Agent Orange Issues & Information

[J.B. Stone]

Legacy of Agent Orange defoliant lives on in Vietnam
http://www.thespec.com/News/BreakingNews/article/696276

December 26, 2009
By Jason Grotto
Chicago Tribune


DONG NAI PROVINCE, Vietnam - The sun beats down on Dao Thi Kieu's straw hat as she hunches over thin strands of bright green rice plants, pulling them from beds submerged in muddy water and replanting them elsewhere.

These are the same paddies Kieu tended as a teenager during the Vietnam War, and she still remembers the planes that came in the mornings to spray Agent Orange and other defoliants while she worked.

"I was about 16 when I saw the planes flying overhead, and I saw the spraying until I was married," said Kieu, 58. "It smelled like ripe guava. No trees could survive. It made my clothes wet."

Her vivid memories are supported by data from spraying missions analyzed by the Chicago Tribune, which show at least seven sorties that dispensed nearly 13,000 gallons of defoliants passed over Kieu's fields.

Since then, the story of Kieu's life can be told with simple, heartbreaking math. She had eight children. Seven of them were born with severe deformities. Of those, five died before age 8. She also lost her husband, who served in the U.S.-backed South Vietnamese army, to cancers associated with herbicide exposure.

Decades after the Vietnam War ended, the most contentious question surrounding the use of defoliants by the U.S. military is the impact on the health of untold numbers of Vietnamese.

At the heart of the controversy is the suspected link between the herbicides and birth defects in Vietnam, where more than five out of every 100 children are born with some form of physical or mental abnormality, a fourfold increase since the start of the war, according to Vietnamese scientists.

The U.S. government spent $13.7 billion last year on disability payments for more than 1 million Vietnam veterans, many of whom were exposed to herbicides. Millions more have been spent compensating veterans' families whose children were born with birth defects. But U.S. officials bristle at acknowledging connections between the defoliants and illnesses in Vietnam.

Since the countries normalized relations in 1995, Congress has allocated at least $125 million to fight HIV/AIDS in Vietnam, whose infection rate ranks 67th worldwide. About $46 million has been provided to help Vietnamese who lost limbs from unexploded bombs dropped by the United States.

Yet, since the war ended 35 years ago, Congress has set aside just $6 million to assist Vietnam with herbicide-related issues, despite evidence that large numbers of civilians in the south - people in whose name the war was fought - were exposed to defoliants that have since been outlawed in the U.S.

Private philanthropies - including the Ford Foundation, the Gates Foundation and Atlantic Philanthropies - have provided nearly three times more money than the U.S. to help the Vietnamese overcome health and environmental damage brought on by the herbicides.

During the war, U.S. officials assured the Republic of Vietnam that the defoliants were harmless. The South Vietnamese government, in turn, sought to convince its citizens that the chemicals were safe. Vietnamese soldiers went so far as to douse themselves in the chemicals and even drink them with water, according to documents from the National Archives.

"Civil servants and cadres explain to the people there the harmlessness of the defoliation by spraying defoliant on the body and water and drinking it before the people," said an October 1963 report from the South Vietnamese government.

Like U.S. soldiers, Vietnamese citizens used empty herbicide barrels for showers and barbecues. Believing the chemicals were harmless, South Vietnamese soldiers often sold empty barrels containing as much as 5 gallons of herbicide residue to civilians in such places as Da Nang and Bien Hoa, government records state.

But many of the compounds weren't safe. They were contaminated with the most toxic man-made chemical known, the dioxin TCDD. The contaminant was an unintended byproduct of the manufacturing process used by U.S. chemical companies to produce an ingredient found in Agents Orange, Purple, Green and Pink - compounds that made up more than 65 percent of the nearly 20 million gallons of herbicides released in Vietnam.

Scientists have tied dioxin to more than a dozen illnesses, including cancer, Parkinson's disease and crippling congenital disorders.

"I never met a hormone system that dioxin didn't like to disrupt," said Dr. Linda Birnbaum, director of the National Institute of Environmental Health Sciences and a leading dioxin expert. "It has widespread effects in nearly every vertebrate species at nearly every stage of development."

As a young obstetrician during the war, Dr. Nguyen Thi Ngoc Phuong brought hundreds of healthy babies into the world in Tu Du Hospital, home to Vietnam's largest maternity ward, in Saigon, now Ho Chi Minh City.
Then, in 1968, two years after U.S. forces expanded the use of herbicides by millions of gallons, Phuong said she delivered a baby born without a brain or a spinal cord.

In the next few months, she said, she delivered dozens of infants with equally severe deformities, three or four a week - babies born with organs on the outside, with no arms, no legs, no eyes.
"It was very horrible for me and my colleagues," she said, her voice cracking as she wiped away tears. "The first case happened on my duty. I didn't show the mother because I was afraid she would go into shock. But the father and other family members demanded to see, and it was horrible."

Finally, she went to friends who wrote for one of the Saigon newspapers. Stories of birth defects linked to the U.S. war in Vietnam soon began to emerge, sparking a bitter controversy that continues today.

The U.S. military ended the herbicide program, known as Operation Ranch Hand, in 1971 after a study for the National Institutes of Health found that a chemical in some of the compounds caused birth defects in laboratory animals. Soon after, the U.S. surgeon general halted the domestic use of the chemical, known as 2,4,5-T. Later it became widely known that 2,4,5-T was contaminated with a highly dangerous form of dioxin, TCDD.

A diabolical toxin that attaches itself to the fat cells of humans and animals, TCDD can remain in the body for decades. Scientists think that once present, it binds with cell proteins known as Ah receptors, which can then trigger a series of molecular events that affect cellular growth, potentially leading to cancer and other illnesses. Researchers also hypothesize that dioxin's impact on the receptors can alter the regulation of genes, leading to changes in a person's DNA.

Multiple genetic and environmental factors can affect a person's reaction to TCDD, and scientists say health effects depend on genetic predisposition, the manner and amount of exposure and other factors that researchers haven't fully figured out.
In the case of birth defects, dozens of experiments show that laboratory animals exposed to TCDD have higher rates of birth defects, with dose and timing affecting risk. In humans, scientists have found some correlations between exposure and defects but have yet to prove a cause-and-effect relationship. Animal research suggests that the chemical can affect reproduction by corrupting sperm and interfering with hormones that regulate the development of fetuses.

The U.S. Department of Veterans Affairs in 2003 began providing disability compensation to the children of female Vietnam veterans if they suffer from any of 18 birth defects - including the first deformity Phuong encountered four decades ago, known as anencephaly.

Male veterans' children are compensated for one defect: spina bifida, a condition in which some vertebrae in the spine are not fully formed, leading to a host of difficulties including paralysis, fluid in the brain, bowel control problems and learning disabilities.

Figuring out how and why children are born with birth defects remains painfully complicated. There can be multiple factors at play, many of which are never known, making the job of isolating one culprit difficult, if not impossible.

What is becoming clear, however, is that people - especially women - who are exposed to even trace amounts of TCDD, which scientists measure in parts per trillion, have a higher risk of bearing children with birth defects.

The controversy over Agent Orange's impact in Vietnam stands at the crossroads of science and politics, a messy affair rife with hard feelings and stubborn assumptions on both sides.

Birth defects are the most emotionally charged part of the disagreement, with some Vietnamese claiming nearly every child born with a deformity is a victim of Agent Orange, while U.S. officials demand definitive proof that defoliants are to blame for any birth defect.

"The Vietnamese authorities, particularly at the local level, tend to lump all of these birth defects together and talk about them being related to Agent Orange," said Michael Marine, the U.S. ambassador to Vietnam from 2004 to 2007. "At the same time, I didn't think the U.S. side was tackling this with enough vigor. It was politically toxic to deal with."
As evidence of the large-scale impact of the herbicides, the Vietnamese point to a study by Columbia University professor emeritus Jeanne Stellman, published in the peer-reviewed journal Nature, that estimated 2.1 million to 4.8 million Vietnamese civilians were exposed to the chemicals during the war.

Still, some U.S. officials view accusations that the defoliants caused widespread birth defects in Vietnam as a centrally controlled propaganda campaign founded on scant scientific evidence.

"We believe the (Vietnamese government) will never permit research that in any way might discredit its two-decade long propaganda campaign, i.e., Agent Orange/dioxin is to blame for a huge range of serious health problems - especially birth defects and mental retardation," said a 2003 memo from the U.S. Embassy in Hanoi.
U.S. officials point to a host of other possible reasons for the high rate of congenital deformities, including malnutrition, a lack of iodine in the diet of pregnant mothers, even alcoholism.

Much of the contentious political rancour is captured inside Tu Du Hospital, which cares for dozens of children with some of the most severe deformities. Many were abandoned at birth and spend their days studying and playing while undergoing physical therapy and other treatments to overcome their disabilities.

The hospital and the children treated there have become symbols of Agent Orange's lingering impact, even though in many cases little is known about whether and how their parents may have been exposed.

In 1968, Phuong and her colleagues began collecting dozens of fetuses and deformed babies who did not survive, storing them at Tu Du in large jars filled with formaldehyde. Foreign news reports about the herbicides often feature images of the jars, again despite a lack of hard evidence about what caused the deformities.

As the Tribune conducted interviews overseas, it was clear that some Vietnamese citizens are quick to blame the defoliants for health problems even when documenting exposure is difficult or the facts make direct exposure impossible. Some who said they were exposed didn't join the military until long after the spraying missions had ceased; others operated in areas where little or no spraying took place.

Still, the Tribune saw many children at Tu Du and elsewhere in Vietnam who suffer from birth defects and illnesses that science has linked to dioxin exposure. In many cases, data on wartime spraying missions supports their parents' stories of exposure to herbicides.

Tram Thi Shu has a 6-year-old son, Ho Cong Duc, who looks more like he's 6 months old. His blue veins are visible beneath his translucent skin. The boy is thin and pale; his breathing is raspy and labored. Shu believes his illnesses, as well as her daughter's seizures, are due to her exposure to defoliants.

"I remember seeing the plane fly over the back of my head," said Shu, 43, who grew up in Quang Nam province. "After it left, all of the leaves from the trees fell down. We were wet because of the spray. I don't remember exactly how many times it happened, but my mother said it was at least three times."

Data from spraying missions in Quang Nam show nearly 24,000 gallons of Agent Orange and 21,000 gallons of Agent Blue - which contained arsenic - were sprayed within two miles of Shu's village.
"I am very worried for my son," Shu said. "If I can live longer than him, it will be OK. But if I pass away, I don't know who will take care of him."

And then there's Dao Thi Kieu, who has lost a husband as well as five children.

Her husband, Lam Ba Trung, served in the U.S.-backed South Vietnamese army along the 17th Parallel in Quang Tri province, where U.S. and South Vietnamese forces sprayed more than 700,000 gallons of herbicides to destroy enemy crops and defoliate dense jungles.

He died in 2004 at 60 after a seven-year battle with lung and throat cancer, illnesses the Institute of Medicine and the U.S. Department of Veterans Affairs link to defoliants used during the war.
Like many Vietnamese citizens, Kieu and her husband spent years blaming themselves for their children's suffering.

"We thought that maybe we had done something bad in a past life," she said, her voice beginning to break. "That's why my husband became a vegetarian."

Almost every day, Kieu rises at 3 a.m. to care for her two surviving disabled daughters, Lam Kim Lien, 39, and Lam Ngoc Huong, 35.

Without the benefit of physical therapy, neither is able to walk, talk or even hold a spoon. Their misshapen, skeletal bodies and cropped hair make them look much younger, while their gaunt, expressionless faces reflect lives spent on a small wooden bed covered with a straw mat.

The couple's only healthy child, Lam Ngoc Nhan, 20, was born after Kieu and Trung waited 10 years to try again, an important detail considering dioxin levels are cut in half in human beings after about 71/2 years; the chemical also passes out of the body as mothers breast feed.
Kieu tends her rice paddies until dusk and then returns home to bathe and feed Lien and Huong. A diminutive woman with an iron resolve, Kieu is well-respected in her village for struggling through hardships, giving her a sense of pride amid all the pain.

But her strength melts away as she speaks about the difficulties she faces and her hopes for the future.

"I don't know what to say. To find justice?" she said, tears streaming from her dark eyes. "I lost five children and a husband. I have two children with disabilities. There are days when I come back from work, and I am so tired I cannot lift up my children."

[J.B. Stone]

http://www8.nationalacademies.org/cp/projectview.aspx?key=49201

Project Title:

Blue Water Navy Vietnam Veterans and Agent Orange Exposure
PIN: IOM-BSP-09-02

Major Unit:

Institute of Medicine

Sub Unit: Board on the Health of Select Populations

RSO: Wedge, Roberta

Subject/Focus Area: Health and Medicine


Project Scope
An IOM committee will conduct a study and prepare a report on whether the Vietnam Veterans in the Blue Water Navy experienced a comparable range of exposures to herbicides and their contaminants (focus on dioxin) as the Brown Water Navy Vietnam Veterans and those on the ground in Vietnam (i.e., specifically with regard to Agent Orange exposure).

The IOM committee's report is expected to include:

1. An historical background on: the Vietnam War; Combat troops (ground troops); Brown Water Navy (includes inland waters); Blue Water Navy; VAO legislation

2. A discussion of exposures (Blue Water Navy in comparison with ground troops in Vietnam): specifically compare exposures on ground with those on ships (discuss all possible routes of exposure); and examining the range of exposure mechanisms for herbicide exposures (i.e., concentrating toxics in drinking water; air exposure possibly from drift from spraying; food; soil; skin.

3. A determination, if possible, of the comparative risks for long-term health outcomes comparing Vietnam veteran ground troops, Blue Water Navy veterans, and other "Era" veterans serving during the Vietnam War at other locations (given the possible dioxin exposure).

4. A review of studies of Blue Water Navy veterans for health outcomes (assuming there are studies specific to that cohort of veterans).

The Project is sponsored by the U.S. Department of Veterans Affairs

The approximate start date for the project is December 2009.

A report will be issued at the end of the project in approximately 18 months.

http://www.mtlegion.org/service_officer ... Update.pdf

C&P Brown Water Navy Tracking Program—Update
As stated in the previous Veterans Affairs and Rehabilitation (VA&R) Bulletin 01-10 dated January 10, 2010, The Department of Veterans Affairs (VA) Compensation and Pension (C&P) Service has initiated a program to collect data on Vietnam naval operations for the purpose of providing regional offices with information to assist with development in disability claims based on herbicide exposure from Navy Veterans. VA has already compiled a list of certain ships which have been confirmed as qualifying for Brown Water service, yet the list is by no means a complete list.

In order to assist advocates in facilitating investigations of other ships which may qualify, there is a website helpful to researching US Navy ships:

http://www.history.navy.mil/danfs/index.html

Advocates can research ships on this website with information provided by the veteran, and may be able to use the resources provided to find the information needed to submit with a veteran’s claim. Advocates should be aware that although this web site may contain information regarding an individual ship’s history that can be used to establish Brown Water service, the site has limitations and the information provided on a particular ship may not be complete.

_________________________
BARRY A. SEARLE, Director
National Veterans Affairs and
Rehabilitation Commission

[J.B. Stone]

http://www.veteranstoday.com/2010/04/11 ... nt-orange/


VA Proposes Change to Aid Veterans Exposed to Agent Orange

April 11, 2010 posted by Robert L. Hanafin
According to Tom Philpott in his article New Agent Orange Rule to Allow Retro Claims by 86,000 about 86,000 Vietnam War veterans, their surviving spouses or estates will be eligible for retroactive disability compensation from the Department of Veterans Affairs — an average of 11.4 years for veterans and 9.6 years for survivors — under a draft VA rule to expand by three the number of diseases presumed caused by herbicide exposure in the war.

The VA issued a media release on March 25, 2010 that covers changes in Agent Orange claims in a broader context.

Proposed Regulation Change Adds Illnesses to List of Diseases Subject to Presumptive Service Connection for Herbicide Exposure

Well over 100,000 Veterans exposed to herbicides while serving in Vietnam and other areas will have an easier path to qualify for disability pay under a proposed regulation published by the Department of Veterans Affairs (VA) that adds three new illnesses to the list of health problems found to be related to Agent Orange and other herbicide exposures.

“This is an important step forward for Vietnam Veterans suffering from these three illnesses,” said Secretary of Veterans Affairs Eric K. Shinseki. “These warriors deserve medical care and compensation for health problems they have incurred.”

The regulation follows Shinseki’s October 2009 decision to add the three illnesses to the current list of diseases for which service connection for Vietnam Veterans is presumed. The illnesses are B cell leukemias, such as hairy cell leukemia; Parkinson’s disease; and ischemic heart disease.

The Secretary’s decision is based on the latest evidence of an association with widely used herbicides such as Agent Orange during the Vietnam War, as determined in an independent study by the Institute of Medicine (IOM).

Even though this is a proposed rule, VA encourages Vietnam Veterans with these three diseases to submit their applications for compensation now so the Agency can begin development of their claims and so they can receive benefits from the date of their applications once the rule becomes final.

Comments on the proposed rule will be accepted over the next 30 days. The final regulation will be published after consideration of all comments received.

“We must do better reviews of illnesses that may be connected to service, and we will,” Shinseki added. “Veterans who endure health problems deserve timely decisions based on solid evidence.”

Over 80,000 of the Veterans will have their past claims reviewed and may be eligible for retroactive payment, and all who are not currently eligible for enrollment into the VA health care system will become eligible.

During the Vietnam War, the U.S. military used more than 19 million gallons of herbicides for defoliation and crop destruction in the Republic of Vietnam. Veterans who served in Vietnam anytime during the period beginning January 9, 1962, and ending on May 7, 1975, are presumed to have been exposed to herbicides.

Used in Vietnam to defoliate trees and remove concealment for the enemy, Agent Orange and other herbicides left a legacy of suffering and disability that continues to the present.

The new rule will bring the number of illnesses presumed to be associated with herbicide exposure to 14 and significantly expand the current leukemia definition to include a much broader range of leukemias beyond chronic lymphocytic leukemia previously recognized by VA.

In practical terms, Veterans who served in Vietnam during the war and who have a “presumed” illness don’t have to prove an association between their illnesses and their military service. This “presumption” simplifies and speeds up the application process for benefits.

Other illnesses previously recognized under VA’s “presumption” rule as being caused by exposure to herbicides during the Vietnam War are:

* AL Amyloidosis,
* Acute and Subacute Transient Peripheral Neuropathy,
* Chloracne or other Acneform Disease consistent with Chloracne,
* Chronic Lymphocytic Leukemia, (now being expanded)
* Diabetes Mellitus (Type 2),
* Non-Hodgkin’s Lymphoma,
* Porphyria Cutanea Tarda,
* Prostate Cancer,
* Respiratory Cancers (Cancer of the lung, bronchus, larynx, or trachea), and
* Soft Tissue Sarcoma (other than Osteosarcoma, Chondrosarcoma, Kaposi’s sarcoma, or Mesothelioma).


Additional information about Agent Orange and VA’s services for Veterans exposed to the chemical are available at www.publichealth.va.gov/exposures/agentorange.

Source Department of Veterans Affairs http://www1.va.gov/opa/pressrel/pressre ... fm?id=1876

While the VA Press Release above mentions, “Over 80,000 of the Veterans will have their past claims reviewed and may be eligible for retroactive payment, and all who are not currently eligible for enrollment into the VA healthcare system will become eligible,” Tom Philpott notes that number to be more realistically 86,000.

According to Tom, the 86,000 are beneficiaries who can reopen previously denied claims for ischemic heart disease, Parkinson’s disease and chronic B-cell blood cancers including hairy cell leukemia. A more detailed listing was made available by the 25 March VA press release. However, Tom notes that another 29,000 claims are expected to be approved this year for Vietnam veterans suffering from these diseases but applying for benefits for the first time. VA plans to hire 1772 new claims processors, starting this October, to be able to handle these claims “without significantly degrading the processing of the non-presumptive workload.”

In the proposed rule published March 25 in the Federal Register, VA officials explained that Secretary Eric Shinseki has cut the usual 60-day public comment period by half “to promote rapid action” on these claims.

Veterans Today Editorial Note: To view either a text or .pdf file on the Proposed Rule changes listed in the Federal Register on 25 March go to http://edocket.access.gpo.gov/2010/2010-6549.htm (test) or http://edocket.access.gpo.gov/2010/pdf/2010-6549.pdf (PDF)

Tom notes that when a final rule is published, soon after April 26, VA claim offices across the country can begin making payments. Veterans with these diseases will need to show they set foot in Vietnam during the war. Those who served aboard ship just off the coast remain ineligible. “Adding ischemic heart disease to the list of presumptive Agent Orange illnesses is by far the most significant part of the new rule, accounting for 82 percent of additional expected payments to beneficiaries.” Philpott said.

The rule defines ischemic heart disease (IHD) as a condition causing inadequate supply of blood and oxygen to the myocardium, the middle and thickest layer of the heart wall. “IHD” can include, but is not limited to, acute, subacute and old myocardial infarction (heart attacks in layman’s terms); atherosclerotic cardiovascular disease including coronary artery disease (or spasm) and coronary bypass surgery, and stable, unstable and Prinzmetal’s angina. (All related to Heart Disease in layman’s terms. Veterans Today Editorial comment).

Because Ischemic Heart Disease (IHD) is a heart disease it “does not include hypertension (high blood pressure alone) or peripheral manifestations of arteriosclerosis such as peripheral vascular disease or stroke,” the draft regulation explains.

Of [the 80,000 to] 86,000 beneficiaries eligible for retroactive claims, VA estimates that nearly 70,000 of them are living Vietnam veterans, their average age now 63. Of those, 62,200 previously were denied compensation for IHD, 5400 were denied for B-cell leukemia and 2300 for Parkinson’s disease. About 53,000 who previously filed claims for these diseases already are receiving VA compensation for other service-related diseases. Of those, roughly 8350 are already rated 100-percent disabled and therefore might not be eligible for retroactive pay.

Tom notes that the VA assumes that veterans with Parkinson’s disease or for B-cell leukemia will be awarded a 100-percent disability ratings. The average rating for ischemic heart diseases is expected to be 60 percent. In calculating VA costs from this change, VA assumes that 80 percent of the eligible population will apply for benefits and 100 percent of those who do will be approved. But eligible vets and suvivors must file claims to get paid; nothing will happen automatically. To file claims online visit: http://vabenefits.vba.va.gov/vonapp/main.asp. Veterans without a computer can call a toll-free helpline at 1-800-749-8387.

VA maintains a directory of veterans’ service organizations with trained staff to help in filing claims. The website: http://www1.va.gov/vso/. Many state, county and local governments also have personnel to help. Find information on these agencies at: http://www.va.gov/statedva.htm.

VA also expects many ineligible veterans to file claims. They will be found ineligible because they can’t show they ever set foot in Vietnam though they suffer from one of the qualifying diseases. Many claims will be filed by veterans with hypertension [high blood pressure] but those will be rejected because that condition is not a “heart disease” under the VA draft regulation.

Veterans Today Editorial Comment: We support legislation that was introduced in Congress during 2009 that would expand eligibility to Veterans serving in the vicinity of Vietnam who may have been exposed to Agent Orange such are Airmen exposed while loading the chemicals or spraying the chemical or Blue Water Navy serving aboard ships off shore participating in spraying operations. H.R. 2254: the Agent Orange Equity Act To amend the law, and to clarify presumptions relating to the exposure of certain veterans who served in the vicinity of the Republic of Vietnam. See also Agent Orange Equity Act of 2009 (HR 2254, 111th Congress) published on the Lawyers for Warriors website.

Philpott reports that in total, VA expects claims volume from presumptive Agent Orange diseases to hit 159,000 this year and to exceed 270,000 by fiscal 2019. The growing list of Agent Orange diseases stems of a court case, Nehmer v. Department of Veterans Affairs, filed in 1986 The class action lawsuit won by veterans, and reinforced by legislation, requires VA to direct the National Academy of Sciences to report every two years on any positive association between new diseases and exposure to herbicides in Vietnam. The NAS reports are to continue through Oct. 1, 2014, with the possibility that more diseases will be found to have an association with herbicide exposure.

Credit for part of this article goes to Tom Philpott for extractions from his article New Agent Orange Rule to Allow Retro Claims by 86,000 to read his full text or to comment, e-mail milupdate@aol.com, write to Military Update, P.O. Box 231111, Centreville, VA, 20120-1111 or visit: www.militaryupdate.com.

To find out more about Tom Philpott, his bio can be found at the link to his entire article.

The bulk of this article is based on Department of Veterans Affairs News Release dated March 25, 2010, and public domain information found in the Federal Register for 25 March 2010.

Robert L. Hanafin, Major, U.S. Air Force-Retired

VA Proposes Change to Aid Veterans Exposed to Agent Orange

Robert L. Hanafin, Major, U.S. Air Force-Retired, Veterans Today News

[J.B. Stone]

http://www.legislativegazette.com/Artic ... esses.html

New benefits available for Agent Orange illnesses
By James Nani
<center></center>
The state Division of Veterans’ Affairs has distributed 5,000 posters to local veterans’ associations and state veterans’ councilors to post around New York. Photo by Division of Veterans’ Affairs.

April 12, 2010
Vietnam Veterans will soon be able to claim health benefits related to three diseases now being attributed to Agent Orange.

The New York state Division of Veteran's Affairs has begun to provide new outreach services for Vietnam era war veterans in response to three diseases being added to the list of presumptive conditions from exposure to Agent Orange. The diseases include B-cell leukemias such as hairy-cell leukemia, Parkinson's disease and ischemic heart disease, bringing a total of 14 conditions assumed to be associated with Agent Orange.

According to Andy Davis, training and outreach coordinator for the New York state Division of Veterans' Affairs, the division has equally distributed 5,000 posters to the New York American Legion, county service veteran agencies, and state veterans' councilors. Fifty counselors who work for the state Division of Veterans' Affairs have been newly trained to inform people about the addition of the diseases. They are also authorized to hang the posters where they deem appropriate.

Davis also said there will be roundtable discussions continuing throughout the next few months statewide to inform veterans about the diseases newly added to the list as well as other information relating to veterans' benefits. The first one will be at Rockland County Community College on April 21 and will be held every two months afterward in places such as Buffalo, the Finger Lakes Region and the Capital Region. The discussions will be geared toward veterans 55 years or older.

Department Vice Commander for the Department of New York American Legion William G. Damson, a Vietnam veteran, said the addition of the diseases is a "long time coming."

"It shouldn't be old news but it is," said Damson about diseases related to Agent Orange. "It will be with some people until they die," he continued, talking about the effects from exposure to Agent Orange.

"We absolutely agree with the new rules. We need to act fast on the new ones [conditions relating to Agent Orange] but also have to remember the other ones as well," said Ned Foote, president of the New York State Council of Vietnam Veterans' of America. He said he is urging veterans in his organization to submit proposals soon to qualify for benefits relating to the addition of the three diseases. He said he has seen some new claims take up to seven years to be processed.

During the Vietnam War from 1961 to 1971, the U.S. military used more than 19 million gallons of herbicides, such as Agent Orange, in the Republic of Vietnam to remove plants and leaves from foliage that provided enemy cover.

According to the U.S. Department of Veterans Affairs, more than 100,000 veterans exposed to herbicides while serving in Vietnam and other areas will have an easier path to qualify for disability pay under these changes. Davis said the conditions relating to exposure only apply to those who served on the ground of Vietnam or the internal waterways.

According to Davis, 80,000 previous claims relating to health benefits from exposure to Agent Orange are expected to be re-examined by the federal government and up to 200,000 new claims overall. New York as of September 30, 2009 had 315,000 Vietnam era Veterans. Davis said there are two types of benefits veterans can receive health care or federal compensation.

"Vietnam Veterans currently make up our largest veterans demographic in New York. The division wants to ensure that they are informed about these changes and the effect it may have on their lives," said James D. McDonough Jr., director of the New York State Division of Veterans Affairs.

"This is an important step forward for Vietnam Veterans suffering from these three illnesses," said United States Secretary of Veterans Affairs Eric K. Shinseki. "These warriors deserve medical care and compensation for health problems they have incurred."

At this stage, the rules to add the disease are technically proposed and not official, but Davis said they are expected to be officially added around summer and veterans are encouraged to submit their applications for compensation now so agencies can begin to working of their claims. Davis said that, as of about six months ago, there were almost a million backlogged claims being processed by the federal government.

"Logically, the overall number of claims can be expected to grow, as will the backlog and processing times due to these new Agent Orange claims. But with these four pilots and the 27 percent increase we have provided to Veterans Benefits Administration's budget in 2011, I expect that we will shape and control the growth in claims, so that by 2015, we will be well on our way to eliminating the backlog," said Shinseki. As of April 5 2010, the backlog for pending claims is 517,271.

[J.B. Stone]

Agent Orange class action: ain't over yet?
http://www.cbc.ca/politics/insidepoliti ... r-yet.html
* April 12, 2010 4:42 PM |
* By Janyce McGregor

On April 1, the Newfoundland and Labrador Court of Appeal decertified a class action lawsuit brought by individuals seeking compensation for illness and other damages suffered as a result of the spraying of Agent Orange, Agent Purple and other defoliants at CFB Gagetown in New Brunswick.

News reports on Justice Margaret Cameron's decision suggested that individuals would now have to pursue their claims individually -- a legal process that could take much longer to resolve, and be far more expensive for those who claim to be suffering as a result of the spray program.

The federal government offered $20,000 in compensation for some individuals affected by the spray program. But this compensation package has been dismissed by critics as covering too few people, for too few diseases, over too short a time period.

From the start, some preferred to pursue damages collectively through a class action, instead of settling for what the government eventually offered.

Merchant Law Group represents the 3,000 individuals from across Canada who were part of this class action. I wondered: was this court decision really the end of the line for those seeking compensation through the class action?

Today I heard back from Casey Churko with Merchant Law:

On April 23, 2010, we are before the Newfoundland Court of Appeal to find out whether they will permit any class action to go forward there. If they answer in the negative, then we will next apply to the Supreme Court of Canada for leave to appeal the Court of Appeal's order.

So it a nutshell: no, it ain't over yet.

[J.B. Stone]

Vietnam vet honored in death
http://news.cincinnati.com/article/2010 ... d+in+death
By Malia Rulon • mrulon@gannett.com • April 19, 2010
WASHINGTON -- William Howard Hegge of Oxford was among 97 veterans remembered Monday at a memorial service honoring members of the armed forces who died prematurely as a result of their service in the Vietnam War era.

Hegge died six years ago of pancreatic cancer, which was caused by exposure to the herbicide Agent Orange while he fought in Vietnam, said his brother, David.

Hegge and others who died decades after the war ended don't qualify to have their names etched onto the Vietnam Veterans Memorial wall in Washington. Under Defense Department guidelines, only men and women who died from wounds suffered in combat zones are eligible. The wall contains 58,261 such names.

But the scars of war stretch far beyond those 58,261 deaths. Each year, the Vietnam Veterans Memorial Fund honors men and women whose noncombat deaths were related to their service, through either emotional suffering caused by their service or complications associated with exposure to Agent Orange, a herbicide used by the U.S. military to remove plants and leaves from foliage that provided enemy cover.

Nearly 2,000 veterans whose names don't qualify to be added to the wall have been honored since the annual memorial service began.

For many of their relatives, seeing their loved ones honored is an overdue but appreciated recognition for their sacrifice.

"It's closure, accountability and respect for the history and his service," Kelly Ongpin said of her father, William Black St. John, whose May 2009 death was tied to Agent Orange.

Hegge, who served in the Marine Corps, was wounded by mortar rounds during a battle in June 1969, for which he received the Purple Heart.

He lived 35 more years, going on to become an environmental biologist for the U.S. Fish & Wildlife Service. He also served as a natural resource specialist with the Bureau of Land Management in Colorado and as a soil conservationist with the U.S. Department of Agriculture.

For two years, he was assigned to an office at the Institute of Environmental Sciences at Miami University in Oxford, where he served as an adjunct faculty member.

David Hegge of Loveland said that family members were at the last-minute unable at attend the ceremony, but that he was honored to see his brother remembered.

"It's a good feeling that he's being recognized for what he did in Vietnam. It certainly pays tribute for what he did for the country and the sacrifices that he made," he said.

He added that although his brother died young, he had a good 54 years.

"He did what he loved. Most people can't say that," David Hegge said. "He was always proud of his service to the Corps."

Other Ohio veterans honored at Monday's ceremony include Jerry Bernard Kline of Akron; Michael Ray Dearth of Dayton; James Joseph Tyson of Liberty Township; John Daniel Johnson of Lorain; Donald Richard Staley of Mount Gilead; Michael Edward Tremmel of Sandusky; and Jerry Lawrence Degnan of Youngstown.

[J.B. Stone]

http://www.newswithviews.com/Roth/laurie216.htm



LET’S MAKE THE VETS WAIT FOR CARE UNTIL THEY ALL DIE



By Dr. Laurie Roth
May 28, 2010
NewsWithViews.com

This seems to be the philosophy of the Veterans Services (VA) administration. Just recently I interviewed Dick Phenneger www.vstnow.org, a leading, whistle blower, former vet and business man, who has investigated health care abuse to our veterans for many years at the hands of the VA. He shared enough violations and horrors with the VA against our troops that I couldn’t help thinking about the dreaded IRS. In my view, both should be gutted and started again with an emphasis in common sense, real service and ethics. Oh…..but back to the bigger than life problem.

Let me cut to the chase and give you a few bottom line facts regarding the VA.

First problem:

Records have been and are being destroyed. Back in 2009, a VA office in Detroit turned in 16,000 unprocessed mail and 717 unprocessed documents that were stuck in storage and hadn’t even been looked at. Many other documents were found in shredding bins, not just in one office but in several regional offices. Phenneger stated during our visit on my national radio show www.therothshow.com (listen to archive, dated May 25th, 1st hour www.therothshow.com) that almost 100% of the time that the typical response of the VA to inquiring and needy Vets seeking care is that ‘we do not have your records.’ Naturally, the responsibility and problem falls again and again on the needy vet, not the out of control, disorganized and corrupt VA that has actually lost, burned, shredded or misplaced the forms!

This is a CLEAR betrayal to our troops. I thought it was bad enough for our troops to face the politically correct crowd in our media and attitude of progressive leftists about this war, but now I find that they come home, needy and maimed from serving their country to face lost forms, hideous service and treatment way too late.

Second problem:

Vets have to complete a 23 page application with absurd amounts of detail, even if their injuries or disabilities are clear and simple. Not only is the form intimidating and TOO LONG, but Phenneger found that there there is a literal quagmire of legal documents and forms (80) to figure out. Many troops reported to Phenneger in his investigation that when asking for help to figure out which form to use, they were constantly told ‘that is your problem and responsibility, not ours.’

What often happens is the needy VET accidentally fills out the wrong form and 6 months later gets the standard refusal for care. They are told that they have to start again with a different form. Typically, another rejection comes 6 months after that and so on. One example Phenniger shared was of Leroy Comer, a Vietnam veteran who had spent over 21 years processing applications with nothing but denials and appeals.

Third problem:

VA policy is to reward denial of claims

Yes, the VA actually has a policy to give bonuses for denied claims. That must explain why 70% of the claims are refused or sent back to be redone. It is an absurd daisy chain which ends of betraying and abusing our troops even more than they already may have been!

Fourth problem:

The VA senior staff and management defend the employee bonus program which honors and rewards turn downs! They talk about their employee accountability, on and on. They seem to certainly be accountable alright….TO THE BROKEN, OUT OF CONTROL AND MISREPRESENTATIVE BUREAUCRACY, NOT THE VETS IN NEED OF CARE.

The VA is an out of control bureaucracy that seems to now exist mostly for itself, not for our vets and their needs. Just recently I had a caller on my radio show talking about his friend not able to get the extra benefits he needed because his file had been mysteriously burned in a fire, thus the VA couldn’t help him. He is told that is his problem not the VA. Naturally, the VET is suffering in the hospital and in need NOW, not years later.

It appears that 1000s of vets are in this situation, where they are filling out the wrong forms and getting turned down again and again. It appears that most of them are in endless wait mode trying to stay alive until they get some care.

Regardless of what the series of problems with the VA are, there is no excuse, especially in a time of war that our troops have to have any kind of delay or problem getting care.
They shouldn’t have to wait anymore than 2-3 weeks for care, not 6 months to 5 years!!! The sign up form (s) should be simplified and dramatically shortened and guidance and help offered before a VET fills out a form so they don’t make a costly mistake which denies them care!

If lack of money is the big problem according to the high up VA leaders then they should be marching into congress and demanding more! Our Government has wasted and spent hundreds of billions of dollars on rubbish. Certainly if they knew there was a budgeting need and revamping need for the VA to function right, they would respond. If they refuse to respond and fix this WE SHOULD ALL MARCH ON WASHINGTON, YELL, SUE, FAX, SCREAM AND DEMAND UNTIL THEY DO SOMETHING REAL ABOUT THIS. It is not just money or lack there of. It is an out of control, disorganized bureaucracy that has betrayed its real mission of health care to Vets, in a timely, affordable and clear manner.

I could care less what the high up leadership of the VA bureaucracy says about how proud they are of accountability, bonus structures and service. The facts are numerous and spreading far and wide, just like the BP oil spill, so their words are nothing but bull rot and lies!

IT IS TIME FOR THE TALK TO STOP AND A TOTAL OVERHAUL, FINANCIAL INTERVENTION AND MANAGERIAL CHANGE TO OCCUR WITH THE VA.

No longer is it acceptable to hear our leaders in congress, the White House, military and media ignore the ongoing treatment of our Vets at the hands of the VA.

© 2010 Dr. Laurie Roth - All Rights Reserved


Dr. Laurie Roth earned a black belt in Tae Kwon Do. In the late 90's, Laurie hosted and produced a successful PBS television show called "CD Highway" that aired nationally on 130 TV stations.

Tune in to The Roth Show, Weeknights from 7:00 to 10:00 pm PAC and find out for yourself! You can listen live on cable radio network (live on the internet) channel 6 or visit The Roth Show web site and click on "where to listen" www.therothshow.com Call the Roth Show at: 1-866-388-9093

E-Mail: Drljroth@aol.com

[J.B. Stone]

Vets have many options for health care, eligibility
Gregory Remus, Park Rapids Enterprise
Published: May 29, 2010 1:00:00 PM CDT


The most common question I receive from veterans is “Am I eligible for VA health care?” The answer is almost always a definite “Maybe”. Prior to January 2003 all veterans were eligible for VA health care. Because of budget cuts, the VA had to shut the door on many veterans and created a priority system to determine who is eligible and who is not. With that said, I’d like to take a shot at answering the question more completely.

The VA operates the nation’s largest integrated health care system with more than 1,300 sites of care, including hospitals, community clinics, nursing homes, domiciliaries, readjustment counseling centers, and various other facilities. The nearest facilities include the Brainerd and Bemidji Community Based Outpatient Clinics and the Fargo, Minneapolis and St Cloud VA Medical Centers.

For most veterans, entry into the VA health care system begins by sending in an application for enrollment. To apply, complete VA Form 10-10EZ, Application for Health Benefits. Once enrolled, veterans can receive services at VA facilities anywhere in the country.

You are automatically eligible if you fall into one of these categories:

1. Veterans with a service-connected disability of 50 percent or more.

2. Veterans seeking care for a disability the military determined was incurred or aggravated in the line of duty, but which VA has not yet rated, within 12 months of discharge.

3. Veterans seeking care for a service-connected disability only.

4. Veterans who served in combat locations during active military service after Nov. 11, 1998, are eligible for free health care services for conditions potentially related to combat service for five years following separation from active duty.

For all other veterans the VA will assign you to a priority group. The priority groups are listed below. You are eligible to enroll in VA health care if you fall into the top 7 priority groups. You are not eligible if you are assigned to priority group 8 unless you enrolled prior to January 2003.

I have used the VA Health Care System for the past 5 years and it works. The physicians and staff are professionals and the volunteers are friendly and helpful. The majority of veterans who use the system come away with positive impressions. If you are a veteran I encourage you to make application to use the VA Health Care System. We have the VA Fm 10-10EZ at our Office.

Group 1: Veterans with service-connected disabilities rated 50 percent or more and/or veterans determined by VA to be unemployable due to service-connected conditions.

Group 2: Veterans with service-connected disabilities rated 30 or 40 percent.

Group 3: Veterans with service-connected disabilities rated 10 and 20 percent, veterans who are former Prisoners of War (POW) or were awarded a Purple Heart, veterans awarded special eligibility for disabilities incurred in treatment or participation in a VA Vocational Rehabilitation program, and veterans whose discharge was for a disability incurred or aggravated in the line of duty.

Group 4: Veterans receiving aid and attendance or housebound benefits and/or veterans determined by VA to be catastrophically disabled. Some veterans in this group may be responsible for co-pays.

Group 5: Veterans receiving VA pension benefits or eligible for Medicaid programs, and non service-connected veterans and non compensable, zero percent service-connected veterans whose annual income and net worth are below the established VA means test thresholds.

Group 6: Veterans of the Mexican border period or World War I; veterans seeking care solely for certain conditions associated with exposure to radiation or exposure to herbicides while serving in Vietnam; for any illness associated with combat service in a war after the Gulf War or during a period of hostility after Nov. 11, 1998; for any illness associated with participation in tests conducted by the Defense Department as part of Project 112/Project SHAD; and veterans with zero percent service-connected disabilities who are receiving disability compensation benefits.

Group 7: Non service-connected veterans and non-compensable, zero percent service-connected veterans with income above VA’s national means test threshold and below VA’s geographic means test threshold, or with income below both the VA national threshold and the VA geographically based threshold, but whose net worth exceeds VA’s ceiling (currently $80,000) who agree to pay co-pays.

Group 8: All other non service-connected veterans and zero percent, non-compensable service-connected veterans who agree to pay co-pays.

The purpose of the Hubbard County Veteran Service Office is to provide assistance and support to eligible veterans, their dependents and survivors in obtaining benefits through the State and Federal Departments of Veterans Affairs, and to provide benefit counseling, claims service, referral and assistance in a variety of other programs. You can contact me at the Hubbard County Veteran Service Office at 201 Fair Ave, Park Rapids, (218) 732-3561. Have a great day!

[J.B. Stone]

...and, if you weren't sick enough ALREADY....

VA hospital may have infected 1,800 veterans with HIV
By the CNN Wire Staff

June 30, 2010 10:57 a.m. EDT

(CNN) -- A Missouri VA hospital is under fire because it may have exposed more than 1,800 veterans to life-threatening diseases such as hepatitis and HIV.

John Cochran VA Medical Center in St. Louis has recently mailed letters to 1,812 veterans telling them they could contract hepatitis B, hepatitis C and human immunodeficiency virus (HIV) after visiting the medical center for dental work, said Rep. Russ Carnahan.

Carnahan said Tuesday he is calling for a investigation into the issue and has sent a letter to President Obama about it.

"This is absolutely unacceptable," said Carnahan, a Democrat from Missouri. "No veteran who has served and risked their life for this great nation should have to worry about their personal safety when receiving much needed healthcare services from a Veterans Administration hospital."

The issue stems from a failure to clean dental instruments properly, the hospital told CNN affiliate KSDK.

KSDK: VA dental patients at risk of infection

Dr. Gina Michael, the association chief of staff at the hospital, told the affiliate that some dental technicians broke protocol by handwashing tools before putting them in cleaning machines.

The instruments were supposed to only be put in the cleaning machines, Michael said.

The handwashing started in February 2009 and went on until March of this year, the hospital told KSDK.

The hospital has set up a special clinic and education centers to help patients who may have been infected. However, Carnahan said he feels more should be done and those responsible should be disciplined.

"I can only imagine the horror and anger our veterans must be feeling after receiving this letter," Carnahan said. "They have every right to be angry. So am I."

This is not the first time this year a hospital has been in hot water for not following proper procedures.

In June, Palomar Hospital in San Diego, California, has sent certified letters to 3,400 patients who underwent colonoscopy and other similar procedures, informing the patients that there may be a potential of infection from items used and reused in the procedures.

http://www.cnn.com/2010/US/06/30/va.hos ... index.html

[J.B. Stone]

GET YOUR E-TICKET RIDE PASS HERE:

V.A. Easing Rules for Users of Medical Marijuana
Tony Demin for The New York Times

http://www.nytimes.com/2010/07/24/healt ... .html?_r=1

David Fox, an Army veteran, at home in Montana. He uses medical marijuana to help quiet the pain from neuropathy.

Published: July 23, 2010


DENVER — The Department of Veterans Affairs will formally allow patients treated at its hospitals and clinics to use medical marijuana in states where it is legal, a policy clarification that veterans have sought for several years.

A department directive, expected to take effect next week, resolves the conflict in veterans facilities between federal law, which outlaws marijuana, and the 14 states that allow medicinal use of the drug, effectively deferring to the states.

The policy will not permit department doctors to prescribe marijuana. But it will address the concern of many patients who use the drug that they could lose access to their prescription pain medication if caught.

Under department rules, veterans can be denied pain medications if they are found to be using illegal drugs. Until now, the department had no written exception for medical marijuana.

This has led many patients to distrust their doctors, veterans say. With doctors and patients pressing the veterans department for formal guidance, agency officials began drafting a policy last fall.

“When states start legalizing marijuana we are put in a bit of a unique position because as a federal agency, we are beholden to federal law,” said Dr. Robert Jesse, the principal deputy under secretary for health in the veterans department.

At the same time, Dr. Jesse said, “We didn’t want patients who were legally using marijuana to be administratively denied access to pain management programs.”

The new, written policy applies only to veterans using medical marijuana in states where it is legal. Doctors may still modify a veteran’s treatment plan if the veteran is using marijuana, or decide not to prescribe pain medicine altogether if there is a risk of a drug interaction. But that decision will be made on a case-by-case basis, not as blanket policy, Dr. Jesse said.

Though veterans of the Vietnam War were the first group to use marijuana widely for medical purposes, the population of veterans using it now spans generations, said Michael Krawitz, executive director of Veterans for Medical Marijuana Access, which worked with the department on formulating a policy.

Veterans, some of whom have been at the forefront of the medical marijuana movement, praised the department’s decision. They say cannabis helps soothe physical and psychological pain and can alleviate the side effects of some treatments.

“By creating a directive on medical marijuana, the V.A. ensures that throughout its vast hospital network, it will be well understood that legal medical marijuana use will not be the basis for the denial of services,” Mr. Krawitz said.

Although the Obama administration has not embraced medical marijuana, last October, in a policy shift, the Justice Department announced that it would not prosecute people who used or distributed it in states where it was legal.

Laura Sweeney, a spokeswoman for the Justice Department, would not comment spefically on the veterans department policy. “What we have said in the past, and what we have said for a while, is that we are going to focus our federal resources on large scale drug traffickers,” she said. “We are not going to focus on individual cancer patients or something of the like.”

Many clinicians already prescribe pain medication to veterans who use medical marijuana, as there was no rule explicitly prohibiting them from doing so, despite the federal marijuana laws.

Advocates of medical marijuana use say that in the past, the patchwork of veterans hospitals and clinics around the country were sometimes unclear how to deal with veterans who needed pain medications and were legally using medical marijuana. The department’s emphasis on keeping patients off illegal drugs and from abusing their medication “gave many practitioners the feeling that they are supposed to police marijuana out of the system,” Mr. Krawitz said.

“Many medical-marijuana-using veterans have just abandoned the V.A. hospital system completely for this reason,” he said, “and others that stay in the system feel that they are not able to trust that their doctor will be working in their best interests.”

In rare cases, veterans have been told that they need to stop using marijuana, even if it is legal, or risk losing their prescription medicine, Mr. Krawitz said.

David Fox, 58, an Army veteran from Pompey’s Pillar, Mont., uses medical marijuana legally to help quiet the pain he experiences from neuropathy, a nerve disorder. But he said he was told this year by a doctor at a veterans’ clinic in Billings that if he did not stop using marijuana, he would no longer get the pain medication he was also prescribed.

A letter written to Mr. Fox in April from Robin Korogi, the director of the veterans health care system in Montana, explained that the department did not want to prescribe pain medicine in combination with marijuana because there was no evidence that marijuana worked for noncancer patients and because the combination was unsafe.

“In those states where medical marijuana is legal, the patient will need to make a choice as to which medication they choose to use for their chronic pain,” Ms. Korogi wrote. “However, it is not medically appropriate to expect that a V.A. physician will prescribe narcotics while the patient is taking marijuana.”

Mr. Fox was shocked by the decision, he said.

“I felt literally abandoned,” he said. “I still needed my pain meds. I thought they were supposed to treat you. It was devastating for me.”

Mr. Fox, who said that at one point he was weaning himself off his pain medication for fear of running out, has held one-man protests in front of the clinic, carrying signs that read “Abandoned by V.A., Refused Treatment.”

Veterans officials would not comment on specific cases, citing medical privacy laws.

This month, Dr. Robert A. Petzel, the under secretary for health for the veterans department, sent a letter to Mr. Krawitz laying out the department’s policy. If a veteran obtains and uses medical marijuana in accordance with state law, Dr. Petzel wrote, he should not be precluded from receiving opioids for pain management at a veterans facility.

Dr. Petzel also said that pain management agreements between clinicians and patients, which are used as guidelines for courses of treatment, “should draw a clear distinction between the use of illegal drugs, and legal medical marijuana.”

Dr. Jesse, the veterans department official, said that formalizing rules on medical marijuana would eliminate any future confusion and keep patients from being squeezed between state and federal law.

Steve Fox, director of government relations for the Marijuana Policy Project, which favors the legal regulation of the drug, called the decision historic. “We now have a branch of the federal government accepting marijuana as a legal medicine,” he said.

But Mr. Fox said he wished the policy had been extended to veterans who lived in states where medical marijuana was not legal.

He said it was critical that the veterans department make its guidelines clear to patients and medical staff members, something officials said they planned on doing in coming weeks.

Said Dr. Jesse, “The whole goal of issuing a national policy is to make sure we have uniformity across the system.”

[J.B. Stone]

The dogs of war
Service animals can help veterans deal with the post-combat demons

Winnipeg Free Press - PRINT EDITION

By: Sandy Klowak

24/07/2010 1:00 AM |

Derrick Zimmerman returned from serving overseas with the Canadian Forces in the early '90s to find his life was a waking nightmare.

"I was living in a world that can only be likened to a hell on earth," said the veteran of the 1991 Gulf War and UN missions in 1992 and 1993.

Zimmerman was buckling under the weight of post-traumatic stress disorder. He suffered flashbacks, hypervigilance and nightmares that made it impossible to function in society. He felt suicidal.

His constant state of mental distress killed his marriage. His wife asked him to leave the home he had shared with her and their three children and he moved into an apartment on his own. He was unable to continue working and is now retired and on disability. Several stints in psychiatric clinics and dozens of daily mind-numbing pills later, Zimmerman was still unable to cope.

He thought, "There's got to be a better way than throwing all these meds down my throat."

So he started researching. He read online about psychiatric service dogs in the United States, helping people with a variety of mental illnesses, including depression, bipolar disorder and PTSD. The dogs help patients cope with daily life, similar to the way seeing-eye dogs help blind people lead independent lives.

But he found few organizations able to provide properly trained dogs in Canada.

So Zimmerman, who lives in Kingston, Ont., started Veteran Canine Connection, a charity that will raise money to train psychiatric service dogs for veterans with PTSD. It is a monumental task as training a dog can cost between $8,000 and $45,000, depending on the needs of the patient. Training costs add up quickly: It can sometimes take years to prepare a service dog for work and that training often consists of 24-hour trainer supervision.

Enter Winnipegger Lori Blande, who is working to get the charity, established in February 2010, up and running on the Prairies.

Blande had seen patients in hospitals and nursing homes respond well to her therapy dog when she took her to visit, something she had done for years. Mix in her military background -- she was a self-described military brat -- and she was an obvious fit for Veteran Canine Connection.

"I've had animals all my life. I know what animals can do for people," she said. "I saw the changes in people who didn't speak or people who weren't aware of their surroundings until the dog came in."

She said soldiers who are deployed overseas in the service of their country should be given everything that can help them when they return.

"We didn't send them away broken. But some of them are coming back broken and this is one way of helping them," she said.

Zimmerman agrees.

"People put yellow ribbons up and fly banners and all this. It's awful nice to support them when they're overseas. But what happens when they come home?"

Walter Gretzky and Sen. Joseph Day recently became patrons of Veteran Canine Connection. And Blande is working hard, networking with local groups to garner support. But the charity-in-the-making has its share of challenges. Organizers are still awaiting a charitable number, for one thing.

Further complications stem from the patchwork of regulations, which change from province to province and country to country, governing psychiatric service dogs. This leaves room for abuse, which Zimmerman understands as his service dog was ill-suited and poorly trained.

"It was supposed to come to me a trained service dog," he said of the animal he paid $6,000 for, who cannot function as a service dog and has now become more of a pet.

Terrance Green, an Ottawa lawyer who is blind, is working to set international standards through his group ASIST/Assister (Animal Services & Integrated Support Teams), which trains service animals to work with people with mental and physical disabilities.

Green said after years of public education, the mainstream accepts that service animals for the blind and deaf are necessary. But there are still miles to go in cases where people suffer from less-understood disabilities but would benefit from service animals.

"There are no standards, there is no certification and there's no one out there that people can go to and say, 'Can you help me? I need a service animal,' " Green said.

ASIST/Assister is developing criteria based on work done in the United States.

"We have been asking to clarify the standards and make usable standards that could be internationally accepted. They're just starting to be recognized. The value of animals... (that's) just starting to be understood."

Zimmerman's goal is to have Veteran Canine Connection work with ASIST/Assister and similar groups, funding training dogs to the standards they've set.

The soldier is disappointed Veterans Affairs Canada, which provides guide dogs to blind veterans, is not as supportive as he'd like.

A Veterans Affairs spokeswoman said they are keeping tabs on new therapies for PTSD but are not providing service dogs for PTSD patients at this time.

"VAC continues to monitor the research on effective treatment programs for PTSD, including the use of service animals," media relations adviser Flora Fahr said in an email.

Zimmerman chalks it up to a lack of understanding of PTSD.

"When I came home, I discovered something was wrong with me, but nobody in the military would acknowledge that," he said.

"The stigma is huge. The army considers you weak if you go to them for help."



For more information about the Veteran Canine Connection, visit veterancanineconnection.com

To donate to the cause, send cheque or money order to

Veteran Canine Connection Inc,

523 Portsmouth Avenue Suite 1004

Kingston, Ont., K7M 7H6

sandy.klowak@freepress.mb.ca

What is PTSD?

Called shell shock in the First World War, war neurosis in the Second, combat stress reaction in the Vietnam War and now post-traumatic stress disorder, this psychological response to extreme traumatic events has been around for ages. Classified as an anxiety disorder, it can affect people of all demographics who have lived through trauma, especially when it's life-threatening. For many, symptoms recede with time, but others struggle with PTSD for much of their lives as it reappears in a cyclical pattern. Symptoms can include nightmares and flashbacks to the event, feelings of emotional numbing and extreme guilt, among others.



What can dogs do for people?

Just as seeing-eye dogs help the blind find their way around, psychiatric service dogs can do the same for those struggling with mental disabilities that impair their ability to function, said Joan Esnayra of the U.S.-based Psychiatric Service Dog Society. Dogs, naturally very observant, are able to notice when their handler is on the verge of an episode and reflect that information back to them, providing the person awareness of their mental state so they can make adjustments.

Through dogs, "information is given to you in a way that's non-threatening and that you can trust," said Esnayra, who has bipolar disorder and has been working in the psychiatric service dog industry for 13 years.

It's not all about the canines

Service dogs are pretty commonplace these days, but what about service ferrets or service monkeys? Dogs make up roughly 85 per cent of service animals, but many other creatures can provide services to the disabled, said Terrance Green of ASIST/Assister. Ferrets have worked wonders with autistic children, he said, and monkeys are helpful for people with mobility issues. Monkeys take about seven years to train, Green said, but it's well worth it as their working life can be up to 35 years. Other surprising service animals include potbelly pigs and cats.

Republished from the Winnipeg Free Press print edition July 24, 2010 A6

[J.B. Stone]

Veterans Agency Made Secret Deal Over Benefits
By David Evans - Sep 14, 2010 10:12 AM MT


Sept. 14 (Bloomberg) -- Bloomberg Markets magazine's David Evans talks about an agreement between the U.S. Department of Veterans Affairs and Prudential Financial Inc. that enabled the insurer to withhold lump-sum payments of life insurance benefits for survivors of fallen soldiers. The veterans agency said today that Prudential will now send beneficiaries a check when they ask for a lump-sum benefit payment rather than keeping the money and mailing a checkbook. Evans speaks with Margaret Brennan on Bloomberg Television's "InBusiness".

Attachment: 2007 VA/Prudential Contract -- Part 1 of 3
Attachment: VA 1999 Internal E-Mail.
Signed Amendment To Prudential Contract

This signed amendment to Prudential's contract is the first document to show how Department of Veterans Affairs officials sanctioned a payment practice that has spurred investigations by lawmakers and regulators. Photographer: Jonathan Fickies/Bloomberg
Secretary of Defense Robert Gates


This signed amendment to Prudential's contract is the first document to show how Department of Veterans Affairs officials sanctioned a payment practice that has spurred investigations by lawmakers and regulators. Photographer: Jonathan

The U.S. Department of Veterans Affairs failed to inform 6 million soldiers and their families of an agreement enabling Prudential Financial Inc. to withhold lump-sum payments of life insurance benefits for survivors of fallen service members, according to records made public through a Freedom of Information request.

The amendment to Prudential’s contract is the first document to show how VA officials sanctioned a payment practice that has spurred investigations by lawmakers and regulators. Since 1999, Prudential has used so-called retained-asset accounts, which allow the company to withhold lump-sum payments due to survivors and earn investment income on the money for itself.

The Sept. 1, 2009, amendment to Prudential’s contract with the VA ratified another unpublicized deal that had been struck between the insurer and the government 10 years earlier -- one that was never put into writing, Bloomberg Markets magazine reports in its November issue. This verbal agreement in 1999 provoked concern among top insurance officials of the agency, the documents released in the FOIA request show.

For a decade, until the contract was formally changed, Prudential wasn’t fulfilling its obligations to survivors of fallen service members, says Brendan Bridgeland, an insurance lawyer who runs the non-profit Center for Insurance Research in Cambridge, Massachusetts.

‘Violated Terms’

“It’s very clear they violated the original terms of the contract,” says Bridgeland, who is retained by the National Association of Insurance Commissioners to represent consumers.

“Every veteran I’ve spoken with is appalled at the brazen war profiteering by Prudential,” says Paul Sullivan, who served in the 1991 Gulf War as an Army cavalry scout and is now executive director of Veterans for Common Sense, a nonprofit advocacy group based in Washington. “Now vets are upset at the VA’s inability to stop Prudential’s bad behavior.”

That the VA allowed Prudential to issue retained-asset accounts for 10 years while the contract required lump-sum payouts is “more evidence that the VA was asleep at the wheel for a decade,” says Sullivan, who was a project manager and analyst at the VA from 2000 to 2006.

“When grieving families check the box that they want a lump sum, they should get it. We remain disappointed and irate at the VA’s failure to provide advocacy for veterans,” he says.

State and U.S. Probes

Since July 28, when Bloomberg Markets first reported that Prudential sent checkbooks instead of checks to survivors requesting lump-sum payouts, state and federal officials have demanded the retained-asset system be investigated and reformed. The VA itself launched a probe of its life insurance program the day the first story was published.

The next day, New York Attorney General Andrew Cuomo launched what he called a “major fraud investigation” of Prudential and other life insurers over their use of retained- asset accounts. Since then, Cuomo’s office has issued subpoenas to Prudential and at least 12 more insurance companies.

The insurance departments in Georgia and New York have also opened probes. The U.S. House Oversight and Reform Committee plans to hold hearings into Prudential’s use of retained-asset accounts to pay money owed to fallen soldiers’ survivors.

‘News to Me’

U.S. Secretary of Defense Robert Gates -- who was in office when the 2009 agreement was signed -- said when the VA started its probe that he had been unaware that survivors were being sent retained-asset accounts.

“Until today I actually believed that the families of our fallen heroes got a check for the full amount of their benefits,” Gates said at the time. “This came as news to me.”

As a result of the VA probe, the agency announced today that it will change its insurance program, allowing survivors to request and receive lump-sum checks.

Under Prudential’s original 1965 contract with the VA and a 2007 revised contract -- both of which were released as part of the FOIA response -- the insurer is required to send lump-sum payouts to survivors requesting them. The contract covers 6 million active service members, their families and veterans.

The checkbooks Prudential sends to survivors are tied to what the insurer calls its Alliance Account. The checkbooks are made up of drafts, or IOUs, and aren’t insured by the Federal Deposit Insurance Corp. Prudential invests the survivors’ money in its general corporate account, where it can earn the insurer as much as eight times as much as it currently pays in interest to beneficiaries.

Bond Income

Prudential held $662 million of survivors’ money in its corporate general account as of June 30, according to information provided by the VA. Prudential’s general account earned 4.2 percent in 2009, mostly from bond investments, according to regulatory filings. The company has paid survivors holding Alliance Accounts 0.5 percent in 2010.

Families that were supposed to receive lump-sum payments under the terms of the contract before it was amended in 2009 may be able to successfully sue Prudential for lost interest, insurance lawyer Bridgeland says.

“Survivors would have a very strong claim for interest earned by Prudential on their money,” he says.

Prudential spokesman Bob DeFillippo says his company is following the terms of its agreement with the VA.

“Prudential is in compliance with its contract with the Department of Veterans’ Affairs,” he says.

DeFillippo declined to comment on whether Prudential was in compliance with its contract between 1999 and September 2009 or to answer any other questions. Prudential chairman and Chief Executive Officer John Strangfeld declined to comment for this story.

Useful Service

In July, DeFillippo said Prudential’s retained-asset account was a useful service for bereaved relatives of soldiers. “For some families, the account is the difference between earning interest on a large amount of money and letting it sit idle,” he said. Survivors can withdraw some or all of their money at any time, he said.

Veterans Affairs Chief of Staff John Gingrich says the agency approved use of the Alliance Account because it wanted to help survivors.

“We needed to give an option to individuals that allowed them more flexibility and time to react to the tragic family situation,” Gingrich says.

Verbal Agreement

VA spokeswoman Katie Roberts declined to say when Veterans Affairs Secretary Eric Shinseki, who was appointed by President Barack Obama in January 2009, learned of the existence of the 1999 verbal agreement and the 2009 amendment. She also declined to make Shinseki available for comment.

The VA official who verbally agreed in 1999 to allow Prudential to change the terms of the 1965 contract and begin offering retained-asset accounts was Thomas Lastowka, the VA’s director for insurance, according to Dennis Foley, a VA attorney. Prudential began sending Alliance Account kits to soldiers’ beneficiaries in June 1999.

Foley says the VA and Prudential would have been better off if they had put their 1999 agreement in writing.

“Could that have been done better?” Foley asks. “Probably. Best practice would have been to legally memorialize it at the time.”

Foley says the 1999 changes to the 1965 contract were valid, even if they weren’t in writing, because they were made by mutual agreement by people empowered to make such decisions.

“It was changed by somebody who was authorized to change it,” he says.

Contract Terms

The language of both the 1965 contract and the 2009 amendment make clear that Newark, New Jersey-based Prudential was required to adhere to the original terms until 2009, regardless of any handshake agreements in 1999, insurance lawyer Bridgeland says.

The 1965 contract says any alterations must be made in writing.

“No change in the Group Policy shall be valid unless evidenced by an amendment thereto,” it says. “No Agent is authorized to alter or amend the Group Policy.”

The VA and Prudential signed a revised contract in 2007, saying it was “amended in its entirety.” That contract, with the exact same words as the 1965 agreement, required that Prudential pay survivors with lump sums.

The 2007 revision included the same procedures in the 1965 agreement requiring any changes be made in writing. It contained no mention of the retained-asset system, or of the verbal agreement struck in 1999.

2009 Amendment

It wasn’t until Sept. 24, 2009, that the changes agreed to by VA official Lastowka and Prudential in 1999 were put into writing. The 2009 amendment allowing Prudential to hold onto death benefit payouts was made retroactive to Sept. 1, 2009, not back to 1999.

By putting in writing a change that was verbally adopted 10 years earlier, the VA is effectively trying to backdate the amendment, says Jeffrey Stempel, an insurance law professor at the William S. Boyd School of Law at the University of Nevada, Las Vegas, who wrote ‘Stempel on Insurance Contracts’ (Aspen Publishers, 2009).

“They’re trying to reinvent history,” Stempel says. “You really can’t do that. This is a blatant giveaway by the VA with nothing for the agency or the people in uniform.”

Nine of every 10 survivors ask Prudential for lump-sum payments, the VA says. Prudential sends those families “checkbooks” instead of checks.

‘Disasters Do Happen’

Documents released in the FOIA request show some signs of concern within the VA after Prudential proposed the retained- asset accounts in 1998. Lastowka, the official who allowed Prudential to introduce the Alliance Accounts, said that the insurer’s “checkbook” system wasn’t protected by the FDIC.

“Disasters do happen,” wrote Lastowka, in an e-mail dated June 9, 1999, to Stephen Wurtz, the agency’s deputy assistant director for insurance.

Lastowka said in his e-mail that the lack of FDIC coverage could backfire on survivors.

“Who is responsible if Alliance goes belly up?” Lastowka asked. “I think we have to also be prepared to defend the use of the Alliance Account.”

Lastowka also asked whether Prudential had adequately disclosed to survivors that the Alliance Accounts weren’t covered by FDIC insurance. “Did Pru alert us to the non-FDIC fact?” he wrote to Wurtz. “Or was it in small print as the notice to beneficiaries?”

Documents turned over by the VA didn’t include a response from Wurtz.

‘Aware of Issues’

Lastowka says his e-mail shows the decision to allow Alliance Accounts was carefully considered.

“This e-mail demonstrates simply that the VA’s Insurance program was aware of issues that might be raised as we implemented the payment method and that we should be prepared to respond to inquiries,” Lastowka says. “We were confident that we were making a decision which would benefit survivors.”

The FOIA documents show that on June 10, 1998, Prudential gave a presentation to the VA. It included 10 pages of key points, saying the Alliance Accounts would benefit survivors because they would provide safety, flexibility in how and when to use their money, competitive interest rates and customer service.

In fine print, at the bottom of one of the pages, was this caveat: “Funds in the Alliance Account are direct obligations of The Prudential Insurance Company of America and are not insured by the Federal Deposit Insurance Corporation.”

Sheila Bair

Twelve years later, the issue of the lack of FDIC protection in retained-asset accounts flared anew.

FDIC Chairman Sheila Bair said in August that consumers could incorrectly conclude that retained-asset accounts were insured by the FDIC.

“The insurance company must take care to avoid implying in any way that these accounts are in fact FDIC-insured,” she wrote in an Aug. 5 letter to state insurance regulators.

Some families of veterans have taken their complaints to court. Five survivors filed a federal fraud lawsuit in Boston on Aug. 30 against Prudential claiming the insurer has earned as much as $500 million in profits by improperly keeping beneficiaries’ money instead of paying it out in a lump sum.

The suit, Lucey vs. Prudential Insurance Co. of America, says the insurer fraudulently claims to beneficiaries that the Alliance Account is a lump sum.

‘This Ruse’

“Initiation of this ruse does not constitute payment of anything to anyone,” the suit says. “The Alliance Account is merely a bookkeeping device used by Prudential to hold on to beneficiaries’ money.”

Prudential hasn’t yet filed a response in court. Spokesman DeFillippo says he can’t comment on the case.

“It is important to note that several federal judges have rejected claims against accounts like our Alliance Account, concluding that beneficiaries are in virtually the same position they would be in had the insurer sent them a check,” DeFillippo says. He cited the dismissal of a case against MetLife Inc. on Sept. 10.

Insurance contract professor Stempel says that regardless of the outcome of that lawsuit, it’s clear that Prudential and the VA wrongly manipulated a federal contract at the expense of military members and their relatives. “At a minimum, survivors ought to be made whole with their missed interest,” he says. “The VA really seems to have had the best interests of the insurance company at heart, instead of those of the soldiers and their families.

To contact the reporter on this story: David Evans in Los Angeles at davidevans@bloomberg.net.

http://www.bloomberg.com/news/2010-09-1 ... efits.html

[J.B. Stone]

VA PUBLISHES AGENT ORANGE PRESUMPTION GUIDELINES

AMVETS applauds extension of benefits for exposed Vietnam veterans

LANHAM, Md., Aug. 30, 2010—This morning the Department of Veterans Affairs published its final guidelines in the Federal Register, outlining how VA will handle benefits claims for presumptive conditions resulting from exposure to the dangerous defoliant Agent Orange during the Vietnam War.

AMVETS leaders applauded the decision to extend benefits to veterans suffering from three new presumptive conditions-- Parkinson’s disease, ischemic heart disease, and chronic lymphocytic leukemias, including all chronic B cell leukemias, such as hairy cell leukemia.

“The latest presumptions will finally ensure that veterans exposed to Agent Orange will be cared for and appropriately compensated through the VA system,” said AMVETS National Commander Jerry Hotop. “AMVETS now urges Congress to approve VA’s guidelines so that veterans can start to receive the care and benefits they deserve.”

Congress has 60 days to review the new guidelines before VA can start to pay the new benefit. The Senate is currently scheduled to review the new regulations in a hearing on Sept. 23 and VA expects to be able to process its first new presumptive claims by November.

For new claims, VA may pay benefits retroactive to the effective date of the regulation or to one year before the date VA receives the application, whichever is later. For pending claims and claims that were previously denied, VA may pay benefits retroactive to the date it received the claim.

Any veteran who served in Vietnam between Jan. 9, 1962, and May 7, 1975, is presumed to have been exposed to herbicides like Agent Orange. Under the new regulation, a veteran who served in Vietnam during that time period who has developed a presumptive condition will not need to prove that the condition was a direct result of herbicide exposure.

Critics of the new presumptions are concerned that veterans suffering from conditions like ischemic heart disease could have developed the condition through causes other than herbicide exposure. However, AMVETS believes the presumption should remain, even if a handful of undeserving veterans could receive benefits.

“We know Agent Orange can lead to these problems, which is why VA created the presumptions based on years of hard evidence,” said Hotop. “To AMVETS, that’s enough. We would rather see a veteran who developed the condition under questionable circumstances receive care and compensation than put one more deserving Vietnam veteran through the ordeal of proving whether or not his particular disease resulted from Agent Orange exposure nearly three decades ago.”

VA expects more than 150,000 veterans to file claims under the new presumptions within the next 12-28 months, and the department also plans to review up to 90,000 previously denied claims for the presumptive conditions.

VA encourages potentially affected veterans to file their claims today to help expedite the process. AMVETS National Service Officers stand ready to assist potentially affected veterans in navigating the claims process at VA Regional Offices nationwide. To find you nearest AMVETS National Service Officer, visit http://www.amvets.org/service/national_ ... icers.html.

About AMVETS:
A leader since 1944 in preserving the freedoms secured by America’s armed forces, AMVETS provides support for veterans and the active military in procuring their earned entitlements, as well as community service and legislative reform that enhances the quality of life for this nation’s citizens and veterans alike. AMVETS is one of the largest congressionally-chartered veterans’ service organizations in the United States, and includes members from each branch of the military, including the National Guard and Reserves. To learn more visit www.amvets.org.

[J.B. Stone]

Latest VA and Agent Orange News: List of Presumptive Diseases

March 26th, 2010 ·

This is just out from the VA.

VA Proposes Change to Aid Veterans Exposed to Agent Orange

Proposed Regulation Change Adds Illnesses to List of Diseases Subject to Presumptive Service Connection for Herbicide Exposure

WASHINGTON – Well over 100,000 Veterans exposed to herbicides while serving in Vietnam and other areas will have an easier path to qualify for disability pay under a proposed regulation published by the Department of Veterans Affairs (VA) that adds three new illnesses to the list of health problems found to be related to Agent Orange and other herbicide exposures.

“This is an important step forward for Vietnam Veterans suffering from these three illnesses,” said Secretary of Veterans Affairs Eric K. Shinseki. “These warriors deserve medical care and compensation for health problems they have incurred.”

The regulation follows Shinseki’s October 2009 decision to add the three illnesses to the current list of diseases for which service connection for Vietnam Veterans is presumed. The illnesses are B cell leukemias, such as hairy cell leukemia; Parkinson’s disease; and ischemic heart disease.

The Secretary’s decision is based on the latest evidence of an association with widely used herbicides such as Agent Orange during the Vietnam War, as determined in an independent study by the Institute of Medicine (IOM).

Even though this is a proposed rule, VA encourages Vietnam Veterans with these three diseases to submit their applications for compensation now so the Agency can begin development of their claims and so they can receive benefits from the date of their applications once the rule becomes final.

Comments on the proposed rule will be accepted over the next 30 days. The final regulation will be published after consideration of all comments received.

“We must do better reviews of illnesses that may be connected to service, and we will,” Shinseki added. “Veterans who endure health problems deserve timely decisions based on solid evidence.”

Over 80,000 of the Veterans will have their past claims reviewed and may be eligible for retroactive payment, and all who are not currently eligible for enrollment into the VA healthcare system will become eligible.

During the Vietnam War, the U.S. military used more than 19 million gallons of herbicides for defoliation and crop destruction in the Republic of Vietnam. Veterans who served in Vietnam anytime during the period beginning January 9, 1962, and ending on May 7, 1975, are presumed to have been exposed to herbicides.

Used in Vietnam to defoliate trees and remove concealment for the enemy, Agent Orange and other herbicides left a legacy of suffering and disability that continues to the present.

The new rule will bring the number of illnesses presumed to be associated with herbicide exposure to 14 and significantly expand the current leukemia definition to include a much broader range of leukemias beyond chronic lymphocytic leukemia previously recognized by VA.

In practical terms, Veterans who served in Vietnam during the war and who have a “presumed” illness don’t have to prove an association between their illnesses and their military service. This “presumption” simplifies and speeds up the application process for benefits.

Other illnesses previously recognized under VA’s “presumption” rule as being caused by exposure to herbicides during the Vietnam War are:

· AL Amyloidosis,

· Acute and Subacute Transient Peripheral Neuropathy,

· Chloracne or other Acneform Disease consistent with Chloracne,

· Chronic Lymphocytic Leukemia, (now being expanded)

· Diabetes Mellitus (Type 2),

· Non-Hodgkin’s Lymphoma,

· Porphyria Cutanea Tarda,

· Prostate Cancer,

· Respiratory Cancers (Cancer of the lung, bronchus, larynx, or trachea), and

· Soft Tissue Sarcoma (other than Osteosarcoma, Chondrosarcoma, Kaposi’s sarcoma, or Mesothelioma).

Additional information about Agent Orange and VA’s services for Veterans exposed to the chemical are available at www.publichealth.va.gov/exposures/agentorange.

Vietnam Veterans Benefit From Agent Orange Rules
Vietnam veterans may be eligible for compensation and health care for certain diseases associated with Agent Orange, the defoliant sprayed to unmask enemy hiding places in the jungles throughout Vietnam.

Special health care and compensation benefits are available to the 2.6 million men and women who served in Vietnam between 1962 and 1975, only 3,300 of whom remain in uniform today. Those discharged during that period are the largest group of veterans receiving VA health care and monthly compensation.

A small percentage of their disability claims are for illnesses that scientists have listed as being associated with Agent Orange. VA presumes that all military personnel who served in Vietnam were exposed to Agent Orange, and federal law presumes that certain illnesses are a result of that exposure. This "presumptive policy" simplifies the process of receiving compensation for these diseases since VA foregoes the normal requirements of proving that an illness began or was worsened during military service.

Based on clinical research, these diseases are on VA's Agent Orange list of presumptive disabilities.

In addition, monetary benefits, health care and vocational rehabilitation services are provided to Vietnam veterans' offspring with spina bifida, a congenital birth defect of the spine. Children of female veterans who served in Vietnam are authorized health care and monetary benefits for certain additional birth defects.

Veterans who served in Vietnam during the war also are eligible for a complete physical examination. If a VA physician suspects a disease might be related to Agent Orange, VA will provide free medical care. Those who participate in the examination program become part of an Agent Orange Registry and receive periodic mailings from VA about the latest Agent Orange studies and new diseases being covered under VA policies.

Vietnam veterans and their families can contact VA for more information about these benefits. For the Agent Orange Registry physical examination, call a local VA hospital or clinic listed in the government pages of your phone book. To file a compensation claim for a current disability related to Agent Orange, veterans can call 1-800-827-1000 for an application form or visit VA's Web site at: http://vabenefits.vba.va.gov.

Agent Orange: Birth Defects in Children of Vietnam Veterans

VA has recognized certain birth defects associated with exposure to Agent Orange or service in Vietnam:

* Spina Bifida (except Spina Bifida Occulta)
A neural tube birth defect that results from the failure of the bony portion of the spine to close properly in the developing fetus during early pregnancy.
* Birth Defects in Children of Women Vietnam Veterans
Covered birth defects include a wide range of conditions associated with women veterans' service in Vietnam.

Benefits

Vietnam veterans’ children with spina bifida or covered birth defects may be eligible for:

* Health care benefits
* Compensation and other benefits

More Information on Agent Orange

* Agent Orange Basics
* Diseases Associated with Agent Orange Exposure
* Agent Orange Registry Health Examination for Veterans
* Health Care Benefits for Diseases Associated with Agent Orange Exposure
* Compensation for Diseases Associated with Agent Orange Exposure
* Research on Health Effects of Agent Orange Exposure
* Resources for Treating and Diagnosing Health Effects of Agent Orange Exposure
* Educating Veteran Patients
* Updates on Agent Orange Research and What VA Is Doing

http://www.publichealth.va.gov/exposure ... efects.asp

VA CONFIRMS NEW AGENT ORANGE PRESUMPTIVE DISEASES -- NOW WHAT?

Approval of ischemic heart disease expected to clog VA's already backlogged disability benefits system.

by Larry Scott, VA Watchdog dot Org



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

Yesterday we presented an article from The New York Times about the VA adding three new presumptive diseases to the Agent Orange exposure roster. That article is here ...
http://www.vawatchdog.org/09/nf09/nf
oct09/nf101309-5.htm

Now, the VA has confirmed this and issued an explanatory press release.

The diseases are: Parkinson's disease, hairy-cell leukemia and ischemic heart disease.

The addition of ischemic heart disease caught many, including myself, by surprise as it opens the door to what could be a tidal wave of claims.

Veterans' Advocate Jim Strickland has similar thoughts and offers the following:

At first glance I couldn't believe that James Dao of The New York Times had made such a mistake. And I told him so. There wasn't enough evidence for Secretary Shinseki to declare Ischemic Heart Disease as a presumptive condition to Agent Orange exposure in Vietnam veterans for one thing. The medical definitions and causes of ischemic heart disease also make it impossible to single out ischemic heat disease and ignore carotid artery disease or claudication.

Ischemic heart disease is caused by conditions that affect the arteries supplying blood to the heart. Most often that condition is referred to as atherosclerosis, sometimes known as hardening of the arteries. If those arteries in the heart are diseased, so too are the arteries in the rest of the body. In other words, you don't have heart disease, you have artery disease. Even if the arteries in your heart are affected first, you're likely to have a sort of total body disease of all the major arteries.

Obstructive Coronary Artery Disease (CAD) is the most common cause of ischemic heart disease. Coronary Artery Disease is caused by atherosclerosis, more commonly known as "hardening of the arteries". Atherosclerosis is a progressive disease that affects all the arteries in the body. Due to known risk factors like hypertension (high blood pressure), smoking, high cholesterol, family history, male gender and obesity, CAD is the leading cause of death in America.

CAD (or ischemic heart disease) isn't a single disease that's easy to define and separate from other closely related issues. A patient with CAD often has similar disease processes in the nearby carotid arteries. The carotids are the vessels in the neck that take fresh blood to the brain. When those vessels are obstructed by atherosclerosis, a stroke may occur. The similarity is such that strokes are sometimes called "brain attacks", similar in nature to heart attacks.

Ischemic heart disease can lead to arrhythmias...those unsynchronized heart beats that may require powerful medicines or even a pacemaker to treat. In some very deadly arrhythmias an Automatic Implantable Cardiac Defibrillator (AICD) can be required to prevent sudden death syndrome.

Now that Secretary Shinseki has approved that "ischemic heart disease" is a presumptive condition for the Vietnam veteran, the mind boggles with the associated conditions that must also apply.

If you are a Vietnam veteran and have angina, shortness of breath, any arrhythmia, any vascular disease (heart, renal, carotid, leg, ED), or any other condition that might be associated with ischemic heart disease, you should begin to file and set your effective date.

If you've ever been denied a benefit for heart disease of any sort, you should begin to file and protest the earlier denial.

The kinks will be ironed out as we see what this brings to us. My bet is that there are easily tens of thousands of veterans who will be eligible for the ischemic heart disease benefit and that many more who will see associated benefits come their way.

If you thought VA was behind in processing claims before...wait a few months, you ain't seen nothing yet.

----------

The Institute of Medicine (IOM) report which brought about these changes can be found here ...
http://www.vawatchdog.org/09/nf09/nfjul ... 2609-2.htm

Use our search engine for more about Agent Orange ... click here ...
http://www.yourvabenefits.org/sessearch.
php?q=agent+orange&op=ph

Diabetes Mellitus (Type II) As A Presumptive Condition for In-Country Vietnam Veterans - Fact Sheet
Diabetes mellitus (Type II, adult onset) has been added as a presumptive condition for in-country Vietnam veterans. Acting Secretary Herschel Gober announced this action on November 9, 2000. In-country service in Vietnam presumes exposure to the herbicide Agent Orange if the veteran meets the criteria outlined in 38 CFR §3.313 regarding dates of service and the condition being claimed is one listed in 38 CFR §3.307 (6)iii. VA is in the process of writing the regulations, which will govern the adjudication of claims for diabetes as a presumptive condition and add diabetes to the aforementioned section of 38 Code of Federal Regulations. (If you do not have Microsoft Word software installed, you may download free viewer and reader software to view all the regulation documents cited on this page.)

http://www.vba.va.gov/bln/21/benefits/h ... abete1.htm

[J.B. Stone]

TRICARE Eligibility

TRICARE is a health benefit program for all seven uniformed services: the Army, Navy, Marine Corps, Air Force, Coast Guard, Public Health Service, and the National Oceanic and Atmospheric Administration. To use TRICARE, you must be listed in DEERS as being eligible for military health care benefits. If you don ’t find answers to your eligibility questions in this section, check with your military service personnel office for specific information.

TRICARE-eligible persons include the following:

* Active duty service members
Note: Active duty service members and activated National Guard or Reserve Members must enroll in one of the TRICARE Prime options:
o TRICARE Prime
o TRICARE Prime Remote
o TRICARE Prime Overseas
o TRICARE Global Remote Overseas
* Spouses and unmarried children of active duty service members

* Uniformed service retirees, their spouses, and unmarried children

* Medal of Honor (MOH) recipients and/or their families.
* Un-remarried former spouse and unmarried children of active duty or retired service members who have died Note: Family members of active duty service members who died while on active duty, and who were on active duty for at least 31 days before death, will continue to be treated as active duty family members for TRICARE cost-sharing purposes for 3 years after their active duty sponsor dies.

* Spouses and unmarried children of reservists and National Guard who are ordered to active duty for more than 30 consecutive days (they are covered only during the reservist ’s active duty tour) or of reservists and National Guard who die on active duty.

* Spouses and unmarried children of reservists and National Guard who die as a result of a line of duty condition may be eligible for health care.

* Persons who have received the Medal of Honor, and their family members, who are not otherwise TRICARE eligible. These persons will be able to obtain health care benefits under TRICARE in the same manner as if they were entitled to retired pay.

* Unmarried children up to age 21 (including stepchildren who are adopted by the sponsor) are still covered by TRICARE even if the spouse gets divorced or remarried. But in the case of a stepchild who was not adopted by the sponsor and the marriage ends in divorce, the stepchild loses eligibility on the date the divorce decree is final. It should be emphasized that stepchildren don ’t have to be adopted by the sponsor to be covered by TRICARE while the sponsor and the mother or father of the stepchildren remains married. A child aged 21 or over may be covered if he or she is severely disabled and the condition existed prior to the child ’s 21st birthday —or, if the condition occurred between the ages of 21 and 23 while the child was enrolled in a full-time course of study in an approved institution of higher learning and is, or was at the time of the sponsor ’s death, dependent on the sponsor for more than one-half of his or her support. A child may also be covered up to the 23rd birthday if he or she is in school full-time.

* Children placed in the custody of a service member or former member, by a court of law; or by a recognized adoption agency in anticipation of legal adoption by the member. TRICARE eligibility is effective July 1, 1994, if a court of law places the child. A child placed by a recognized adoption agency is eligible effective October 5, 1994.

* Children of current or former service members or their spouses born out of wedlock may be eligible for TRICARE benefits under certain conditions. Check with your Beneficiary Counseling and Assistance Coordinator (BCAC)/Health Benefits Adviser (HBA), or TRICARE Service Center (TSC).

* Certain family members of active duty service members who were court-martialed and separated for spouse or child abuse. The victims of the abuse within the family are eligible for health benefits for the period that the abused family member is receiving “transitional compensation ” under Section 1059 of Title 10, U.S. Code. Cost sharing will be the same as for other active duty families.
Click here to find out more!


* Certain abused spouses, former spouses, and dependent children of service members who were eligible for retirement, but had that eligibility taken away as a result of abuse of the spouse or child. This benefit is effective for medically necessary services and supplies provided under TRICARE Standard (CHAMPUS) on or after October 23, 1992.

* Spouses and children of North Atlantic Treaty Organization (NATO) and "Partners for Peace" (PFP) nation representatives who are officially accompanying the NATO or PFP nation representatives while stationed in, or passing through, the United States on official business. These family members are eligible for outpatient benefits only (including ambulatory surgery). They are not listed in the DEERS files, and should check with a BCAC/HBA/TSC for assistance before getting care or filing claims. (NATO and PFP family members cannot enroll in TRICARE Prime.)

* Former spouses of active, retired or former military members may be eligible for TRICARE if they meet the following requirements:
1. Must not have remarried. (If remarried, the loss of benefits remains applicable even if the remarriage ends in death or divorce.)
2. Must not be covered by an employer-sponsored health plan.
3. Must not be the former spouse of a North Atlantic Treaty Organization or Partners for Peace nation member.

http://www.military.com/benefits/tricar ... ligibility

TRICARE Inpatient Costs Increase for Fiscal Year 2010
September 30, 2009
TRICARE Press Release

FALLS CHURCH, Va. – Every year the costs for TRICARE-covered inpatient services are reviewed and are subject to change. For the coming fiscal year 2010, which runs from Oct. 1, 2009 to Sept. 30, 2010, the increase for some out-of-pocket costs paid by TRICARE Standard beneficiaries at civilian hospitals for inpatient care and inpatient behavioral health services is small.

For active duty family members using TRICARE Standard and TRICARE Extra, the daily cost share for inpatient admissions at civilian hospitals has increased from $15.65 to $16.30 per day or $25 per admission, whichever is greater. There is no charge for separately billed professional services.

The daily cost share for retirees, their families and other eligible beneficiaries using TRICARE Standard for inpatient admissions at civilian hospitals has increased from $535 to $645 per day or 25 percent of the total charge, whichever is less. Additionally, these beneficiaries pay 25 percent of the TRICARE-allowable charge for separately billed professional services.

The out-of-pocket costs for retirees, their families and other eligible beneficiaries for inpatient behavioral health services at low-volume civilian hospitals has increased from $193 to $197 per day or 25 percent of the billed charge, whichever is less.

For additional information about copayments and cost-shares for TRICARE-covered services, visit our website
http://www.military.com/news/article/tr ... -2010.html

Higher TRICARE premiums on Gates' cost-cut agenda
Last updated
Wednesday, August 18, 2010 - 6:00pm


Defense Secretary Robert Gates has signaled that the department's fiscal 2012 budget request to be sent to Congress early next year will include recommendations to raise TRICARE premiums for some beneficiaries.

If past proposals are a reliable guide, the target of higher fees is likely to be military retirees rather than active duty families. The Bush administration had tried for three straight years to raise fees for working age retirees. Congress blocked those efforts.

Defense officials hope lawmakers, facing with mounting federal debt and tightening defense budgets, will be more receptive to the argument that TRICARE fees haven't been raised since they were set in 1995.

During a Pentagon press conference where he unveiled a host of initiatives to cut "overhead" in defense budgets, including shutting down the Joint Forces Command in Norfolk, Va., Gates said proposals to control burgeoning health care costs will be unveiled in the months ahead.

The issue arose when Gates was asked by a reporter when it would be time to control rising health care costs, either through TRICARE premium increases or reducing plan coverage. "Yesterday," Gates responded.

"Health-care reform is on my agenda," he added. It will be part of a new "track" of cost-cutting reforms identified by the Quadrennial Defense Review and endorsed by other reports for curbing defense spending.

"And so we have studies going on now...that will help shape our FY '12 budget submission. They involve logistics. They involve health care and personnel policies, more restructuring and organizational changes [and] continued acquisition reform."

Gates continued, "There are no sacred cows, and health care cannot be excepted" from cost-control plans, not to lower overall defense budgets but to free up funds for more pressing defense needs.

"Everybody knows that we're being eaten alive by health care. I believe there is a growing understanding on [Capitol] Hill about this. It cost us $19 billion in 2000 or 2001. It'll cost us over $50 billion in FY '11, and will cost us about $65 billion in FY '15. And particularly when the top line [of defense budgets] is only growing at a percent or thereabouts, it's unsustainable and therefore it has to be a part of our effort."

Dr. Jonathan Woodson, nominated to take charge of health care policy as the new assistant secretary of defense for health affairs, stayed mum on the hot-button issue of higher TRICARE fees during his Aug. 3 confirmation hearing before the Senate Armed Services Committee.

Asked by Committee Chairman Carl Levin (D-Mich.) how he would address rising health costs, Woodson said, "What we need to do is work with a number of constituents and try and stem rise of that cost." He referred to more cost-efficient "therapies" and addressing "waste in the way we deliver care because of the culture of medicine. And there's opportunity to decrease the variability of care that might result in cost savings."

Sen. John McCain, ranking committee Republican, said Woodson's major challenge will be getting costs under control. McCain questioned whether he can do it, given the steady rise of national health costs.

Woodson, an Army Reserve brigadier general and vascular surgeon who has deployed in most every recent conflict, is Army assistant surgeon general for force management, mobilization, readiness and reserve affairs.

In his written responses for the committee, Woodson said retirees and their families are 53 percent of all TRICARE beneficiaries and account for 57 percent of the DoD health care budget.

20-for-60 clarified

Last week I erred in describing a point made by the Defense Business Board task force in arguing that military retirement costs are unsustainable. A slide used by the task force listed among "unsustainable trends" the fact that the government pays "the military and their families for 60 years to serve for only 20 years."

I had rephrased the point awkwardly, leaving the impression that the task force assumes retirees draw retired pay for an average of 60 years. I heard from many retirees angered by that false notion.

The point Arnold Punaro, task force chairman, more tried to make with that slide is in the transcript of his presentation to the board:

"This system encourages our military to leave at 20 years, when they are most productive and experienced, and then pays them and their families, and their survivors, for another 40 years," he told the board.

Chapter 61 concurrent receipt

In his defense budget request last February, President Obama called on Congress again to phase in "concurrent receipt" - payment of some military retired pay in addition to disability compensation -- for 103,000 "Chapter 61" veterans, those of them forced by service-connected disability to retire short of 20 years.

But the administration disappointed advocates for this change, including Rep. Ike Skelton (D-Mo.), chairman of the House Armed Services Committee, by not identifying new money or else "offsets" from other entitlement accounts to pay for this change. The estimated cost is $5.4 billion over the first 10 years. As a result, neither the House nor Senate version of the defense bill, at least so far, authorizes Obama's CR initiative.

House Democrats did try to slip it into the American Jobs and Closing Tax Loopholes Act (HR 4213). But in final negotiations with the Senate over this bill, only an extension of federal unemployment benefits survived.

Uncomfortably for some, the president still took credit for his unfunded effort in a speech before the Disabled American Veterans convention Aug. 2.

"We've kept our promise on concurrent receipt by proposing legislation that would allow severely disabled retirees to receive your military retired pay and your VA disability benefits. It's the right thing to do," he said to applause.

Right thing to do, say vet advocates. But it hasn't yet been done.

To comment, send e-mail to milupdate@aol.com or write to Military Update, P.O. Box 231111, Centreville, VA, 20120-1111.

VA Health Care Eligibility & Enrollment
http://www4.va.gov/healtheligibility/el ... upsAll.asp

VA PUBLISHES AGENT ORANGE PRESUMPTION GUIDELINES

AMVETS applauds extension of benefits for exposed Vietnam veterans

LANHAM, Md., Aug. 30, 2010—This morning the Department of Veterans Affairs published its final guidelines in the Federal Register, outlining how VA will handle benefits claims for presumptive conditions resulting from exposure to the dangerous defoliant Agent Orange during the Vietnam War.

AMVETS leaders applauded the decision to extend benefits to veterans suffering from three new presumptive conditions-- Parkinson’s disease, ischemic heart disease, and chronic lymphocytic leukemias, including all chronic B cell leukemias, such as hairy cell leukemia.

“The latest presumptions will finally ensure that veterans exposed to Agent Orange will be cared for and appropriately compensated through the VA system,” said AMVETS National Commander Jerry Hotop. “AMVETS now urges Congress to approve VA’s guidelines so that veterans can start to receive the care and benefits they deserve.”

Congress has 60 days to review the new guidelines before VA can start to pay the new benefit. The Senate is currently scheduled to review the new regulations in a hearing on Sept. 23 and VA expects to be able to process its first new presumptive claims by November.

For new claims, VA may pay benefits retroactive to the effective date of the regulation or to one year before the date VA receives the application, whichever is later. For pending claims and claims that were previously denied, VA may pay benefits retroactive to the date it received the claim.

Any veteran who served in Vietnam between Jan. 9, 1962, and May 7, 1975, is presumed to have been exposed to herbicides like Agent Orange. Under the new regulation, a veteran who served in Vietnam during that time period who has developed a presumptive condition will not need to prove that the condition was a direct result of herbicide exposure.

Critics of the new presumptions are concerned that veterans suffering from conditions like ischemic heart disease could have developed the condition through causes other than herbicide exposure. However, AMVETS believes the presumption should remain, even if a handful of undeserving veterans could receive benefits.

“We know Agent Orange can lead to these problems, which is why VA created the presumptions based on years of hard evidence,” said Hotop. “To AMVETS, that’s enough. We would rather see a veteran who developed the condition under questionable circumstances receive care and compensation than put one more deserving Vietnam veteran through the ordeal of proving whether or not his particular disease resulted from Agent Orange exposure nearly three decades ago.”

VA expects more than 150,000 veterans to file claims under the new presumptions within the next 12-28 months, and the department also plans to review up to 90,000 previously denied claims for the presumptive conditions.

VA encourages potentially affected veterans to file their claims today to help expedite the process. AMVETS National Service Officers stand ready to assist potentially affected veterans in navigating the claims process at VA Regional Offices nationwide. To find you nearest AMVETS National Service Officer, visit http://www.amvets.org/service/national_ ... icers.html.

About AMVETS:
A leader since 1944 in preserving the freedoms secured by America’s armed forces, AMVETS provides support for veterans and the active military in procuring their earned entitlements, as well as community service and legislative reform that enhances the quality of life for this nation’s citizens and veterans alike. AMVETS is one of the largest congressionally-chartered veterans’ service organizations in the United States, and includes members from each branch of the military, including the National Guard and Reserves. To learn more visit www.amvets.org.