DOCUMENTED: VA Maneuvers to Deny C-123 Veterans' Exposure Claims

VA's Post Deployment Health (PDH) has informed VA's Compensation and Pension (C&P) that C-123 veterans' claims for exposure to military herbicide are to be denied. This was confirmed through the Director of C&P as well as through the now-Acting Director PHD.

That official also told a Senate staffer, words to the effect that "VA just couldn't permit any more veterans" with new AO claims of exposure to be granted disability. And certainly, VA has followed through, denying every C-123 veteran's claim at their regional offices, with those offices even provided boiler-plate language to simplify the process. 

VA denies all these claims, but also tells the veterans' legislators that no such blanket policy preventing claims exists. VA prevents JSRRC from responding with solid confirmation of veterans' claims, and prevents DOD from acknowledging the C-123s (now destroyed as toxic waste) as Agent Orange Exposure Sites.

Of course, the process followed by VA is illegal. The law provides veterans benefits to veterans proving exposure to military herbicides, as C-123 veterans have done. VA takes the position that these veterans must satisfy an additional burden beyond that in the law...C-123 vets must prove bioavailability to meet the VA's new redefinition of exposure.

In this post, we examine the treatment of an advisory opinion issued by C&P, following a regional office's inquiry about a C-123 veteran's claim they wanted to approve. C&P directed the claim be denied. Let's look at their letter back to the RO and see the deceit.

It is the heart of the deception, revealing VA's bold determination to bar C-123 claims:

(Text from Compensation & Pension Advisory Opinion, summarizing CDC/Agency for Toxic Substances & Disease Registry, which actually CONFIRMED  veterans' TCDD exposure.)

Dr. Sinks is the respected Deputy Director of the CDC/Agency for Toxic Substances and Disease Registry. That agency has the statutory responsibility, and scientific expertise, to provide expert findings in such situations but VA dismissed the agency's official finding. Note the last sentence: "no conclusive evidence that TCDD causes adverse health effects." Here, C&P is denying this veteran's claim with the assertion that TCDD (the toxin in Agent Orange) is harmless.

This last sentence was inserted as though it was part of the ATSDR conclusion...it absolutely was not. Dr. Sinks said no such thing – ATSDR determined exactly the opposite – veterans were indeed exposed! But VA opted to deceive in their zeal to keep VA hospital doors locked to C-123 veterans.

And the VA did even more: Dr. Sinks' report to the VA found that C-123 veterans had a 200-fold greater risk of cancer and their exposures aboard their aircraft were 180 times Army standard values. Most importantly, Dr. Sinks reported "I believe aircrews operating in this, and similar, environments were exposed to TCDD."

We do not see these, the most important parts of Dr. Sinks' official report on behalf of the CDC/Agency for Toxic Substances and Disease Registry, in the C&P summation. Not only did the VA deliberately twist the ATSDR's finding that vets were exposed into a denial of the harm of TCDD, but VA deliberately avoided mention of the extremely persuasive parts of the ATSDR report.

What should one conclude? That VA was bent on preventing the C-123 claims. That VA was so committed to preventing these claims that VA would deliberately mischaracterize an official finding by another federal government agency. And deliberately avoid mention of any affirming statements such as were submitted by Dr. Sinks. Everything confirming the veteran's claim was ignored.

The Sinks finding was subsequently reaffirmed by the Director of ATSDR, Dr. C. Portier, and then later by the Acting Director, Rear Admiral R. Ikeda, MD US Public Health Service. Those supporting documents have been ignored by VA, and VA has also ignored the official finding of other federal agencies, including FDA, US Public Health Service, and the National Toxicology Program. Further, the physicians who submitting opinions confirming the veteran's exposure were simply ignored, including the VA oncologist treating the veteran and who is an acknowledged Agent Orange researcher.

VA is by law required to be veteran-friendly, non-adversarial, and review and weigh veterans claims materials "sympathetically." Here, VA did not comply with any of these requirements. Further, in this Advisory Opinion, VA refused to recognize expert opinions supporting the veteran's Agent Orange exposure claim from a number of recognized Agent Orange scientists, stating that these scientists were not qualified to comment on medical nexus. Scientists from Oregon Health Sciences University, Columbia University, Boston University were dismissed.

But the scientists addressed the requirement in the law for proving exposure...their comments had nothing to do with medical nexus which is not something veterans need to prove – it is presumed for veterans with proof of exposure. Clearly, here the VA report was an unmistakable prevarication...a deception using true words to deceive.

And C&P succeeded – the claim was denied. Of course the veteran can appeal, and the current wait time is over 900 days. On top of the three years since the claim was filed, that's six years of locked VA doors. Hopefully, some veterans will survive this process, but Compensation and Pension isn't doing anything to speed up things...the fewer veterans surviving the claims process, the greater the savings.

We're not making this up. Print out the CDC/Agency for Toxic Substances and Disease Registry report on the C-123 veteran, and print out the Compensation and Pension Advisory Opinion ordering the claim denied. Compare, and also be aware that the veteran submitted over 100 other documents from physicians, scientists, universities, research reports and other federal agencies supporting his claim...remember, too, the regional office recommended approval, but was overturned by C&P.

I have to ask...the VA's heavy-handed slam-down is obvious. And obviously unlawful. VA knows it. The Senate knows it. The veterans and their service organizations know it. Why isn't anything done?

Because the VA is responsible for administering the Nation's veterans laws, VA decides which to obey and which to ignore. If a few staffers in an office get a perspective that they don't want to do something, it doesn't get done. In this case, a few folks in VA's Post Deployment Health section decided to redefine exposure to prevent C-123 claims, and directed C&P to make certain all such claims are denied.

If a veteran were to have attempted such deceptions as done by the VA, VA would prosecute for attempted fraud. 

Here is the ATSDR finding confirming C-123 veterans' Agent Orange exposures:

Here is the Advisory Opinion from C&P, dismissing all expert input and denying the claim by deceitful, unethical and perhaps illegal manipulation of the ATSDR opinion 

VA Leader Denies Agent Orange Claim – Insists Agent Orange causes “no health effects”

(Update Note: On December 4 2015, following action in the US District Court of Washington DC, the Justice Department released this statement from the VA:

"VA states as follows: The statement regarding TCDD exposure and adverse health effects was written in error and was incomplete." VA's error, but it sufficed to deny the veteran's claim for three more years.)

Figure 1: claim denied re: no adverse health effects from TCDD (12/3/2015-VA now says this was written in error)

The VA, along with virtually every other government agency, acknowledges Agent Orange as harmful to humans. TCDD, the toxin in Agent Orange, is recognized as the most toxic of toxins, and as a human carcinogen. The EPA data sheet is perhaps the most comprehensive.

Above: Advisory opinion from VA's Director of Compensation and Pension Service (C&P,) dated 25 Sept 2012. C&P ordered an Agent Orange-exposed veteran’s disability claim denied on C&P's director's own opinion that TCDD (dioxin, the toxin in Agent Orange) is harmless. In 2012, EPA officially classified TCDD as "carcinogenic to humans." In fact, the director was quoting from the opinion by Deputy Director Dr. Tom Sinks, Agency for Toxic Substances & Disease Registry who concluded veterans were exposed, and but Compensation and Pension clearly twisted ATSDR's summary by 180 degrees– Dr Sinks' ACTUAL summary: "I believe aircrew operating in this, and similar, environments were exposed to TCDD." I guess C&P didn't have space to type that part???

Below: Despite C&P’s preference to prevent claims, the law specifies herbicide exposure as the sole requirement for a veteran to be treated for Agent Orange illnesses. C&P’s actions were arbitrary and obviously, contrary to the 1991 Agent Orange Act, Title 38 as well as the Federal Register of 8 May 2001 page 23166, in which VA states all veterans exposed to military herbicides will be treated the same as Vietnam veterans, for Agent Orange-presumptive illnesses and diseases.

Figure 2: Federal Register 8 May 2001, p. 23166

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There are several other illegal or, at best, wildly illogical excuses by which VA evades the law to deny C-123 veterans' Agent Orange claims. All are invalid. Here are the proofs. 

1. No exposure. In 2012 VA redefined for their own agency the very word "exposure" to prevent all veterans from being able to prove exposure. The CDC more scientifically defines exposure as the contact (or inhalation or ingestion) with a contaminant. The VA, however, insists that the veteran also prove "bioavailability," which is not part of the law. No other health or regulatory agency agrees with VA’s bioavailability issue...in fact, authoritative agencies have directly challenged VA on their acts.
2. No Agent Orange on the veterans' C-123 airplanes. However, the USAF confirmed dioxin on all aircraft stored in the desert"Boneyard" in 1996. AF toxicologists labeled the planes "heavily contaminated" and "a danger to public health."

Figure 3: C-123 Smelting, June 2010

3. The airplanes are safe in their present configuration. This VA statement implies the C-123 airplanes are not toxic – and this is true only because they were all smelted as toxic waste in June 2012. Their "present configuration" is aluminum ingots or tin cans.
4. Regulations prohibit acknowledging exposure on these airplanes. This is boilerplate language provided by Washington to their regional VA offices for use in denying C-123 veterans' claims. However, in two years of research the Library of Congress and the US Senate can find no such VA regulation! Actually, even if there were a regulation, it would have had to be published first in the Federal Register, which has never happened (the Administrative Procedures Act.) Finally, VA repeatedly responded to Freedom of Information Act requests seeking such a regulation with their response “no such document exists.”

5. VA has no way to determine which aircraft were in Vietnam spraying Agent Orange. Actually, that proof has been provided the VA by the USAF Historical Records Research Agency by specific tail number of each Agent Orange spray C-123, such as the provenance of Patches, Tail #362.

6. VA has no way to determine which veterans flew any Agent Orange contaminated aircraft. The veterans can help the VA here, but rather than ask VA makes their negative statement. In fact Air Force aircrews are provided "Form 5s" which detail missions, tail number of aircraft, personnel on board, type of mission, and other details. Veterans also can provide individual or crew flight orders, flight logs, and VA 21-4138 forms certifying their duties aboard known contaminated aircraft.
7. PhD toxicologists are not qualified to comment on medical nexus (per Compensation & Pension Service) Actually, the PhDs who wrote the VA were certifying our exposure, not commenting on medical nexus, because exposure is the only concern under the law. Still, it is illogical for VA to refuse such opinions which were provided by the CDC, NIH, EPA and other federal agencies, as well as medical schools and schools of public health. The toxicologists who provided opinions include Dr. Jeanne Stellman and Dr. Linda Birnbaum, Dr. Fred Berman, Dr. Wayne Dwernychuk and others.

8. PhD toxicologists are not qualified to comment on medical nexus. This is not a duplicate of the item above (7). Here, the VA refused PhD opinions and also completely ignored the physicians' opinions which were provided. Ignored were opinions from Rear Admiral R. Ikeda MD US Public Health Service, Dr. Mark Garzotto VA Portland, Dr. Arnold Schecter University of Texas Medical School, CAPT A. Miller US Public Health Service, and other physicians.VA, requiring a physician's opinion but refusing the scientists', then dismissed the physicians...even VA physicians who are acknowledged Agent Orange-prostate cancer researchers, by simply ignoring their opinions. Veterans’ laws require VA to address each of the proofs put forward by a veteran in a disability claim, which is why VA ignored the physicians altogether. VA perhaps did not note, or believes itself above, the decisions by both the 8^th and 9^th US Circuit Courts that held arbitrary government dismissal of qualified toxicologist opinions regarding exposure issues is illegal.

9. The Memorandum concluded by stating "it is not possible to derive quantitative estimates of any increased health risks for those individuals who came into contact with the UC-123 aircraft from 1972 to 1982." Here, VA quotes the 2012 Air Force C-123 exposure study.

In fact, the AF report simply states that by 2012 it proved impossible to decide the health risks caused by veterans who flew the C-123 fleet thirty years earlier – the AF study in no way dismissed exposure but simply said time's passage made precise measurements of health impact impossible. VA twisted that to their perspective that NO health impact was possible, clearly a prevarication. Further, scientists and physicians have challenged the AF report as "unscientific."

10. There is a low probability TCDD penetrated through the skin of these aircrews. Again, exposure itself is the sole question under the law, however even Department of Defense literature specifies dermal (skin) absorption as a significant route of dioxin exposure. Other VA, EPA and CDC literature recognizes occupational dermal exposure as perhaps the principal route of TCDD exposure. A 1995 study in Organohalogen Compounds by medical researchers reports that, based on its review of the scientific literature, “dermal uptake to TCDD is probably the primary route of exposure in the workplace."
11. Air Force testing concluded that the level of Agent Orange that crewmembers of C-I'23 aircraft were potentially exposed to, was "unlikely to have exceeded standards set by regulators or to have put people at risk for future health problems. Again from the Air Force C-123 study, this VA twist is deceptive, because there are no "standards set by regulators" and the law specifies exposure, not any requirement for the veteran to prove or indeed even experience "future health problems." Obviously, however, the C-123 veterans seeking VA medical care have experienced health problems, typically suffering a number of the “Agent Orange presumptive illnesses.”

12. Currently, there is no equivalent legal basis for acknowledging"secondary" or "remote" Agent Orange exposure, such as that from contact with material or equipment previously used in Vietnam. This statement from Under Secretary A. Hickey misses the point – exposure is exposure, and the law does not specify secondary, remote, what flavor, what color or anything else. It clearly, precisely specifies exposure. And the contamination level on these aircraft was firmly established by the USAF as well as the CDC/Agency For Toxic Substances and Disease Registry whose director himself officially and directly informed the US Army Joint Services Records Research Center. Air Force tests identifying our airplane as "heavily contaminated" and "a danger to public health" are statements well beyond the VA's threshold of equipoise!

The VA is required to inquire of the JSRRC whenever a non-Vietnam War veteran claims exposure, and JSRRC, per Mr. Dominic Baldini, its chief, has ample US government opinion and archival information to respond positively to every VA C-123 inquiry. In fact, the VA could even (foolishly) assert that TCDD/Agent Orange is beneficial, and that would still have no impact at all on the legality of an exposed veteran's claim. (3 Oct 2014 update: JSRRC has begun providing adequate documentation of exposures)

13. The general claim of AO exposure among stateside C-123 crewmembers is based on a wipe test sample of residual 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) (the carcinogenic element in AO herbicide) found in only one C-123. This statement by Secretary Shinseki is amazing, in that indeed, the first two tests (Conday, 1979 & Porter/Weisman, 1994) confirming dioxin on our airplanes was on a single aircraft, however Secretary Shinseki ignored, for whatever policy reason, the subsequent test in 1996 which showed ALL seventeen C-123s stored by the AF remained contaminated with dioxin. This toxicity was identified even 25 years after the last C-123 Agent Orange spray missions. Here again, the Secretary was poorly informed before he signed his letter containing this blatant misstatement to Senators Burr and Merkley.
After 2003 the Air Force (355 AMDS/SGPB Captain Borma) grew concerned that no amount of testing would eliminate liability and concern about C-123 dioxin contamination, and the cost of wipe tests ($1,500 each C-123) led to the AMARC decision to cease sampling. Further, better and more definitive air sampling was ordered halted. The AF decision to avoid more definitive characterization of the toxin hazard cannot be used as some illogical proof the C-123s were not contaminated...all testing done proves otherwise. In 2009 AMARC, with Air Staff approval, determined all aircraft would be smelted as toxic waste, completed in June 2010. Approval correspondence from the Office of Secretary of Defense consultant to AF officials, and from them to their supervisors,  included official concerns already exposed veterans would learn of the contamination and seek veterans benefits. (Fig 4)

14. Government documents provided by a retired U.S. Air Force Colonel and leading expert on tactical herbicides, do shed light on the issue. Heis the Office of Secretary of Defense consultant who recommended destruction of the toxic C-123s, noting that exposed veterans might otherwise apply for VA care. One is reminded of C&P’s decision that non-physician opinions are unacceptable to VA, yet the consultant's views are in line with the VA’s decision to bar C-123 veterans’ claims, and thus decisive.

In 2011, the consultant referred to the C-123 veterans as "trash-haulers, freeloaders, looking for a tax-free dollar." Such prejudice renders anything from him unacceptable. Further, his views, which have been defensive of Agent Orange use, are directly countered by experts with the US Public Health Service, the EPA, the CDC and the National Institutes of Health.

Figure 4: Consultant's correspondence re: C-123 veterans

15. Wipe sampling is a universally accepted method used to detect at what level a chemical is present on a surface, but cannot be directly extrapolated to represent human health risk. Here again the Secretary errors. Wipe samples were the standard when the C-123s were first tested, and they are the standard today in civil and military situations. In fact, the military's "gold standard" on toxicology is Army TG312 which specifies wipe sample use. Further, under the law and Title 38, VA is prohibited from requiring any extrapolation of threat to health, or any other thing, for veterans exposed to Agent Orange claiming Agent Orange-presumptive illnesses.

Indeed, air samples might have further confirmed the contamination, but wipe samples were perfectly adequate, as confirmed by the Director, CDC/Agency for Toxic Substances and Disease Registry (Rear Admiral (MD USPH) R. Ikeda as well as the Director, NIH/National Toxicology Program (Dr. L. Birnbaum). Air sampling was done on C-123s initially but along with wipe samples stopped because of cost per airplane exceeding $1500, with no level of decontamination possible...the decision to save money and stop testing cannot then be used as proof against veterans' claims.

16. Given that the evidence from actual participants in Operation Ranch Hand does not show a health risk from direct exposure to TCDD, it is  difficult to ascertain a basis upon which to find a health risk among crew members of Post-Vietnam C-123 crews. Again the Secretary errs and ignores the laws he swore to enforce. Exposure itself is the question, not whether Vietnam-era veterans had more or less exposure than C-123 crews. Indeed, Dr. Jeanne Stellman, Professor Emerita at Columbia's Mailman School of Public Health, calculated that C-123 veterans had more Agent Orange exposure than the average Vietnam ground soldier, and somewhat less than the Ranch Hand crews.

The Secretary further errs in failing to consider that the C-123 crews flew their toxic airplanes for a full decade, not the eleven months that constituted a tour in Vietnam.

17. Chemical intake must also be taken into account. Actually, no.  In fact, it cannot be taken into account! The law specifies exposure, not chemical intake. Here the Secretary swaps around with "bioavailability' and "medical nexus," neither of which is legal to consider in a veteran's Agent Orange claim for presumptive illnesses, and such terms might be applicable only for illnesses not recognized by the VA as associated with Agent Orange.

[1] Kerger et. al., Validating Dermal Exposure Assessment Techniques for Dioxin Using Body Burden Data and Pharmacokinetic Modeling, 25 Organohalogen Compounds 172, 172 (1995)

Agent Orange Harmless, Claims VA Leader

Agent Orange is harmless, or so claims VA's Director of Compensation and Pension Services (C&P.)

His exact words were, "There is no conclusive evidence that TCDD exposure causes any adverse health effects." At least, Agent Orange is harmless only so far as veterans' Agent Orange exposure claims are concerned if they reach the director's desk for prompt denial.

TCDD is the toxic contaminant in Agent Orange, or, more specifically, 2,3,4,8-Tetrachlorodibenzenzodioxin. It is a recognized human carcinogen, recognized as such by EPA, WHO and other authorities, and also by the VA! Again, quite harmful except where Agent Orange-exposed veterans' claims are concerned...pretending otherwise is merely part of VA's campaign to deny medical care to qualified veterans.

C&P's statement was part of his September 2012 order that an Agent Orange-exposed war veteran's claim be denied. The VA's Portland Regional Office had recommended approval, but C&P then directed the refusal over his signature once he was made aware of the veteran's claim.  The director of C&P was asked about his position, obviously contrary to both law and science, during a face-to-face February 2013 meeting with C-123 Association members Wes Carter and Marlene Wentworth at VA's 1800 G Street headquarters.

He and his staff seemed unaware of his action in this particular case, but did nothing then or subsequently to revise the order denying the veteran's claim. Thus, it remains the position at the Department of Veterans Affairs that Agent Orange has not been shown to cause adverse health effects...their pretense is that it is harmless.

Apparently objecting to the veteran's submitting an Agent Orange exposure claim, the diretor went so much further in his order forbidding this veteran's application. Because numerous government and university scientists provided substantial proofs of the vet's exposure situation, He directed that all input from toxicologists, chemists, epidemiologists and environmental scientists input be flatly rejected and only physician input be acceptable. This flies in the face of decisions by the 8th and 9th Circuit Courts which ruled such arbitrary dismissal of expert toxicological input illegal and unfair.

Actually, numerous physician statements of support were also included in the veteran's claim and these should have meet C&Ps requirement. These were submitted by the vet's own VA physician (Dr. Mark Garzotto, an acknowledged Agent Orange researcher and also professor of medicine at Oregon Health Sciences University), from Rear Admiral R. Ikeda (MD, USPHS) Director CDC/Agency for Toxic Substances and Disease Registry, CAPT Aubrey Miller (MD) US Public Health Service, and Professor Arnold Schecter (MD) at the University of Texas Medical School.

However, these physicians were all dismissed by simply ignoring them without comment of any sort, either in C&P's order or in the actual claim denial. By pretending their nonexistence, VA skirted the need to permit this convincing evidence to support the veteran's claim.

The determination of Compensation and Pension Service to prevent this veteran's claim was made even clearer in their mischaracterization of the C-123 Agent Orange study completed by the Air Force and release in May 2012. The VA twisted the fact, saying the Air Force concluded exposures by crewmembers were unlikely to have exceeded regulatory standards. In fact, the AF made that conclusion only for passengers, not for crew members who were in the C-123 much more over a full decade of flying. And besides, there are no published regulatory standards for dioxin exposure, because any exposure is considered harmful by regulators.

Conclusion: strictly for policy reasons alone and disregarding the 1991 Agent Orange Act, Title 38 and the Federal Register of 8 May 2001, and disproving promises by Secretary of Veterans Affairs Eric Shinseki that all C-123 claims will be carefully considered, the VA is determined that C-123 veterans' claims will be denied regardless of proof, legal sufficiency, medical or scientific justification. At least, if C&P has any say.

C-123 Veterans Claims SITREP: 4 Aug 2013

It is highly likely that you and other crew members were exposed to the herbicides and to their highly toxic contaminant, dioxin.

        - Dr. Jeanne Stellman, Profesor Emerata, Columbia University

Aircrew operating in this, and similar environments, were exposed to dioxin.

       - Dr. Christopher Portier, (then) Director, CDC/Agency for Toxic Substances & Disease Registry

I am in agreement. (with Dr. Portier's finding, above)

       - Rear Admiral R. Ikeda MD, Director, CDC/Agency for Toxic Substances & Disease Registry

• VA will NOT permit C-123 veterans' claims.

       - Deputy Director, VA Post-Deployment Health

• We all die.

       - Dr. Michael Peterson, Chief Consultant, VA Post-Deployment Health

(responding to veteran asking VBA to reach accurate rating decisions before the veteran's death and not force two year appeals delay, March 2012)

(Received June 24 from the incoming Director of the Agency For Toxic Substances & Disease Registry)

Dear Major Carter,

Thank you for your email and warm welcome regarding my new acting position.  I have recently been briefed about ATSDR actions related to this situation.  I have also reviewed the ATSDR correspondence related to C-123 aircraft and I am in agreement with it.  I understand that the VA has already received our letters and that ATSDR staff have spoken with VA staff about your situation. 

The letter from ATSDR to General Hickey regarding exposures at Camp Lejeune was somewhat different.  We sent that letter after completing an extensive dose-reconstruction model of exposures to volatile organic compounds at Camp Lejeune.  We were obliged to notify the VA because they had been relying on out-of-date information previously generated by us. 

The limited, but high quality, sampling of C-123 aircraft that we reviewed in 2012 confirm that some post-Vietnam era C-123 aircraft were contaminated with TCDD dioxin.   All C-123 aircraft have since been destroyed.  Thus, it is no longer possible to further characterize human exposure pathways through additional sampling.  Without additional environmental sampling information, an official health consultation would not shed additional light on this situation beyond that provided in January 2012 and March 2013.  I understand that United States Air Force restricted entry into these contaminated planes once they were found to be contaminated.  ATSDR concurs with this position and believes it would also have applied to pilots and crew had these planes remained operational. 

I hope this email is helpful.  Thank you again for your service to our country.  

Robin

 Robin M. Ikeda, MD, MPH

RADM, USPHS

Deputy Director, Noncommunicable Disease, Injury, and Environmental Health

Acting Director, National Center for Environmental Health/Agency for Toxic Substances and Disease Registry

Centers for Disease Control and Prevention

4770 Buford Highway, MS F-39

Atlanta, GA 30341

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From: Wes Carter [mailto:c123kcancer@gmail.com]

Sent: Monday, June 10, 2013 2:55 PM
To: Ikeda, Robin (CDC/ONDIEH/OD)
Cc: Sinks, Tom (CDC/ONDIEH/NCEH)
Subject: Opinion provided earlier by Dr. Sinks and Dr. Portier re: C-123 Agent Orange contamination and exposure

Dear Dr. Ikeda,

Congratulations on your assuming the helm at ATSDR. We are the C-123 Veterans Association, and in the past ATSDR has been very kind to provide opinions over the signatures of Dr. Sinks and Dr. Portier. These opinions confirmed our exposure to Agent Orange for the years we flew the C-123 medium assault transports used earlier in Vietnam for spraying Agent Orange.

Last week I visited with several senators and congressional representatives, as well as with Ms. Amanda Meredith and Mr. Steve Robertson of the Senate Veterans Affairs Committee. We have asked the assistance of both the staff director and the Republican General Counsel in approaching the Department of Veterans Affairs regarding our veterans' claims.

I was asked, and they also asked me, why the previous letters from ATSDR have been disregarded by the VA. In one instance, VA's Compensation Services summarized Dr. Sinks' opinion (without mentioning his conclusion that veterans were exposed) by appending the sentence, "In conclusion there is no conclusive evidence of long-term TCDD harm." In another, the Manchester NH Veterans Affairs Regional Office denied a veteran's claim by grouping Dr. Sinks' and Dr. Portier's findings in the unacceptable "lay evidence" category, and into that group also put the findings by the NIH and US Public Health Service. Dr. Linda Birnbaum is also very familiar with this issue, as is Dr. Jeanne Stellman at Columbia.

Similar official letters from ATSDR have been accepted by VA for Camp Lejeune, and we cannot understand why the VA rejects their merit here. Obviously the issue is critical for us, because most of our veterans are not retired military and not otherwise VA-eligible, so they are turned away when seeking care for typical Agent Orange illnesses by the VA hospitals.

The matter has recently reached the desk of Secretary Shinseki. May I again ask ATSDR's leadership in restating to the General the opinion that we were exposed, and if possible, in the form of an official health consultation? Reading the criteria for an official health consultation, it seems to fit the requirements. 

Because the C-123 contamination had been kept "in official channels only" by the Air Force until released via FOIA in 2010, we only recently began presenting claims to the VA, and in every instance the claims have been denied, and all those reaching the VA's Board of Veterans Appeals a year or more later have been overturned in favor of the C-123 veteran. At our age and with our illnesses, however, we need very much for appropriate decisions to be made on the initial claims, rather than years later in appeal. 

I hope we can continue to count on Dr. Sinks, you and the ATSDR for help.

Sincerely,

Wesley T. Carter, Major, USAF Retired

Chair