Legion and Stellman have continued to fight for changes that include, in a 2010 decision, ischemic heart disease, Parkinson’s disease and B-cell leukemia among conditions presumed to be connected to Agent Orange. The Legion has also fought to expand eligibility beyond those who served only with “boots on the ground” during the Vietnam War, including “blue-water” veterans exposed to the defoliant on U.S. Navy vessels and U.S. Air Force crews who handled it.

In August 2012, the Legion passed Resolution 128 to mitigate legal problems for the more than 1,500 veterans who must prove they suffer health problems associated with herbicide exposure.

Click here for a slide show and synopsis of the report.

A high resolution photo of Nat. Cmdr. Dellinger is available at www.legion.org.

Hill AFB and Davis-Monthan Officials Deceived Public & Media

In June 2010 the Air Force managed quite well a non-event. Press releases were prepared to not be released.

That's right...press releases were wordsmithed and approved, just in case the media made inquiries. But nobody did. It was a total non-event, just as planed.

The non-event was the destruction as toxic waste of the surplus fleet of obsolete former Agent Orange spray airplanes, the C-123. Davis-Monthan AFB's famous Boneyard had stored them for decades. Something had to be done with what the AF leaders, medical folks and scientists all called "the Agent Orange airplanes."

Why destroy them? Because the EPA was a constant threat...if EPA found out about the earlier base civilian employee complaints, or if the inspectors were able to locate the special HAZMAT quarantine storage area the planes had been moved to, a potential $3.4 billion fine could be levied against the USAF.

$30,000 a day, warned Air Force officials to each other!

So destruction of the C-123 fleet was approved, and accomplished by shredding and smelting the scraps in April-June 2010. All very hush-hush.

The idea was spelled out in base memos...keep everything below the radar. Of particular concern to the Office of Secretary of Defense Consultant was his worry that veterans who'd flown the C-123s after Vietnam, and who were already exposed to Agent Orange residue, would turn to the VA for treatment of their Agent Orange-associated illnesses.

Logical enough from the veterans' perspective. Must be prevented, from base officials' perspective.

The consultant guided base public affairs in eliminating those attention-grabbing words like "Agent Orange." "dioxin," "toxin," and instead created a masterpiece of PA manipulation and press deception..."the airplanes were recycled in an environmentally safe manner to free up desert storage space."

The news was that Agent Orange airplanes were being destroyed by special process because they were too toxic for landfill and too poisonous to be sold. The news was that veterans...already exposed....were to be kept from news that they'd been exposed to the Agent Orange residue left in the warplanes after Vietnam.

At first this was all innocent...nobody seemed to know the planes had remained contaminated. But that fact became known in 1994 when USAF toxicologists learned the planes were heavily contaminated and a danger to public health...their words in sworn federal court testimony.

The AF decided not to tell the veterans. According to senior Air Force leaders, the decision to keep mum was "to prevent undue distress."

Now, the VA and AF both deny the possibility of the veterans having become exposed. VA did this by redefining the word "exposure" in 2012 to require veterans to prove that Agent Orange had affected them..decades after the fact that's an impossibility. The AF opted to simply say it couldn't decide one way or the other, but probably no exposure occurred.

Anything to prevent another 2000 or so veterans burdening the overtaxed VA medical facilities!

Fortunately for the veterans, researchers Drs Jeanne Stellman, Peter Lurker, Fred Berman and Richard Clapp published their article, "Post-Vietnam Military Herbicide Exposures in UC-123 Agent Orange Spray Aircraft." This appeared in the Journal of Environmental Research, and establishes the fact of the veterans' exposures. Not only did the authors contradict the AF and VA positions, they also sharply criticized both agencies' lack of scientific basis for obstructing veterans' claims.

Sometimes, scientists deserve a salute, too!

VA Public Information & Science Reporting Standard

“VA will ensure and maximize the quality, objectivity, utility, and integrity of information it disseminates to the public."

(unless they need to deceive)

VA Definition of “EXPOSED” – Another Scientist Challenges VA

VA: “Exposure = contamination field + bioavailability.” 

The term exposure was redefined (from the VA perspective, not by regulatory authorities or industrial standards nor any other peer-reviewed action) to include bioavailability,VA's objective being evasion of requirements in the law for providing exposure care to C-123 veterans. The flyers’ exposures were redefined away with VA’s novel redefinition of exposure. No bioavailability = no exposure =denied claim.

The VA redefinition of exposure was apparently first utilized at the VA’s poster display for Society of Toxicology 2012, where the line appeared as part of the historical perspective of Agent Orange, the focus of the poster. It was an official VA poster, with none of the usual disclaimers about not necessarily reflecting agency typical…indeed, usually recommended, on such scientific displays. After SOT 2012, VA continues to deny veterans’ claims insisting the veterans failed to prove bioavailability.

In fact, the bioavailability requirement was grasped by VA’s Post Deployment Health and included by them in the VA’s poster, Agent Orange: 50 Years of History which staff of Post Deployment Health presented themselves. The VA need for a creative redefinition of exposure became apparent when the Federal Register of 31 August 2010 carried a VA statement that the Department would provide “presumptive service connection” to non-Vietnam War veterans able to prove their exposure to Agent Orange. 

Post Deployment Health was faced with either treating the exposed veterans, which policy opposed, plus yet another significant impact on the Department’s health care budget...or VA could create some ways preventing C-123 exposure from being acknowledged.

Thus was born the VA redefinition of a fundamental toxicological term. The VA redefinition is unique, not used elsewhere in science, medicine or government. VA has no statutory or regulatory authority to define such terms. The agencies which do have such authority include the CDC/Agency for Toxic Substances and Disease Registry, and the National Institutes of Health/National Toxicology Program. Both agencies have taken exception to the VA’s redefinition.

In particular, objections were voiced by Dr. Linda Birnbaum, Director of the National Toxicology Program. She wrote,” In all my years as a toxicologist, I have never heard bioavailability as part of the exposure field. Exposure is skin contact (or inhalation or ingestion) with a chemical of any type.”

courtesy of Professor. R.S. Pollenz, Univ. South Florida

Bioavailability itself MUST follow exposure , but not all exposures have the subsequent event of bioavailability. Further, bioavailability is a complex concept based on the chemical nature of the agent.  There is also the major concept of biotransformation since nearly all compounds are metabolized once they enter the body.  TCDD and PCBs however, are somewhat resistant to the biotransformation, since humans do not have enzymes that are able to remove the CL molecules (this is one reason why CL is used as a halogenating agent in creating T45T and other chemicals that kill stuff).  

Readers may be able to find similar schematics on line and in some of the toxicology text books.  Note that the connections may not be linear and are different for each chemical, but this gives the various terms to keep in mind and the complexity of the process.  If there has been an adoption of any term PRIOR to exposure, or definition of exposure to include another subsequent toxicological event as a required component, this is not correct because one MUST be exposed before anything can happen.  

Perhaps, VA has been focusing on the bioaccumulation from a standpoint of whether the amount that someone may carry is BIOAVAILBLE to do anything.  This has always been a hot area regarding the risk assessment of these halogenated compounds.