Wednesday, May 5, 2010

Health Effects of the Vietnam War The Aftermath

I really adore my friends. This one came in from Shelia over at Agent Orange Quilt of Tears

Opening Statement of Hon. Bob Filner, Chairman, Full Committee on Veterans' Affairs
I would like to thank everyone for attending today’s hearing entitled, “Health Effects of the Vietnam War—the Aftermath. The stated purpose of today’s hearing is to examine the health effects that our veterans sustained during the War in Vietnam as a result of being exposed to the toxic dioxin-based concoctions that we now generally refer to as Agent Orange.

As such, we will follow-up on VA’s outstanding promise to finally conduct the National Vietnam Veterans Longitudinal Study (NVVLS). In this vein, we will try to stop the stovepiping in VA by also looking at how all of these issues relate to providing benefits for all Agent Orange combat veterans for presumptive conditions under current law.

I want to ensure that we do not leave any of our veterans exposed to Agent Orange while fighting overseas uncompensated for their injuries and left behind due to VA technicalities. It has been 10 long years since Congress mandated that the VA study the long-term lifetime psychological and physical health impact of the Vietnam war on the veteran of that era. In 2000, Congress required that the VA conduct a longitudinal study by building on the findings of the National Vietnam Veterans Readjustment Study of 1984.

The 1984 study was a landmark study, which provided a snapshot of the psychological and physical health of Vietnam veterans. A follow-up longitudinal study is needed to understand the life course of health outcomes and co-morbid events that have resulted from the traumas our men and women endured during the Vietnam war.

Initially the VA adhered to the letter of the law, but halted the NVVLS study in 2003 by not renewing a three-year non-competitive sole source contract that they awarded back in 2001. The VA cited cost reasons, noting that the original estimate for completing the NVVLS had ballooned from $5 million to $17 million.

The VA took no further steps and ignored the law until this Committee received a proposal from former Secretary Peake in January of 2009. Former Secretary Peake recommended substituting the NVVLS with a study of twins who served in the Vietnam War and a study of women Vietnam war veterans, which would cost about $10 million.

Given the cost of the alternative option, it seems to me that the VA could have completed the NVVLS on time had the Department chosen to allocate the $10 million to the original contract award back in 2003.

This Committee did not see the merit of the alternative proposal and has continued to advocate for the completion of the NVVLS. In September 2009, Secretary Shinseki committed to carrying out the NVVLS study and while I applaud the Secretary for his commitment, I remain cautious and vigilant about this issue.

Through today’s hearing, I would like to better understand the progress that the VA has made in conducting the NVVLS study. I also hope to learn about the potential barriers that we can proactively address so that VA remains on track to complete the study. Also, Congress passed several measures to address disability compensation issues of Vietnam veterans.

The Veterans’ Dioxin and Radiation Exposure Compensation Standards Act of 1984 (P.L. 98-542) required the VA to develop regulations for disability compensation to Vietnam veterans exposed to Agent Orange.

In 1991, the Agent Orange Act (P.L. 102-4) established for the first time a presumption of service-connection for diseases associated with herbicide exposure. The Agent Orange Act authorized the VA to contract with the IOM to conduct a scientific review of the evidence linking certain medical conditions to herbicide exposure.

Under this law, the VA is required to review the biennial reports of the IOM and to issue regulations to establish a presumption of service-connection for any disease for which there is scientific evidence of a positive association with herbicide exposure. However, VA illogically back-tracked on the Agent Orange Act regulations by reversing its own policy to move to require a “foot on land occurrence” by Vietnam veterans in order to prove service-connection. This means that the Vietnam Service Medals, etc. would no longer be accepted as proof of combat.

This change excluded nearly 1 million Vietnam veterans who had served in our Navy, Air Force, and in nearby border combat areas. This is an unfair and unjust result that has been litigated endlessly-- and ultimately against these veterans. I am trying to undo this injustice in my bill, the Agent Orange Equity Act of 2009, H.R. 2254. I thank all of my fellow colleagues for their support of my bill and urge all Committee Members to become a co-sponsor.

Today, I hope to hear from VA why it reversed its policy that now excludes our Blue Water service members from presumptive consideration for service-connection and treatment. I also want to know why it is ignoring the latest 2009 IOM recommendation that members of the Blue Water Navy should not be excluded from the set of Vietnam-era veterans with presumed herbicide exposure. I know that VA has asked the IOM to issue a report on Blue Water veterans in 18 months, but that’s 18 months too long.

The “foot on land” requirement is especially unreasonable when you consider that these servicemembers were previously treated equally to other Vietnam Veterans for benefits purposes. Moreover, several Australian Agent Orange studies long ago concluded that their Blue water veterans who served side-by-side with our Blue Water veterans were exposed to Agent Orange and because of the water distillation process on the ships ingested it more directly.

While I applaud VA for recently adding the three new presumptions for Parkinson’s Disease, ischemic heart disease and B-cell leukemias for Agent Orange exposed veterans, those are three new presumptions for which Blue Water veterans may suffer and will not be treated for or compensated. I urge VA to start compensating these veterans now. Just like it reversed itself in 2002, I strongly urge VA to reverse itself now and compensate these deserving veterans.

Finally, I want to know for sure that VA plans to make sure Blue Water veterans are also included in the NVVLS so that they and their families and survivors have a chance to get the benefits they deserve on equal footing with other Vietnam veterans. I look forward to hearing from all of our witnesses today and thank you for being here to examine these long-standing issues.



Health Effects of the Vietnam War – The Aftermath
Room 334 Cannon House Office Building Multimedia Link
Opening Statements
Hon. Bob Filner, Chairman, Full Committee on Veterans' Affairs
Hon. Harry E. Mitchell, a Representative in Congress from the State of Arizona
Witness Testimonies
Panel 1
Richard A. Fenske, Ph.D., M.P.H., Professor and Acting Chair, Environmental and Occupational Health Sciences, School of Public Health and Community Medicine, University of Washington, Seattle, and Chair, Committee on Review of the Health Effects in Vietnam Veterans of Exposure to Herbices, (Seventh Bienniel Update) Board on the Health of Select Populations, Institute of Medicine, The National Academies
Charles R. Marmar, M.D., Chair, Department of Psychiatry, New York University Langone School of Medicine, New York, NY
Randall B. Williamson, Director, Health Care, U.S. Government Accountability Office
Panel 2
Richard F. Weidman, Executive Director for Policy and Government Affairs, Vietnam Veterans of America
Joseph L. Wilson, Deputy Director, Veterans Affairs and Rehabilitation Commission, American Legion
Commander John B. Wells, USN (Ret.), Cofounder and Trustee, Veterans Association of Sailors of the Vietnam War
John Paul Rossie, Executive Director, Blue Water Navy Vietnam Veterans Association
Vivianne Cisneros Wersel, Au.D., Chair, Government Relations Committee, Gold Star Wives of America, Inc.
Panel 3
Joel Kupersmith, M.D., Chief Research and Development Officer, Veterans Health Administration, U.S. Department of Veterans Affairs
Victoria Anne Cassano, M.D., MPH, Director, Radiation and Physical Exposures and Acting Director, Environmental Agents Service, Veterans Health Administration, U.S. Department of Veterans Affairs
Panel 4
Submissions for the Record
Reserve Officers Association of the United States, and Reserve Enlisted Association

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